Senate Finance advances bill to create 'complex care residential homes' after departmental briefing

The Senate Finance Committee advanced House Bill 73 on March 19 after hearing departmental testimony that the measure would establish a new licensure category for community-based residential care for Alaskans with complex medical, behavioral and mental health needs.

Tracy Dompling, acting commissioner of the Department of Family and Community Services, told the committee the bills (HB 73 and companion SB 76) “establish the statutory framework ... necessary for the Department of Health to license and regulate this new type of residential setting.” She said the change would allow people with complex care needs "to receive services in environments that are specifically designed to meet those needs." The departments said stakeholders have designed pilot models and that the lack of a specific licensure type has been a primary barrier to expanding such placements.

Dr. Robert Lawrence, chief medical officer for the Department of Health, described the proposed license as a residential, home-like setting with the capacity to deliver 24-hour multidisciplinary care for people whose needs exceed typical assisted living but do not require hospital-level services. He cited examples including children treated out of state who cannot easily transition back into community settings, adults with severe persistent mental illness, and seniors with dementia and behavioral challenges.

Emily Ritchie, deputy commissioner with the Department of Health, summarized differences between HB 73 and its companion SB 76: both bills create the complex care residential-home license; HB 73 removes a 15‑bed limitation that appears in SB 76 and drops conditional language in a section that had constrained piloting, which the department said will allow programs to stand up demonstration projects more quickly.

Senators asked about public safety and the difference from assisted living. Dr. Lawrence and Commissioner Dompling said the new homes would be staffed to provide 24‑hour awake care, in some cases one-to-one supervision, and interventions intended to keep residents safe and reduce reliance on acute or institutional settings.

On fiscal impacts, the committee heard several fiscal notes summarized by Senator Kiel. The Behavioral Health Administration fiscal note is listed for FY 2027 in the text of the note as “01/2006,” split between federal receipts and a general fund match and covering one permanent full‑time position; Health Facilities Licensing and Certification listed year‑one costs as $210,800 and an out‑year figure written as “217.8”; Medicaid Services noted regulatory changes with no estimated net new cost; and the Department of Family and Community Services listed indeterminate costs and fund sources. The fiscal notes also noted an expectation the new designation could lead to roughly 15 licensed facilities under certain assumptions.

Senator Stedman moved that the committee report HB 73 (committee substitute, version I) from Finance with individual recommendations and the attached fiscal note; there was no objection and the bill was sent to the next committee of referral.

The committee adjourned; HB 73 will now proceed to the subsequent referral(s) named in Senate procedures for further consideration.