HOUSE FINANCE COMMITTEE APRIL 30, 1997 2:00 P.M. TAPE HFC 97 - 117, Side 1, #000 - end. TAPE HFC 97 - 117, Side 2, #000 - end. TAPE HFC 97 - 118, Side 1, #000 - #071. CALL TO ORDER Co-Chair Gene Therriault called the House Finance Committee meeting to order at 2:00 P.M. PRESENT Co-Chair Therriault Representative Kohring Representative Davies Representative Martin Representative Davis Representative Moses Representative Foster Representative Mulder Representative Grussendorf Representative Kelly Representative Hanley was not present for the meeting. ALSO PRESENT Representative Joe Ryan; Patti Swenson, Staff, Representative Con Bunde; Mark Rosen, Staff, Representative Joe Ryan; Catherine Reardon, Director, Division of Occupational Licensing, Department of Commerce and Economic Development; Connie Sipe, Director, Division of Senior Services, Department of Administration; Katherine Tibbles, Social Services Program Coordinator, Family and Youth Services, Department of Health & Social Services; Ron Cowan, (Testified via teleconference), Department of Health and Social Services, Anchorage. SUMMARY SB 29 An Act relating to certain programs of state aid to municipalities and recipients in the unorganized borough; and providing for an effective date. HCS CS SB 29 (FIN) was reported out of Committee with a "do pass" recommendation and with a fiscal note by the Senate Finance Committee dated 2/6/97. HB 127 An Act relating to the citizen review board and panels for permanency planning for certain children in state custody; renaming the Citizens' Review Panel For Permanency Planning as the Citizens' Foster Care Review Board; extending the 1 termination date of the Citizens' Foster Care Review Board; and providing for an effective date. HB 27 was placed in Subcommittee with Representative Mulder as Chair and with members Representative J. Davies and Representative Kelly. HB 217 An Act relating to certified nurse aides; and providing for an effective date. CS HB 217 (FIN) was reported out of Committee with a "do pass" recommendation and with fiscal notes by the Department of Commerce and Economic Development and the Department of Health and Social Services dated 4/17/97. HOUSE BILL 127 "An Act relating to the citizen review board and panels for permanency planning for certain children in state custody; renaming the Citizens' Review Panel For Permanency Planning as the Citizens' Foster Care Review Board; extending the termination date of the Citizens' Foster Care Review Board; and providing for an effective date." PATTI SWENSON, STAFF, REPRESENTATIVE CON BUNDE stated that HB 127 would change existing state laws for the Citizens' Foster Care Review Panel which are currently inadequate. The existing statutes do not give enough power to the local panels. * Existing statutes make foster care review panels look like a weak duplication of some Division of Family and Youth Service functions. * Existing statutes do not permit the local panel's recommendations to be placed into the court records for consideration in the disposition of a case. * Existing statutes do not require state departments to supply necessary aggregate data. Specific data is needed to measure the performance of the child protection system. * Existing statutes do not give local panels the authority to develop priority for early reviews of the worst cases. * Existing statutes require the current foster 2 care review system to sunset on June 30, 1997. HB 127 would correct the weaknesses in our current statutes and would give a strong independent voice to local review panels. The legislation would establish local review panels throughout the State which will advocate for children, their families and for needed changes in our child protection system. The National Association for Foster Care Reviewers will guide the implementation of the Alaska program. There are 26 states with active state review boards and foster care review panels. Those who have served on foster care review panels throughout the United States have found the effort worth their time. All state boards and local review panels share the same goal to decrease the amount of time children linger in out-of-home care. Ms. Swenson stressed that the legislation is needed by everyone who deals with Alaska's child protection system. She urged the Committee's favorable consideration of HB 127. Co-Chair Therriault questioned the increased the number of voting number to the newly established State board. Ms. Swenson replied that originally there were four administrative types on the board; the Commissioner of Health and Social Services, the Director of the Office of Public Advocacy (OPA), the Attorney General and a designee from the Public Defenders office. Those positions were deleted and the State board was increased from seven to nine members; public board members were also increased. The increased number will expand the representation each district has in the four judicial districts. Representative Martin asked if there would be a distinction between public board members and voting board members. Ms. Swenson explained that in the initial legislation, the administrative members were also voting members; in the next version of the bill, they were advisory only and in the following version, those members were completely removed. All nine public members are voting members. Co-Chair Therriault pointed out that the State panel previously met twice a year. The new legislation recommends that the State panel meet at least twice a year. Ms. Swenson pointed out that some of the meetings could take place telephonically, although, initially, when the board is formed, it will be important that they meet when creating policy and regulations. Co-Chair Therriault referenced Section #13, pointing out that the program coordinator position would be replaced by 3 an executive director at a greater fiscal impact. Ms. Swenson advised that an executive director would not be required to be a social service person. The $139 thousand dollar request currently in the FY98 budget would cover one full-time administrative clerk, one 30 hour social worker coordinator, and one full-time social worker II. The additional funding request in the fiscal note would add an executive director who would work with the State board and would be responsible for grant writing. That position would interface with all local panels to effectively implement the program. Representative Mulder suggested that if the board was assuming some of the functions of the Division of Family and Youth Services, the fiscal note should indicate a negative amount. Ms. Swenson replied that when the board initially forms, they will not be entitled to any of the federal Title IVE fund. Down the line, the board would be able to apply for federal funds under Title IV. Ms. Swenson noted that the Anchorage program has been in existence for four years. Co-Chair Therriault felt that Anchorage should be able to fulfill the federal requirements to qualify for some of those funds. Ms. Swenson explained that the panel has been operating on a very low budget, with capabilities of reviewing only one-third of the Anchorage cases. In order to reorient, a State board is needed. Increasing the number of cases will require a larger number of volunteers. The panel, with current funding, has not been able to adequately train volunteers. Co-Chair Therriault questioned the $29 thousand dollar travel component of the fiscal note. Ms. Swenson responded that amount would cover costs for the executive director to provide the training and allow a board member from each area to participate. Co-Chair Therriault questioned if the full amount was warranted. CONNIE SIPE, DIRECTOR, DIVISION OF SENIOR SERVICES, DEPARTMENT OF ADMINISTRATION, commented that forming a state board would provide the benefits of tapping upon a large group of volunteers throughout the State. Currently, only one-third of the total Anchorage cases are being reviewed. It would take an active, trained group of 80-100 volunteers to address the cases only in Anchorage. Most volunteers can hear one case per month. A State board would be providing a constant recruitment and training of volunteer panel members which would hear foster care child cases. Ms. Sipe stressed that "volunteerism" must be managed well or a poor system will result. The State board will be responsible for a positive functioning group. She pointed 4 out that the consideration before the Committee would leap from one-third of one city's foster child group to the State's entire population. Until the burden is removed from Division of Family and Youth Services (DFYS), there will be duplication of services. The State board will be a very busy operation. They will be trying to make maximum use of citizen volunteers. Co-Chair Therriault asked the amount of federal funds that the State brings in for the IVE match. KATHERINE TIBBLES, SOCIAL SERVICES PROGRAM COORDINATOR, DIVISION OF FAMILY AND YOUTH SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, advised that the requirement for getting any IVE dollars is that six month reviews are provided on all kids in out-of-home care. The $7 million dollar federal funding would be reduced when the service was not done effectively. Co-Chair Therriault asked if it was reasonable to think that a volunteer panel could assume these responsibilities and functions in relieving the Department from their effort. Ms. Sipe explained that Title IV requirements include the 180 day review. If that requirement and all the others are met by the State, the State will then be given $7 million dollars to help pay for foster care for those children. DFYS currently attempts to get citizens from outside to help review cases. Twenty-six other states throughout the nation currently use the State board panel to tap those funds. Ms. Tibbles added, an additional function of the panel would be to develop packets. The panels are not funded at this time. Co-Chair Therriault asked if a certain level of expertise and education would be necessary before the federal government would allow the IVE monies to be disbursed. Ms. Tibbles said no, although, there are specific requirements which must be met: * The review must occur within six months of removal of a child; * The process must be open to participation of the parents; and * The Court reviews must occur within twelve months. Beyond that, there are an additional eighteen procedural protection steps. She stressed that the system develops the "expertise" not the "agency". The panels could take over the functions. 5 (Tape Change HFC 97-117, Side 2). Co-Chair Therriault observed that the initial intent was to cover the Anchorage area. He pointed out the frustration in the rest of the State that their foster care concerns also be met. Ms. Sipe commented that at this time, there is no State board, only an Anchorage panel. The Anchorage panel does not have voting powers and can not set policy for the new panels. There is a lot of work which needs to be done in the first year. The phase-in will be expensive in establishing a State board responsible for policy and regulations. Implementing one-third of one town is very different than implementing the entire State. Providing service for part of the cases would be difficult and would result in duplication of services with DFYS. She added, the legislative intent would be to bring one town up to 100%, so the entire system could see how well it works and then, as quickly as possible, begin to up-date the rest of the State. She stressed that the intent is not to discriminate. Current recommendations are to stagger implementation of the program and then begin with start-up grants for all regions. Ms. Sipe stressed the need for adequate program funding. Historically, when the bill was passed in 1991, it carried a $750 thousand dollar fiscal note. The suggested new fiscal note could max out at $550 thousand dollars. She summarized, no one wants to live with the constant criticism that the Legislature has established a goal without providing the proper resources. Representative Mulder inquired if there was a less expensive alternative to the proposed program. Co-Chair Therriault asked if there was something in the public agency system which would make more sense. Ms. Sipe replied that the Governor supports the concept that whenever the reviews occur in the agency only, all of the parties of that case witness it as an administrative function. The value of getting away from the agency, and using citizens that care about kids would be valuable. Over the long term, there will be maximum savings, money and advocacy on behalf of kids. This is a complex system, and the volunteerism must be handled carefully as it is a delicate issue. Ms. Sipe responded to Representative Mulder's repeated concern regarding fiscal costs. She reminded members that most states do not realize cost savings in the first two years. The Commission on Justice pinpointed this as their prime recommendation. It will save money in the long-run. 6 Co-Chair Therriault agreed that in the out-years the budget subcommittees will look at the effort and determine if a shift of monies could be made. He placed the legislation in a Subcommittee with Representative Mulder as Chair and with members Representative J. Davies and Representative Kelly. He asked the Subcommittee to address the legislation's wording and the fiscal note phase-in. HB 127 was HELD in Committee for further consideration. SENATE BILL 29 "An Act relating to certain programs of state aid to municipalities and recipients in the unorganized borough; and providing for an effective date." Senator John Torgerson noted that the legislation would change the name of the Revenue Sharing program to "priority Revenue Sharing for Municipal Services", changes the Municipal Assistance Fund to the Safe Communities Fund and would require that payments from the Safe Communities Fund be used for specific prioritized purposes. The intent of these changes is to more accurately reflect the purposes for which payments received are used. These programs appear to have fostered the perception that it is a type of "slush fund" for communities. The change in name and the requirements for use of the monies help to dispel that notion. He noted that communities are required to spend funds received from the Safe Communities Fund on specific purposes in the following priorities: 1. Police protection and related public safety services; 2. Fire protection and emergency medical services; 3. Water and sewer services not offset by user fees; 4. Solid waste management; and 5. Other services the governing body determines to have the highest priority. Communities are not, however, required to fund all requests for services in a category before funding services in another category. Communities that levy and collect property taxes are required to list the allocation received from the Safe Communities Fund and it's equivalent will rate on the "Notice to Taxpayers". Senator Torgerson noted that the bill also would revise how appropriations continue to be reduced, allocations to, and 7 the resulting payments from the base amount account be proportionately reduced. In the past, the account was "held harmless" and appropriation reductions were taken entirely from the per capita account which resulted in an inequitable reduction of payments to communities. The minimum entitlement to communities is increased to $40 thousand dollars based on the FY97 appropriation. If, however, appropriations continue to decline, this minimum entitlement may be proportionately reduced along with payments from the base amount and the per capita accounts. Senator Torgerson concluded that the date of payment was changed so that communities receive entitlement from both Priority Revenue Sharing and the Safe Communities Fund on July 31st. Previously, payments from revenue sharing were made on July 31st and municipal assistance payments were made on February 1st. Representative Mulder MOVED that 0-LS02181\H, Cook, 4/28/97, be the version before the Committee. There being NO OBJECTION, it was adopted. Representative Mulder MOVED to report HCS CS SB 29 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. HCS CS SB 29 (FIN) was reported out of Committee with a "do pass" recommendation and with a fiscal note by the Senate Finance Committee dated 2/6/97. HOUSE BILL 217 "An Act relating to certified nurse aides; and providing for an effective date." MARK ROSEN, STAFF, REPRESENTATIVE JOE RYAN, introduced HB 217 which would give the Board of Nursing the authority to oversee the training, supervision, utilization and registration of Certified Nurse Aides. CATHERINE REARDON, DIRECTOR, DIVISION OF OCCUPATIONAL LICENSING, DEPARTMENT OF COMMERCE AND ECONOMIC DEVELOPMENT, explained there are 2,800 Certified Nurses Aides (CNA's) working in Alaska's long-term care facilities and home health agencies. These aides provide care to those most unable to care for themselves, the aged and the infirm. The Certified Nurse Aides work under the supervision of a nurse licensed by the Board of Nursing, performing only those duties specifically delegated by that nurse. The 8 Omnibus Budget Reconciliation Act of 1987 (federal) required that states establish Nurse Aide Certification programs for aides working in long-term care and home health agencies receiving Medicare and Medicaid funding. Since 1989, the responsibility for the Certified Nurse Aide program has been divided between the Department of Health and Social Services (DHSS), Division of Medical Assistance, Health Facilities and Licensing and Department of Commerce and Economic Development (DCED), Occupational Licensing, Board of Nursing. The legislation would delineate responsibility for oversight of Certified Nurse Aides clearly to the Board of Nursing. The Board of Nursing has been responsible for establishing minimum training standards, approval of training programs and maintenance of the Certified Nurses Aide registry. HB 217 protects Alaska's most vulnerable population by insuring that the people who care for them are properly trained and that oversight of that care be provided. She proceeded to explain the differences between the Finance and Labor & Commerce Committees version of the bill. Representative Martin recommended that the Board of Nursing screen themselves at their own expense. Ms. Reardon replied that the program was required by State statute to be financially self- sufficient. The fees charged to the nurse aides must cover those costs. The Board of Nursing is aware that the fees will increase as a result of the legislation. She pointed out that this would be a general fund/program receipts. Ms. Reardon spoke to the fiscal note which indicates new State expenditures. The way to calculate fees for each occupation is through audits. Part of the costs of running the board are shared by spreading the costs on a per capita basis. Any direct costs caused by nurse aides would be included as would the administrative indirect costs. Representative G. Davis asked if there was an established indirect cost rate. Ms. Reardon replied that the cost would be $35 dollars. All costs are related to license processing and billings. (Tape Change HFC 97-118, Side 1). RON COWAN, (TESTIFIED VIA TELECONFERENCE), DEPARTMENT OF HEALTH AND SOCIAL SERVICES, ANCHORAGE, offered to answer any questions of the Committee, noting that the Department fully supports the proposed legislation. Representative Martin MOVED that 0-LS0737\L, Lauterbach, 4/30/97, be the version before the Committee. There being 9 NO OBJECTION, it was adopted. Representative J. Davies MOVED to report CS HB 217 (FIN) out of Committee with individuals recommendations and with the accompanying fiscal notes. Co-Chair Therriault noted that he would like to change the DCED fiscal note to reflect that the funds are program receipts. Following discussion between Co-Chair Therriault and Representative J. Davies on the effect of that intent, there was NO OBJECTION, and the bill was moved from Committee. CS HB 217 (FIN) was reported out of Committee with a "do pass" recommendation and with fiscal notes by the Department of Health and Social Services dated 4/17/97 and the Department of Commerce and Economic Development. ADJOURNMENT The meeting adjourned at 3:40 P.M. 10