SB 125-LICENSING MEDICAL OR CARE FACILITIES  10:02:44 AM CHAIR SEEKINS announced SB 125 to be up for consideration. DR. RICHARD MANDSAGER, director, Division of Public Health, introduced SB 125. CHAIR SEEKINS advised the committee they were working off of Version \F. DR. MANDSAGER informed the committee he would use a slide presentation to introduce SB 125. The slide presentation, "Protecting and Promoting the Health of all Alaskans", can be found in the bill packet. 10:04:05 AM DR. MANDSAGER announced he is please to introduce SB 125 on behalf of the Governor. The bill does two things; one is implementation and standardization of the licensing and certification functions in the Department of Health and Social Services (DHSS), and it is also a background review of employees working in the programs who serve vulnerable populations. The present statutory and regulatory environment has developed over time with different sets of statutes and different sets of regulations. There are great differences in how different provider types are evaluated in terms of their employees, and as institutions, different background checks. 10:06:23 AM CMS, the national organization for Medicare is pushing a move nationally to deal with the issue of background checks and to try and improve the knowledge about employees working in fields in terms of long-term care. Alaska was awarded a pilot program grant in December of 2004 to determine whether DHSS could reduce the amount of fraud and neglect. Slide 4 Currently 19 programs are administered under at least 12 different statutory schemes for licensure by DHSS. 10:10:19 AM Slide 5 The three units that have been consolidated represent Phase I of the consolidation process. SENATOR FRENCH asked Dr. Mandsager to explain the green pentagon. DR. MANDSAGER advised it represented certification and licensing, which is a new unit created this year. Slide 6 Centralized Licensing and Related Administrative Procedures Slide 7 How CSSB 125 impacts the existing statutory definition of current DHSS licensing programs. Slide 8 What's in CSSB 125? Addition of a new chapter to centralize licensing and administration of covered entities Addition of a new article to centralize background checks and registry functions Updates to existing statutes Establishes the timeline for implementation 10:12:38 AM Slide 9 The key provisions of CSSB 125 Slide 10 Excerpt from current regulatory crosswalk This concluded the slide presentation. 10:16:25 AM SENATOR GUESS asked a question regarding childcare regulations. She explained she had two constituents who lost their childcare license, one because of check fraud and one for being arrested for assault while being potentially sexually assaulted. Both situations ended up in the new regulations under the variance section. She asked whether the variance licensing would be continuing or changing. MS. STACY KRALY, senior assistant attorney general, Department of Law (DOL) answered the majority of the new licensing scheme could be very easily characterized as a cut and paste. The DOL kept the licensure provisions that are still consistent. 10:19:08 AM DR. MANDSAGER added the language is useful from both perspectives. Variances should be able to be issued. He offered to explain his proposed two amendments, most of which had to do with renumbering. 10:20:37 AM DR. MANDSAGER commented there were many different kinds of volunteers and DHSS needs to foster them. Volunteers would be defined in regulation and would be subject to background checks. 10:24:12 AM DR. MANDSAGER explained immunity protection is offered to those who report abuse. 10:25:20 AM MS. KRALY explained an individual would be notified when placed on the registry so that they could challenge their placement if need be. 10:27:24 AM SENATOR THERRIAULT moved Amendment 1. Amendment to CSSB 125 (HES) in SJUD    Page 8, following line 19: Insert a new bill section to read: "*Sec. 16. AS 44.62.330(a) is amended by adding a new paragraph to read: (45) Department of Health and Social Services as to the licensing centralized registry under AS 47.05.330 - 47.05.390;" Renumber the following bill sections accordingly. Page 14, line 21, following "employee": Insert "or volunteer" Page 14, line 22, following "(1)": Insert "decisions," Following "applicant": Insert "," Delete "or" Page 14, line 23: Delete "the" Following "employee": Insert ", or volunteer" Page 14, line 24, following "jurisdiction": Insert "or medical assistance fraud under AS 47.05.210 or a substantially similar provision in another jurisdiction" Page 15, line 2: Delete "and" Following "employees": Insert ", and volunteers" Page 15, following line 2: Insert new subsections to read: "(d) An entity, individual service provider, or employee or volunteer of an entity or individual service provider shall report to the department if a court issues a decision, order, judgment, or adjudication that the entity, individual service provider, or the employee or volunteer committed medical assistance fraud or abuse, neglect, or exploitation of a child or a vulnerable adult. An entity, individual service provider, or employee or volunteer of an entity or individual service provider shall make a report under this subsection within 24 hours of receiving a decision, order, judgment, or adjudication of medical assistance fraud or abuse, neglect, or exploitation of a child or vulnerable adult. (e) An entity or individual service provider shall report to the department any allegation that an employee, volunteer, or former employee or volunteer has committed, not more than 10 years ago, medical assistance fraud or abuse, neglect, or exploitation of a child or vulnerable adult receiving services from the entity or individual service provider. An entity or individual service provider shall make a report under this subsection within 24 hours of receiving notice of the allegation." Page 15, line 3: Delete "(d)" Insert "(f)" Page 15, line 5: Delete "(e)" Insert "(g)" Page 15, lines 10 - 11: Delete all material. Insert "(h) Information contained on the registry is confidential and not subject to public inspection and copying under AS 40.25.110 - 40.25.125. However, in accordance with this section and regulations adopted under AS 47.05.380, information contained on the registry may be released to authorized entities, individual service providers, and governmental agencies." Page 15, lines 9 - 11: Delete all material. Insert "(i) A person who makes a report of medical assistance fraud, abuse, neglect, or exploitation or submits information to the registry, or an entity or individual service provider that fails to hire or retain an employee because the employee is included on the registry, is presumed to be acting in good faith and shall be immune from civil liability and criminal liability." Page 15, line 15: Delete "(h)" Insert "(j)" Page 15, line 29, following "AS 47.32.010(b)" Insert "and an owner, officer, director, member, and partner of the entity" Page 36, line 26: Delete "34" Insert "35" Page 40, line 13: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 40, line 15: Delete "34" Insert "35" Page 40, line 16: Delete "34" Insert "35" Page 40, line 18: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 40, line 19: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 40, line 21: Delete "34" Insert "35" Page 40, line 24: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 40, line 27: Delete "19" Insert "20" Page 40, line 28: Delete "19" Insert "20" Page 40, line 30: Delete "19" Insert "20" Page 41, line 2: Delete "19" Insert "20" Page 41, line 3: Delete "34" Insert "35" Page 41, line 6: Delete "19" Insert "20" Page 41, line 8: Delete "19" Insert "20" Page 41, line 11: Delete "19" Insert "20" Page 41, line 14: Delete "19" Insert "20" Delete "34" Insert "35" Page 41, line 15: Delete "19" Insert "20" Page 41, line 17: Delete "19" Insert "20" Page 41, line 21: Delete "34" Insert "35" Page 41, line 22: Delete "34" Insert "35" Page 41, line 23: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 41, line 31: Delete "17" Insert "18" Page 42, line 1: Delete "18" Insert "19" Page 42, line 2: Delete "20" Insert "21" Page 42, line 3: Delete "21" Insert "22" Page 42, line 4: Delete "22" Insert "23" Page 42, line 5: Delete "23" Insert "24" Delete "24" Insert "25" Page 42, line 6: Delete "26" Insert "27" Page 42, line 7: Delete "27" Insert "28" Page 42, line 8: Delete "28" Insert "29" Page 42, line 9: Delete "29" Insert "30" Page 42, line 10: Delete "30" Insert "31" Page 42, line 11: Delete "31" Insert "32" Page 42, line 12: Delete "32" Insert "33" Page 42, line 13: Delete "33" Insert "34" Page 42, line 14: Delete "37" Insert "38" Page 42, line 15: Delete "40" Insert "41" Page 42, line 20: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 42, line 26: Delete "34" Insert "35" Page 42, line 29: Delete "34" Insert "35" Page 43, line 8: Delete "34" Insert "35" Page 43, line 9: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 43, line 11: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 43, lines 13 - 14: Delete "secs. 1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "secs. 1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 43, line 19: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 43, line 22: Delete "1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 43, line 24: Delete "34" Insert "35" Page 43, line 28: Delete "34" Insert "35" Page 44, line 6: Delete "19" Insert "20" Page 44, line 8: Delete "19" Insert "20" Page 44, line 9: Delete "19" Insert "20" Page 44, line 10: Delete "19" Insert "20" Page 44, line 12: Delete "19" Insert "20" Page 44, line 15: Delete "19" Insert "20" Page 44, line 17: Delete "19" Insert "20" Page 44, lines 24 - 25: Delete "secs. 1 - 18, 20 - 34, 36 - 41, and 43 - 50" Insert "secs. 1 - 15, 17 - 19, 21 - 35, 37 - 42, and 44 - 51" Page 44, line 28: Delete "19 and 35" Insert "16, 20, and 36" Page 45, line 3: Delete "56" Insert "57" Page 45, line 4: Delete "52, 54, and 56" Insert "53, 55, and 57" Page 45, line 6: Delete "41" Insert "43" Page 45, line 7: Delete "19 and 35" Insert "16, 20, and 36" Page 45, line 8: Delete "56(b)" Insert "57(b)" Page 45, line 10: Delete "58 - 60" Insert "59 - 61" SENATOR GUESS objected for the purpose of discussion and asked who is tasked with making the report within 24 hrs. MS. KRELY advised it would be a mandatory reporting requirement and either the employer of DHSS would make the report to the keeper of the registry. SENATOR GUESS asked about an off-hours system. MS. KRELY advised an 800 number or e-mail would be available. CHAIR SEEKINS advised the committee he intended to have the amendments incorporated into a committee substitute (CS) and give them an opportunity to view the final document before voting on it. SENATOR GUESS asked the penalty for late reporting. DR. MANDSAGER advised it was defined in the regulations. Amendment 1 was adopted. SENATOR GUESS moved Amendment 2. Amendment #2 to CSSB 125 (HES) in SJUD Page 22, following line 27: Insert a new subsection to read: "(b) The department shall, within 90 days after receiving a written request that it do so, delegate its powers relating to child care facilities under this chapter to a municipality that has adopted an ordinance providing for child care licensing under home rule powers under AS 29.10.010 or as authorized under AS 29.35.200 - 29.35.210. A municipality to which these powers have been delegated may adopt, by ordinance, additional requirements for child care facilities operating within its boundaries if the requirements meet or exceed the requirements adopted by the department." Page 22, line 28: Delete "(b)" Insert "(c)" Hearing no objections, the motion carried. 10:35:00 AM CHAIR SEEKINS advised Representative Sharon Cissna the committee adopted two amendments for incorporation into a CS. He asked that her testimony be confined to that. REPRESENTATIVE CISSNA noted the committee had not progressed to the point in SB 125 that she was concerned about. She offered to speak at a future hearing. 10:38:56 AM SB 125 was held in committee.