SENATE LABOR AND COMMERCE COMMITTEE April 8, 1999 1:40 P.M. MEMBERS PRESENT Senator Jerry Mackie, Chairman Senator Tim Kelly, Vice Chairman Senator Dave Donley Senator Loren Leman MEMBERS ABSENT Senator Lyman Hoffman COMMITTEE CALENDAR CS FOR SENATE BILL NO. 56(HES) "An Act allowing the disclosure of reports with regard to inspection and investigations of certain health care facilities, home health agencies, hospice programs, and assisted living homes; authorizing the Department of Health and Social Services to license home health agencies; and providing for an effective date." -MOVED CSSB 56(L&C) OUT OF COMMITTEE SENATE BILL NO. 59 "An Act relating to the certificate of need program for nursing care facilities and other facilities; and providing for an effective date." -MOVED CSSB 59(L&C) OUT OF COMMITTEE CS FOR SENATE BILL NO. 82(HES) "An Act requiring that the cost of contraceptives obtained by prescription and related health care services be included in health insurance coverage." -SCHEDULED BUT NOT HEARD PREVIOUS SENATE COMMITTEE ACTION SB 56 - See HESS minutes dated 3/3/99, 3/8/99 and 3/15/99. SB 59 - See HESS minutes dated 3/3/99, 3/8/99 and 3/15/99. SB 82 - See HESS minutes dated 3/24/99. WITNESS REGISTER Senator Gary Wilken State Capitol Bldg. Juneau, AK 99811-1182 POSITION STATEMENT: Commented on SB 56 and SB 59. Mr. Elmer Lindstrom, Special Assistant Department of Health and Social Services P.O. Box 110601 Juneau, AK 99811-0601 POSITION STATEMENT: Supported SB 56. Ms. Larraine Derr, President Alaska State Hospital and Nursing Home Association(ASHNHA) 426 Main St. Juneau, Ak 99811-1182 POSITION STATEMENT: Supported SB 56. Mr. David Pierce, Certificate of Need Coordinator Department of Health and Social Services P. O. Box 110601 Juneau, AK 99811-0601 POSITION STATEMENT: Commented on SB 59. ACTION NARRATIVE TAPE 99-10, SIDE A Number 001 SB 56-HOME HEALTH AGENCIES/HOSPITALS/HOSPICES CHAIRMAN MACKIE called the Senate Labor and Commerce Committee meeting to order at 1:40 p.m. and announced SB 56 to be up for consideration. SENATOR WILKEN, sponsor of SB 56, said the Long Term Care Task Force met over the interim and this legislation is a result of their third recommendation. It provides that when DHESS approves different care giving facilities across the state, the final report is made public within 14 days of being finished. The second thing it does is gives the statutory authority to DHESS to do this review which it has already been doing for a number of years. SENATOR WILKEN noted that he has a proposed CS, version I, that addresses a concern from the Alaska State Hospital Nursing Home Association about what time in the process the final report was made public. It sets forth the fact of what is the final report and that it is released fourteen days after it is given to the care giving facility. SENATOR LEMAN moved to adopt CS version I, 4/7/99 Lauterbach, to SB 56. There were no objections and it was so ordered. MR. ELMER LINDSTROM, Special Assistant, Department of Health and Social Services, said the reporting provision is a good consumer provision and is very straight forward. The other element giving specific statutory authority to license home health agencies is something they have done for years anyhow under the general powers of the Department, but the Department of Law pointed out that it would be more appropriate to have the specific authority when it comes time for promulgating regulations. He noted the zero fiscal note, since this is a function they are already doing. MS. LARRAINE DERR, President, Alaska State Hospital and Nursing Home Association, concurred with Mr. Lindstrom's comments and supported CSSB 56(L&C). SENATOR KELLY moved to pass CSSB 56(L&C) from committee with individual recommendations. There were no objections and it was so ordered. SB 59-CERTIFICATES OF NEED FOR HEALTH FACILITY CHAIRMAN MACKIE announced SB 59 to be up for consideration. SENATOR WILKEN said SB 59 was recommendation 21 from the Long Term Care Task Force which suggests that legislation be introduced to adopt a new standard for the Nursing Home Certificate of Need Program. Currently, if he were to build a care facility, the State would be interested in two aspects: its accessibility and its quality. SB 59 adds a new standard: whether the facility is cost effective recognizing that a care facility bed may be worth $100,000 per year of which the State picks up 40 percent. The Alaska State Hospital and Nursing Home Association asked for a change on page 2, line 26 after "foster" to insert "unnecessary" which both he and the Department agree with. SENATOR KELLY moved to adopt that as an amendment. There were no objections and it was so ordered. MR. LINDSTROM testified that Certificates of Need are issued for a variety of facilities. The purpose of this bill is to have separate and more appropriate standards specifically for long term care nursing beds and allowing them to include consideration of the cost to the State of the construction of the additional beds which are paid for by the State through the Medicaid Program. They have no objection to the amendment. There is a fiscal note in the amount of $26,500 which allows them to implement the new standards as it is a very complex program. CHAIRMAN MACKIE noted that if there was no fiscal note, the bill would not have to go through Finance Committee. MR. LINDSTROM said the costs were appropriate. MR. DAVID PIERCE, Certificate of Need Coordinator, Department of Health and Social Services, said the fiscal note is an estimated one-time cost to develop the standard based on prior work done by consultants. CHAIRMAN MACKIE asked if it was something that could be done within the Department. MR. PIERCE answered that it is somewhat unusual as it hadn't been done by any state before. The main thing they would be doing is a comparison of assisted living and long term care and how many assisted beds should be in a community before new long term beds will be allowed. The trend is to move towards assisted living and more community based services. The State does not have the expertise to do it. SENATOR LEMAN asked if there was someone uniquely qualified to do that. MR. PIERCE answered that he hadn't identified anyone, but the state of Georgia is now working on it and maybe we could get some help from them. He is the only person who works on the Certificate of Need Program and wouldn't have the time to do it. MS. DERR testified that they support this bill with the inclusion of the word "unnecessary". She explained it leaves it open for more support. SENATOR LEMAN noted the words "relating" in sections four and five should be changed to "related". SENATOR LEMAN moved to pass CSSB 59(L&C) from committee. There were no objections and it was so ordered. SB 82-INSURANCE COVERAGE FOR CONTRACEPTIVES CHAIRMAN MACKIE announced that SB 82 would be held over for a further hearing and adjourned the meeting at 2:00 p.m.