SCR 11 - LONG-TERM CARE TASK FORCE SENATOR BERT SHARP, sponsor of SCR 11, gave the following overview of the measure. As Alaska's senior citizen community continues to increase in size, the state needs to plan for the long term care and needs of these citizens. While most families desire to provide home care for their elderly parents, the reality is that most will live in a long term care facility sooner or later. Either way, the cost of providing long term care is becoming insurmountable to the state and to private citizens. In an effort to assure that Alaska's senior citizens can plan and get the best care possible, the Legislature established a working group in 1996 to analyze long term care services available in the state and the projected costs of such care. SCR 11 will create a long term care task force to review the working group's findings and to develop equitable plans for providing actuarially sound and affordable long term care options for all senior citizens. He urged committee members to support SCR 11 so that the dialogue to find the answers to the long term care needs of senior citizens within the State of Alaska will continue. SENATOR WARD stated the task force will be comprised of four majority members, two minority members, and six non-elected members. He expressed concern that this task force will be making recommendations to the Legislature, yet because of its make-up, might not adequately reflect the views of the majority of the Legislature. He asked Senator Sharp if he thought the composition of the task force could be a problem. SENATOR SHARP said he thinks this particular topic lends itself more toward common ground than most. He explained the task force is designed to determine options and their costs to individuals and group plans, and not to dictate a specific course of action. The task force will establish what the need for, and marketplace is, for long term care. He thought representatives from the various commissioners' offices will add expertise in their particular fields and will not control the direction or the outcome of the task force's work because the need is universal. SENATOR WARD maintained that although the task force will be working on a common goal, the resolution directs it to submit proposed legislation. He repeated his concern that the task force will have eight non-majority members. Number 137 CHAIRMAN WILKEN noted he only had one copy of the work group's report which he offered to pass around to committee members. He then took testimony from participants on the teleconference network. BOB HUFMAN, a Fairbanks resident, testified in favor of SCR 11 because establishing an actuarially sound system of long term care for senior citizens is an admirable goal. In checking over a number of long term care policies offered by several underwriters, he found they all fell short of what is truly required in the way of benefit needs and costs. Judging from what is available on the market today, the state could devise an adequate plan that may be an attractive proposal to middle-aged people whose participation would help balance out the payment schedule. The results of the McDowell Group report show the tremendous impact the cost of supporting residents in the Pioneer Homes will have on the state budget as the rates rise to the full cost of care by the year 2003. The cost of state monetary assistance will rise from $1,408,000 in 1997 to over $15,800,000 in 2003. That figure alone justifies underwriting a long term care policy, either by the state alone or in concert with a reputable company. Alaskans desperately need assistance with this monumental problem. He urged formation of the task force as soon as possible. MERRILL HAKALA testified from Fairbanks and thanked Senator Sharp for introducing SCR 11. She believes SCR 11 is very important to senior citizens of the state because the cost of Pioneers' Homes is increasing dramatically. Most seniors enter Pioneers' Homes with a few dollars in the bank, but are wiped out once they enter long term care. The dignity of senior citizens needs to be preserved. FLOYD HEIMBUCH, Executive Director of the Older Persons Action Group (OPAG), testified from Anchorage on his own behalf. He stated the Anchorage Advisory Commission is undertaking a study on this subject and it intends to produce a study without the bias that a funding corporation or entity might build into it. He hoped a new task force will be careful when determining the focus of the plan and who is working on the plan. The following areas of concern are basic to what senior citizens are thinking about: mental health; access; finding an acceptable institution when one needs help; physical activity; secure surroundings; financial problems; at-home family care; and consumer protection. He encouraged the task force to use the Alaska Commission on Aging's information effort, OPAG's publication Voices, and senior center newsletters to focus on what is available now, rather than on what will be available after the plan is made. Mr. Heimbuch concluded that people are living longer and we are using outdated concepts to deal with their needs. He suggested looking at a plan that will allow people to "bank" volunteer services, while they are able, to be applied toward the cost of long term care in the future. MS. DULCE NOBLE, Executive Director of the Alzheimer's Association, spoke in support of SCR 11. The work group's studies resulted in an analysis of the current long term care system. The group determined the strengths of the current system and the challenges that lie ahead. The creation of a task force is essential to implement some of the group's recommendations. Because of demographic trends, the number of seniors in need of help in 10 to 15 years will increase, and many caregivers will be feeling the impact. The task force will need to create an infrastructure to address these needs. Number 276 KAY BRANCH, Bristol Bay Native Association (BBNA) Elderly Services Manager, and a board member of the Alzheimer's Association, stated she is familiar with the long term care needs of people in rural areas and supports SCR 11. She believes it is important to take the analysis that was recently completed and convert it into an equitable plan. The costs of long term care are exceedingly high. BBNA received money from the Division of Senior Services to conduct its own research on the need for assisted living in the Dillingham area. At present there are no nursing homes or assisted living facilities. BBNA held seven community forums throughout the region: the sizeable attendance at all meetings was indicative of the strong concern people have about ensuring that their elders are cared for in the best way possible. In those areas, people want their elders to remain as close to home as possible. When families cannot care for their elderly relatives at home they have to send them to long term care facilities in Anchorage and Fairbanks. She suggested that a rural Alaskan who is familiar with senior issues be appointed to the task force if SCR 11 passes. KATHLEEN DALTON testified on her own behalf from Fairbanks. She is a conservator-guardian for an 82 year old woman who is in an assisted living facility. She expressed concern that SCR 11 may be redundant and she questioned where the funds for activities of the task force will come from. In addition, she asked that no commissioners or designees be appointed to the task force because those people represent the bureaucracy and will provide no original thinking. She suggested using people in those positions as resources. She requested a copy of the McDowell Group report. Number 350 DON HOOVER testified as a member of the Alaska Commission on Aging, and on his own behalf, in support of SCR 11. He said SCR 11 does not only apply to the elderly, but to people of all ages who need long term care. Alaska rates second highest in the nation in the increase in the number of senior citizens. Growth projections indicate that the population of people 65 and older by the year 2015 will be 80,957. About one-third of those people will be in the 80 to 85 year old age group; over 48 percent of those will have Alzheimer's disease which requires long term care. He expressed concern that SCR 11 requires the task force to complete its work between legislative sessions which will not provide enough time. FLORENCE ORR, representing the Igloo and Womens' Auxiliary of the Pioneers in Anchorage, the National Association of Retired Federal Employees, and the Anchorage Senior Center, testified from Anchorage. Ms. Orr said as a person in her late 80's she is very personally interested in SCR 11. Most of her contemporaries are recognizing that they cannot get along alone anymore and some are panicking about where to go. FRANK APPEL, representing the Alzheimers Association Board, testified in support of SCR 11 and made the following comments. Because the elderly population is likely to increase enormously in the next 20 years, it is important to build upon the analysis completed by the working group. The state will likely experience costs for those people with insufficient assets or income to pay for long term care. The state needs to create a plan to provide funding for effective, efficient, and equitable long term care. FRANK McGILVARY thanked Senators Sharp and Duncan for introducing SCR 11 and expressed support for the measure. JOHN HANCHETT testified on his own behalf from Fairbanks in support of SCR 11. He noted he is a member of the Alzheimers Association, an insurance agent, and has taken care of seniors for 23 years, so is familiar with this issue from a variety of perspectives. He believes the long term care issue is a problem for the current population of senior citizens but will be moreso for the next generation. Besides coming up with alternatives, the task force can give this issue the publicity and attention it needs to get the public to react. BOB HANSEN, testifying from Fairbanks, informed committee members he has provided care for his aging mother for many years. He stated the cost of residency in a Pioneer Home is becoming outrageous and unaffordable for most people. Some seniors have had to move out because of the cost. He believes that is a disgraceful thing to do to pioneers. ED BARBER JR., representing himself, testified from Anchorage and made the following comments. There are many perceived, as well as actual, problems involved in addressing the long term care of senior citizens. He recommended greater emphasis be placed on the membership of the task force so that there is more representation by senior groups and less from the bureaucracy. He commended the drafters of SCR 11 for including a sunset clause and noted his support of the resolution. Number 474 SENATOR LEMAN stated he appreciated the comments about appointing more senior citizens to the task force. He said he thinks it is important to get other input, but maybe in an ex-officio capacity. BETTY HUFMAN testified from Fairbanks in support of SCR 11. She believes this resolution will have an impact on all Alaskans because a lot of young people are caring for elderly relatives. Facilities are not only lacking but are also inadequate, and there is a crying need for assisted living homes for people who do not need full-scale nursing homes. She believes the committee should consist of a broader cross-section of the population, and the time limit should be extended. MARIE DARLIN, representing the Alaska Federation of the National Association of Retired Federal Employees (AFNARFE), stated at its last convention, AFNARFE passed a resolution in support of SCR 11. AFNARFE's constituency consists of seniors, and those who are not yet seniors but are caring for parents and/or children in need of long term care. AFNARFE is concerned that recommendations put forth by the working group be acted upon and that policies and a plan be established to meet the reported needs. She noted she will give committee members copies of the Alaska Commission on Aging's latest bulletin which contains updated information on the future demographics of Alaska's senior population. AFNARFE is glad to see this issue is going to get some attention. CHAIRMAN WILKEN asked Ms. Darlin if she is familiar with a report put out in the last year by a commission headed by Amos Alder. MS. DARLIN was not aware of it. CHAIRMAN WILKEN said he was interested to hear what people think of that report. Number 542 VERA GAZAWAY, representing OPAG, stated OPAG has viewed long term care as an inter-generational issue for the reasons previously mentioned. OPAG believes more training and access for home caregivers for people with long term illnesses needs to be provided with state funds. For a number of years, OPAG has endorsed the need for in-home health care and actually had training programs for in-home health care but many of the trainees eventually went to work for hospitals. Also, she noted there is a need for more respite care. One day per week of respite care is a great help to full-time caregivers. LARRAINE DERR, representing the State Hospital and Nursing Home Association, stated the number one goal of the long term care committee is the formation of a long term care task force to address long term care problems in the state. The committee has been reviewing reports over the last few years and has realized that little progress has been made in this area. The committee has a task force appointment scheduled and is willing to offer its support to the task force in SCR 11 in any way it can. The group is definitely in favor of the resolution. SENATOR LEMAN suggested holding the resolution until the next meeting to restructure the make-up of the task force and update the time-frame during which it will operate. CHAIRMAN WILKEN announced SCR 11 will be held in committee until the following Wednesday.