SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE Work Session February 2, 2000 1:35 p.m. MEMBERS PRESENT Senator Gary Wilken Senator Kim Elton MEMBERS ABSENT Senator Mike Miller, Chairman Senator Pete Kelly, Vice-Chairman Senator Drue Pearce COMMITTEE CALENDAR SENATE BILL NO. 204 "An Act extending the termination date of the Alaska Commission on Aging; and providing for an effective date." -HEARD AND HELD CS FOR HOUSE BILL NO. 85(FIN) am "An Act relating to licensure and professional discipline of members of the teaching profession and providing for related penalties; relating to grounds for dismissal of a teacher; relating to the Professional Teaching Practices Commission; relating to limited immunity for procedures under the Educator Ethics Act; making conforming amendments; and providing for an effective date." -HEARD AND HELD Presentation by the State Independent Living Council (SILC) PREVIOUS SENATE COMMITTEE ACTION SB 204 - No previous committee action. HB 85 - No previous committee action. WITNESS REGISTER Margaret Evans 1615 Birchwood St. Anchorage, AK 99508 POSITION STATEMENT: Discussed SILC's PSA program Linda Bjorge P.O. Box 756 Wrangell, AK 99925 POSITION STATEMENT: Commented on Assisted Living Home Rates Jerie Best P.O. Box 426 Soldotna, AK 99669 POSITION STATEMENT: Discussed Transportation Needs of the Disabled Patrick Reinhart Director, State Independent Living Council 1016 W. 6th Ave. #205 Anchorage, AK 99501 POSITION STATEMENT: Presented John Woodward, SILC Chairman David Jacobson Executive Director of the State Independent Living Council 4214 Mathison Court Fairbanks, AK POSITION STATEMENT: Discussed Housing Needs of the Disabled Ruth L'Hommedieu 3282 Adams Drive Fairbanks, AK POSITION STATEMENT: Discussed Employment Needs of the Disabled Sanna Green, Executive Director Professional Teachers Practices Commission 344 3rd St. #127 Anchorage, AK 99508 POSITION STATEMENT: Presented HB 85 Jane Demmert Executive Director, Older Alaskans Commission PO Box 110209 Juneau, AK 99811-0209 POSITION STATEMENT: Presented SB 204 Beth Lape, Special Assistant Department of Education 801 W 10th St. Ste 200 Juneau, AK 99801-1894 POSITION STATEMENT: Supports SB 204 ACTION NARRATIVE TAPE 00-03, SIDE A Number 001 SENATOR WILKEN called the the work session of the Senate Health, Education and Social Services (HESS) Committee to order at 1:35 p.m. Senator Wilken announced that Chairman Miller was ill, Senator Pearce was on business in Washington, D.C., and Senator Pete Kelly was on business in McGrath. The first order of business to come before the committee was a presentation by the State Independent Living Council. MR. PATRICK REINHART, Director of the State Independent Living Council (SILC), noted that John Woodward would begin the presentation. MR. REINHART informed committee members that copies of the SILC annual report were provided to the committee. Number 248 MR. JOHN WOODWARD, Chairman of SILC, stated that SILC is a governor-appointed group of people with disabilities. Mr. Woodward said the State is heading in the right direction regarding independent living services for Alaskans with disabilities which is apparent in SILC's annual report. The amount invested in independent living services by the Legislature last year was the largest ever and that investment has paid big dividends. SILC's five centers for independent living helped 18 Alaskans leave institutional care and begin a life in a community of their choice. SILC helped another 165 individuals receive services that prevented them from having to enter a nursing home or hospital. Most of these clients are on Medicaid therefore SILC's services saved the State more than $13 million. Number 428 MS. RUTH L'HOMMEDIEU, liaison to the Governor for SILC, said employment issues among disabled people is her main focus. President Clinton recently signed into law the "Ticket to Work and Work Incentive Improvement Act of 1999," a law that will go a long way to remove outdated Medicaid and Medicare coverage rules that created barriers for people with disabilities who want to work. The Act allows individuals on Medicaid to buy into the program when they are employed so that they will not lose their Medicaid health coverage. As a result, SILC anticipates more Medicaid dollars coming into Alaska which will allow the State to expand its Medicaid program. Alaska was one of the first states to pass legislation allowing for the Medicaid buy-in; it has been acknowledged as a forerunner in this area. Approximately 70 percent of disabled Alaskans are unemployed. People with disabilities want the opportunity to find a job and live independently in their own communities. Ms. L'Hommedieu personally thanked Senator Elton for intervening on behalf of a Juneau client with a kidney dialysis need. MR. DAVID JACOBSON, Executive Director of Access Alaska, reported that SILC's mission is to help persons with disabilities live and work in the community of their choice - one activity that makes that goal possible is making homes accessible. People with disabilities typically do not have the financial resources available to make necessary modifications. Access Alaska helps to make those homes accessible throughout the State. Last year over 340 homes were made accessible for persons with disabilities to enable people to live safely, comfortably and independently. Mr. Jacobson asked the committee to continue to support those types of services. The Alaska Housing Finance Corporation (AHFC) has requested $250,000 for a special needs program to help make homes accessible for people with disabilities. SILC actively seeks multiple funding resources; it works in partnership with many different programs to help find funding and equipment. SENATOR WILKEN asked if Access Alaska gets State money through AHFC and federal money as a match or a grant. MR. JACOBSON said that the federal dollars go directly to a broad array of services targeted at independent living services. AHFC funds are used for specialized housing needs. SENATOR WILKEN asked if the $250,000 is an ongoing appropriation. MR. JACOBSON said the amount was larger in the previous year. He added, "They did get a match with the Mental Health Trust, so it is that match that the $250,000 AHFC plus about $150,000 from the Trust, so they are combined." SENATOR ELTON asked if AHFC money can be used for people who already own homes not financed by AHFC. MR. JACOBSON said that is correct, it is for anyone who has the need for home modifications. Number 995 MS. LINDA BJORGE, a board member of SILC from Wrangell, informed committee members she is a licensed practical nurse. She currently runs an assisted living home in Wrangell. When she opened her assisted living home, there were not a lot of programs or funds available, now AHFC offers loans for assisted living homes. She asked committee members to support Senator Miller's bill that increases the rate paid by the state for clients at assisted living homes from $37.50 to $75 per day. Disabled people are better off staying within their own communities, to be near family and friends, but at $37.50 per day, most family members cannot afford to stay home to care for a relative with a disability. SENATOR WILKEN said one thing that became evident from testimony heard by members of the Long Term Care Task Force was that people need to remain in some sort of home base whenever possible, which is the intention of Senator Miller's bill. SENATOR ELTON commended Senators Wilken and Miller for being instrumental on addressing some of the issues discussed today. MS. BJORGE stated that ideally, the ability of people to stay in their homes should not change because of a disability. Number 1224 MS. MARGARET EVANS, a resident of Fairbanks, informed committee members that she uses personal assistance services on a daily basis and that, without that service, she would be unable to complete daily tasks, work, and attend school. SILC is creating a new self directed care model for the Personal Care Attendants Program. The new model will enable the clients who use personal care attendants to direct their own care by hiring and firing their own personal care attendants. SILC is also trying to get more personal care attendants involved in the program and to get salary increases for longevity in the program. The program is funded by Medicaid. She asked for legislators' continued support of the Medicaid program. A website, named PCA.infoinsights.com, contains more information about that program. SENATOR WILKEN asked if the self-directed PCA program is funded with a federal grant from Senator Stevens, and whether that program will be available throughout the state in a few years. MS. EVANS said SILC hopes to get the program up and running later this year. SENATOR WILKEN noted the career ladder for PCAs is limited at this time. He has been working with the University of Alaska to provide PCAs with a stepped RN program that will take two or four years. In addition, the Alaska Vocational Technical Center (AVTEC) is very interested in offering a two year program for PCA's. Number 1418 MS. JERIE BEST introduced SILC's new board member, Peter McDowell. MS. BEST informed committee members she focuses on transportation issues for SILC. Funding for capital expenses, such as buying vans and equipment, is surprisingly easy to find. SILC has received money from the Department of Agriculture, the Department of Transportation, and the Alaska Mental Health Trust Authority (AMHTA), so purchasing equipment to transport people is fairly easy. Finding funding for operations is not easy. Existing transit systems cannot buy fuel, pay drivers or buy tires. Kodiak's transit system recently shut down, and Mat-Su's is currently in a holding pattern. New transit systems need time to establish a large enough clientele to operate on their own. Lack of transportation is a big issue for people with disabilities who are trying to live independently. SILC coordinates and pairs its transit systems with those used by senior citizens. MS. BEST asked that highway funds be earmarked for transit systems, especially for the smaller, rural areas. Fairbanks, Anchorage, and Juneau can get federal funds because of their sizes. She also suggested using one percent of the proposed fuel tax for SILC's transit system. The opportunity to buy bulk fuel and other items, such as tires or insurance, by coordinating with state or municipal agencies, would reduce operating costs. The Native villages' priorities need to be dealt with and they need help making appropriate choices when purchasing community vehicles. For example, a village may choose to buy an ambulance as the community vehicle but ambulances only carry a driver, passenger, and patient, and they are too high off of the ground for elderly people to get into. MS. BEST explained that SILC gets "5311" federal money for areas with large populations and for communities that are close to each other. That program works for communities like Kenai and Soldotna, but it does not work for the Mat-Su Valley because transit between Wasilla and Palmer is too far and operational costs are too high. SENATOR WILKEN asked if, when federal money is granted, a slice automatically goes toward disabled transportation. MS. BEST replied that federal requirements mandate that any city that gets federal funds for a transit system must make that system accessible to the disabled. SENATOR WILKEN asked how a system is judged to be accessible. MS. BEST replied the system must be accessible to wheelchair users. In addition, specific federal regulations require that additional service be provided outside of the transportation corridor in certain instances. The service must be equal and the fare for disabled riders cannot be higher than the regular fare. Anyone who has an I.D. card for the disabled transit system can ride anywhere within the United States; that benefit is very popular. SENATOR WILKEN thanked the participants and announced the next order of business to come before the committee was SB 204. SB 204-EXTEND ALASKA COMMISSION ON AGING MS. JANE DEMMERT, Executive Director of the Older Alaskans Commission (OAC), said the OAC is very involved in bringing together the interests of many organizations that represent seniors across the State. The State demographer recently projected a population of 80,000 elderly people within the next 15-18 years in Alaska. Over 180 communities in Alaska are affected by the funding given to local non-profit organizations by OAC that provide direct services to older Alaskans. OAC programs are available to all people age 60 and over, with the exception of the Senior Employment Program which is available to people aged 55 and older. OAC administers four grant programs. OAC will be working with organizations to provide community support in whatever area is necessary. The only increase in funding that OAC has received over the past few years is through the Alaska Mental Health Trust Authority (AMHTA). State agencies have coordinated services to meet the needs of both seniors and people of all ages who are disabled, transportation being a prime example. OAC works in partnership with the AMHTA and AHFC to meet the transportation and housing needs of seniors and disabled people. Anything legislators can do to help AHFC maintain its capacity to meet seniors' needs in a consistent manner is very important to prevent a crisis 15 years from now. MS. DEMMERT commented that the Long Term Care Task Force has been very instrumental in moving forward much needed legislation, and it has also provided an opportunity for agencies to come together and see how many issues are integrated. She thanked task force members for their efforts and noted that people were most appreciative at the Common Ground Conference. MS. DEMMERT said she provided an update to the committee on the work the OAC has done since last session in regard to the long-term care ombudsman position. The OAC has restructured its by-laws and its committees to accommodate the steps necessary to enable the ombudsman function to be robustly supported within the OAC. The OAC is about to begin recruitment for a new long term care ombudsman. Ms. Demmert thanked the Legislature for all the support it has given to the OAC. Number 2316 SENATOR WILKEN noted that one recommendation in the Legislative Budget and Audit (LBA) report is to separate the long term care ombudsman position from the Department of Administration. He asked if that is being done. MS. DEMMERT said that as the OAC went through this process, it drew material from four entities that fit the criteria: the Alaska Legal Services and the Disability Law Center, and the State ombudsman's office and the AMTHA. The OAC concluded that the long term care ombudsman position should be retained within a State agency. The OAC felt that having the ombudsman function in a legal setting would not be as conducive to the progress that needs to be made, and that placing it within government would have more impact than placing it in a non-profit setting. The OAC had extensive discussions with the state ombudsman and the AMHTA. The state ombudsman did a review of options and concluded that key points of divergence between the state ombudsman and long term care ombudsman offices would make those offices incompatible and that combining the two would not be beneficial to either function. The AMHTA remains interested, but it is premature for them to make a decision. AMHTA is promulgating regulations to create a redress mechanism for beneficiaries of the trust. AMHTA has acknowledged that the work of the trust and the work of the long term care ombudsman are quite compatible so it is open to discussion about a future relationship. Two representatives of the AMHTA have agreed to be on the search committee for the long term care ombudsman. A new OAC standing committee will have oversight of that position and the committee will report to the full OAC. SENATOR WILKEN asked if the committee will establish the "arms- length" relationship that LBA thought was missing. MS. DEMMERT replied that is correct. SENATOR WILKEN asked about the other LBA recommendations. MS. DEMMERT said some of the accounting recommendations were addressed when OAC made new grant awards. The new awards provide for some of the notification that had been omitted in the past. Second, OAC sped up its process of notifying grantees of the proportion or amount of grantee funds that are federal so that they will be notified on a timely basis if they come under federal audit requirements. A third recommendation regarding a cost allocation plan issue is in the process of being finalized by OAC. Number 2245 SENATOR WILKEN noted the LBA recommended that the OAC be extended to 2004. He also noted the committee is awaiting a fiscal note. MS. DEMMERT affirmed that the fiscal note was delivered. SENATOR ELTON thanked Ms. Demmert for her discussion about the long term care ombudsman, and pointed out that one can make an argument that the long term care ombudsman is an advocate as well as an ombudsman so it differs from the state ombudsman. SENATOR WILKEN asked whether anyone is opposed to the extension of the OAC. MS. DEMMERT said she is not aware of any opposition. MARIE DARLIN, representing the Capital City Task Force of AARP, made the following comments. AARP supports the extension of the OAC because it is vital to the concerns of AARP members. AARP will be watching long term care issues this year, particularly the assisted living home issue. There being no further testimony on SB 204, SENATOR WILKEN announced it will be held until the next meeting. HB 85-TEACHERS'LICENSES, DISCIPLINE & ETHICS SANNA GREEN, Executive Director of the Professional Teaching Practices Commission (PTPC), explained that the PTPC is an ethics board whose major function is discipline. HB 85 pulls many provisions related to ethics and licensing into one section of statute. Very few changes have been made to the licensure provisions. One proposed change is replacing the word "certificate" with "license" to follow a national trend. A license indicates a level-entry qualification while the word "certificate" is used to denote a higher level of recognition. This name change makes no changes to the licensing qualifications. SENATOR WILKEN asked if the PTPC will require teacher's licenses rather than certificates. MS. GREEN said that is correct. SENATOR WILKEN asked how other states compare. MS. GREEN was not sure of the number, but repeated it is a national trend. Number 2039 SENATOR WILKEN asked the reason for the change. MS. GREEN stated that a license is generally recognized as an entry level credential while a certificate is recognized as requiring a more stringent process. She noted that most states that attended the Western States conference are changing the word to "license." SENATOR WILKEN asked if the fact that Alaska gives a teacher's exam has anything to do with the name change. MS. GREEN said it does not. SENATOR WILKEN pointed out that a criminal history background check has been added to page 1, line 13. MS. GREEN replied the background check is not being added, it is already required. Many of the provisions related to teaching practices are being incorporated into one place in the statutes. SENATOR ELTON indicated that he is waiting for a response from the Department of Education regarding the ability to waive licensure, a matter he has discussed with Ms. Green. MS. GREEN noted that PTPA's main concern is the safety of children in classrooms and, because schools are a victim-rich environment, PTPA must continually be on the alert for sexual abuse by educators. Alaska must be cognizant of the fact that it is viewed as quite remote but it has effective ways to deal with the problem. A national network has been created; that network registers educators who have been disciplined. Those records can be checked when teachers apply for positions in Alaska, however not all states report. She fears that offenders from states that do not participate in the registry look to Alaska as the farthest place they can go where their reputations will not follow them. She repeated that PTPC has been very careful in that regard. MS. GREEN referred to the sponsor statement and reviewed the new provisions contained in HB 85. First, a new section includes a compilation of the grounds for denial of application. The PTPC currently recommends application denials to the certification office in the Department of Education (DOE) but the reasons for denial are not contained in statute. Second, the bill allows reciprocal discipline of an educator who was disciplined in another jurisdiction. At present, if another state has revoked a license from a teacher who is also licensed in Alaska, Alaska must hold a due process hearing before it can revoke the license. SENATOR ELTON questioned how many teachers have licenses in multiple states. MS. GREEN said many. She noted that Alaska has about 8,000 teachers in the State but it has jurisdiction over 25,000 certificates. She pointed out that two teachers with Alaska teaching certificates had their licenses revoked by the State of Florida after which the PTPC revoked the Alaska licenses. MS. GREEN explained that the bill expands the waiting period for license reinstatement from one year to five years. SENATOR WILKEN asked how that compares to the rest of the nation. MS. GREEN replied that some states can revoke a license for life, Alaska cannot. She said five years is average. SENATOR WILKEN asked how the phrase, "resided out of state" on page 2, line 23, is defined. MS. GREEN explained that a teacher does not have to apply for a renewal unless that teacher's license has expired, regardless of whether the teacher is residing in state or not. A renewal application will require a criminal history check and applies when a teacher has not been residing in Alaska and requests a renewal. Alaska will have no record of what that teacher has been doing while residing out-of-state. SENATOR ELTON asked what the PTPC currently does when a person applies for reinstatement after one year of being disciplined. MS. GREEN said the PTPC reviews the entire record and any material presented by the applicant. SENATOR ELTON asked if a small community was comfortable rehiring a teacher who was disciplined after one year whether the new provision would prevent the community from doing so. MS. GREEN said that is correct but added that licenses are not revoked unless the offense is very serious. MS. GREEN continued to explain the new provisions in HB 85. A misrepresentation of a material fact on an employment application can be considered as a ground for discipline. Currently, the PTPC can only consider that as a ground for discipline if the misrepresentation is made on the certification application, not on applications for employment with school districts. Such an offense would not result in license revocation. In addition, HB 85 allows PTPC to put conditions on a teaching license. PTPC has taken that liberty already but the Department of Law advised that authorizing language be put in statute. The next provision gives the PTPC the authority to impose civil fines against teachers who are regulated by state law but do not hold licenses. That group includes teachers in higher education, private school educators, unlicensed administrators, and others. Although that group falls under the jurisdiction of the PTPC, the PTPC has no way to discipline that group. SENATOR ELTON asked what kind of authority the PTPC exercises over private school educators and why some administrators do not have to be licensed. MS. GREEN said most administrators do have to be licensed, but legislation has been proposed that would allow superintendents to be unlicensed. She noted some personnel directors are not licensed teachers. Most private school educators have certificates but some do not. Most private school contracts require those educators to obey the code of ethics which falls under the jurisdiction of PTPC. SENATOR ELTON asked if the PTPC only has jurisdiction over those educators who have signed contracts that refer to the code of ethics. MS. GREEN said that is correct and, as far as she knows, the PTPC has no jurisdiction if the contract does not mention the code. SENATOR ELTON asked if the PTPC gets a fee from private schools for doing that kind of work. MS. GREEN said it does not get a fee. MS. GREEN indicated the next new provision would preclude a person, whose license is suspended or revoked from employment as a member of the teaching profession, even if the position does not require a license. She explained that PTPC had a case against a superintendent at Adak for gross fiscal mismanagement. PTPC's only jurisdiction was over the superintendent's certificate, which it revoked. The superintendent was then hired at Chevak as an uncertificated, paid consultant. After rigorous objection, the district backed down because, under those circumstances, a certificate would have had no meaning. This provision does not allow a person to be reemployed as an educator immediately after his license has been revoked. SENATOR ELTON asked if this provision would give the PTPC the authority to prevent a school district from hiring a teacher with a revoked license as a lobbyist. MS. GREEN said she was not sure how far that provision would extend, but the intent was to prevent the teacher from working in the central office as a consultant. SENATOR ELTON expressed concern that, by extending PTPC's authority to preclude employment by contract, PTPC is setting up two classes because a person whose license was revoked in another state would not be precluded from taking that job. He expressed interest in continuing the dialog on how far PTPC's authorities extend over contract employees at another time. MS. GREEN agreed to discuss that question with the Department of Law and expressed concern that the PTPC does not want to hamstring villages from hiring for the services they need. SENATOR ELTON pointed out he believes a school district would be foolish to hire a person whose license was revoked but he does not want to create a two class system. MS. GREEN added that licenses are revoked in very severe cases only. For other cases, licenses are suspended or conditions are applied. SENATOR WILKEN asked Ms. Green to respond to Senator Elton's concern when the bill is scheduled for another hearing. MS. GREEN explained that a provision was included to protect the confidentiality of minors and of investigatory files. Although initials are used to protect confidentiality, initials are recognizable in smaller villages therefore a different notation needs to be used. PTPC does not share any information from its files from cases in which the charges were not proven or found to be frivolous, to prevent a person's reputation from being ruined. SENATOR ELTON asked whether an investigatory file is considered an open file once the PTPC has decided to revoke a license. MS. GREEN replied that only evidence which the PTPC provides at the hearing. SENATOR ELTON asked if only that information used to make the decision is available. MS. GREEN said yes and noted that hearings are public so that information would be available at the hearing. The last new provision allows immunity from liability for persons who participate in good faith in investigations and proceedings of the PTPC. MS. GREEN noted the PTPC would like to change its name to the Educator Ethics Commission which clarifies the Commission's mission. In law, her position is referred to as "executive secretary." She has adopted the title of "executive director." She asked that the title be changed in statute. Number 785 SENATOR WILKEN asked whether the entire Commission supports HB 85. MS. GREEN said yes and that members went through the legislation line-by-line. SENATOR WILKEN asked about the Department of Education's position. BETH LAPE, Special Assistant, Department of Education, stated that DOE supports the legislation. MS. GREEN clarified that she and her assistant attorney general instigated this legislation. There being no further business to come before the committee, SENATOR WILKEN adjourned the meeting at 3:04 p.m.