9:08:36 AM CS FOR HOUSE BILL NO. 105(FIN) "An Act relating to coverage for adult dental services under Medicaid; and providing for an effective date." This was the second hearing for this bill in the Senate Finance Committee. Co-Chair Green noted Co-Chair Wilken had raised questions at the previous hearing and has drafted language with assistance of the bill sponsor. 9:09:11 AM Amendment #1: This amendment inserts "Subject to appropriation, the" to subsection (a) of Sec. 47.07.067. Payment for adult dental services., added through Section 2 on page 2, line 5. This amendment also inserts a new subsection to Sec. 47.07.067 on page 2, following line 13 to read as follows. (b) On or before June 30 of each fiscal year, the department shall review appropriations available for the purposes of this section for the following fiscal year, and estimate the scope of services to be used and number of eligible recipients anticipated to be served during the following fiscal year. Notwithstanding the maximum amount of benefits specified in (a)(1) of this section, the department shall reduce, by regulation, that specified maximum amount of benefits for the following fiscal year if the department's estimates under this subsection would exceed appropriations available for that fiscal year. Notwithstanding any contrary provision of AS 44.62.250 and 44.62.260, the department may adopt emergency regulations to implement this subsection. Co-Chair Wilken moved for adopted and objected to provide an explanation. Co-Chair Wilken expressed concern about the cost of this program and his intent that it not "grow uncontrolled", as has occurred with other programs. He informed the Department of Health and Social Services that he would not support a supplemental appropriation, if requested, the following legislative session. 9:10:37 AM JANET CLARKE, Assistant Commissioner, Department of Health and Social Services, testified that in meeting with Co-Chair Wilken she learned his intent to consider language that would place a tighter restraint on spending. He also wanted a letter from the commissioner outlining a plan to operate the proposed program within the allocated funding amount. Co-Chair Wilken also intended to allocate these funds in a separate appropriation to allow the legislature to track the funds independently. Ms. Clarke stated that a new fiscal note was prepared to reflect the intentions of Co-Chair Wilken. She explained that funding allocated through a separate appropriation could not be transferred to another Budget Request Unit (BRU) component. STACIE KRALY, Chief Assistant Attorney General, Statewide Section Supervisor, Human Services Section, Civil Division, Department of Law, testified that the amendment before the Committee would provide for a yearly adjustment of the program. At the conclusion of each fiscal year, the Department of Health and Social Services make a determination of the number of participants of the program the previous fiscal year, the services provided and the amount expended. If costs exceeded allocation, the maximum benefit amount for each patient would be reduced on a pro rata basis. All patients would be allowed to participate; however, fewer funds would be available for preventive maintenance procedures. 9:14:26 AM Co-Chair Green asked if the provisions of the amendment were consistent with the letter of intent accompanying this legislation that was adopted by the House of Representatives. Ms. Clarke affirmed. 9:14:45 AM Co-Chair Wilken removed his objection to the adoption of the amendment. Without further objection the amendment was ADOPTED. 9:14:54 AM Co-Chair Wilken commented that many people would be eligible to receive services through this program; however, it was brought to his attention that an insufficient number of dentists operating in the state accept Medicaid. Some dentists list their reasons as Medicaid reimbursement for services is inadequate to cover the cost of delivery, too many Medicaid covered patients fail to keep appointments, and liability. He intended to collaborate with the Department to entice dentists to provide this care. Such enticement would not be possible under current statute and he did not intend to include any relevant changes in this legislation. However, he would address the issue in the future. He supported the proposed program. 9:17:03 AM Co-Chair Wilken moved for adoption of a letter of intent signed by the Committee's co-chairs. Co-Chair Wilken offered a motion to report CS HB 105(FIN), as amended, from Committee with individual recommendations, letter of intent, and a new fiscal note. There was no objection and SCS CS HB 105 (FIN) was MOVED from Committee with a letter of intent and a new fiscal note dated 5/4/06 in the amount of $2,633,000 from the Department of Health and Social Services.