Legislature(2009 - 2010)HOUSE FINANCE 519
04/14/2010 08:30 AM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB230 | |
| SB144 | |
| SB269 | |
| SB235 | |
| HB317 | |
| HB69 | |
| SB305 | |
| HB69 | |
| HB421 | |
| SB219 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 230 | TELECONFERENCED | |
| + | SB 144 | TELECONFERENCED | |
| + | SB 219 | TELECONFERENCED | |
| + | SB 235 | TELECONFERENCED | |
| + | SB 269 | TELECONFERENCED | |
| + | SB 305 | TELECONFERENCED | |
| + | HB 69 | TELECONFERENCED | |
| += | HB 317 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 421 | TELECONFERENCED | |
CS FOR SENATE BILL NO. 219(FIN)
"An Act establishing a traumatic or acquired brain
injury program and registry within the Department of
Health and Social Services; and relating to medical
assistance coverage for traumatic or acquired brain
injury services."
4:20:30 PM
SENATOR LESIL MCGUIRE, SPONSOR, spoke to the subject of
traumatic brain injury (TBI). She reported that Alaska has
the highest incidence of TBI in the nation. There are a
variety of causes, including accidents, snow machine
crashes, and domestic violence; in addition, many senior
citizens have brain injuries as a result of stroke,
aneurism, and tumors. She highlighted that the numbers
increase as veterans return from service in Iraq. She
reminded the committee of a past presentation where
soldiers with TBI had testified. She noted that Alaska
Natives in particular have been affected by TBI.
Senator McGuire informed the committee that SB 219 would
establish a new brain injury program within the Department
of Health and Social Services (DHSS) as well as a registry
for TBI. Alaska has not had such a program in its history.
She added that Alaska leads the nation in TBI, especially
in the categories of veterans, the elderly, and Alaska
Natives.
Senator McGuire pointed out that the fiscal note was fairly
minimal. She felt the program was sustainable. The goal is
to have a place for citizens to go to access resource and
information about TBI. The Alaska Brain Injury Network,
Inc. (ABIN) was founded by people who were affected by TBI.
She hoped the new program in DHSS would allow access to
federal Medicaid dollars in the form of matching money. She
referred to an earlier plan to create a waiver; she had
come up with a solution with less fiscal impact in response
to concerns. She noted that the program coordinator would
access other Medicaid funds already in existence and
harness them for families who cannot afford treatment for
TBI; federal funds matched 50/50 with state funds.
4:25:49 PM
Senator McGuire hoped that Alaska could become part a
larger information and resource network. She hoped that the
DHSS coordinator for the program would network with other
groups, including the Department of Military and Veterans
Affairs (DMVA), the Native corporations, and the survivor
network. She concluded that TBI is a permanent, life-
altering injury; there is no way to re-generate brain
cells. However, with early intervention and treatment,
people can live productive lives.
Co-Chair Stoltze asked whether the bill was endorsed by
veterans.
ESTHER CHA, STAFF, SENATOR LESIL MCGUIRE, replied that the
sponsor had been in contact with veterans who suffer from
TBI; the ATBI has been working with DMVA and hoped to
increase cooperation.
Vice-Chair Thomas asked whether Fetal Alcohol Spectrum
Disorder (FASD) and Alzheimer's disease were covered under
the bill. Ms. Cha replied that FASD and Alzheimer's and
other degenerative diseases are not covered under the
program because they are covered under other Medicaid
waiver services.
Vice-Chair Thomas queried a letter by the Department of
Corrections stating that 42 percent of the population has a
diagnosable mental health disorder. Ms. Cha thought the
statistic was correct. Vice-Chair Thomas was concerned
about co-mingling in the prisons.
4:30:31 PM
Co-Chair Stoltze opened public testimony.
STEVE WILLIAMS, PROGRAM OFFICER, ALASKA MENTAL HEALTH TRUST
AUTHORITY (via teleconference), testified on behalf of Jeff
Jesse in support of the legislation. He reported that the
Alaska Mental Health Trust Authority (AMHTA) in partnership
with DHSS, ABIN, and other community stakeholders and
providers have worked for several years towards the
improvement of service for Alaskans with traumatic or
acquired brain injuries. Unfortunately, a significant
number of Alaskans suffer from TBI; DHSS reports that there
are 800 cases per year that result in either death or
hospitalization. It is estimated that 3,000 Alaskans visit
a hospital emergency room each year with a mild TBI and
over 10,000 Alaska are estimated to be living with a
disability resulting from a TBI.
Mr. Williams stated that AMHTA supports SB 219 and sees it
as an integral step for Alaska towards the development of
an integrated system of care for Alaskans with traumatic or
acquired brain injuries, including partnering with tribal
organizations, DMVA, and community and non-profit partners
who are providing services and support to these
individuals. The trust does not think that it is efficient
for different entities develop their own systems of care
for folks with TBI; SB 219 is an integral step towards
pulling the groups together to increase efficiency.
Mr. Williams noted that the 42 percent statistic mentioned
by Representative Thomas regarding the number of prison
inmates with mental health disorders came out of a study
done in December 2007. He offered to send the results of
the study.
4:34:30 PM
JILL HODGES, EXECUTIVE DIRECTOR, ALASKA BRAIN INJURY
NETWORK (via teleconference), spoke in support of the bill.
She explained that ABIN has traveled to many communities
and heard from thousands of Alaskans who have experienced
brain injury. She relayed that every brain injury is
unique, but the needs and concerns have been consistent
across the state. There is not an official home in Alaska
state government to address the concerns; there is also no
rehabilitation program.
Ms. Hodges noted that there are both long-term goals and
short-terms components of the legislation. She highlighted
the case management aspect of the bill, which she believed
to be a good starting point for state government; it
utilizes a significant number of federal receipts and
provides a service that can be accessible to both rural and
urban Alaskans. The services would be put in the hands of
community providers.
Ms. Hodges continued that the military has brought
attention to brain injury and also the development of case
management. Studies have shown that the approach reduces
emergency room visits and deters more costly care. Most
importantly, the approach increases readiness for
employment and vocational rehabilitation efforts. The
network has consistently heard that people with TBI want to
return to work, military personnel want to return to duty,
and Alaska Natives want to participate in subsistence
activities again. Case management can help build the
ability to do these things.
Ms. Hodges referred to research showing the amazing
abilities and the elasticity of the brain. She informed the
committee that ABIN strongly supports SB 219.
DR. CHRISTIE ARTUSO, DIRECTOR, NEUROSCIENCE SERVICES,
PROVIDENCE ALASKA MEDICAL CENTER, ANCHORAGE (via
teleconference), testified in support of SB 219. She told
the committee that Alaska has outstanding acute care
services but there is a shortage of the services needed.
She noted that Alaskan youth, athletes, and military
personnel are affected. She relayed the story of a 41-year-
old man who suffered TBI who was re-hospitalized 27 times
in 18 months; there were no appropriate services for him.
Dr. Artuso reported that the Providence Alaska Medical
Center neuroscience services department wants to partner
with the state, the AMHTA, and ABIN to develop the needed
services. She urged the committee to support the
legislation.
4:41:30 PM
KRISTIN ENGLISH, CHIEF OPERATING OFFICE, COOK INLET TRIBAL
COUNCIL (via teleconference), spoke in support of SB 219.
She explained that the tribal council provides social
services for many in the Anchorage area, but also provide
services to primarily Alaska Natives throughout the state.
She pointed to a correlation between substance abuse and
TBI; 46 percent of clients in the residential and de-tox
center have self-reported TBI and 36 percent have reported
TBI in outpatient services. She pointed out that the
numbers are probably low.
Ms. English noted that TBI has been linked to mood, stress,
and behavior disorders, which are in turn linked to
substance abuse. The tribal council believes the bill will
provide support to the substance abuse community.
MARTHA MOORE, CHAIR, ALASKA BRAIN INJURY NETWORK, testified
in support of the legislation.
Co-Chair Stoltze closed public testimony.
Representative Fairclough queried the two positions in the
fiscal note.
ANGELA SALERNO, DIVISION OF SENIOR & DISABILITY SERVICES,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES, replied that the
department did not request the positions because they
believed existing staff could do the work.
Representative Fairclough MOVED to report CSSB 219(FIN) out
of Committee with individual recommendations and the
accompanying fiscal notes. There being NO OBJECTION, it was
so ordered.
CSSB 219(FIN) was REPORTED out of Committee with a "do
pass" recommendation and with attached previously published
fiscal notes: FN1 (DHS), FN2 (DHS).
4:47:24 PM RECESSED