SFIN-260512-0900

It's too many people. All the Senate Finance Committee to order. Today's May 12th. We're in Senate Finance, State Capitol.

Present today, Chairman Steadman, Chairman Olson, Senator Keehl, Senator Merrick, Senator Kaufman, Senator Cronk, and myself, Senator Hoffman. We have a full contingent to conduct business.

There are 3 items on today's calendar for this morning, the first being HB 314, Architects, Engineers, and Surveyors; HB 96, Home Care Employment Standards Advisory Board; and finally, HB 14, Repeal of Catastrophic Illnesses Medical Assistance.

HB 314, Architects, Engineers, and Surveyors. This is the first hearing on this bill. It is a companion to Senate Bill 246 that we heard in February.

I invite Senator Prox to the finance table to reintroduce the legislation to the Senate Finance Committee. Representative Brooks, gave you a little promotion there.

Oh no. Oh great. Yes. Debatable. Yeah, collateral.

Oops. Yep. A little catastrophe.

[FOREIGN LANGUAGE] Senate Finance Committee back to order. Representative. Good morning, Co-Chair Hoffman and members of the Senate Finance Committee. Thank you for hearing HB 314 today. I'm Mike Prox, representative to District 33.

North Pole-Badge Road area in the Fairbanks North Star Borough. House Bill 314 largely mirrors Senate Bill 54 that was passed last year but was vetoed by the governor. Senate Bill— or House Bill 314 addresses the issues that prompted the governor's veto. First, the bill keeps current statutes regarding design-build projects for DOT, that, that statute remains unchanged. And then we worked with the language for the exemption for certified wastewater installers to— based on drafting concerns raised by legal and the DEC, we think we have resolved that.

And finally, the bill maintains an 11-member board but increases the governor's flexibility on who they can appoint by removing the requirement to choose specific disciplines for the engineering seats. And then, of course, it establishes the registered interior designers. And with that, we are ready to answer any questions or do this sectional if you would like. We have some invited testifiers also and folks to answer other questions. Members of the Senate Finance Committee have any questions for the prime sponsor?

We do have an amendment, but before we get to that amendment, Senator Kaufman, we will have here the invited testimony, if that's all right with you.

With that, we will go to invited testimony and hear from Senator Yount, who is sponsor of companion bill Senate Bill 154, please come forward, Senator Yonten.

I'm on the wrong bill.

There I go. The invited testimony is Chris Curtis online. Chris, you have the floor.

Good morning, this is Chris Curtis, your State Legislative Auditor. Division of Legislative Audit conducted a sunset review of the State Board of Registration for Architects, Engineers, and Land Surveyors. That audit was dated April of 2024, and it was a clean audit. We had no recommendations for improvement, and we did recommend the full 8-year extension. I'm available for questions.

Any questions for Chris Curtis, the legislative auditor. Seeing none, the second individual is Charles Bettisworth, Architect Online. Mr. Bettisworth, please give the committee your invited testimony.

This is Charles Bettisworth. Thank you. For the record, my name is Charles Bettisworth. I live at 204 Front Street, Fairbanks. I'm a licensed architect.

I'm a member of the American Institute of Architects. Thanks for the opportunity to testify this morning in support of HB 314. I fully support the passage of HB 314, and I testified before the committee on this, on the Senate bill back in February. And so rather than recount that testimony, please refer to that testimony. I fully approve this bill and hope that you would pass it.

And that's all I've got to say. I'm available for questions. Thank you, Mr. Besworth. There is no questions for you at this time. We do have Sylvan Robb, the director of CDPL in person for any members of the Finance Committee to ask questions.

We do have one amendment. Senator Kaufman.

Yes, thank you, sir. I move Amendment No. 1. I will object for explanation. The intent of Amendment No.

1 Is to restore the bill to its form before the, uh, floor amendment that reduced the number of land surveyors. So in essence, it's to remove one of the engineering positions and replace that, um, with one surveyor for a total of two surveyors. Um, and the, uh, the intent of that is to provide the ability for the respective, uh, surveyors on the board to be able to work collaboratively. If there's just one, there's not an opportunity for collaboration on what is a very unique skill set that's not otherwise represented by the board members. The ability to provide peer review on the board between the two that are dealing with issues, I believe, is very useful.

And again, this amendment returns the bill to its original form when it went to the House floor or the floor of the other body. And then also, as we roll up on the semi-quincentennial, it's worth remembering that George Washington was a surveyor. And I think it's the patriotic thing to do. Thank you, Senator Kaufman.

Representative Braxton, you have comment upon the amendment that's before the committee? Well, I guess I would prefer to just maintain the number of surveyors, which is in the House version, currently in the House version of the bill. But it might be a good idea to have the director of the Division of Corporations, Business and Professional Licensing weigh in on this question. That would be Sylvan Robb.

Please, Sylvia Robb, comment on the amendment, please.

Good morning. Thank you, Mr. Chair. For the record, Sylvan Robb, Director of the Division of Corporations, Business and Professional Licensing. The composition of the board is truly a policy question to be decided by the legislature.

Thank you. I would request Senator Clayman to come forward, if you would, since you have a companion legislation. Do you have comment on the amendments?

Thank you, Mr. Chair. I, I I support the version that came out of the House that has the 5 engineers and the 1 land surveyor. The information that Ms. Robb may be able to provide would be the total number of engineers, the total number of land surveyors, and other professions that are supervised by the board, because I think what the numbers of engineers are in the thousands, the number of land surveyors I think is less than 400. And so when you see others on the other representation on the board having 2 land surveyors, from my perspective, I think it's consistent with the House amendment that it's a more balanced representation on the board to have one more engineer and only one land surveyor.

Thank you. Any additional questions of the 2 people that are sponsoring this legislation at at this time? Representative and the senator? Seeing none, I will maintain my objection. Senator Kaufman, do you have any closing comments?

No, sir. Just thank you for hearing this amendment and look to the will of the committee. Roll call, please. I'll maintain my objection.

No. Yes. Yes. Senator Kaufman? Yes.

Senator Steadman? No. Senator Hoffman? No. Senator Olson?

No. 3 Yeas, 4 nays. That amendment fails. We will go to Senator Keel to— are there any additional amendments to come before the committee this time? Seeing none, Senator Keel, review of the fiscal notes.

Thank you, Mr. Mr. Chairman, House Bill 314 has a pair of fiscal notes. The first comes from the Department of Commerce, Community and Economic Development, Incorporations, Business and Professional Licensing. They note that there is $67.3 thousand in the governor's FY '27 request and that the bill would lead them to need another $175.7 thousand. 6, And 1 full-time position that is in receipt-supported services designated general fund. So those sum up and drop down just a little bit after startup costs to a total in the out years of $228.2 million, again, all receipt-supported services, and they will need to update or change regulations.

The second fiscal note— is from the Department of Environmental Conservation and Water Quality Infrastructure Support and Financing, and they assign a zero fiscal note. They can implement the little change to their statutes with existing resources.

Members of the Finance Committee have questions on the fiscal notes at this time. Senator Steadman. Thank you, Mr. Chairman. I move that the Finance Committee substitute for House Bill 314, version A.A., from committee with attached fiscal notes and individual recommendations. Is there objection?

Seeing none, that bill moves on to the next committee of referral, which will be the Rules Committee. That brings up the second item on today's calendar, HB 96, Home Care Employment Standards Advisory Board. This is the first hearing on this bill. It is a companion to Senate Bill 154 that we heard in March. I invite Representative Prax as well to the table.

Representative, can you reintroduce the bill to the Senate Finance Committee?

Thank you, Co-Chair Hoffman.

And members of the Senate Finance Committee, once again for the record This is Representative Mike Prox representing District 33 in North Pole.

My experience in meeting with caregivers has been very enlightening and kind of heartbreaking. There's just a real shortage of care, but they're really compassionate people and dedicated to what they do. It's clear that the industry is not on a sustainable course. I'm grateful that we have the Guidehouse study this year to validate the approach outlined in House Bill 96. The provisions outlined in this bill are the product of Extension collaboration and include the Department of Health, and they represent the best way to get our caregivers back on track.

Thank you, Representative. Do members of the Finance Committee have questions? Questions of the prime sponsor?

Seeing none, we will go to invited testimony. Now we can hear from Senator Yount.

Senator, you have the floor. Thank you, Mr. Chairman. For the record, Senator Rob Yount from Wasilla. Simply put, we're living a lot longer than we used to.

It's a good problem to have, but it's something we need to course correct right now. In my opinion, the sooner the better. The age of 85 years and up is gonna increase by 500% in the next 25 to 30 years, they're figuring. That's, again, like I said, I think that's fantastic, but it leads to a lot more issues, Alzheimer's, different things. Taking care of our elders in their own home is by far the cheapest way to do it in the long run.

Nobody's lucky enough to have all their kids and grandkids around to help with that. And even if they are, sometimes they need professional help. And that's really what this bill is set out to do, is take care of the professionals that are doing that and make sure that they're taken care of and that they're able to continue to do this. So any tough questions, we'll take them now. So thank you.

Thank you, Senator. Second individual to to testify on this piece of legislation is Jenny Kimball, Executive Director of the Alaska Association of Personal Care Supports. Ms. Kimball, please identify yourself for the record and proceed with your invited testimony.

Good morning, Co-Chairs and members of the committee. Quick mic check before I begin. Can everyone hear me? Yes, we can. Okay, wonderful.

Thank you for inviting me. It's my first time providing public testimony before a committee, and I appreciate the opportunity to share the provider perspective. My name is Jenn Kimball. I am the Executive Director of the Alaska Association for Personal Care Supports, representing providers serving Alaskans across the state through the personal care services program. I want to begin by saying clearly that providers support strengthening the direct care workforce and improving caregiver compensation.

This workforce is essential to keeping seniors and individuals with disabilities safely in their homes and communities, and we share the goal of building a more stable and sustainable system. We also support Section 1 of this legislation and the creation of the Home Care Employment Standards Advisory Board. In many ways, SEIU's own presentation reflects exactly why the board is needed. The board is intended to investigate workforce conditions, analyze payment adequacy, collect statewide data, and develop recommendations around wages, workforce sustainability, and access to care. We agree with that approach.

Our concern is that Section 2 imposes fixed wage requirements before the work of the new board has actually occurred. Right now, providers are operating within a system that has not yet been modernized and still carries substantial administrative and compliance burdens, most of which are required by regulation. Personal care services are not simply caregiver wage and benefit services. Agencies are operating highly regulated Medicaid healthcare programs that require electronic visit verification review, documentation oversight, fraud prevention monitoring, supervision, service coordination, onboarding, training, audits, and ongoing compliance infrastructure behind every single care visit. I also want to briefly address two to the testimony presented earlier regarding consumer-directed services and the suggestion that agencies in this model perform substantially less work because individuals receiving care are responsible for recruiting, hiring, and training caregivers, therefore allowing for a greater wage pass-through percentage.

Respectfully, that is not fully reflective of the operational realities of this program. Consumer direction is incredibly valuable because it allows individuals to direct how services are delivered in their homes and according to their personal preferences. Clients teach or train caregivers things like how they like their meals prepared, where groceries are stored, and how they prefer tasks completed, or the routines that allow them to remain comfortable and independent in their home. But that's very different from the training, oversight, and service coordination agencies are still responsible for providing. We work and are responsible to ensure training and comprehension of state in home setting workplaces: CPR, first aid, emergency response, bloodborne pathogens, face lifting and transfers, critical incident reporting, fraud, waste, abuse, neglect prevention, restrictive intervention, all within the Medicaid requirements.

These represent real and substantial expenses. Agencies also help individuals manage and navigate a very complex Medicaid program. Improper utilization of services, Even unintentionally can place vulnerable clients at risk for repayment obligations, losses of caregivers, interruptions of services, or potentially loss of Medicaid-funded support. The support from the agency helps monitor these services and ensures compliance in a way that protects both the individual receiving the care and the integrity of the program itself. Additionally, because personal care services are considered high risk for fraud and abuse at both the federal and state level, providers are required to maintain significant oversight systems that ensure services are appropriately delivered and documented.

The challenge is that reimbursement rates have not kept pace with the true cost of operating that infrastructure. The Safe Zone Rate Study conducted by GuideHouse identified that 40% of service costs are tied to required non-wage functions and operational overhead. Yet Section 2 would effectively force providers into labor allocation that do not adequately account for those required costs. Without meaningful modernization efforts and reductions in administrative burden first, through efforts of the new board in Section 1, these requirements may ultimately produce the opposite outcome of what everyone in this room wants. And nowhere is that risk greater than in rural Alaska.

Rural communities are already the most difficult and expensive areas to serve. Providers must absorb travel costs, maintain staffing across large geographic regions, and often coordinate services in communities with limited workforce availability and infrastructure. When the 2019 rate cuts occurred, we saw providers respond by implementing wait lists, moratoriums, and reductions in rural service capacity because agencies had to immediately look for ways to reduce operational losses. If Section 2 is implemented on July 1st before the Advisory Board has completed its work, before modernization efforts are implemented, and before administrative burdens are reduced, I'm deeply concerned we could see similar outcomes. We are also concerned that the hardship exemption framework referenced in the bill does not currently exist operationally.

The agencies most likely which require these exemptions, particularly smaller agencies, They would not even be able to apply for this relief today because the criteria, the definitions, and the processes still need to be created through future regulations. Without a viable delivery system behind it, higher wage requirements alone will not necessarily translate into a stable or sufficient workforce. Providers support workforce assessment. We support thoughtful wage discussions. We support transparency and accountability.

But we believe those conversations should occur through the advisory board process established in Section 1 before fixed mandates are imposed through Section 2. In closing, I respectfully urge the committee to remove Section 2, allow the Board to complete its work, evaluate reimbursement accuracy, identify modernization opportunities, and develop informed recommendations before implementing statutory labor rate requirements. That may unintentionally reduce access to personal care services across the state, shifting vulnerable Alaskans into higher-cost settings such as assisted living, institutional care, or greater reliance on emergency services. Thank you for your time and consideration, and I would welcome any questions through the chair regarding Alaska's personal care service program or provider operations. Thank you, Ms. Kimball, for that Dena'ina testimony.

We will now We will now go to Tacoma, Washington, where we will hear from Alexis Rodich, with the research and policy director of SEIU 775. Please identify yourself for the record and proceed with your invited testimony.

Thank you, Mr. Chair, and through the chair, I'm Alexis Rodich. I'm the state director for the Caregivers Union in Alaska. We represent more than 60,000 direct care workers in Washington, Montana, and Alaska. And today, I would just like to speak directly to the concerns that were raised regarding the 80% allocation for direct care worker pay and benefits and the suggestion that this might lead to a rash of agency closures.

I want to clarify that this pass-through is not a specific wage requirement for agencies. It is simply a guardrail to ensure ensure that a fair and adequate portion of the rate goes to the direct care worker pay and benefits. We believe that the agency with choice service provision model, safeguards that are built into the bill itself, and the advisory group all suggest otherwise. Speaking to the model, which you just heard a little bit more about, in states like Alaska, where most personal care services are provided through a consumer-directed agency with choice model, far less of the rate needs to go to overhead because while the agency has some responsibilities for basic training and regulatory compliance, they have far fewer responsibilities than a traditional agency model. Agencies— excuse me, it is the client and not the agency that is responsible for recruitment, which is a huge job, scheduling, managing, and training, and hiring their own caregiver.

And while the agency provides some support, this is a big offset in cost that they would otherwise be responsible for. So, when considering the impact of this provision, it's important to consider that this is an inherently low overhead business. Second, the agencies also don't need to be in every single community that they're providing services. However, the direct care workers themselves do need to be in those communities and often have to bear the cost of increased gas prices, heating oil, heating oil, etc. Secondly, the bill itself contains safeguards.

Section 2 includes a hardship and small agency exemptions which will be defined by the department which will include a stakeholder process. There are 4 years— there's a 4-year runway before this requirement increases effect, which is plenty of time for these definitions to be created, for agencies to prepare, and for the state to adjust the rate accordingly. And finally, to that end, the advisory board itself is tasked with assessing whether the rate is adequate to ensure ensure access to services and to make recommendations accordingly. The board will also have several years to dig into this question and provide input on the adequacy of the rates before this 80% requirement goes into effect.

Despite the difficulties of the job, which I know most of you have heard firsthand from your constituents, direct care workers generally love their work care deeply for their clients and have no interest in seeing their employers go out of business. The opposite is true. We want to see strong, sustainable, profitable agencies that can offer family-sustaining pay and benefits to all of its employees, regardless of whether they provide direct care or not, and that can recruit, train, and retain a workforce that meets the growing demand anywhere in the state. We believe that this This bill, as written, is an important step to getting there. Thank you.

Thank you. I have a question for Tony Newman with the Department of Health Division— the Health Division of Senior and Disability Services. Mr. Newman, can you comment upon Ms. Kimball's concern about Section 2?

Good morning. I'm Tony Newman. I'm the Director of the Division of Senior and Disability Services at the Alaska Department of Health. Section 2 of the bill would require— I'm going to get to the bill here.

Section 2 of the bill would require that agents— that the The department, when it pays out a rate to a personal care services agency, that 80% of that rate eventually will be paid out in the form of compensation to the direct care worker at the agency.

This was going to be a requirement of the federal government under the Ensuring Access Rule that was passed in 2024. We've since learned that that provision is going to be rescinded by the federal government so that states will no longer be required to comply with that, what we call the 80% rule. The federal government has said they will issue written guidance on this point in the coming weeks or months, and that they intend to work with states to help them develop their own methods to ensure that there is adequate workforce payment in the future for personal care services agencies. So the question that I have is, does your— is your opinion that this should be included or excluded from the legislation? Mr.

Chair, the department doesn't have a position on that. We have a fiscal note submitted because there would be some positions required to help us comply with the provisions of the bill. So we don't have a position on whether or not. We do know that the federal requirement that this state develop this sort of payment regime has been eliminated. So we're no longer federally required, we understand, to abide by this provision.

Further questions that members of the Finance Committee have? Senator Keele. Thank you, Mr. Chairman. Mr. Newman, maybe you can help with sort of some expectations. About downstream impacts.

We've heard from some folks that the rates just aren't adequate and to do this the rates are absolutely going to have to go up. We've heard from some other folks that that's just not going to be a problem.

If the— given what you know about the agencies that provide— that employ these care workers, the wages they pay and the sort of supply and demand balance, Given what you know about the rates, what is your expectation? If we pass the bill, are we in a pretty decent place with our rates? Are rates going to be too low?

Through the chair, Senator Keele, I think it's important that we differentiate between the rates and the payment that the worker receives. So as it was mentioned earlier, the firm Guidehouse conducted a rate study. Of the various services that are offered through the Division of Senior and Disability Services. They found that personal care services agencies needed a 32% rate increase, and I think I'm, I'm safe saying that, that we would agree with that finding, that the rates for personal care services work needs to increase. The department has historically and traditionally left it to the agencies to determine how much they will pay their their individual workers.

That— now I couch that by saying there is a regulation in place right now that says that 50% of the rate paid to an agency needs to go out in the form of compensation to the worker. That has been on the books for years, and if we were to adjust the payment— if we were to play a role in dictating that wages need to be higher, we would need to adjust that regulation. So we would agree that rates for personal care services agencies need to be increased. We are working internally to determine if we are able to do that in our upcoming rate rebasing work that we will be doing in the coming fiscal year. Senator Keele.

Thank you very much.

I guess the question here, so The answer to the first question was the rates are already way too low, got to go up. But the bill sets a direct relationship between the rates and compensation to the workers. Correct. Okay.

So I guess the next question is, is it your understanding— and again, you direct this division and have just a better knowledge of the supply and demand situation of workers and wages, and also the needs of the Alaskans who are getting served. If we fix the rates, does the wage problem go away, or do we need to do this as well?

Through the chair, Senator Keel, I would say that in fixing the rates, we go a long way toward addressing the wage issue. Because I've been speaking with personal care services agencies administrators. They say they push as much of the rate toward wages as they possibly can. And so if we were to increase the rates, I have no doubt that many of those agencies would boost their pay in order to attract more workers to the field. Now the question is whether we should dictate whether they should do that.

As I mentioned earlier, so far the department has stuck with a 50% expectation that 50% of that rate go out in the form of wages. It would be a policy call as to whether we should continue to mandate that agencies increase that still higher. Senator Keehl. Mr. Chairman, if I may, I'd be interested in the sponsor's take on exactly the same question.

Representative. Yes, thank you. Through the chair to Senator Kiel, I appreciate the concerns raised by the agency's representative.

In my— this bill was written a couple years ago, started when the expectation was that this would be a federal requirement, and now it appears that that requirement either isn't going to be implemented or will be rescinded. And Section 5 of the bill, the conditional effect, in my mind, if the federal requirements don't come down the line, then this is simply a state requirement. And then everything will have to be negotiated and left up to a state internal decision. I guess I— after thinking about this for quite a while, I'm a fan of measurable goals and objectives as required by the Executive Budget Act. This sort of imposes that.

And if we find out— if this Commission or committee finds out that this really isn't workable, then it won't happen because we're going to bump into at some point where rates for assisted living or some other option would limit the eventual amount that could be paid, but we think there's quite a bit of room for that. I think it is good to set the goal and then let it up to the Commission, and I think Section 5 provides for that latitude. So I'm comfortable with Section 5— or with Section 2. Thank you, Senator Keogh. Further discussion on the legislation?

If not, we will go to fiscal notes. Senator Keogh? Oh, Senator Hoffman, didn't see your hand there. Thank you. It's a quiet hand.

Thank you. To the bill sponsors, one of the things I'm wondering about, Ms. Newman, And maybe you can address some of this, the constellation of providers that are out there, how many are small, how many are larger. And I respect the goal that's here of trying to improve the ratio of service delivery for dollars spent. I think we have to do that. 50% Sounds pretty low, and I think that's important.

I was just wondering if any thought was given to some sort of size consideration. So a smaller provider is inherently— they have efficiencies, but they don't have the same efficiency of scale that a large provider where they can avoid kind of the impact of some of these things. And that it might be suppressing some of the smaller providers that just can't quite make the cut because they are already tapped. Can you just address that and what might be done to mitigate the negative impacts of a good bill, a good intent, a good idea to try and improve ratio of dollars spent to service delivery? Mr. Newman.

Thank you, Mr. Chair. Senator Kaufman, I would need to go back and do a little bit of research and deliver that back to the committee. I can tell you there are about 13 agency-based personal care services providers and there's about 55 consumer-based personal care services providers in the state right now. We would have to make a decision as to what constitutes a small relative to a large agency to give you that number.

But together those agencies are serving about 2,300 individuals with personal care services. So I would be happy to return to the committee with that information. Senator Kaufman. Thank you. I think that would be an interesting perspective on it and there may be a something in that nuance that would enable implementation of an idea that would help deliver more services without avoiding some of the suppressive effects on the smaller operators.

Thank you. Thank you, Senator Kaufman, for the discussion. Representative. Yes, thank you, Mr. Chairman. In my view, this bill provides for that eventuality.

They were talking about the hardship exemption, and that is in there to address the problem of smaller-scale businesses that probably would have higher costs, fixed costs, if you will.

But that's something that the committee— or the advisory board is, in my view, designed to address. If that comes out, I think that can be worked out.

I think the bill allows for it to be worked out, shall I say. Thank you, Senator Kaufman. Senator Cronk. Thank you, Mr. Chair.

I appreciate the bill because I've actually had firsthand experience with this with my parents and it's really difficult to find home care. I do know some people that do home care and their wages simply are appalling. And they're doing— this saves the state so much money because I know we couldn't find home care for my father, so he's in senior care in Fairbanks paying $7,500 a month out of his own pocket just to be in a place where he doesn't need somebody to care for him. He just needs to be somewhere where they have the ability— if he has to go to the hospital, he's going to the hospital. And I have people that are home care people in Delta where they go and check on these people and they have to go to Fairbanks for a medical appointment.

They are not paid mileage and they are not covered by their time of the entire trip that they go and take these people there. So we have a big problem because these people are doing this because they love what they're doing and they're caring. But it just seems to me 50% of what we're paying out is getting back to them. I think that is— that really needs needs to be addressed because they are literally saving the state millions and millions of dollars by this. And this problem is not going away because there's going to be more and more people that are getting older and they need this care.

And keeping them in their home is literally the best thing we can do for them. So I appreciate the bill, but there's got to be some changes here because, um, these people come, they're very passionate about what they do, and they're not getting compensated for everything they do and that needs to be addressed. Thank you, Senator Cronk. Further discussion? Mr. Newman.

Thank you, Mr. Chair. Senator Cronk, I appreciate those thoughts. I hear that story many times, that kind of story many times. I just wanted to clarify that the 50% expectation in regulation is a minimal expectation.

And from talking to personal care services agencies, from speaking with the department's program integrity people. I understand that most agencies are paying considerably more than that minimum 50% because they have to in order to attract people to do the work. Senator Cronk. Thank you, Senator Cronk. Further discussion?

Seeing none, we will go to fiscal notes. Senator Keele. Thank you, Mr. Chairman. House Bill 96 has one fiscal note from the Department of Health. Senior Disability Services.

They show a first-year FY '27 increase of $206,600 unrestricted general funds and 1 new full-time position. In the next fiscal year, they add a second permanent full-time position, so that brings the cost to a total of $378,900 unrestricted general fund. That's all associated with those positions, not with rates and the department notes that they will need to change regulations to implement the bill. Members of the Senate Finance Committee have questions on the fiscal note?

Seeing none, closing comments, Representative? Well, thank you. I think this is a good bill. It was, as I say, it was initially drafted because we thought there were federal regulations coming down the pike. But I think that this will help provide more service, which is sorely needed by raising the rates that the state pays to the providers and then in turn, or the agencies, and the agencies in turn for the providers.

I think it will end up actually saving money, at least per person care, when, as Senator Cronk was mentioning, going to the next level of care is really expensive. So I think it will work out to be a win-win situation, and I think there's enough latitude in the bill to work out the different cost structures between small providers and large providers as far as margins. And, you know, it's a market. It's hard to say exactly how this is going to work, but I think that this will work out to be a win-win situation for everybody. Thank you.

Senator Young. Yeah, thank you, through the Chair. So I wanted to build on that conversation a little bit. So right now there's a there's an issue in the free market. And so birth rates are declining nationwide.

And because of that, there are folks that have been building facilities like this for a long time that are very reluctant to do so right now. And so we're gonna wind up in a situation where maybe our next set of parents can't get into the facility that Senator Cronk's dad is at, right? Because the free market's gonna adjust as it should. Birth rates are declining. We're gonna wind up in a pickle here, and home care is the answer.

So the advisory board, there's so many things that we haven't even discussed right now that still need to be worked through, and that's really where the advisory board comes into. So whether the federal requirements stay in place or not, I see this as a net positive. So it's definitely a conflict of interest, I think, for this body, probably. No, just kidding. I'll leave it at that.

Thank you, Senator Yant, for looking in the mirror.

With that, we'll set this bill aside and go to the last item on today's calendar, which is HB 14, repeal of catastrophic illness and medical assistance. This is the first hearing on this piece of legislation. Invite Representative Stack to the table and bring any assistance you may need to introduce the legislation to the Senate Finance Committee. Representative, come forward.

Chairman, members of the Senate Finance Committee, thanks for having me. Really briefly, HB 14 basically repeals a program that has served no Alaskans for the last 6 years. It's called Catastrophic and Acute Medical Assistance. For the record, Representative Staff, East Fairbanks, Fort Wainwright, Madre, House District 32. Appreciate that, Senator.

So just a little history of CAMMA. CAMMA has been around a long time. Basically, the program was designed for individuals who were not Medicaid eligible. As that program expanded over time throughout the history of the state and other programs and in different federal programs were expanded throughout the level, fewer and fewer Alaskans qualified for Chronic and Acute Medical Assistance to the point by 2021 the program only served one Alaskan and has not served a single Alaskan since that year. Two years ago during the conference committee, the funding for the program was removed from the budget.

Budget is prorated on statute of the funds, so even if someone were to qualify for the program, they couldn't be on it unless you restored funding. The nucleus of the program extended from— the Department of Health was doing thousands of applications for a program nobody could qualify for. So we got rid of it and saved them a bunch of administrative heartache, and my hope is to finish repealers in the statute so they can move on to do bigger and better things. And with the permission of the Chairman or the Committee, I could have my staff go through the section if you'd like so. That's fine.

I see that you've had a haircut for the Committee. You look very sharp, Representative. I have two people that are in the— that are available for questions, we have Deb Etheridge, who is the Director of the Division of Public Assistance, and Courtney Enright, the legislative liaison for the Department of Health, if members of the Senate Finance Committee have questions of them. Are there any questions of the prime sponsor or the two individuals that I mentioned?

Questions? We will go to fiscal notes. Senator Keele. Thank you, Mr. Chairman. House Bill 14 has one zero fiscal note from the Department of Health, Public Assistance, Field Services, although they will have to update some regulations.

Questions on the fiscal note? Closing comments, Representative, before we set this bill aside for further deliberation? Thank you, Chairman, members of the Senate Finance Committee. Obviously I had to get the haircut because you always want to make sure you're prime time when you come before Senate Finance Chairman. Thank you.

Thank you very much. We will set this bill aside. We'll be hearing it in the very near future. That concludes the agenda for today's— this morning's meeting. Our next scheduled meeting is this afternoon at 1:30.

We'll see if we have anything to bring forward. With that, we are adjourned.