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State legislators Tuesday looked into the state's response to a moratorium imposed by Medicare and Medicaid officials last summer after the state's home health program failed to meet federal guidelines.

The moratorium shocked both officials with the state Division of Senior and Disability Services and those who needed the home health programs, said Rebecca Hilgendorf, division director.

"We don't want to ever have a moratorium ever again," she said.

Members of the Senate Health and Social Services Committee, meeting in Anchorage, praised the division for its response to the moratorium, but questioned why it was imposed in the first place.

Hilgendorf said the agency began doing assessments in-house of Alaskans eligible for Medicaid-provided home health services, which has previously been contracted out.

Use of Medicaid money for such services in the home instead of a nursing home requires a waiver from the federal Centers for Medicaid and Medicare Services, but Alaska failed to meet the conditions of the waivers. Among those conditions was regular reassessments to see if recipients were getting too much or too little service, the feds said.

Among the programs swept up in the moratorium were personal care assistance, as well as several waiver programs for seniors, those with disabilities, or children with complex medical conditions.

Hilgendorf said the state got behind in the assessments and found that doing a thorough assessment was more expensive and time consuming to do than had been expected.

"It's important for us to not rush through those assessments," she said.

At the same time, they had to be done in person, sometimes in tiny villages far from the road system.

Hilgendorf said they'd budgeted $100,000 for travel, which proved inadequate.

This year, she said, the cost is "well over $300,000 to send these assessors to people's homes across the state."

The personal care assistance moratorium was lifted in early August. The rest of the moratorium was lifted in late August. Federal officials said they were convinced the state was making adequate progress in working through the backlog.

Hilgendorf said the state 38 temporary assessors have been brought in to work through the backlog, and they've completed 627 as of Monday with 298 remaining.

"It's been a rough few months," she said.

Members of the committee, chaired by Sen. Bettye Davis, D-Anchorage, praised the state's response, with Sen. Fred Dyson, R-Eagle River, leading a round of applause.

The committee also heard testimony from the public about the importance of the various home care programs, and what had gone wrong.

Brian Richardson, CEO of Immediate Care, Inc., a personal care assistance and respite care company, said the state's system lacked accountability. Richardson recalled before the moratorium, Medicaid investigators had asked him when his last state inspection was - "Never."

"Though (the Division of Senior and Disability Services) does a good job of interacting with us, they don't seem to be closing the loop," he said.

Jim Beck, executive director of Access Alaska, a non-profit independent living center, complimented the response to the moratorium, but said rural residents were not getting their personal care assistance services in a timely manner.

"Especially in rural Alaska, most elders have given up on the PCA, he said.

Providing assistance at home instead of in a nursing home can both save money for the state and improve the lives of residents, but sometimes they can't get the care," Beck said.

"They want to live their life out next to the river where they were born, and they're forced to die in a nursing home in Anchorage," he said.

• Contact reporter Pat Forgey at 523-2250 or patrick.forgey@juneauempire.com.