State of Alaska
Fiscal Note
Bill Version: CSHB 292(HSS)
2022 Legislative Session
Fiscal Note Number: 3
(H) Publish Date: 4/20/2022
Identifier: HB292-DOA-OAH-02-24-22 Department: Department of Administration
Title: HOME AND COMMUNITY-BASED WAIVER Appropriation: Centralized Administrative Services
SERVICES Allocation: Office of Administrative Hearings
Sponsor: SNYDER OMB Component Number: 2771
Requester: (H) HSS
Expenditures/Revenues
Note: Amounts do not include inflation unless otherwise noted below. (Thousands of Dollars)
Included in
FY2023 Governor's
Appropriation FY2023 Out-Year Cost Estimates
Requested Request
OPERATING EXPENDITURES FY 2023 FY 2023 FY 2024 FY 2025 FY 2026 FY 2027 FY 2028
Personal Services 56.4 56.4
Travel
Services 5.0 5.0
Commodities 5.0 5.0
Capital Outlay
Grants & Benefits
Miscellaneous
Total Operating 0.0 0.0 66.4 66.4 0.0 0.0 0.0
Fund Source (Operating Only)
1007 I/A Rcpts (Other) 66.4 66.4
Total 0.0 0.0 66.4 66.4 0.0 0.0 0.0
Positions
Full-time
Part-time 1.0 1.0
Temporary
Change in Revenues
None
Total 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Estimated SUPPLEMENTAL (FY2022) cost: 0.0 (separate supplemental appropriation required)
Estimated CAPITAL (FY2023) cost: 0.0 (separate capital appropriation required)
Does the bill create or modify a new fund or account? No
(Supplemental/Capital/New Fund - discuss reasons and fund source(s) in analysis section)
ASSOCIATED REGULATIONS
Does the bill direct, or will the bill result in, regulation changes adopted by your agency? No
If yes, by what date are the regulations to be adopted, amended or repealed? N/A
Why this fiscal note differs from previous version/comments:
Not applicable, initial version.
Prepared By: Ken Truitt, Legislative Liaison Phone: (907)465-8464
Division: Office of the Commissioner Date: 02/24/2022
Approved By: Leslie Isaacs, Administrative Services Director Date: 02/25/2022
Agency: Department of Administration
Printed 4/19/2022 Page 1 of 2 Control Code: YxHvw
 CSHB 292(HSS) - Fiscal Note 3
FISCAL NOTE ANALYSIS
STATE OF ALASKA BILL NO. HB 292
2022 LEGISLATIVE SESSION
Analysis
Termination or Reduction of Medicaid Home and Community-Based Waiver Services, S1915(k) Community Choice
Services, and Personal Care Services
This bill makes termination and reduction of Medicaid Home and Community-Based Waiver Services, 1915(k) Community
Choice Services, and Personal Care Services subject to the provision of AS 47.07.045. The current version of the statute
only applies to the complete termination of Medicaid Home and Community-Based Waiver Services.
This bill also amends AS 47.07.045 to require that prior to any termination or reduction of these services, that the
Department must conduct an assessment that shows that the recipient can functional and live independently in a home
setting without the services, in the event of termination, or at the reduced level of services, in the event of reduced
services. Before any such reduction or termination occurs, the assessment must be reviewed by an independent third-party
reviewer. This section also removes and relocates some definitions to a different portion of the statute.
This bill will allow a "legally responsible person" (parent of a minor, guardian, spouse) to provide personal care services to a
recipient, and will allow recipients who had their services reduced between January 1, 2019 and January 1, 2022 to request
a reassessment.
Impact and Implementation Cost for the Office of Administrative Hearings
The Office of Administrative Hearings (OAH) hears appeals from the Department of Health and Social Service's (DHSS)
decisions regarding Medicaid Home and Community-Based Waiver Services, Community Choice Services and Personal Care
Services.
The effect of these proposed changes upon OAHs caseload, staffing requirements, and cost impact is difficult to project
where, as here, there is an independent third-party reviewer. It is possible that the inclusion of termination/reduction in
individual Waiver services and the termination/reduction of Personal Care Services and 1915(k) services could result in
less terminations/reduction of services, and a consequential reduction in hearing requests. However, the independent
third-party reviewer could also generally defer to DHSSs assessments and not reverse or change DHSSs conclusions on
termination/reduction. In other words, the third-party review process and its effect on OAHs caseload is difficult to project
with any degree of accuracy.
At the same time, it is anticipated that allowing legally responsible parties to be Personal Care Services providers would
result in a slight increase in hearing requests. It has been OAH's experience that when a Personal Care Services provider is
closely tied to the recipient (such as non-spouse significant other, relative, or close friend), there is vigorous advocacy for
continued or increased services. Furthermore, it is unclear what the effect of the reassessment/retroactivity provision
would be and whether this would also result in additional hearing requests.
For these reasons, it is difficult to determine the effect of the proposed legislation would have on OAH's caseload. Thus,
the department has submitted a fiscal note showing the fiscal impact OAH could conceivably see in FY2024 and FY2025.
Increase in caseloads most likely would not occur until the latter part of FY2023 and any increase in FY2023 should be
capable of being absorbed by current staffing.
One part-time Administrative Law Judge 1 (range 24, Anchorage) is required for increase in litigation activity that could
result from this legislation. The need for this position is not anticipated after FY2025 as litigation will likely slow after the
initial increase, and should be able to be absorbed by existing OAH personnel.
(Revised 11/23/2021 OMB/LFD) Page 2 of 2
HB292-DOA-OAH-02-24-22 Page 2 of 2 Control Code: YxHvw


Statutes affected:
HB0292A, AM HB 292, introduced 01/27/2022: 47.07.045
HB0292B, AM CSHB 292(HSS), introduced 04/20/2022: 47.07.045, U.S.C