Legislature(2019 - 2020)ADAMS ROOM 519

04/12/2019 01:30 PM FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 25 EXTEND BOARD OF DENTAL EXAMINERS TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 22 EXTEND SUICIDE PREVENTION COUNCIL TELECONFERENCED
Heard & Held
-- Public Testimony --
HOUSE BILL NO. 22                                                                                                             
                                                                                                                                
     "An Act extending the termination date of the                                                                              
     Statewide Suicide Prevention Council; and providing                                                                        
     for an effective date."                                                                                                    
                                                                                                                                
1:49:38 PM                                                                                                                    
                                                                                                                                
Co-Chair  Wilson  thanked  Representative Tarr  for  quickly                                                                    
running through the bill earlier in the week.                                                                                   
                                                                                                                                
REPRESENTATIVE GERAN  TARR, BILL SPONSOR, reviewed  the bill                                                                    
which  reauthorized the  suicide prevention  council through                                                                    
2027, an 8-year extension.  The extension came following the                                                                    
successful audit  recommending the extension.  She indicated                                                                    
the committee would hear from  the auditor about a couple of                                                                    
recommendations later  in the meeting. She  had talked about                                                                    
her experience  serving on the  board previously.  She spoke                                                                    
of  a  couple of  key  reasons  why  the membership  was  so                                                                    
important.  She had  mentioned in  a previous  meeting about                                                                    
the diverse  membership and  the statutory  requirement that                                                                    
there  be a  Veteran  or military  representative, a  person                                                                    
from the  Alaska Federation of  Natives (AFN), and  a person                                                                    
from a  faith-based organization  in addition to  other more                                                                    
expected membership representing agencies and legislators.                                                                      
                                                                                                                                
Representative Tarr discussed the  importance of the Veteran                                                                    
and military  connection. Alaska  had the highest  number of                                                                    
Veterans per capita in the  country, and suicide was a major                                                                    
problem with  Veterans. She referenced in  members' packets,                                                                    
"Suicide Facts and  Figures" (copy on file).  She pointed to                                                                    
the Alaskan Veteran suicide rate  which was much higher than                                                                    
the Western  Region and the  national Veteran  suicide rate.                                                                    
She reiterated the importance  of having representation from                                                                    
military and  Veteran affiliation.  She reported  other data                                                                    
that suggested someone who served  in the military was twice                                                                    
as likely to commit suicide.                                                                                                    
                                                                                                                                
Representative Tarr  talked about  the importance  of having                                                                    
representation  from AFN.  A member  from AFN  had knowledge                                                                    
and  connections  to  tribal organizations  and  the  Alaska                                                                    
Native community.  Suicide was an issue  that affected rural                                                                    
communities  harder than  anywhere  else in  the state.  She                                                                    
reported that  the group of  individuals who were  dying the                                                                    
most from suicide were Alaska  Native males between the ages                                                                    
of 19  to 25. The council  had partnered with AFN  at all of                                                                    
the  recent  meetings   to  provide  information,  training,                                                                    
prevention work, and  healing. She spoke of a  suicide at an                                                                    
AFN conference a few years  prior. The incident made it even                                                                    
more  clear the  importance  of continuing  to  work on  the                                                                    
issue and how impactful it was to communities and families.                                                                     
                                                                                                                                
Representative  Tarr  stressed   the  importance  of  having                                                                    
someone  with   a  faith-based  background  on   the  board.                                                                    
Churches and schools, especially  in small communities, were                                                                    
some  of  the  more  stable organizations.  They  were  good                                                                    
organizations to  partner with.  Also, an important  part of                                                                    
healing from trauma or abuse  was a person's faith. Over the                                                                    
years  the council  had  worked with  members  in the  faith                                                                    
community  to offer  training for  people who  were leaders.                                                                    
Often times  people went to  their faith leaders  for advise                                                                    
when  they were  experiencing  a challenging  time in  their                                                                    
life.                                                                                                                           
                                                                                                                                
1:53:57 PM                                                                                                                    
                                                                                                                                
Representative  Tarr  suggested  that  the  state's  suicide                                                                    
rates were  rising. She referred  to the suicide  fact sheet                                                                    
again.  She   thought  another  piece  of   data  which  was                                                                    
important to consider in relation  to the number of suicides                                                                    
which was the  number of calls to the Care  Line. The number                                                                    
of calls had jumped substantially.  In 2012 there were 6,956                                                                    
contacts  for the  entire year.  In 2018  there were  20,976                                                                    
calls.  Even though  the suicide  rates  had increased,  the                                                                    
call line  numbers were  very large.  She thought  both data                                                                    
points should  be taken  into consideration  together. There                                                                    
was no  way of knowing  whether the outcome could  have been                                                                    
different  if  those individuals  had  not  called the  Care                                                                    
Line. The  calls to the  careline cemented the idea  that it                                                                    
was essential to provide resources for people in crisis.                                                                        
                                                                                                                                
Representative  Tarr spoke  about  the recommendations  from                                                                    
the audit. She wanted to  talk about an additional piece she                                                                    
hoped  members  would  consider.  The  council  produced  an                                                                    
annual  report  - the  third  report  was recently  released                                                                    
recasting the net. She highlighted  a checklist found at the                                                                    
end of the report of  things that individuals, families, and                                                                    
communities   could  do.   The  council   always  tried   to                                                                    
incorporate things that  it learned into its  work. The list                                                                    
reflected some  of the  data the  council knew  was working.                                                                    
She  suggested  to  legislators to  provide  information  in                                                                    
their newsletters and talk about  the council's resources at                                                                    
constituent meetings.  She thought  having a  diverse group,                                                                    
coordinating  and  designing  a  plan and  sharing  it  with                                                                    
communities, organizations,  and churches  would be  how the                                                                    
state would achieve the desired change.                                                                                         
                                                                                                                                
Representative Tarr  relayed that  the fiscal note  would be                                                                    
addressed in the  committee and the funding  was included in                                                                    
the base  for the Department  of Health and  Social Services                                                                    
(DHSS). She  noted funding for  the related grant  which was                                                                    
incorporated into the  work of the council 5  years ago. She                                                                    
reported that  the grants went  through the council  and out                                                                    
through the  Department of  Education and  Early Development                                                                    
(DEED)  to schools  for primary  prevention (very  promising                                                                    
early  intervention type  of work  with  young people).  The                                                                    
money was in the budget,  however, the legislature needed to                                                                    
pass the bill extending the council.                                                                                            
                                                                                                                                
1:57:42 PM                                                                                                                    
                                                                                                                                
Representative  Carpenter was  looking at  the findings  and                                                                    
recommendations  of  the audit  and  the  prior 2012  sunset                                                                    
audit  recommendations. He  asked  about the  recommendation                                                                    
for  the   council  to  develop  performance   measures.  He                                                                    
wondered  how the  council was  measuring  success with  the                                                                    
program.  He saw  a  chart  that showed  2007  to 2016  with                                                                    
categories of Alaska Native,  Alaska Non-Native, Alaska, and                                                                    
U.S.  and with  a rate  per 100,000.  Co-Chair Wilson  asked                                                                    
Representative  Carpenter  to  identify   the  page  he  was                                                                    
looking at.                                                                                                                     
                                                                                                                                
Representative Carpenter was looking at  page 7 of the audit                                                                    
report, Exhibit 3. He knew  it was difficult to quantify how                                                                    
many  people did  not commit  suicide but  wondered how  the                                                                    
council was measuring the effectiveness of the program.                                                                         
                                                                                                                                
Representative Tarr  indicated it  was difficult  to measure                                                                    
success. It was  unknown who might have  been thinking about                                                                    
committing suicide.  She brought up  the number of  calls to                                                                    
the Care Line  as a way of measuring success.  The Care Line                                                                    
reported  quarterly   to  the  suicide   prevention  council                                                                    
meetings. She  encouraged people  to contact the  council to                                                                    
find out more  about the work performed by  the council. She                                                                    
could  not   provide  an  answer  to   the  representative's                                                                    
question. However,  the council  looked to the  numbers from                                                                    
the Care Line as an indication  that the demand and need was                                                                    
growing  for individuals  looking  for  services to  address                                                                    
when  they were  feeling in  a crisis  situation. She  added                                                                    
that when looking at the grants,  some of them did work that                                                                    
involved a  training program.  She used  iTalk Assist  as an                                                                    
example  of  a  program  used in  high  schools  and  taught                                                                    
students  to speak  up  if they  saw  something. It  allowed                                                                    
students to be  a part of a support network  for people. She                                                                    
thought  looking at  metrics  geared  towards how  providing                                                                    
services  and  training  could be  achieved  would  be  more                                                                    
quantifiable. She  did not  think it  was possible  to track                                                                    
the number of deaths that were prevented.                                                                                       
                                                                                                                                
Representative  Carpenter relayed  that  there  were 39  per                                                                    
100,000 in 2007, and in 2016  the number was 42 per 100,000.                                                                    
Over the time  span the numbers had not  changed much. There                                                                    
was  a  marginal  increase.  The  state  was  spending  over                                                                    
$500,000 per year without apparent  results. He wondered how                                                                    
to know the council's effectiveness.                                                                                            
                                                                                                                                
2:02:42 PM                                                                                                                    
                                                                                                                                
Representative Tarr  responded that most people  thought the                                                                    
number would be  much higher without the  program. She noted                                                                    
the village  of Hooper  Bay and the  contagion of  suicide a                                                                    
few years back.  She noted that when looking  at the smaller                                                                    
segment of  population sometimes an  event, such as  the one                                                                    
in Hooper Bay, influenced the date significantly.                                                                               
                                                                                                                                
Representative Carpenter  asked what the  suicide prevention                                                                    
council did in the instance of the deaths in Hooper Bay.                                                                        
                                                                                                                                
Representative  Tarr  responded  that after  the  event  the                                                                    
council  got  people  from   the  community  connected  with                                                                    
resources for  the postvention.  The council  sent resources                                                                    
to the community and tried  to provide the support necessary                                                                    
for a small community to  respond to such tragic events that                                                                    
happened  in close  succession. She  noted that  the council                                                                    
wanted to do  more of the postvention training.  In terms of                                                                    
the training, none  of it was happening  previously. More of                                                                    
the training  had been offered  in the past 5  years because                                                                    
money was more  available currently. It was  reported to the                                                                    
council that  the training had  been critical to  the crisis                                                                    
response after the incidents.                                                                                                   
                                                                                                                                
2:05:46 PM                                                                                                                    
                                                                                                                                
Representative  Sullivan-Leonard asked  for examples  of the                                                                    
work done through  the council regarding the  grants and how                                                                    
the grants were dispersed. She  also about what was actually                                                                    
happening out in the communities.                                                                                               
                                                                                                                                
Representative  Tarr replied  that earlier  the council  had                                                                    
been  working on  setting up  framework.  The framework  had                                                                    
been a  coalition model.  There was  a Juneau  Coalition and                                                                    
two coalitions  in Anchorage. There  were others  around the                                                                    
state as  well. Some had  been more successful  than others.                                                                    
One of the things the council  noticed was that in the urban                                                                    
centers, in  churches and  schools, it  had been  easier for                                                                    
the sustainability and longevity  of the coalitions. In some                                                                    
of Alaska's  smaller communities it had  been more difficult                                                                    
to sustain the coalitions over  time. The council was trying                                                                    
to build  and strengthen the coalitions  in the communities.                                                                    
The  coalitions often  included people  from the  council or                                                                    
people who were working closely  with JAMI in Juneau or NAMI                                                                    
in  Anchorage.   For  example,  Juneau   Suicide  Prevention                                                                    
Coalition  conducted training  events  and held  conferences                                                                    
getting  out into  communities. NAMI  focused on  supporting                                                                    
families.                                                                                                                       
                                                                                                                                
Representative  Tarr continued  that the  grants awarded  to                                                                    
schools were geared towards  primary prevention programs and                                                                    
teaching. Much  of the  work recently  was focused  on being                                                                    
trauma-informed.  They  recently   completed  some  training                                                                    
models that  could be used  for education  professionals and                                                                    
was  accessible online  by dedication  a  certain number  of                                                                    
slots for  the public.  The funds were  used to  produce the                                                                    
training  which  had longevity  because  it  was done  in  a                                                                    
webinar format. She was hoping  that individuals that worked                                                                    
with  children, such  as  individuals  working at  childcare                                                                    
centers, could  potentially go online  to use  the resource.                                                                    
She  noted   there  was  prevention  and   postvention  work                                                                    
occurring in communities as well.                                                                                               
                                                                                                                                
2:09:54 PM                                                                                                                    
                                                                                                                                
Co-Chair Wilson invited Ms. Fishel to comment.                                                                                  
                                                                                                                                
SHARON  FISHEL,  EDUCATION   SPECIALIST  II,  DEPARTMENT  OF                                                                    
EDUCATION  (via teleconference),  responded  that the  grant                                                                    
program  saved lives  including  the lives  of children  and                                                                    
teachers. There  was a tremendous effort  in training staff.                                                                    
She reported  that in 2012 there  was a law passed,  SB 137,                                                                    
that required  all educators  to receive  suicide prevention                                                                    
training.  Since then,  through the  department's e-Learning                                                                    
system there  had been  over 18,000  of DEED's  23,000 users                                                                    
that have taken 1 of  4 suicide prevention courses developed                                                                    
by  the   department  in  collaboration  with   the  suicide                                                                    
prevention  council.  The   depart  also  developed  several                                                                    
trauma courses.                                                                                                                 
                                                                                                                                
Ms.  Fishel  continued  that  over  the  5  years  that  the                                                                    
department had  the grants,  there had  been 20  grants that                                                                    
had  gone  out  to   different  school  districts  and  some                                                                    
particular schools. School districts  were moving to a peer-                                                                    
to-peer model  training students  how to recognize  signs of                                                                    
suicide.  They  were  teaching  students  how  to  encourage                                                                    
individuals by  letting them know  they were not  alone. She                                                                    
mentioned several  school districts that were  utilizing the                                                                    
funds. She  spoke highly of  the program. She  provided some                                                                    
examples  of  school  districts and  how  they  were  making                                                                    
efforts to  educate students  about suicide  prevention. She                                                                    
noted that a federal grant  manager commented that the small                                                                    
grant  for  suicide  prevention  saved  lives  and  had  the                                                                    
largest  impact  of  all  of  the  millions  of  dollars  he                                                                    
managed. Every  3 years  districts were  asked to  apply for                                                                    
the grants. They were all  required to use an evidence-based                                                                    
practice. She  reported that over 137,000  Alaskans had been                                                                    
touched  or were  part of  the program  in the  previous two                                                                    
grant cycles.                                                                                                                   
                                                                                                                                
2:14:37 PM                                                                                                                    
                                                                                                                                
Co-Chair   Wilson  asked   for  information   regarding  the                                                                    
allocation of grants.                                                                                                           
                                                                                                                                
Representative Carpenter  asked if  the department  kept any                                                                    
non-attributable statistics  on suicide  ideation, attempted                                                                    
suicide,  or successful  interventions. He  was looking  for                                                                    
verification that the program was saving lives.                                                                                 
                                                                                                                                
Ms. Fishel reported the information  would point to specific                                                                    
individuals   and  would   break  privacy   provisions.  She                                                                    
mentioned the youth risk behavior  survey done every 2 years                                                                    
included  questions  about   depression,  whether  a  person                                                                    
considered suicide, and whether  a person attempted suicide.                                                                    
The last statistics  the department had were  from 2017. The                                                                    
information was  currently being  administered, and  she was                                                                    
unsure  of the  trend line.  The survey  was collected  from                                                                    
students. However,  the data  the representative  was asking                                                                    
for was not collected by DEED.                                                                                                  
                                                                                                                                
Representative   Carpenter  thought,   going  forward,   the                                                                    
department  should  keep   non-attributable  information  in                                                                    
order   facilitate  a   conversation  about   the  program's                                                                    
success. He did  not approve the measure  that was currently                                                                    
in  place.   He  thought  measures  of   effectiveness  were                                                                    
necessary in managing a program.                                                                                                
                                                                                                                                
Co-Chair Wilson asked if there was  a fee attached to any of                                                                    
the courses being offered.                                                                                                      
                                                                                                                                
Ms.  Chambers responded  in the  negative.  All the  courses                                                                    
were free.                                                                                                                      
                                                                                                                                
2:18:48 PM                                                                                                                    
                                                                                                                                
Vice-Chair   Ortiz  asked   about  the   issue  of   suicide                                                                    
prevention  and awareness.  He wondered  if it  was possible                                                                    
that the  state had more documented  suicides because people                                                                    
were paying more  attention to the issue. He  thought it was                                                                    
possible  that  previously  suicides  might  not  have  been                                                                    
documented  prior  to the  new  level  of awareness  in  the                                                                    
state.                                                                                                                          
                                                                                                                                
Co-Chair  Wilson  thought  Vice-Chair Ortiz's  question  was                                                                    
valid.  However, Representative  Tarr  already testified  on                                                                    
the difficulty of measuring success of the program.                                                                             
                                                                                                                                
Representative   Tarr   added   that  DHSS   could   provide                                                                    
additional information. Sometimes suicide  was not listed on                                                                    
a  death certificate  as the  cause of  death. She  provided                                                                    
additional Care  Line numbers. The numbers  reflected a jump                                                                    
at each  measure taken. There  continued to be  an increase.                                                                    
People were finding out about  the service. She believed the                                                                    
care line might have more information.                                                                                          
                                                                                                                                
Representative Tilton  asked for a  list of grantees  of the                                                                    
past history  of the  program. She wondered  if most  of the                                                                    
grantees   were  going   out  to   government  agencies   or                                                                    
faith-based  organizations. Co-Chair  Wilson asked  if a  2-                                                                    
year look back was a large enough timeframe.                                                                                    
                                                                                                                                
2:22:57 PM                                                                                                                    
                                                                                                                                
Representative  Tilton  responded  in the  affirmative.  She                                                                    
mentioned  that  in  the  fiscal note  it  stated  that  the                                                                    
Statewide    Prevention   Council    was   developing    and                                                                    
implementing   a  plan,   the  council's   most  significant                                                                    
statutory  duty. There  was a  new revised  plan that  moved                                                                    
away from an  intervention plan to more of  a prevention and                                                                    
promotion plan. She asked Representative  Tarr to talk about                                                                    
the change.                                                                                                                     
                                                                                                                                
Representative   Tarr  replied   that  it   was  essentially                                                                    
recasting the net. It was  available online, and a checklist                                                                    
was provided. In  her work in public health, she  had seen a                                                                    
shift from a crisis response  model - the costliest point of                                                                    
intervention  - to  an earlier  intervention and  prevention                                                                    
model.   The  grants   were  awarded   to  a   promising  or                                                                    
evidence-based    practice.    People    wanted    to    use                                                                    
evidence-based models  to know for  sure that the  model was                                                                    
effective.  She reported  that evidence-based  models showed                                                                    
that the  earlier intervention and  prevention was  the most                                                                    
effective and  cost-effective model.  She suggested  that in                                                                    
working with young  people it helped them  to develop skills                                                                    
for  themselves  in how  they  experienced  and addressed  a                                                                    
personal crisis as well as  being a resource for others. She                                                                    
mentioned the vulnerable group of  young men, ages 19-25 and                                                                    
the hope of  reaching them and providing tools  to them that                                                                    
would help them to be resilient.                                                                                                
                                                                                                                                
Representative LeBon wondered if  the history of the funding                                                                    
for  the  program  had   been  static.  Representative  Tarr                                                                    
responded that it had been  static. She reported that in the                                                                    
earlier years  there had  been just  one staff  person. Once                                                                    
the grants  were factored  in, the  funding had  been pretty                                                                    
consistent over the  prior 5 years. The  funding covered the                                                                    
cost of  staff, travel, and  the grants. During her  time on                                                                    
the council  she had visited  multiple sites  which provided                                                                    
significant  insight.  There  were travel  funds  and  grant                                                                    
monies. She indicated the fiscal  note estimated the cost of                                                                    
the position, travel, and the  grants. Under Governor Walker                                                                    
there had  been a travel  freeze. For  a couple of  years it                                                                    
appeared  that travel  came  under budget,  but  it was  the                                                                    
freeze that influenced the number.                                                                                              
                                                                                                                                
2:27:33 PM                                                                                                                    
                                                                                                                                
Representative LeBon  pointed to  the graph  on page  7 that                                                                    
confirmed that  Alaska had  a real  problem with  suicide in                                                                    
the state. However, the graph  did not specify the number of                                                                    
suicides  prevented by  the  state's  actions. He  suggested                                                                    
that one  option would be  to zero  out the program  and see                                                                    
how many  suicides occurred, however  he did not  believe it                                                                    
was a good strategy.                                                                                                            
                                                                                                                                
Representative Josephson  thought that  in a  failed attempt                                                                    
there could  be great costs  borne by the public  in degree,                                                                    
far greater  than the fiscal  note. He  asked Representative                                                                    
Tarr if he was correct.                                                                                                         
                                                                                                                                
Representative    Tarr    responded    affirmatively.    She                                                                    
highlighted the handout regarding  suicide facts and figures                                                                    
which spoke to Representative's  question. She read from the                                                                    
handout:                                                                                                                        
                                                                                                                                
     Suicide cost Alaska a total of $226,875,000 combined                                                                       
     lifetime medical and work loss cost in 2010, or an                                                                         
     average of $1,383,382 per suicide death.                                                                                   
                                                                                                                                
Representative Tarr  relayed that the cost  of someone dying                                                                    
at  a young  age was  very  costly. Beyond  the dollar,  she                                                                    
conveyed  losing her  brother  to suicide  and the  personal                                                                    
impact to family and friends.                                                                                                   
                                                                                                                                
2:29:47 PM                                                                                                                    
                                                                                                                                
KRIS  CURTIS,   LEGISLATIVE  AUDITOR,  ALASKA   DIVISION  OF                                                                    
LEGISLATIVE  AUDIT,  read  a portion  of  the  audit  dated,                                                                    
August 3, 2018 (copy on file):                                                                                                  
                                                                                                                                
     The audit  found the council  operated in  the public's                                                                    
     interest by actively  broadening the public's awareness                                                                    
     of suicide  prevention and coordinating the  efforts of                                                                    
     other  suicide  prevention   entities  including  State                                                                    
     agencies,  regional   groups,  coalitions,   and  local                                                                    
     communities.  Additionally, the  council fulfilled  its                                                                    
     statutory  duty   by  issuing  the   2018-2022  Suicide                                                                    
     Prevention Plan  and working closely  with stakeholders                                                                    
     to  add and  refine the  plan's strategies,  resources,                                                                    
     and   indicators.  The   audit   also  concluded   that                                                                    
     administrative  improvements  were   needed  to  ensure                                                                    
     council meetings are adequately  public noticed and the                                                                    
     executive  director  is  consistently evaluated  on  an                                                                    
     annual basis.                                                                                                              
                                                                                                                                
     In accordance  with AS 44.66.010(a)(7), the  council is                                                                    
     scheduled to  terminate on June 30,  2019. We recommend                                                                    
     that the  legislature extend the  council's termination                                                                    
     date to June 30, 2027.                                                                                                     
                                                                                                                                
Ms. Curtis directed  members to turn to page 4  of the audit                                                                    
showing  expenditures and  funding sources.  It showed  that                                                                    
the   council   was   funded  entirely   by   general   fund                                                                    
appropriations  and that  in FY  18 the  council spent  just                                                                    
under $600,000. She  referred to a detailed  list of council                                                                    
activities conducted during the audit  period on pages 9 and                                                                    
10. She reported  there were two minor  recommendations as a                                                                    
result  of  the  audit  beginning  on  page  12.  Both  were                                                                    
administrative in nature and easily addressed:                                                                                  
                                                                                                                                
     The  council's executive  director  should develop  and                                                                    
     implement  procedures  to  ensure  public  notices  for                                                                    
     meetings are published timely and accurately.                                                                              
                                                                                                                                
     From  July  2014  through  March  2018,  5  of  the  18                                                                    
     meetings held  (28 percent) were not  public noticed or                                                                    
     not  public noticed  properly.  Specifically, two  were                                                                    
     not  published on  the  State's  Online Public  Notices                                                                    
     system,  two  were  published  with  incorrect  meeting                                                                    
     dates,  and one  was  published one  day  prior to  the                                                                    
     meeting.  The deficiencies  were  caused by  a lack  of                                                                    
     written procedures to ensure  notices are posted timely                                                                    
     and contain accurate meeting dates.                                                                                        
                                                                                                                                
Ms. Curtis reviewed the second recommendation:                                                                                  
                                                                                                                                
     The council chair should develop and implement                                                                             
     written  procedures to  ensure performance  evaluations                                                                    
     are  completed  annually  for the  council's  executive                                                                    
     director.                                                                                                                  
                                                                                                                                
     Between July 2014 and March  2018, two evaluations were                                                                    
     completed  for  the  executive director;  however,  two                                                                    
     more  should have  been completed.  Specifically, there                                                                    
     were no evaluations for the  period of November 2014 to                                                                    
     November  2015, and  November 2015  to  June 2016.  Per                                                                    
     discussion with council staff  and the previous council                                                                    
     chair,  it  is unclear  why  the  evaluations were  not                                                                    
     completed for the executive director.                                                                                      
                                                                                                                                
Ms. Curtis  restated that the  recommendations were  easy to                                                                    
address. She indicated  the responses to the  audit could be                                                                    
found  on page  23. She  reported that  the commissioner  of                                                                    
DHSS and  the counsel  chair agreed  and concurred  with the                                                                    
report conclusions and recommendations.                                                                                         
                                                                                                                                
Representative Josephson  asked if it  was true that  in all                                                                    
of  the cost  saving measures  the administration  proposed,                                                                    
they wanted the council untouched. Ms. Curtis did not know.                                                                     
                                                                                                                                
Co-Chair Wilson  indicated the  committee would  ask someone                                                                    
from DHSS.                                                                                                                      
                                                                                                                                
2:32:46 PM                                                                                                                    
                                                                                                                                
Co-Chair Johnston  asked about how the  division audited the                                                                    
coordination  between  the  suicide  groups  and  the  state                                                                    
agency. She thought Ms. Curtis had seen improvement.                                                                            
                                                                                                                                
Ms. Curtis clarified Vice-Chair Johnston's question.                                                                            
                                                                                                                                
Vice-Chair Johnston restated her query.                                                                                         
                                                                                                                                
Ms. Curtis explained that as  part of the audit her division                                                                    
sampled,  reviewed,  and  read the  board  meeting  minutes,                                                                    
reviewed  annual   reports,  and  conducted   interviews  of                                                                    
stakeholders and council members  to reach their conclusions                                                                    
about  coordinating.  The  council  served  in  an  advisory                                                                    
position to  the legislature  and the  governor. Legislative                                                                    
Audit looked  at whether the council  had been accomplishing                                                                    
its statutory  mandate, which she thought  they had. Another                                                                    
statutory duty  was to  develop a  statewide plan  which had                                                                    
been done  in a timely  fashion. Legislative Audit  had been                                                                    
looking  at  the  council  since  inception.  Initially  the                                                                    
council had a  rough start. At one point  the division might                                                                    
have recommended termination in  the council's early stages.                                                                    
The   current  audit   and  the   prior   audit  were   very                                                                    
complimentary of  the council in  how it  conducted business                                                                    
and coordinated throughout the state.                                                                                           
                                                                                                                                
Co-Chair  Wilson asked  Vice-Chair  Johnston  to comment  on                                                                    
Representative  Josephson's  question  regarding  the  money                                                                    
that was put back in  the budget that was originally removed                                                                    
in the governor's version of the budget.                                                                                        
                                                                                                                                
Vice-Chair  Johnston  responded  that  she  had  better  not                                                                    
answer the question.                                                                                                            
                                                                                                                                
Representative Josephson commented  that the governor wanted                                                                    
to keep the monies in place.                                                                                                    
                                                                                                                                
Vice-Chair  Johnston commented  that it  was interesting  to                                                                    
listen to  the governor's  report because they  were listing                                                                    
the priorities of the departments. On  a scale of 1 to 5 the                                                                    
item had a 1, the lowest  number on the scale. She commented                                                                    
that it was interesting that the governor wanted it funded.                                                                     
                                                                                                                                
2:36:14 PM                                                                                                                    
                                                                                                                                
Co-Chair Wilson  turned to page  3 of the audit  report. She                                                                    
wondered about item 13 under public member:                                                                                     
                                                                                                                                
     13. one public member.                                                                                                     
                                                                                                                                
     The council is  staff ed by a program  assistant and an                                                                    
     executive  director. The  council's executive  director                                                                    
     also  serves as  the  executive director  for AMHB  and                                                                    
     ABADA. The  co-location is  formalized by  a memorandum                                                                    
     of   agreement   between   the   three   entities   and                                                                    
     facilitates  collaboration  through  shared  resources.                                                                    
     Per  the agreement,  AMHB and  ABADA  pay the  personal                                                                    
     services and  travel costs  for the  executive director                                                                    
     until such  time as  the council  has the  resources to                                                                    
     contribute.                                                                                                                
                                                                                                                                
Co-Chair Wilson asked  if they were looking  for other funds                                                                    
outside of  general funds  at the time  the council  was put                                                                    
together.                                                                                                                       
                                                                                                                                
Ms.  Curtis responded  that in  the prior  sunset audit  the                                                                    
division  had a  recommendation  of a  co-location that  had                                                                    
been  put  together  and working  well.  There  was  nothing                                                                    
documented between  the three entities. The  person was just                                                                    
serving. The  auditor indicated an agreement  was needed. In                                                                    
the  current audit  there  was an  agreement  in place.  She                                                                    
assumed they meant general funds.  Legislative Audit did not                                                                    
look  at what  the  three entities  were  thinking when  the                                                                    
agreement was made.                                                                                                             
                                                                                                                                
Co-Chair Wilson asked if Ms.  Curtis knew whether the mental                                                                    
health board  had ever  participated in  funding any  of the                                                                    
program  since they  were a  benefactor. Ms.  Curtis replied                                                                    
that she  knew that the  suicide council was not  paying the                                                                    
cost of personal services. Per  the agreement, the other two                                                                    
entities paid  the personal services  and travel  costs. She                                                                    
clarified that the  personal services on page 4  was not the                                                                    
executive director,  rather, it  was a  staff person  to the                                                                    
executive director.                                                                                                             
                                                                                                                                
Co-Chair Wilson was  trying to figure out who  else would be                                                                    
contributing  based  on the  way  things  were written.  Ms.                                                                    
Curtis reported that the other  two entities were paying for                                                                    
the executive  director. She thought  they assumed  that the                                                                    
suicide  prevention council  would help  contribute at  some                                                                    
point when monies became available.                                                                                             
                                                                                                                                
Co-Chair  Wilson  indicated  there were  invited  testifiers                                                                    
online.                                                                                                                         
                                                                                                                                
2:39:09 PM                                                                                                                    
                                                                                                                                
BARBARA  FRANKS, CHAIR,  ALASKA SUICIDE  PREVENTION COUNCIL,                                                                    
NINILCHIK (via teleconference), was a  mother of a child who                                                                    
died  by  suicide.  She  provided a  personal  story  as  it                                                                    
related  to the  death  of her  family  member. The  suicide                                                                    
prevention  program helped  her  tremendously  when her  son                                                                    
committed suicide  and her husband  died of cancer.  She had                                                                    
lived in  Juneau for over  30 years. While she  was visiting                                                                    
she had found out about someone  she knew who had jumped off                                                                    
the  Douglas  Bridge.  She  spoke  of  the  coalition  built                                                                    
through  the  council.  The Juneau  Suicide  Prevention  was                                                                    
there  and  would  be  at the  gentleman's  funeral  in  the                                                                    
following week.  She spoke of  the need for young  people to                                                                    
know how  to talk about  suicide. She advocated  not waiting                                                                    
for  a  crisis to  happen  to  call the  suicide  prevention                                                                    
number.  She  spoke of  the  benefits  of  the tool  of  the                                                                    
program. She thanked the committee.                                                                                             
                                                                                                                                
2:43:35 PM                                                                                                                    
                                                                                                                                
JAMES  BIELA, AMERICAN  FOUNDATION  FOR SUICIDE  PREVENTION,                                                                    
BETHEL (via teleconference), reported  that for the previous                                                                    
4  years  the Alaska  chapter  had  drastically improved  on                                                                    
working  with the  Statewide Suicide  Prevention Council  by                                                                    
sharing information  provided by trainings. The  council had                                                                    
also  assisted him  at the  elder and  youth conference  the                                                                    
previous  6 years.  He  had the  pleasure  of doing  chapter                                                                    
presentations  on   suicide  loss,  lived   experience,  and                                                                    
surviving after  a suicide. The  council had  also increased                                                                    
their participation  in the International Suicide  Loss Day,                                                                    
which was  held the Saturday before  Thanksgiving. He talked                                                                    
about the  benefits of  the council and  being able  to have                                                                    
access to suicide prevention. He spoke in support of HB 22.                                                                     
                                                                                                                                
Mr. Biela  was aware  the nation had  reported a  30 percent                                                                    
increase in suicides in the  previous year. Alaska rates had                                                                    
risen by 13  percent. The state did not  have any statistics                                                                    
for the  number of lives  that had  been saved. He  spoke of                                                                    
the Statewide  Suicide Prevention  Council assisting  him in                                                                    
responding to  suicides in  the Southwest  Region. Regarding                                                                    
fiscal  goals, he  worked full-time  as an  itinerant school                                                                    
social  worker.  In 2017  he  had  been trained  in  suicide                                                                    
prevention  and had  trained roughly  1,395 students.  There                                                                    
had been  222 requests  from people to  take the  course. He                                                                    
reported that  of the 119  requests 89 kids  had entertained                                                                    
thoughts  of suicide.  He highly  recommended extending  the                                                                    
Statewide Suicide Prevention Council.                                                                                           
                                                                                                                                
2:47:06 PM                                                                                                                    
                                                                                                                                
Co-Chair Wilson OPENED Public Testimony.                                                                                        
                                                                                                                                
2:47:20 PM                                                                                                                    
                                                                                                                                
LILY  WERTZ, SELF,  ANCHORAGE  (via  teleconference), was  a                                                                    
lifelong  resident of  Anchorage.  She was  bipolar and  had                                                                    
been saved  through the suicide  hotline. She  provided some                                                                    
suicide statistics.  She urged support  for HB 22  to extend                                                                    
the council until 2027 and beyond.                                                                                              
                                                                                                                                
2:48:26 PM                                                                                                                    
                                                                                                                                
TINA  WALSH, SELF,  ANCHORAGE  (via teleconference),  [Note:                                                                    
Testimony was inaudible].                                                                                                       
                                                                                                                                
2:51:20 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:54:02 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair Wilson  thanked the previous testifier  for calling                                                                    
in.                                                                                                                             
                                                                                                                                
SAM  TRIVETTE, JUNEAU  SUICIDE PREVENTION  COALITION, JUNEAU                                                                    
(via  teleconference), had  been a  member of  the coalition                                                                    
for 11 years. He thanked  the sponsors for introducing HB 22                                                                    
which would extent the  Statewide Suicide Prevention Council                                                                    
for 8 years. He reported it  being the third session that he                                                                    
had  testified on  behalf of  the council  extension in  the                                                                    
previous decade. He  was a survivor of suicide  loss. He and                                                                    
his wife lost their son to  suicide on June 28, 2007. He and                                                                    
his  wife  had  utilized  the  resources  available  of  the                                                                    
program  and had  been  involved with  the  council for  the                                                                    
prior  10 years.  He had  participated  in a  number of  the                                                                    
statewide conferences, regional  conferences, and trainings.                                                                    
The  council had  linked him  to some  national experts  and                                                                    
resources  to  help  him  tackle  the  major  public  health                                                                    
problem.                                                                                                                        
                                                                                                                                
Mr. Trivette opined that the  council was the glue that kept                                                                    
everyone  together  and  kept   people  working  on  suicide                                                                    
issues.  He  noted  positive  changes  happening  constantly                                                                    
because of the work of the  council. He provided a couple of                                                                    
examples of  the work  done by  the council.  He spoke  of a                                                                    
recent council meeting  in Juneau. A group  had trained high                                                                    
school students about suicide  prevention. Those high school                                                                    
students  were  then  going  into  the  middle  schools  and                                                                    
elementary   schools  talking   about  suicide   prevention,                                                                    
delivering  tools on  a peer-to-peer  basis.  He noted  that                                                                    
suicides  would  continue.  However, with  more  information                                                                    
getting out into  the public was resulting in  more calls to                                                                    
the Care  Center. All of  the calls went to  Fairbanks where                                                                    
there  were folks  answering calls.  He  continued with  his                                                                    
testimony.  He  personally was  aware  there  were no  stats                                                                    
available with the  exception of the number of  calls on the                                                                    
Care  Line.  He  thought  the council  had  helped  make  an                                                                    
impact. He appreciated the committee's time.                                                                                    
                                                                                                                                
3:02:04 PM                                                                                                                    
                                                                                                                                
Co-Chair Wilson CLOSED Public Testimony.                                                                                        
                                                                                                                                
Co-Chair Wilson commented  that it was the job  of the House                                                                    
Finance Committee to question  where dollars were spent. She                                                                    
asked Ms. Brazak to review the fiscal note.                                                                                     
                                                                                                                                
3:02:49 PM                                                                                                                    
                                                                                                                                
LINDA  BRAZAK, ADMINISTRATIVE  OPERATIONS MANAGER,  DIVISION                                                                    
OF  BEHAVIORAL  HEALTH,  DEPARTMENT  OF  HEALTH  AND  SOCIAL                                                                    
SERVICES,  reviewed the  fiscal note.  The note  represented                                                                    
one position;  a classified,  full-time, range  16 position.                                                                    
She mentioned  travel funds used  to bring board  members to                                                                    
meetings.  The  services   represented  department-wide  and                                                                    
statewide   charge  back   costs.  Commodities   represented                                                                    
materials for the council and the grant.                                                                                        
                                                                                                                                
Co-Chair Wilson asked  about the cost to keep  the Care Line                                                                    
going. Ms. Brazak could provide the information in writing.                                                                     
                                                                                                                                
Representative  Tilton asked  about  previous reductions  to                                                                    
travel costs  affecting the council. Ms.  Brazak deferred to                                                                    
Mr. Morrison.                                                                                                                   
                                                                                                                                
3:04:42 PM                                                                                                                    
                                                                                                                                
ERIC  MORRISON, PROJECT  ASSISTANT,  DIVISION OF  BEHAVIORAL                                                                    
HEALTH,   DEPARTMENT   OF   HEALTH  AND   SOCIAL   SERVICES,                                                                    
introduced himself.                                                                                                             
                                                                                                                                
Representative Tilton restated her question.                                                                                    
                                                                                                                                
Mr. Morrison  replied that originally  the council  tried to                                                                    
meet on  a quarterly basis  across the state.  Several years                                                                    
ago it  had not been  feasible with the funding  the council                                                                    
had.  Instead,   the  council  had  gone   to  having  video                                                                    
conferences  in   the  summer.  The  travel   freeze  became                                                                    
effective  in  2015  or  2016.   The  council  went  to  two                                                                    
quarterly meetings,  then down  to one quarterly  meeting in                                                                    
communities. Going to the sites  was the largest outreach in                                                                    
communities each year.  He mentioned a number  of places the                                                                    
council  had met  in and  around the  state. There  were key                                                                    
partnerships started at the site visits. Teleconferences                                                                        
were not as effective when it came to building                                                                                  
relationships.                                                                                                                  
                                                                                                                                
Co-Chair Wilson announced amendments were due for HB 22 and                                                                     
SB 35 by 5:00 P.M. on the following Monday.                                                                                     
                                                                                                                                
HB 22 was HEARD and HELD in committee for further                                                                               
consideration.                                                                                                                  
                                                                                                                                
Co-Chair Wilson reviewed the agenda for the following week.                                                                     
                                                                                                                                

Document Name Date/Time Subjects
SB 25 Board of Dental Examiners Sunset Review.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
SB 25 HFIN Hearing Request 4.3.2019.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
SB 25 Letters of Support.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
SB 25 Sponsor Statement.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
HB 22 Supporting Documents-Suicide Facts.pdf HFIN 4/12/2019 1:30:00 PM
HB 22