HOME CARE EMPLOYMENT STANDARDS ADV BOARD, the official text

00Enrolled HB 96
01Establishing the Home Care Employment Standards Advisory Board; relating to payment for 
02 personal care services; and providing for an effective date. 
03 _______________ 
04 * Section 1. AS 44.29 is amended by adding new sections to read: 
05 Article 10. Home Care Employment Standards Advisory Board. 
06 Sec. 44.29.900. Home Care Employment Standards Advisory Board. The 
07 Home Care Employment Standards Advisory Board is established in the department. 
08 Sec. 44.29.905. Composition of the board. The board consists of 
09 (1) the commissioner of health or the commissioner's designee, who 
10 shall serve as the chair and is a nonvoting member, except in the case of a tie; 
11 (2) the commissioner of labor and workforce development or the 
12 commissioner's designee, who is a nonvoting member; and 
13 (3) eight members appointed by the commissioner of health, as 
14 follows:

01(A) two voting members who represent covered providers, 
02 including at least one agency that provided at least 700,000 units of personal 
03 care services during the previous calendar year and one agency that provides 
04 habilitation services; 
05 (B) two voting members who represent direct care workers, at 
06 least one of whom is a labor representative of at least 300 direct care workers; 
07 a member appointed under this subparagraph may not be a representative of an 
08 organization or association that advocates for the interests of covered providers 
09 or agencies that provide covered services; 
10 (C) one voting member who is an enrollee or a representative 
11 of enrollees receiving covered services; 
12 (D) one voting member who represents the office within the 
13 department with responsibility for rate review; 
14 (E) one nonvoting member who represents the Alaska 
15 Commission on Aging or another organization that represents seniors in the 
16 state; and 
17 (F) one nonvoting member who represents the Governor's 
18 Council on Disabilities and Special Education established under AS 44.29.600 
19 or another organization that represents people with disabilities in the state. 
20 Sec. 44.29.910. Term of office, vacancies, and removal of appointed 
21 members. (a) The members of the board appointed under AS 44.29.905(3) serve two- 
22 year terms and may be reappointed. 
23 (b) A member of the board appointed under AS 44.29.905(3) serves at the 
24 pleasure of the commissioner, except that the commissioner shall remove a member 
25 who no longer meets the qualifications of the seat for which the member was 
26 appointed. 
27 (c) The commissioner may appoint an individual to fill a vacancy under 
28 AS 44.29.905(3) only after providing public notice of the vacancy and soliciting 
29 applications for the appointment. The commissioner shall fill the vacancy within six 
30 months after the date the vacancy occurs. An appointment to fill the vacancy is for the 
31 remainder of the unexpired term.

01Sec. 44.29.915. Meetings. The board shall meet at the call of the chair. The 
02 board shall meet at least three times each year and shall hold additional meetings as 
03 often as necessary to accomplish the duties of the board. A meeting may be held by 
04 teleconference or other electronic means. At each meeting, the board shall provide 
05 time for public testimony. 
06 Sec. 44.29.920. Quorum. A majority of the voting members of the board 
07 constitute a quorum for the transaction of business, and a majority of a quorum present 
08 at a meeting is sufficient to approve a recommendation of the board. 
09 Sec. 44.29.925. Compensation. Members of the board receive no 
10 compensation for service on the board but are entitled to per diem and travel expenses 
11 authorized for boards and commissions under AS 39.20.180. 
12 Sec. 44.29.930. Powers and duties of the board. (a) The board shall 
13 (1) advise and consult with the department on the medical assistance 
14 program payment rates for covered services and payment rate adequacy and 
15 compliance with federal requirements regarding reporting of payment adequacy data; 
16 (2) investigate matters related to the wages, working conditions, and 
17 workforce adequacy of workers providing covered services in the state, including 
18 (A) the adequacy of wages, benefits, and other compensation to 
19 ensure the provision of quality services and sufficient levels of recruitment and 
20 retention; 
21 (B) the sufficiency of levels of recruitment for and retention of 
22 workers, particularly in an area that is not on a road system; 
23 (C) the sufficiency of service levels of and the effect of service 
24 level reductions on covered services, as the services pertain to wages and 
25 working conditions; 
26 (D) the adequacy and enforcement of training requirements; 
27 (E) the effect of workforce shortages on service recipients and 
28 on family members and friends of service recipients providing unpaid care, 
29 including compliance with federal requirements to report information to the 
30 United States Department of Health and Human Services, Centers for 
31 Medicare and Medicaid Services, regarding wait times for covered services

01 and the percentage of authorized hours for covered services; 
02 (F) the economic impact of achieving a living wage for direct 
03 care workers and reducing levels of unpaid care; 
04 (G) the adequacy of payment practices and policies related to 
05 the payment rates of certified providers of covered services; and 
06 (H) the effect of the state's long-term care system on wages and 
07 working conditions. 
08 (b) A state agency that receives a reasonable request for data, information, or 
09 testimony from the board shall comply with the request as soon as is reasonably 
10 practicable, and, when the board requests direct testimony for a board meeting, the 
11 head of the agency or the designee of the head of the agency shall appear at the 
12 meeting and provide testimony. 
13 Sec. 44.29.935. Biennial report. (a) The board shall biennially prepare a 
14 written report in digital format, submit the report to the commissioner, the legislative 
15 committees having jurisdiction over health and social services, and the senate 
16 secretary and the chief clerk of the house of representatives, and notify the legislature 
17 that the report is available. The commissioner shall make the report available to the 
18 public on the department's Internet website. 
19 (b) The biennial report must be based on the results of the board's 
20 investigation under AS 44.29.930(a)(2) and must include key findings and 
21 recommendations regarding 
22 (1) rates and service levels of covered services; 
23 (2) adequacy of rates and service levels of covered services to ensure 
24 the provision of quality services, improved recruitment and retention, and compliance 
25 with federal standards; 
26 (3) safe and healthy working conditions for workers providing covered 
27 services; 
28 (4) reducing any barrier to recruiting for and retaining workers 
29 providing covered services throughout the state, particularly in an area that is not on a 
30 road system; 
31 (5) reducing the level of unpaid care in the state and systemic

01 overreliance on family members and friends of service recipients who provide unpaid 
02 care; and 
03 (6) sufficiency of covered services payment adequacy data and access 
04 to care metrics. 
05 (c) The department shall take the recommendations of the board into 
06 consideration when setting rates for covered services. If the rate set by the department 
07 for a covered service differs significantly from the rate recommended by the board, the 
08 commissioner shall notify the board and the chair of each legislative committee having 
09 jurisdiction of health and social services in writing. 
10 Sec. 44.29.940. Publication of reports. On July 1 of each year, or within 30 
11 days after receiving the biennial report from the board, the department shall publish on 
12 the department's publicly available Internet website an annual report containing the 
13 weighted average of and median hourly wages, by agency, for workers providing 
14 covered services. 
15 Sec. 44.29.945. Definitions. In AS 44.29.900 - 44.29.945, 
16 (1) "board" means the Home Care Employment Standards Advisory 
17 Board; 
18 (2) "commissioner" means the commissioner of health; 
19 (3) "covered provider" means an eligible Medicaid provider certified 
20 by the department to provide one or more covered services; 
21 (4) "covered services" means 
22 (A) chore services provided under a section 1915(k) option 
23 under 42 U.S.C. 1396n; 
24 (B) hourly respite services provided under a waiver in 
25 accordance with 42 U.S.C. 1396 - 1396p; 
26 (C) personal care services; 
27 (D) habilitation services; 
28 (5) "department" means the Department of Health; 
29 (6) "direct care worker" means an individual who is employed by a 
30 covered provider to provide one or more covered services; 
31 (7) "habilitation services" means services designed to assist individuals

01 in acquiring, retaining, and improving the self-help, socialization, and adaptive skills 
02 necessary to reside successfully in home and community-based settings, provided 
03 under a waiver in accordance with 42 U.S.C. 1396 - 1396p; 
04 (8) "personal care services" means services provided under a section 
05 1915(k) option under 42 U.S.C. 1396n, under AS 47.07.030, or under a waiver in 
06 accordance with 42 U.S.C. 1396 - 1396p. 
07 * Sec. 2. AS 47.07.045 is amended by adding new subsections to read: 
08 (f) Except as provided in (g) of this section, an agency providing home and 
09 community-based services shall pay as compensation and benefits to its employees 
10 performing personal care services, 
11 (1) beginning July 1, 2027, at least 70 percent of the total annual 
12 amount of funding the agency receives for personal care services from the department; 
13 and 
14 (2) beginning July 1, 2030, at least 80 percent of the total annual 
15 amount of funding the agency receives for personal care services from the department. 
16 (g) The department may grant to an agency providing home and community- 
17 based services a hardship exemption from the requirements of (f) of this section if the 
18 agency is facing extraordinary circumstances or is a small provider, as defined by the 
19 department. The department shall adopt regulations establishing procedures and 
20 objective criteria for granting a hardship exemption under this subsection. An agency 
21 that is granted a hardship exemption shall pay as compensation and benefits to its 
22 employees performing personal care services, 
23 (1) beginning July 1, 2027, at least 60 percent of the total annual 
24 amount of funding the agency receives for personal care services from the department; 
25 and 
26 (2) beginning July 1, 2036, at least 80 percent of the total annual 
27 amount of funding the agency receives for personal care services from the department. 
28 (h) The amount calculated under (f) and (g) of this section for compensation 
29 and benefits paid to employees may not include costs expended on employees by an 
30 agency for personal protective equipment, required training, and travel costs such as 
31 mileage reimbursement or public transportation.

01 (i) In this section, "personal care services" has the meaning given in 
02 AS 44.29.945. 
03 * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 
04 read: 
05 APPOINTMENTS AND FIRST MEETING. (a) The first meeting of the Home Care 
06 Employment Standards Advisory Board established under AS 44.29.900, added by sec. 1 of 
07 this Act, must take place on or before October 1, 2027. 
08 (b) The commissioner of health shall appoint all board members under 
09 AS 44.29.905(3), added by sec. 1 of this Act, before the board's first meeting. 
10 * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 
11 read: 
12 MEDICAID STATE PLAN. To the extent necessary to implement this Act, the 
13 Department of Health shall amend and submit for approval by the United States Department 
14 of Health and Human Services the state plan under AS 47.07.045, as amended by sec. 2 of 
15 this Act. 
16 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 
17 read: 
18 CONDITIONAL EFFECT; NOTIFICATION. (a) Section 2 of this Act takes effect 
19 only if, and to the extent that, on or before January 1, 2027, the United States Department of 
20 Health and Human Services 
21 (1) approves amendments submitted in accordance with sec. 4 of this Act; or 
22 (2) determines that approval of the amendments to the state plan under 
23 AS 47.07.045 is not necessary. 
24 (b) The commissioner of health shall notify the revisor of statutes in writing within 30 
25 days after the United States Department of Health and Human Services approves amendments 
26 to the state plan or determines that approval is not necessary under this section. 
27 * Sec. 6. If sec. 2 of this Act takes effect, it takes effect on the day after the date on which 
28 the United States Department of Health and Human Services approves the amendments to the 
29 state plan submitted under sec. 4 of this Act or determines that approval is not necessary 
30 under sec. 5 of this Act. 
31 * Sec. 7. Except as provided in sec. 6 of this Act, this Act takes effect July 1, 2027.