MINUTES SENATE FINANCE COMMITTEE April 2, 1993 8:45 a.m. TAPES SFC-93, #44, Side 1 (87-end) SFC-93, #44, Side 2 (000-355) CALL TO ORDER Senator Steve Frank, Co-chair, convened the meeting at approximately 8:45 a.m. PRESENT In addition to Co-chairs Frank and Pearce, Senators Jacko, Kelly, Kerttula, Rieger, and Sharp were present. ALSO ATTENDING: Kimberly Busch, Director, Division of Medical Assistance, Department of Health & Social Services; Janet Clark, Director, Division of Administrative Services, Department of Health & Social Services; Margaret Lowe, Director, Division of Mental Health & Developmental Disabilities, Department of Health & Social Services; Jeff Morrison, Director, Administrative & Support Services Division (ASSD), Department of Military & Veterans Affairs; Mike Greany, Director, and Nancy Slagle, Jeff Hoover, Joan Kasson, Karen Rehfeld, Fiscal Analysts, Legislative Finance Division; and aides to committee members. SUMMARY INFORMATION SB 175 - An Act making appropriations for the operating and loan program expenses of state government and to capitalize funds; and providing for an effective date. Subcommittee budgets were presented for the following departments: Department of Corrections Department of Labor Department of Law Department of Health & Social Services Department of Military & Veterans Affairs SENATE BILL NO. 175: An Act making appropriations for the operating and loan program expenses of state government and to capitalize funds; and providing for an effective date. Department of Corrections CO-CHAIR STEVE FRANK outlined subcommittee increments and decrements to the corrections of the FY94 operating budget for the Department of Corrections (copy of handout on file titled "Governor's Amended FY94 DOC Budget (Total Funds)). He said that overall the subcommittee had made reductions from the Governor's budget but was still an increase from last year. He said it contained funding for the Wildwood facility. He stated that the subcommittee had worked with the department and although the department was not happy, he felt the budget was a good one. SENATOR JAY KERTTULA voiced his dissatisfaction with the short notice departments received after budget subcommittee close-outs. He felt that had made it difficult to bring amendments to the budgets. Co-chair Frank assured Senator Kerttula that SB 175 would not move out of committee today and members would have the opportunity to offer amendments. In regard to the Department of Corrections budget reductions, Senator Kerttula questioned the across-the-board reduction of medical components. He felt the institutional medical situation already had problems. Senator Frank said the nursing staff had been reduced but a nurse would be available to the institution. Senator Frank said that the medical component in the Department of Corrections is an area of escalating costs, and that the subcommittee suggested that the department go more to a medical administrator rather than a physician administration. He said the department is prepared to sign a "preferred provider agreement" with one of the Anchorage hospitals that should result in a $500.0 reduction in fees for prisoner major medical care. Senator Kerttula also voiced his concern regarding the reduction in the training component for the Department of Corrections. Senator Frank said that the subcommittee recognizes the importance of training. CO-CHAIR DRUE PEARCE MOVED for ADOPTION of subcommittee recommendations for the Department of Corrections budget into SB 175. Senator Kerttula OBJECTED. Co-chair Frank asked for a show of hands. The motion CARRIED on a vote of 6 to 1. (Senators Frank, Jacko, Kelly, Pearce, Rieger, and Sharp were in support. Senator Kerttula was opposed.) Department of Labor SENATOR TIM KELLY outlined subcommittee decrements to the corrections of the FY94 operating budget for the Department of Labor (copy of handout on file, memo dated April 1, 1993, subj: Department of Labor Subcommittee FY94 Budget Proposal). He explained that the subcommittee took into consideration that the department had taken reductions the last two years. Senator Kerttula said that he had some amendments for this budget but would hold them until later. SENATOR BERT SHARP MOVED for ADOPTION of subcommittee recommendations for the Department of Labor budget into SB 175. Senator Kerttula OBJECTED. Co-chair Frank asked for a show of hands. The motion CARRIED on a vote of 6 to 1. (Senators Frank, Jacko, Kelly, Pearce, Rieger, and Sharp were in support. Senator Kerttula was opposed.) Senator Kerttula MOVED for ADOPTION of amendment #1 that would add $184.4 in general funds to the labor market information section of the budget (copy on file). Senator Kelly OBJECTED. Co-chair Frank asked for a show of hands. The motion FAILED on a vote of 6-1. (Senators Frank, Jacko, Kelly, Pearce, Rieger, and Sharp were opposed. Senator Kerttula was in support.) Department of Law Senator Kelly outlined subcommittee decrements and increments to the corrections of the FY94 operating budget for the Department of Law (copy of handout on file, memo dated April 1, 1993, Subj: Department of Law Subcommittee FY94 Budget Proposal). He said that in order to reach the cap recommended by the chair, the subcommittee recommended a reduction in Exxon funding by $1.5M, and denial of an increment of 12 new positions (4 were allowed). Overall, a 2.8 percent reduction was recommended. He believed that next year it would be much more difficult to reach the cap. Discussion followed between Senator Kerttula, Kelly, and Frank regarding the tremendous legal costs for the mental health trust lands settlement. Senator Kerttula MOVED for ADOPTION of subcommittee recommendations for the Department of Law budget into SB 175. No objections being raised, it was ADOPTED. At Ease 9:07am Reconvene 9:12am Department of Health & Social Services SENATOR STEVE RIEGER outlined subcommittee decrements to the corrections of the FY94 operating budget for the Department of Health & Social Services (copy of handout on file titled "FY94 Senate Finance DHSS Subcommittee Recommendations"). Senator Kerttula asked for an explanation to the Waivers Program on page 3 of the handout. KIMBERLY BUSCH, Director, Division of Medical Assistance, DH&SS, said the department applied for a waiver to the Medicaid Program under the direction of the legislature, and it has been granted. She explained that it allows the department, with the help of federal funds, to cover special services for children who would be eligible in an institution income-wise, but are not eligible in the community because of the parents' income. Senator Kerttula asked who in the department recommended the transfer of clients out of Harborview. JANET CLARK, Director, Division of Administrative Services, DH&SS, said the department did not recommend the transfer of DD clients out of Harborview. She said the department worked with the House to ensure that the numbers would be correct in the event funding was provided in the DD component to transfer residents out of Harborview. She restated that the Governor's budget retained those individuals in Harborview. In answer to Senator Kerttula, Ms. Busch said that Project Choice was a project in which federal funds can be directed to people in the community so that they have a choice between a nursing home, a hospital, a group home, or an assisted living situation. The federal money would follow the individual rather than the institution. End SFC-93 #44, Side 1 Begin SFC-93 #44, Side 2 Senator Rieger MADE a motion to RESCIND his motion made in an earlier meeting, and provided the committee with a handout that outlined reductions that would be reincorporated into the mental health component in the drug and alcohol grants in the amount of $67.7 (copy on file). No objections having been raised, the amendment was ADOPTED. SENATOR GEORGE JACKO asked if the 3 percent reduction to community health aid training was the same as in the House budget. Senator Rieger answered affirmatively. Senator Kerttula MADE a motion to amend the DH&SS budget by transferring funds of $300,000 from the Community DD program back to Harborview (copy on file). Senator Kerttula expressed his concern over the reduction to Harborview. Senator Rieger informed the committee that there is a transfer in of $172.3 as well as the transfer out of $300.0. He said the trend is away from institutionalization of individuals. Senator Kerttula said he agreed with the move away from institutionalization but spoke to the population of those individuals in crisis. Senator Kerttula said that Harborview had received 47 referrals in the last year for difficult and special-needs patients. Senator Rieger said his understanding was that 13 patients in Harborview would like to leave to live in their own community. He understood that the transfer of $300.0 would help facilitate that. Senator Kerttula asked what would be done with the other individuals that were unable to leave Harborview. Ms. Clark explained that Harborview had two distinct populations. Three wings hold the developmentally disabled and those individuals could move into the community. The fourth wing, the sour dough unit, serves long-term, medically-fragile individuals who have dementia, some of whom are elderly. The Governor's budget would have added another wing for this population because of the waiting list. She said that the $300.0 grant would be appropriate for this population group. MARGARET LOWE, Director, Division of Mental Health & Developmental Disabilities, DH&SS, explained that it was important for Harborview's budget to be slightly increased. She said that the sour dough unit has sixteen patients who receive itinerant psychiatric support from API (a psychiatrist visits once a month for several days). The individuals in the sour dough unit are long-term, many life- time care patients and do not need the acute care of API. She explained that they were on medication and needed the support of a medical doctor. She also pointed out that Harborview has developed a tremendous expertise in psycho- social management. It can deal with difficult patients who suffer from dementia, head injury, etc. with assaultive and impulsive behavior. The nursing homes in the state are not trained or have had to deal with this extreme behavior. She reiterated that there is a waiting list from nursing homes and families all over the state of about 40 to 50 individuals for the sour dough unit. This is separate from the developmentally disabled people, some severely impaired, at Harborview who, as funds are available, will be able to move back into the community. Senator Rieger pointed out that the Older Alaskans' Commission and the Alzheimer's Association are opposed to expansion of Harborview. Ms. Lowe voiced her respect for both organizations but felt their concern was that older people would involuntarily be placed in institutions such as Harborview. She explained that all the individuals on the waiting list for Harborview were in dire need and did not have the option of community care. At ease 9:50am Reconvene 9:51am Senator Kerttula reiterated the need to expand the sour dough wing at Harborview and asked the committee to pass his amendment transferring $300.0 back to Harborview. Senator Rieger said he was OPPOSED to the amendment. Discussion followed between Senators Kerttula and Rieger regarding the construction of API. Co-chair Frank asked for a show of hands. The motion FAILED on a vote of 6 to 1. (Senators Frank, Jacko, Kelly, Pearce, Rieger, and Sharp were opposed. Senator Kerttula was in support.) Senator Kelly MOVED for ADOPTION of subcommittee recommendations for the Department of Health & Social Services budget into SB 175. Senator Kerttula OBJECTED. Co-chair Frank asked for a show of hands. The motion CARRIED on a vote of 5 to 1. (Senators Frank, Jacko, Kelly, Rieger, and Sharp were in support. Senator Kerttula was opposed. Senator Pearce was absent from the meeting at the time the vote was taken.) (See April 3, 1993 minutes for the adoption of letters of intent.) Department of Military & Veterans Affairs SENATOR GEORGE JACKO outlined subcommittee decrements to the corrections of the FY94 operating budget for the Department of Military & Veterans Affairs (copy of handout on file titled "Senate -- DM&VA departmental budget cuts" dated April 2, 1993). He said the total reduction of $400.0 was a 4.1 percent reduction of general funds and 1.5 percent reduction of the total budget. In answer to Senator Kerttula, Senator Jacko said the elimination of the VSO director was a general fund reduction. Senator Jacko said that the reductions could effect $60.0 in federal funds. In answer to Senator Kelly, JEFF MORRISON, Director, Administrative & Support Services Division (ASSD), Department of Military & Veterans Affairs, said the state active duty component of $100.0 is authorization to receive funds from other state agencies or municipalities in the event individuals are placed on active duty to fight fires, assist troopers or other emergency situations. He said there were no general funds involved if someone is placed on active duty. Senator Kelly asked for a breakdown of the department's expenditure for that component for last year. Senator Kerttula said that he would bring up an amendment to add $100.0 to the Veteran's Services budget for the grant program for veteran service organizations at a later time (copy on file). Senator Jacko MOVED amendment #4 to delete $329.6 and insert $429.6 in veteran's services (copy on file). Senator Kerttula asked to be shown as co-sponsor of amendment #4. No objections being raised, it was ADOPTED. Senator Jacko MOVED letters of intent #5 and #6 relating to the Veterans Service Officer grant program (copies on file). No objections being raised, they were ADOPTED. Co-chair Pearce MOVED for ADOPTION of subcommittee recommendations for the Department of Military and Veterans Affairs budget into SB 175. No objections being raised, it was ADOPTED. ADJOURNMENT The meeting was adjourned at approximately 10:02 a.m.