HB 148-SENIOR CARE 3:03:13 PM CHAIR WILSON announced that the first order of business would be HOUSE BILL NO. 148, "An Act relating to the senior care program; and providing for an effective date." 3:03:42 PM KARLEEN JACKSON, Commissioner, Department of Health & Social Services (DHSS), presented HB 148, paraphrasing from a prepared statement, which read as follows [original punctuation provided]: The SeniorCare program helps low-income seniors in Alaska by providing cash assistance of $120 a month or a prescription drug subsidy for Medicare Part D. The SeniorCare program is due to sunset June 30 of this year. More than 7,000 seniors use the program 15 percent of the state's senior population demonstrating that it is needed and used by Alaska seniors. Governor Palin is proposing this legislation to improve the program and extend SeniorCare for another five years. Changes to SeniorCare will help keep it effective and simplify the administration of the program includes updating the income limit for eligibility and eliminating the prescription drug assistance program. The current SeniorCare income eligibility threshold, frozen at 135 percent of the 2005 federal poverty limit, does not reflect the reality of rising costs. The current, annually adjusted federal poverty level for Alaska must be used to keep pace with the rising cost of living, which is what this legislation proposes. By tying SeniorCare eligibility to current federal poverty rates, updated each year, modest cost-of- living adjustments to seniors' income, such as Social Security, will not nudge them over the income limit for eligibility. The change would raise eligibility levels only modestly: at the 2007 poverty level, the SeniorCare income limit would rise to $17,240 for a single person and $23,112 for a couple (Current SeniorCare eligibility: $16,133/Single, $17,240/couple). The liquid assets these seniors would be allowed to hold would stay the same vidual and $9,000 for a couple. There is low demand for the SeniorCare prescription drug subsidy that assistance. A statewide survey found many seniors have access to insurance which covered premiums and deductibles, or they qualified for other assistance, which is why we had such low participation. Therefore we are eliminating this benefit, and simplifying the administration of the SeniorCare program. 3:07:07 PM REPRESENTATIVE SEATON referred to the annual federal poverty guidelines, stipulated on page 2, line 7, and asked if these are published, and available for implementation, when a senior makes application to the program, or if application is based on the previous year's poverty guidelines. 3:07:52 PM ELLIE FITZJARRALD, Acting Director, Division of Public Assistance (DPA), Department of Health & Social Services (DHSS), responded that the annual, federal, poverty guidelines are published at the beginning of each calendar year, and implemented immediately by the state. 3:08:31 PM REPRESENTATIVE SEATON clarified that a senior applying at anytime, during the year, would have a possibility to be eligible for the program. MS. FITZJARRALD explained that a senior's renewal process is based on their income on the date of the application. This can change any given month, based on the fluctuation of a senior's monthly income; however, she noted that most of the seniors have static incomes. To a follow-up question, she stated that, if a senior's application is denied based on the poverty guidelines, the senior is counseled to reapply. 3:11:14 PM CHAIR WILSON established that the state's fiscal year begins st annually on July 1, and asked how the federal guidelines interface with Alaska's budgeting process. MS. FITZJARRALD answered that the division uses a historical average for budget requests. 3:12:04 PM MICHAEL FORD, Alaska Native Health Board, stated support for HB 148, and said that it represents an important aspect of a low income senior's monthly income. He recommended that an amendment be considered to remove the sunset date. 3:13:31 PM HERB SIMON, stated support for HB 148, and asked how the poverty level is determined. CHAIR WILSON responded that it is a federally established level, and the state department decides "what percentage of that we're going to accept." MR. SIMON pointed out that the federal employees draw a cost of living allowance (COLA), and suggested that the federal standard may be skewed with what the actual living costs are in Alaska. CHAIR WILSON agreed, and observed this as the reason that Alaska uses 135 percent of the federal poverty level vs. 100 percent, when determining eligibility for this benefit. MR. SIMON inquired how this contrasts with previous senior benefit levels. CHAIR WILSON speculated that a set amount was utilized, and offered to have this clarified by the department. REPRESENTATIVE FAIRCLOUGH offered that the amount had been frozen, using the 2005 poverty level, but that has now been released to allow the benefit to keep pace with cost of living increases. CHAIR WILSON opined that this modification should protect seniors from being denied benefits, if they are borderline eligible, as happened in the past year. MR. SIMON commented that a "one size fits all" approach does not always work in Alaska, with the wide variation of living costs between the urban and remote areas. He urged passage of the bill. 3:17:38 PM PAT LUBY, Advocacy Director, American Association of Retired Persons (AARP), stated support for HB 148, citing the importance of the governor's proposal to include annual indexing of the program based on the federal poverty level. He suggested three areas that require additional consideration by the legislature: the assets test limiting the savings of elders; raising the monthly stipend from $120 to possibly $150; and the gap, which 140 seniors experienced, due to the federal poverty level adjustment. 3:20:02 PM CHAIR WILSON closed public testimony. 3:20:14 PM REPRESENTATIVE SEATON referred to the fiscal note, and asked why the yearly total for FY 2013 indicates a $7 million increase to $12 million; the previous 5 year totals are approximately $5 million. 3:20:48 PM JANET CLARKE, Assistant Commissioner, Department of Health & Social Services (DHSS), explained how the FY 2013 total is effected by the five year sunset clause, requiring legislative action for reauthorization. She described the fiscal note in further detail. 3:24:52 PM REPRESENTATIVE ROSES stated that the fiscal note is confusing, particularly because it is projected for a future budget. Further, he attempted to establish how the Alaska Longevity Bonus (ALB) projections and the Senior Care Program costs interface in the fiscal note analysis. MS. CLARKE directed the committee's attention to the second page of the fiscal note, labeled Assumptions, and explained that the fiscal note is consistent with the established assumptions. [Further committee discussion ensued to clarify the fiscal note assumptions in conjunction with the two senior programs.] 3:28:36 PM REPRESENTATIVE SEATON requested that the committee receive an analysis for HB 148, without the complication of other issues, or a contingency based on the passage of another bill. He referred to page 2, line 4, and asked if the age 65 requirement should state "must be Medicare eligible," to correspond with any federal changes that may occur. MS. CLARKE responded, "This is a state funded program; the state can set the rules. The current rules are 65." She pointed out that this is a cash benefit, which sets it apart from a Medicare health benefit. 3:36:02 PM REPRESENTATIVE FAIRCLOUGH moved to report HB 148 out of committee with individual recommendations and the accompanying amended fiscal notes. There being no objection, HB 148 was reported out of the House Health, Education and Social Services Standing Committee.