MINUTES SENATE FINANCE COMMITTEE March 17, 1994 9:45 a.m. TAPES SFC-94, #43, Side 2 (200-000) SFC-94, #44, Side 1 (000-120) CALL TO ORDER Senator Drue Pearce, Co-chair, convened the meeting at approximately 9:45 a.m. PRESENT In addition to Co-chairs Pearce and Frank, Senators Rieger, and Kerttula were present. Senator Jacko joined the meeting after it was in progress. Senators Sharp and Kelly did not attend. ALSO ATTENDING: David Gray, aide to Representative Jerry Mackie, sponsor of HB 3 and HB 4; Pat O'Brien, Social Services Program Director, Division of Family & Youth Services, Department of Health & Social Services; Fran Jamison, Older Alaskans Commission, Division of Senior Services, Department of Health & Social Services; and Mike Greany, Director, Legislative Finance Division; aides to committee members and other members of the legislature. SUMMARY INFORMATION SCSHB 3(JUD): An Act relating to public home care providers; and providing for an effective date. David Gray, aide to Representative Jerry Mackie, sponsor of HB 3, testified in support of the bill. Pat O'Brien, Social Services Program Director, Division of Family & Youth Services, Department of Health & Social Services, spoke to the Department's concerns. Discussion was had between Senators Kerttula and Rieger regarding home care providers and the vulnerability of some elderly people. Fran Jamison, Older Alaskans Commission, Division of Senior Services, Department of Health & Social Services, spoke in support of HB 3. HB 3 was REPORTED OUT of committee with a "do pass," with a fiscal note for the Department of Health & Social Services #0259 for $15.0, and zero fiscal notes for the Department of Health & Social Services #1629, Department of Safety #1190, and Department of Administration #1981. CSHB 4(JUD): An Act relating to failure to report harm or assaults of the elderly or disabled. David Gray, aide to Representative Jerry Mackie, sponsor of HB 4, testified in support of the bill. Pat O'Brien, Social Services Program Director, Division of Family & Youth Services, Department of Health & Social Services, spoke to the Department's concerns. Discussion was had between Senators Kerttula and Rieger regarding home care providers, their ethical responsibility and the vulnerability of some elderly people. HB 4 was REPORTED OUT of committee with a "do pass," and zero fiscal notes for the Departments of Administration, Health & Social Services, and Community & Regional Affairs. CSSB 190(JUD): An Act relating to income withholding and other methods of enforcement for orders of support; and providing for an effective date. Scheduled but not heard. SENATE CS FOR HOUSE BILL NO. 3(JUD): An Act relating to public home care providers; and providing for an effective date. Co-chair Pearce invited David Gray, aide to Representative Mackie, sponsor of HB 3 and HB 4, to join the members at the table and speak to the bill. DAVID GRAY said HB 3 had been around for awhile and had not changed too much. The bill originated after a senior passed away who had a health care provider and there was a complaint from the family that the estate had been misused. In response, Representative Mackie looked at the home health care provider situation and how dependent the senior could become on this person. It could involve handling a senior's money and other matters. The bill's main effect would prohibit home care providers to be the sole power of attorney, and anyone who was using public moneys was required to have a criminal background check. Representative Mackie also felt this bill was in tune with the administration's efforts to turn to more home health care service for seniors. Senator Kerttula stated this bill was related to his own personal concerns. He supported a system where more than one person would be involved, and also supported a background check. In answer to Senator Rieger, Mr. Gray said the statutes defined when the state would pay for a home care provider. Mr. Gray said definitions of different kinds of care were scattered throughout the statutes. He said the effort was to have a broader and more consistent definition throughout all parts of the statutes that dealt with the programs and protection of the elderly. PAT O'BRIEN, Social Services Program Director, Division of Family & Youth Services, Department of Health & Social Services, said she had been following HB 3 and HB 4 for four years. She said in order for the division to put regulations in place by March 15, 1995, a fiscal note was needed. She went on to say that if the vulnerable adults bill passed, there would be a collaboration with the Division of Senior Services to develop those regulations. In response to Mr. Gray's prior statement, she said a public home care provider was not currently defined in statute. In answer to Senator Kerttula, Ms. O'Brien said that there was more detail than listed on the fiscal note. In order to implement this bill, regulations must be implemented. She said regulations would address due process. In addition, procedures must be revised in the workers' manuals and some changes in reporting must be made. She said the residential child care regulations were more than ten years old. There was a backlog of very important sets of regulations and prioritizing this bill in front of other regulations was not something the department wanted to do. She said the department would contract out the writing of the regulations. In her experience, she had found that regulations often take a year, and sometimes longer. Senator Kerttula understood that there was not enough money to handle the many problems the Department of Health & Social Services faced, but it was discouraging to him that it would take a year to implement regulations. Senator Rieger asked if the person who was the recipient of home care services under the circumstances of HB 3, ever was a ward of the state. Ms. O'Brien said that children would be the only case, or children in foster homes where respite care would be provided. Adults were never wards of the state. Again, in answer to Senator Rieger, Ms. O'Brien said this was easiest to talk about in regard to a very elderly person. The home care provider who went into the elderly person's home might be the only individual that the person sees and the two might develop a close bond. There had been cases of abuse where the elderly person felt dependent on the individual for emotional support. In that case, the elderly person would not be strong enough to take steps to protect him/herself. She said someone could report this matter to the department and in some cases, it would be necessary for the department to ask the individual to be removed. In answer to another question by Senator Rieger, Ms. O'Brien said in licensing outside contractors, the Department of Law had advised the statement regarding removal in order to provide for due process. Senator Rieger voiced his concern that the state was creating another way to leave itself open to lawsuits where none existed before. FRANK JAMISON, Older Alaskans Commission, Division of Senior Services, Department of Health & Social Services, said the Commission was in support of HB 3. She added that people hired to become home care providers would be required to have a criminal record check. The incident that instigated this bill was a person that had a record in California, and because no record check was done here, no one knew. She stated it was an important bill for vulnerable adults. In answer to Co-chair Pearce, Mr. Gray said that he did not know how the testimony had gone in Senate Judiciary. He did know that due process was key to this situation. Senator Kerttula made a statement that elderly adults could be very vulnerable and family may not be close by. He cited another situation where a parent had Alzheimer's and its problems. Senator Kerttula MOVED for passage of HB 3 from committee with individual recommendations. No objection being heard, it was REPORTED OUT of committee with a "do pass," zero fiscal notes for the Department of Health & Social Services- Administration, and a fiscal note for the Department of Health & Social Services-#2059 for $15.0. Co-chairs Pearce and Frank, Senators Rieger, Kerttula, and Jacko signed "do pass." CS FOR HOUSE BILL NO. 4(JUD): An Act relating to failure to report harm or assaults of the elderly or disabled. Co-chair Pearce asked David Gray, aide to Representative Mackie, prime sponsor of HB 4, to return to the table to speak to the bill. David Gray said that HB 4 was a companion bill to HB 3. It would increase the penalties that exist for people who provided home care services to elderly adults and the disabled, and make it consistent with other law. It increased the penalty from a violation to a class "B" misdemeanor. An earlier version added harm to senior citizens as an aggravating factor. This was taken out. It had another provision that said if a provider was convicted of doing harm, the court should notify the appropriate licensing agency. Senator Kerttula said that a piece of legislation had already passed regarding this issue. He thought the social services people were required to investigate reports. Mr. Gray said he did not know about reporting requirements. Senator Rieger asked how this would tie in with a mental health professional or a family therapist in regard to professional and ethical confidentiality towards the family. Co-chair Frank asked Senator Rieger if he meant a case where a family member may confess to some abuse to a parent. Senator Rieger agreed and said the person that needed counseling would not receive the therapy he/she needed. Mr. Gray pointed out that presently it was a class "B" penalty to harm a disabled person where harm to a senior citizen was only a violation. Senator Rieger did not see what that had to do with it. Senator Kerttula suggested that health care professionals be excluded from this bill. Discussion continued between Co-chair Frank and Mr. Gray regarding health care providers and reporting of abuse. Ms. O'Brien said the department had wrestled with many of these same questions. In fact, she heard testimony by mental health care providers on these issues. She said they support being included in the mandatory reporting laws. Health care providers warn their clients that they must report violations if it would come up in counseling sessions, and it may keep the client from speaking freely. Senator Rieger again said that people that needed the help may not go for help. He was not comfortable with this part of the bill. End SFC-94 #43, Side 2 Begin SFC-94 #45, Side 1 Ms. O'Brien said there was the understanding with reports to law enforcement officers, that when it was reported to social services, unless the law had been broken, social services could then go into the home and talk with individuals to stop the behavior. She said when it got to a criminal level, that was another area. Senator Kerttula said this was a problem with social services. Sometimes it would have to reach a criminal stage before someone was helped. In answer to Senator Rieger, Mr. O'Brien said that the definition of harm would be revised under the vulnerable adults law if that law passed. Senator Kerttula MOVED for passage of HB 4 from committee with individual recommendations. No objection being heard, it was REPORTED OUT of committee with a "do pass," and zero fiscal notes for the Department of Administration-#1631 and Kerttula signed "do pass." Senator Rieger signed "no recommendation." SCHEDULED BUT NOT HEARD: CS FOR SENATE BILL NO. 190(JUD): An Act relating to income withholding and other methods of enforcement for orders of support; and providing for an effective date. ADJOURNMENT The meeting was adjourned at approximately 10:15 a.m.