HB 103-ASSISTED LIVING HOMES: HOUSE RULES  3:41:52 PM CHAIR KREISS-TOMKINS announced that the final order of business would be HOUSE BILL NO. 103, "An Act relating to house rules for assisted living homes." 3:42:09 PM JOHN LEE, Director, Senior and Disability Services, explained that Home and Community-Based [Services] (HCBS) and the 1915(c) Home and Community-Based Waivers exist to provide significantly lower cost home and community-based options for individuals who qualify for nursing home or institutional care. He stated that HB 103 would bring Alaska law into compliance with the HCBS Final Rule, which was issued by the Centers of Medicare and Medicaid Services (CMS). He related that currently, Alaska statutes are not in compliance with federal regulation that requires HCBS providers to give individuals on waivers the same access "to community and people" as those who are not on waivers. He indicated that the bill adds a citation to state statutes related to setting house rules in assisted living homes; for example, assisted living settings may not adopt house rules that unreasonably restrict the right of one resident over the right of another resident. He noted that Alaska statutes must be in compliance before March 2023 in order for the state to continue receiving federal reimbursements for Home and Community-Based Waiver Services. He expounded the bill would address the federal requirements by inserting language into AS 47.33, which would bring Alaska into compliance with recent CMS changes related to HCBS. These requirements ensure that assisted living homes provide care that is as close to independent community living as possible. He reported that Alaska has approximately 700 assisted living homes that would be required to abide by the conditions defined in HB 103. The new statutory language would afford all residents in assisted living homes the same rights regardless of whether or not the home accepts Medicaid payment. He noted that of the 700 assisted living homes, more than 650 are already compliant through participation in the Medicaid waiver program. 3:48:08 PM REPRESENTATIVE VANCE questioned whether a legal notice would be sent out to notify the homes of the required compliance changes. MR. LEE reiterated that providers certified through SDS [Senior and Disability Services] are already in compliance. He deferred to Mr. Baxter for further explanation of how additional providers would be notified of the requirements. 3:49:06 PM CRAIG BAXTER, Assisted Living Home Manager, Division of Health Care Services, Department of Health and Social Services, confirmed that providers without current house rules that meet the setting standards would be notified. REPRESENTATIVE VANCE asked how much time providers would have to come into compliance. MR. BAXTER approximated "somewhere between 30 and 90 days" to update their house rules. He speculated that DOL would be consulted with first, adding that he did not want to be heavy handed in forcing facilities to update in a short period of time. 3:50:03 PM REPRESENTATIVE VANCE referenced a supporting document, titled "HCBS Settings Final Rule: 42 CFR 441.301(c)" [included in the committee packet], noting that the highlighted section states that individuals are allowed to have visitors of their choosing at any time. She asked whether that would apply during the COVID-19 pandemic. MR. LEE noted that the change to statute is required regardless of COVID-19. He explained that during the pandemic, certain regulations, such as the one referenced by Representative Vance, were waived. MR. BAXTER stated that during the pandemic, limitations were placed on visitation to protect the residents of the facilities. He said the bill would affect facilities "outside the scope of the COVID-19 pandemic," adding that once COVID-19 restrictions were lifted, the expectation for visitation would go into effect. 3:51:50 PM REPRESENTATIVE VANCE pointed out that state and federal regulations [pertaining to COVID-19] are not consistent and asked which purview is being followed. MR. LEE said the flexibility to manage the waiver programs are contingent on the federal public health emergency. From perspective of SDS, he said, the regulations are waived because of the public health emergency. 3:52:59 PM REPRESENTATIVE CLAMAN noted that the public health emergency is no longer in place unless the legislature takes action. He asked how that impacts SDS. MR. LEE explained that because SDS flexibility is contingent on the federal public health emergency, the state's decision whether to extend the disaster declaration would have no impact on the bill. 3:53:33 PM CHAIR KREISS-TOMKINS [announced that HB 103 was held over.]