HOUSE BILL NO. 124 "An Act extending the termination date of the Board of Nursing Home Administrators; and providing for an effective date." Senator Rieger MOVED to adopt CSHB 124 (FIN) "G" version as a working draft. No objection being heard it was ADOPTED. Benjamin Brown, Legislative Aid to Rep. Toohey was asked to give testimony on the original bill and the sponsor's statement. He stated that HB 124 is introduced to extend the sunset date of the Board of Nursing Home Administrators, which must exist according to federal regulation as a condition for the state's receipt of Medicaid funds. After the initial bill was introduced, the State Hospital and Nursing Home Administration decided on its own, that they did not want a Board of Nursing Home Administrators. It would be easier to abolish the Board and transfer its duties to the Division of Occupational Licensing. The Division was happy with the proposed change which evolved into a CS from the H&SS Committee. The House Finance Committee changed the bill further, giving the Division the ability to deny a license to a Nursing Home Administrator who falsifies information on the application. There was a loophole in the statute, meaning they would have had to give the license, and then take it back if they found out there was falsification. The bill is needed because without it, the State will be at risk at not receiving $157 million in Medicaid in the coming fiscal year, from the Federal Department of Health. The moratorium on long term care beds is a means of controlling the growth of the facilities component of the Medicaid budget. Catherine Reardon, Director, Division of Occupational Licensing, Dept of Commerce & Economic Development, testified that as of July 1st, the Board will go out of existence if this legislation does not pass. The elimination of the Board and the change to have the Division directly manage the licensing program, will save approximately $1.0 to $1.3 in travel costs. The primary advantage is that it is much easier to issue licenses in a timely fashion. Jay Livey, Deputy Commissioner, Dept of Health & Social Services, addressed Section 14: Moratorium on Nursing Home Certificates of Need. The department is in favor of this section. Nursing home care is expensive. The department spent $50 million on nursing home care. A two-year moratorium will give the State a chance to develop less expensive alternatives that are currently being developed through the home and community based waiver program. The moratorium allows for more services at less cost. Kip Knutson, Aid to Rep. Hanley said the state pays for 87% of the long term beds through the Medicaid program. Their addition drives the cost of Medicaid up. Cost increases amount to 10-15% each year in the Medicaid budget. The Certificate of Need process is broken. The department needs attention before new beds are added. Harlan Knudson, President, Alaska Hospital and Nursing Home Association, spoke in favor of the original version of HB 124 and speaking in opposition to CSHB 124 as far as the moratorium on nursing home beds. There is agreement with the original HB 124 and the intent. With regard to the moratorium on nursing home beds, there is agreement that nursing home care is very expensive. There is also agreement where there are situations where very frail, ill, or disabled individuals, who need home care. The Certificate of Need determines who needs how many beds. He asked to move forward with the Certificate of Need process. It has all the tools needed to stop unnecessary beds. He stated that community based care will increase costs because many people will never go to a nursing home since the family is currently taking the extra effort to care for the individual. The non-facility portion of the budget reflects a higher rate, meaning a new level of service to a new level of clients. There will still be a need for increased nursing beds. There will be an increase in the Medicaid Program for community based care. Senator Rieger inquired as to the percentage of people that could be placed in the community based care that are currently receiving nursing beds within the institutions? Mr. Knudson responded that he could not answer that question. Senator Sharp MOVED to adopt CSSB 124 with individual recommendations and a zero fiscal note. No objections being heard, CSSB 124 was REPORTED OUT of committee with a zero fiscal note from the Dept of Health & Social Services and a "do Pass" from Co-chairs Halford and Frank, along with Senators Rieger and Sharp. Senator Phillips recommended "do not pass". Senators Donley and Zharoff signed, "no recommendation". The meeting RECESSED at approximately 10:00 a.m. The meeting RECONVENED at approximately 2:45 p.m. PRESENT Co-chair Halford, along with Senators Rieger, Zharoff, and Sharp were present.