Compare versions
--- version:HB 96+++ version:(document, no version)@@ -1,274 +1,51 @@-HB0096a -1- HB 96- New Text Underlined [DELETED TEXT BRACKETED]+REPRESENTATIVE MIKE PRAX+ALASKA STATE LEGISLATURE HOUSE DISTRICT 33-34-LS0297\I+SESSION+Alaska State Capitol+Juneau, AK 99801+Phone: (907) 465-4797+Toll Free: (800) 860-4797- HOUSE BILL NO. 96+DISTRICT+1292 Sadler Way, Suite 308+Fairbanks, AK 99701+Phone: (907) 451-2723+Fax: (907) 456-3346-IN THE LEGISLATURE OF THE STATE OF ALASKA+HB 96 Sponsor Statement (34-LS0297/T) 4.28.25+ "An Act establishing the Home Care Employment Standards Advisory Board; relating to+payment for personal care services; and providing for an effective date."-THIRTY-FOURTH LEGISLATURE - SECOND SESSION+Seniors are the fastest growing demographic in the state of Alaska1 and are living longer lives.2 The+state’s 85+ population is expected to increase by 500% between 2022 and 2050, of which, 1/3 will+experience Alzheimer’s and Related Dementia.3 The Alaska Department of Labor and Workforce+Development predicts home care, a part of Alaska’s continuum of care services for seniors and+people with disabilities, to be one of the fastest growing and most in demand occupations in the+state.4-BY REPRESENTATIVES PRAX, Fields, Kopp, Jimmie, Dibert, Hall, Johnson, Bynum, Ruffridge, Mina,-Costello, Galvin, Schrage, Josephson, Eischeid, Gray, Story, Frier+Alaska faces an acute shortage of direct care workers, particularly outside of population centers.+The potential provider workforce demographic, those age 18 to 64, is in decline. Furthermore, low+pay and lack of benefits force many caregivers out of the profession and make recruitment and+retention increasingly more difficult for agencies providing in-home care services.56-Introduced: 2/12/25-Referred: Health and Social Services, Labor and Commerce, Finance+We need to create strong and long-lasting home care infrastructure in Alaska which will expand+access to quality, affordable home and community-based care for seniors and people with+disabilities, keep people in their homes and out of costly facilities, and bolster the creation of jobs.+We also need to ensure that Medicaid funding for personal care services is wisely spent, with an+adequate portion of the rate going to pay and benefits for direct care workers, in order to help+address the workforce shortage. HB 96 accomplishes both of these objects by:+• Establishing a Home Care Employment Standards Advisory Board that will investigate,+advise, and develop recommendations on Medicaid rates and other policies to improve the+wages, working conditions, and recruitment and retention of direct care workers.+• Requiring that agencies providing personal care services spend at least 70 percent of the+total annual funding they receive from the department for personal care services on the pay+and benefits of Personal Care Assistants providing such services.-A BILL--FOR AN ACT ENTITLED--"An Act establishing the Home Care Employment Standards Advisory Board; relating 1-to payment for personal care services; and providing for an effective date." 2-BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3- * Section 1. AS 44.29 is amended by adding new sections to read: 4-Article 10. Home Care Employment Standards Advisory Board. 5-Sec. 44.29.900. Home Care Employment Standards Advisory Board. The 6-Home Care Employment Standards Advisory Board is established in the department. 7-Sec. 44.29.905. Composition of the board. The board consists of 8-(1) the commissioner of health or the commissioner's designee, who 9-shall serve as the chair and is a nonvoting member, except in the case of a tie; 10-(2) the commissioner of labor and workforce development or the 11-commissioner's designee, who is a nonvoting member; and 12-(3) eight members appointed by the commissioner of health, as 13-follows: 14- 34-LS0297\I-HB 96 -2- HB0096a- New Text Underlined [DELETED TEXT BRACKETED]--(A) two voting members who represent covered providers, 1-including at least one agency that provided at least 700,000 units of personal 2-care services during the previous calendar year and one agency that provides 3-habilitation services; 4-(B) two voting members who represent direct care workers, at 5-least one of whom is a labor representative of at least 300 direct care workers; 6-a member appointed under this subparagraph may not be a representative of an 7-organization or association that advocates for the interests of covered providers 8-or agencies that provide covered services; 9-(C) one voting member who is an enrollee or a representative 10-of enrollees receiving covered services; 11-(D) one voting member who represents the office within the 12-department with responsibility for rate review; 13-(E) one nonvoting member who represents the Alaska 14-Commission on Aging or another organization that represents seniors in the 15-state; and 16-(F) one nonvoting member who represents the Governor's 17-Council on Disabilities and Special Education established under AS 44.29.600 18-or another organization that represents people with disabilities in the state. 19-Sec. 44.29.910. Term of office, vacancies, and removal of appointed 20-members. (a) The members of the board appointed under AS 44.29.905(3) serve two-21-year terms and may be reappointed. 22-(b) A member of the board appointed under AS 44.29.905(3) serves at the 23-pleasure of the commissioner, except that the commissioner shall remove a member 24-who no longer meets the qualifications of the seat for which the member was 25-appointed. 26-(c) The commissioner may appoint an individual to fill a vacancy under 27-AS 44.29.905(3) only after providing public notice of the vacancy and soliciting 28-applications for the appointment. The commissioner shall fill the vacancy within six 29-months after the date the vacancy occurs. An appointment to fill the vacancy is for the 30-remainder of the unexpired term. 31- 34-LS0297\I-HB0096a -3- HB 96- New Text Underlined [DELETED TEXT BRACKETED]--Sec. 44.29.915. Meetings. The board shall meet at the call of the chair. The 1-board shall meet at least three times each year and shall hold additional meetings as 2-often as necessary to accomplish the duties of the board. A meeting may be held in 3-person or by teleconference or other electronic means. At each meeting, the board 4-shall provide time for public testimony. 5-Sec. 44.29.920. Quorum. A majority of the voting members of the board 6-constitute a quorum for the transaction of business, and a majority of a quorum present 7-at a meeting is sufficient to approve a recommendation of the board. 8-Sec. 44.29.925. Compensation. Members of the board receive no 9-compensation for service on the board but are entitled to per diem and travel expenses 10-authorized for boards and commissions under AS 39.20.180. 11-Sec. 44.29.930. Powers and duties of the board. (a) The board shall 12-(1) advise and consult with the department on the medical assistance 13-program payment rates for covered services and payment rate adequacy and 14-compliance with federal requirements regarding reporting of payment adequacy data; 15-(2) investigate matters related to the wages, working conditions, and 16-workforce adequacy of workers providing covered services in the state, including 17-(A) the adequacy of wages, benefits, and other compensation to 18-ensure the provision of quality services and sufficient levels of recruitment and 19-retention; 20-(B) the sufficiency of levels of recruitment for and retention of 21-workers, particularly in an area that is not on a road system; 22-(C) the sufficiency of service levels of and the effect of service 23-level reductions on covered services, as the services pertain to wages and 24-working conditions; 25-(D) the adequacy and enforcement of training requirements; 26-(E) the effect of workforce shortages on service recipients and 27-on family members and friends of service recipients providing unpaid care, 28-including compliance with federal requirements to report information to the 29-United States Department of Health and Human Services, Centers for 30-Medicare and Medicaid Services, regarding wait times for covered services 31- 34-LS0297\I-HB 96 -4- HB0096a- New Text Underlined [DELETED TEXT BRACKETED]--and the percentage of authorized hours for covered services; 1-(F) the economic impact of achieving a living wage for direct 2-care workers and reducing levels of unpaid care; 3-(G) the adequacy of payment practices and policies related to 4-the payment rates of certified providers of covered services; and 5-(H) the effect of the state's long-term care system on wages and 6-working conditions. 7-(b) A state agency that receives a reasonable request for information or 8-testimony from the board shall comply with the request as soon as is reasonably 9-practicable, and, when the board requests direct testimony for a board meeting, the 10-head of the agency or the designee of the head of the agency shall appear at the 11-meeting and provide testimony. 12-(c) The department shall ensure the board has access to current and proposed 13-payment rates, payment adequacy reporting information for covered services that is 14-provided by the state to the United States Department of Health and Human Services, 15-Centers for Medicare and Medicaid Services, as required by federal law, and access to 16-metrics created by the state that contain information regarding wait times for covered 17-services and the percentage of authorized hours for covered services. 18-Sec. 44.29.935. Biennial report. (a) The board shall biennially prepare a 19-written report, submit the report to the commissioner, the legislative committees 20-having jurisdiction over health and social services, and the chief clerk of the house of 21-representatives and the senate secretary, and notify the legislature that the report is 22-available. The commissioner shall make the report and all materials presented before 23-the board available to the public on the department's Internet website. 24-(b) The biennial report must be based on the results of the board's 25-investigation under AS 44.29.930(a)(2) and must include key findings and 26-recommendations regarding 27-(1) rates and service levels of covered services; 28-(2) adequacy of rates and service levels of covered services to ensure 29-the provision of quality services, improved recruitment and retention, and compliance 30-with federal standards; 31- 34-LS0297\I-HB0096a -5- HB 96- New Text Underlined [DELETED TEXT BRACKETED]--(3) safe and healthy working conditions for workers providing covered 1-services; 2-(4) reducing any barrier to recruiting for and retaining workers 3-providing covered services throughout the state, particularly in an area that is not on a 4-road system; 5-(5) reducing the level of unpaid care in the state and systemic 6-overreliance on family members and friends of service recipients who provide unpaid 7-care; and 8-(6) sufficiency of covered services payment adequacy data and access 9-to care metrics. 10-(c) Upon receiving the biennial report, the commissioner shall review the 11-board's findings and recommendations. The commissioner may 12-(1) accept or reject a recommendation; and 13-(2) require the board to conduct new or further investigations and 14-develop new recommendations. 15-(d) If the commissioner accepts a recommendation in the biennial report, the 16-department shall adopt regulations necessary to implement the recommendation. If the 17-commissioner rejects a recommendation in the biennial report, the commissioner shall 18-provide a written explanation of the commissioner's decision to all board members and 19-the legislative committees having jurisdiction over health and social services. If the 20-reason for rejection includes budgetary constraints, the commissioner shall work with 21-the Office of the Governor and the legislature to develop a budget proposal that would 22-allow the commissioner to accept the recommendation. 23-Sec. 44.29.940. Publication of reports. On July 1 of each year, or within 30 24-days after receiving the biennial report from the board, the department shall publish on 25-the department's publicly available Internet website an annual report containing the 26-weighted average of and median hourly wages, by agency, for workers providing 27-covered services. 28-Sec. 44.29.945. Definitions. In AS 44.29.900 - 44.29.945, 29-(1) "board" means the Home Care Employment Standards Advisory 30-Board; 31- 34-LS0297\I-HB 96 -6- HB0096a- New Text Underlined [DELETED TEXT BRACKETED]--(2) "commissioner" means the commissioner of health; 1-(3) "covered provider" means an eligible Medicaid provider enrolled 2-with the department to provide one or more covered services; 3-(4) "covered services" means 4-(A) chore services provided under a section 1915(k) option 5-under 42 U.S.C. 1396n; 6-(B) hourly respite services provided under a waiver in 7-accordance with 42 U.S.C. 1396 - 1396p; 8-(C) personal care services; 9-(D) habilitation services; 10-(5) "department" means the Department of Health; 11-(6) "direct care worker" means an individual who is employed by a 12-covered provider to provide one or more covered services; 13-(7) "habilitation services" means services designed to assist individuals 14-in acquiring, retaining, and improving the self-help, socialization, and adaptive skills 15-necessary to reside successfully in home and community-based settings, provided 16-under a waiver in accordance with 42 U.S.C. 1396 - 1396p; 17-(8) "personal care services" means services provided under a section 18-1915(k) option under 42 U.S.C. 1396n, under AS 47.07.030, or under a waiver in 19-accordance with 42 U.S.C. 1396 - 1396p. 20- * Sec. 2. AS 47.07.045 is amended by adding new subsections to read: 21-(f) Except as provided in (g) of this section, an agency providing home and 22-community-based services shall pay as compensation and benefits to its employees 23-performing personal care services, 24-(1) beginning July 1, 2026, at least 70 percent of the total annual 25-amount of funding the agency receives for personal care services from the department; 26-and 27-(2) beginning July 1, 2030, at least 80 percent of the total annual 28-amount of funding the agency receives for personal care services from the department. 29-(g) The department may grant to an agency providing home and community-30-based services a hardship exemption from the requirements of (f) of this section if the 31- 34-LS0297\I-HB0096a -7- HB 96- New Text Underlined [DELETED TEXT BRACKETED]--agency is facing extraordinary circumstances or is a small provider, as defined by the 1-department. The department shall adopt regulations establishing procedures and 2-objective criteria for granting a hardship exemption under this subsection. An agency 3-that is granted a hardship exemption shall pay as compensation and benefits to its 4-employees performing personal care services, 5-(1) beginning July 1, 2026, at least 60 percent of the total annual 6-amount of funding the agency receives for personal care services from the department; 7-and 8-(2) beginning July 1, 2036, at least 80 percent of the total annual 9-amount of funding the agency receives for personal care services from the department. 10-(h) The amount calculated under (f) and (g) of this section for compensation 11-and benefits paid to employees may not include costs expended on employees by an 12-agency for personal protective equipment, required training, and travel costs such as 13-mileage reimbursement or public transportation. 14-(i) In this section, "personal care services" has the meaning given in 15-AS 44.29.945. 16- * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 17-read: 18-APPOINTMENTS, FIRST MEETING, AND PRELIMINARY REPORT. (a) The first 19-meeting of the Home Care Employment Standards Advisory Board established under 20-AS 44.29.900, added by sec. 1 of this Act, must take place on or before October 1, 2025. 21-(b) The commissioner of health shall appoint all board members under 22-AS 44.29.905(3), added by sec. 1 of this Act, before the board's first meeting. 23-(c) The commissioner of health or the commissioner's designee and the commissioner 24-of labor and workforce development or the commissioner's designee shall conduct a 25-preliminary investigation into the wages, working conditions, and adequacy of the Medicaid 26-workforce providing covered services in the state and present the results of the preliminary 27-investigation to the board at the board's first meeting. 28- * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 29-read: 30-PRELIMINARY INTERNET WEBSITE PUBLICATION. Notwithstanding 31- 34-LS0297\I-HB 96 -8- HB0096a- New Text Underlined [DELETED TEXT BRACKETED]--AS 44.29.940, added by sec. 1 of this Act, the Department of Health shall make the first 1-publication of the reports required by AS 44.29.940, added by sec. 1 of this Act, on the 2-department's Internet website not later than July 1, 2026. 3- * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 4-read: 5-MEDICAID STATE PLAN. To the extent necessary to implement this Act, the 6-Department of Health shall amend and submit for approval by the United States Department 7-of Health and Human Services the state plan under AS 47.07.045, as amended by sec. 2 of 8-this Act. 9- * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 10-read: 11-CONDITIONAL EFFECT; NOTIFICATION. (a) Section 2 of this Act takes effect 12-only if, and to the extent that, on or before January 1, 2026, the United States Department of 13-Health and Human Services 14-(1) approves amendments submitted in accordance with sec. 5 of this Act; or 15-(2) determines that approval of the amendments to the state plan under 16-AS 47.07.045 is not necessary. 17-(b) The commissioner of health shall notify the revisor of statutes in writing within 30 18-days after the United States Department of Health and Human Services approves amendments 19-to the state plan or determines that approval is not necessary under this section. 20- * Sec. 7. If sec. 2 of this Act takes effect, it takes effect on the day after the date on which 21-the United States Department of Health and Human Services approves the amendments to the 22-state plan submitted under sec. 5 of this Act or determines that approval is not necessary 23-under sec. 6 of this Act. 24- * Sec. 8. Except as provided in sec. 7 of this Act, this Act takes effect July 1, 2025. 25+1 https://health.alaska.gov/acoa/documents/ACoA_SeniorSnapshot_Feb2021.pdf+2 https://alaskamentalhealthtrust.org/wp-content/uploads/2020/07/ACOA-Presentation-1.24.23-REVISED.pdf+3 https://alaskamentalhealthtrust.org/wp-content/uploads/2020/07/ACOA-Presentation-1.24.23-REVISED.pdf+4 “Workforce Development.” Alaska Mental Health Trust, Accessed February 19, 2021. https://alaskamentalhealthtrust.org/alaska-mental-health-trust-+authority/what-we-do/workforce-development/+5 The Alaska State Plan for Senior Services FFY 2020 -2023,” Alaska Commission on Aging, 2023, 170.+6 The Alaska State Plan for Senior Services FFY 2020 -2023,” Alaska Commission on Aging, 2023, 170.
Diffs are computed deterministically from extracted bill text and show additions, deletions, and section moves. Scanned-PDF text extracted via OCR is flagged where confidence is low; see methodology.