SB 135-MENTAL HEALTH INFO/RECORDS/COMMUNICATIONS CHAIRMAN TAYLOR announced SB 135 to be up for consideration. TAPE 01-22, SIDE A    MS. PAT DAVIDSON, legislative auditor, said, "Without data, the Department is unable to determine if services are being paid dual billed, paid for both with Medicaid funds and state funds nor can they offer the providers feedback about services and associated costs." SENATOR THERRIAULT asked if this concern came from the findings of an audit. MS. DAVIDSON answered yes. The first audit was on mental health services in 1997. Senate Finance was concerned about escalating costs in that program. They found and in the subsequent follow-up (January 2001) is that a fee for service Medicaid financing plan and a state funded grant program are inherently difficult to work with. Providing client data to the Department to do the analysis will allow that Department to actually manage the program the way it needs to be done. CHAIRMAN TAYLOR noted for the record that he was the one who requested that audit in 1997. He added that: We found that the reserve accounts of a couple of our larger providers had grown significantly to the place where they had between half and two-thirds of a year cash income reserves setting in their account. Nobody was asking them to spend down those reserves before we gave them state money even though my mental health programs in Ketchikan and other places where communities assisted them, before the community would step in and assist, they would make sure those reserves were spent down to the place where they had maybe a month or six weeks worth of reserves. Some of these larger entities had six to nine months reserves and were paying themselves significant salary increases. In one year, south central paid a 14 percent across the board salary increase to every one of the employers, including their executive director, which would have violated state law, had they been paying it under state monies… SENATOR ELLIS asked why the entire mental health record of an individual client is needed. He asked if it was possible to transmit only the information that was necessary for the express purpose. He also said that the broad title of this bill troubles him, although there was nothing specific he wanted to preclude. Number 364 MS. ANN HENRY, Special Projects Coordinator, Division of Mental Health and Developmental Disabilities, answered Senator Ellis' question saying: The information that we gather is demographic information that uses a unique identifier rather than the individual's name and social security number. We use initials, the last four digits of the social security number and the person's birth date to identify that person and then link that person to subsequent documents, which give information about the kind of encounters they have had, the duration of the encounter, that sort of thing… She said they don't request the entire file or go through progress notes. "It's just the diagnosis, the person's housing situation, their legal status, things like that that allow us to determine what kind of help different communities need and what we're seeing in the big picture for the mental health situation for the state." SENATOR THERRIAULT said, "We need to get enough information so that we can track how services are being offered to this person. If we're looking for some accountability, you've got to know what the person is getting." He also explained regarding the title, that when he had the bill drafted, he wasn't anticipating any chicanery or things tacked on. He wasn't opposed to tightening the title. MS. HENRY continued saying that her division had worked with the community mental health providers for several years trying to get this data from them and haven't been successful for various reasons. She said the lawsuit by the Board of the Mental Health Center that was suing will be put aside with passage of this bill. That is why the bill covers some of the issues that it covers. She explained that they had also amended the initial bill to include requiring that the mental health centers provide data for the last two years. SENATOR THERRIAULT said that the lawsuit was initiated by a Fairbanks provider and he concurred that they backed away from the litigation with the introduction of this bill. SENATOR ELLIS moved to tighten up the title to SB 135. There were no objections and it was so ordered. SENATOR COWDERY moved to pass CSSB 135(JUD) from committee with individual recommendations. There were no objections and it was so ordered.