HB 44 - ADMISSION TO PIONEERS' HOMES Number 0062 REPRESENTATIVE TOM BRICE, Sponsor of HB 44, said the concept of this legislation was brought to his attention during the last campaign by one of his constituents who, while on the waiting list for the Alaska Pioneers' Home, inquired if he would be denied admission if the monthly rent increased to a point where he couldn't afford it. While it is current policy that the Pioneers' Home will not disqualify a person based on failure to make an initial payment or provide security for monthly payments, his concern is that policy could change during the annual policy update. House Bill 44 would place that policy in statute, thus protecting the state's senior population from being denied admission into the Pioneers' Home. Number 0140 REPRESENTATIVE BRICE made a motion to adopt Amendment 1 which reads: Page 1, line 10: Following "on" Insert "financial" CHAIRMAN BUNDE objected for the purpose of discussion. REPRESENTATIVE BRICE withdrew Amendment 1 because his concern was addressed on line 13. Number 0260 CHAIRMAN BUNDE pointed out the Department of Administration had submitted a zero fiscal note, yet there would be people at the Pioneers' Home at state expense. He inquired at what point is it determined that a person cannot pay. REPRESENTATIVE BRICE said a person would be required to pay as much as possible based on the current determination process. This legislation basically states a person unable to provide security or make an initial payment will not be denied admission. CHAIRMAN BUNDE remarked the zero fiscal note is misleading in that it does cost money, just not additional money. Number 0335 REPRESENTATIVE JOE GREEN asked if that's the case, is HB 44 necessary? REPRESENTATIVE BRICE responded it is necessary because policy is just that - policy, and given that policies can change without legislative approval, he wants that policy codified to statute. REPRESENTATIVE GREEN said, "Last summer, I visited the Pioneers' Home in Anchorage and there were several people in there who were not Alzheimer or dementia people and because they were up to some 80 percent of the people that lived there suffering from some form of dementia, the costs were escalating extremely rapidly. Now if that's the case - and these people were saying they were in danger of being thrown out - if the policy is that if they can't pay, they get to either come in or get to stay in, there's a confusion factor here because the people were already there and fearful that they were going to be thrown out because they could not longer afford these elevated prices." REPRESENTATIVE BRICE agreed that was a good point and added the purpose of HB 44 is to alleviate some of that concern and fear. REPRESENTATIVE GREEN said, "If that's the case and people will make application, the costs are going up because you're treating dementia patients, is that going to exacerbate the problem at the Pioneers' Home because costs are going up to cover the cost of operation, but these people are coming in not paying the costs, which makes them go up even higher." REPRESENTATIVE BRICE responded this will ensure that individuals will not be denied admission to the Pioneers' Home because of their inability to pay. Individuals living at the Pioneers' Home have never paid the full cost of care, yet it is true that individuals are helping to pay the increased costs of having to care for individuals with dementia. He added, "What this might help us with is possibly ensuring that those - as the prices increase and the costs are shifted, that folks still have access because frankly, I don't know too many people who come from the era of the folks who are involved in the Pioneers' Home, who could afford to pay the full cost on the fixed level of retirement they're getting out of jobs they had in the 70s ...." REPRESENTATIVE GREEN said, "If that's happening - if we're treating more and more dementia related illnesses, mental illnesses if you will, in Pioneers' Home, have we lost the idea of the Pioneers' Home originally, should we go back to having a Pioneers' Home and if we have that many mental illness faces, then I think Mental Health ought to come in and take care of those people and not confuse the issue with the Pioneers' Home." REPRESENTATIVE BRICE shared Representative Green's point of view and has drafted legislation that would codify the role of the Pioneers' Home as a communal living environment, breaking off the dementia related illnesses to a separate facility so as to become Medicaid eligible, and refinance their care by 50 percent of federal funds. Number 0660 CHAIRMAN BUNDE observed there have been a number of policy decisions made relating to the Pioneers' Homes. He asked if there was further discussion on HB 44. Hearing none, he closed public testimony and asked the wish of the committee. Number 0697 REPRESENTATIVE BRICE made a motion to pass HB 44 out of committee with individual recommendations and attached zero fiscal notes. CHAIRMAN BUNDE asked if there was objection. There being none, HB 44 moved from the House Health, Education and Social Services Standing Committee.