The Alaska Legislature began the second of a two-year session on January 18, 2022, hitting the ground running since members were already seated in their committees and leadership positions (unlike the 2021 delay in getting organized into majority and minority caucuses). Bills introduced last session are still potentially in play, in addition to this year’s crop of bills, both pre-filed before session and introduced since the start.
AARP Alaska advocacy staff and volunteers have spent the interim since last session watching and participating in the special sessions on long-term fiscal plans and their various components. Our position on the fiscal crisis remains focused on new revenues over continued cuts to government services, driven by our 2021 member survey. While we continue to encourage legislators to think broadly about potential revenue solutions, long-term fiscal planning is taking a back burner this session, partly because it’s an election year, and partly because the rebound of oil prices and the investment market has reduced the perceived urgency of the issue.
However, AARP Alaska’s 2022 legislative priorities support the same goal as our fiscal plan position, concentrating on making sure that our state and communities are places where Alaskans can choose how they live as they age. Empowering Alaskans 50+ to make choices about where and how they age means ensuring access to reliable and affordable healthcare, the cornerstone of our 2022 legislative plan.
This year, we have collaborated with tribal and behavioral health partners, patient advocacy groups, and healthcare provider groups to make Medicaid coverage of expanded telehealth a priority for passage in this session. We are also working in partnership with senior services providers and advocates to make coordinated asks of the legislature, including waiver services, grant funding, and increased support for dementia-related care. Our focus on working with partners ensures that our state’s aging resource and service providers present a united front in support of the growing number of older Alaskans.
During the week of Feb. 14, our 2022 Legislative Action Team – including volunteers from Fairbanks to Ketchikan – advocated for these priorities, sharing their own stories and how older Alaskans would benefit from the success of these measures.
Permanent Expansion of Medicaid Coverage for Telehealth Flexibilities – HB265 and SB175
Prior to 2020, many insurers, including the Alaska Medicaid program, limited telehealth access by setting restrictions on provider type, service type, and delivery methods. To ensure that beneficiaries could receive medical care during the COVID-19 pandemic, federal and state governments temporarily lifted many of these coverage standards. These flexibilities bolstered telehealth access, which Alaskans have embraced.
Telehealth benefits older adults by reducing or eliminating distance and transportation barriers, including cost, travel and wait times, and more. Access to telehealth can also improve independence and autonomy. Telehealth benefits can be particularly significant for older adults in rural areas or underserved communities or those with physical limitations or disabilities. These groups face added barriers to care and may have to travel further or incur additional costs when visiting providers and specialists.
Telehealth can also support family caregivers’ efforts to take care of their loved ones. Access to telehealth may offer working or long-distance family caregivers an alternative way to participate in their loved one’s medical care. By reducing travel, wait times, and costs associated with in-person care, telehealth can also allow caregivers more time to tend to their own needs, which can alleviate some of the stress linked to balancing caregiving responsibilities with other obligations.
AARP supports telehealth that expands access and improves quality of care for patients; improves the ability to live at home or in community; and/or enhances the skill level, health, and wellbeing of family caregivers.
Home & Community Based Medicaid Waiver Services
Medicaid is the publicly funded health insurance program for low-income individuals, paid for through a combination of federal and state money. It is the primary public payer for long-term services and supports, including nursing home care and “home and community-based services” (HCBS) waivers for daily living services. Waivers also support Alaska’s over 80,000 unpaid family caregivers in keeping friends and family members at home instead of costly long-term care facilities. To qualify for HCBS waivers, older Alaskans must meet qualifications for financial need and receive a needs assessment determination that they need help with activities of daily living. These activities include eating, bathing, dressing, and walking, as well as more instrumental activities like shopping, medication management, bill paying and light housework.
Existing home care services and community programs support older Alaskans in remaining at home and living independently. They also save the state significant funds by reducing the demand for nursing home care.
However, there are ways to continue to expand and improve HCBS waiver services, which AARP strongly supports. With the fastest growing senior population in the country, expansion of these programs is increasingly critical.
AARP supports continued expansion and improvement of HCBS waiver services by:
o Adjusting reimbursement rates for inflation
o Addressing the service needs of Alaskans with Alzheimer’s & Related Dementias
o Implementing a participant-directed care model
o Increasing access to Care Coordination
Increase Senior & Disability Services grant funding
For those who don’t qualify for waiver services but still need help, the Division of Senior and Disabilities Services (SDS) makes grants to nonprofit organizations who provide supportive services such as meals on wheels, congregate meals, transportation, light housekeeping, chore services, health promotion, adult day programs, and education and respite for family caregivers. Older Alaskans who are ineligible for Medicaid HCBS and/or unable to afford private services receive in-home care and community support through state SDS grants.
Funding for senior grant services has remained essentially flat for the past ten years, neither keeping up with inflation nor accounting for the 50% increase in Alaska’s senior population during the last decade. To serve Alaska’s seniors, an increase in senior grant funding is crucial.
AARP is asking for a 6.5% increase in Senior Community Grant funding and regular future cost of living increases.
Alzheimer’s and Related Dementias as a public health issue
While many may be under the impression that Alzheimer’s Disease and Related Dementia (ADRD) is a natural effect of aging, ADRD is a chronic disease. Although advanced age is the biggest risk factor for developing Alzheimer’s and other dementias, there are many modifiable risk factors that can be influenced through public health interventions related to nutrition, physical activity, brain injury prevention, alcohol use, and socialization.
Recognizing these potential preventive measures, the 2018 federal Building Our Largest Dementia Infrastructure Act (P.L. 115-406) established a public health infrastructure to address dementia and has funded six states public health programs so far. Passing HB308 will position the State of Alaska DHSS Division of Public Health to apply for and receive Act funding to implement a public health approach to ADRD.
Increased public awareness and healthcare provider training can lead to risk reduction, delayed onset, and earlier diagnosis - all of which lead to better patient outcomes and reduced healthcare costs. Currently, Alaska pays millions of dollars for acute levels of care without addressing prevention and risk reduction.
AARP Alaska supports HB308 to address Alzheimer’s and Related Dementias with a public health approach that increases early detection and diagnosis, reducing risk, preventing hospitalization and supporting dementia caregivers.
Marge Stoneking is the Associate State Director of Advocacy for AARP Alaska.
