Legislature(2001 - 2002)
01/24/2002 03:03 PM House HES
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HB 338-APPROP: GRANTS TO PREVENT YOUTH SUICIDE CHAIR DYSON announced that the first order of business would be HOUSE BILL NO. 338, "An Act making a special appropriation for a grant to Boys and Girls Clubs of Southcentral Alaska for a youth suicide prevention program; and providing for an effective date." Number 031 LORALI CARTER, Staff to Representative Kevin Meyer, Alaska State Legislature, presented HB 338 on behalf of the House Community and Regional Affairs Standing Committee (HCRA), the bill's sponsor. She introduced the bill by reading from a statement as follows: Between 1990 and 1998, more than 180 Alaska communities were affected by suicide. More than one- fourth of all suicides were committed by youth between the ages of 15 and 24. Last year, suicide was the fifth leading cause of death in Alaska. The suicide rate for young Alaskans is 37.8 deaths per 100,000 in population - a rate almost four times greater than the national rate. The money appropriated to fund the youth suicide prevention program will be divided between each of the 32 clubhouses statewide. This legislature has made children a top priority. House Bill 338 continues the commitment to a strong and healthy future by recognizing the need for suicide prevention programs in Alaska. MS. CARTER indicated that House Community and Regional Affairs Standing Committee members recognize the state's fiscal situation. She continued to read from a statement as follows: The co-chairs hope that you will focus on the health and social service provided by this bill and pass it out of committee. Certainly, the Finance Committee will prioritize the needs and wants before them and make a final decision on the fiscal impact. With me today is Mr. John Oates, the CEO of the Boys & Girls Clubs of Southcentral Alaska. He will be able to answer your questions and give an overview of the program. Number 063 REPRESENTATIVE CISSNA indicated she is a "big fan" of Boys & Girls Clubs. She noted that the goals and objectives, outlined in the "Youth Suicide Prevention Project Goal" chart, target management, not program strategies. "I wonder if you do have goals for the program itself," she said. She pointed out that none of these objectives address the effectiveness of the program. She emphasized the importance of built-in assessment to ascertain the effectiveness of the program's implementation. Number 091 MS. CARTER drew attention to the footnote on the goal chart. She indicated that the chart was created as a project template. Number 095 REPRESENTATIVE CISSNA queried whether objectives were built into the program that assess the effectiveness of the goal stated in the bill's title. MS. CARTER responded that results-based language would not be found in the bill. She stated, "We certainly didn't want to ask the Boys & Girls Club[s] to report back to us." Perhaps it is something Representative Cissna would like to see implemented, she stated. Number 114 REPRESENTATIVE CISSNA reiterated the need for "measurable improvement." She noted the general trend toward measurable goals and objectives. Number 122 CHAIR DYSON stated that he concurred with Representative Cissna [regarding the need for measurable outcomes]. He added that since both the Senate and House had implemented missions and measures, that was a legitimate question. He noted that it was incumbent upon the committee to evaluate various programs to determine a reasonable result that members could expect. Chair Dyson agreed that suicide rates should go down as a result of this program. Number 145 REPRESENTATIVE JOULE agreed that specifying desired outcomes is necessary. He stated that he had served on the alcohol and drug board. Often that budget reflected a treatment priority, when, in fact, prevention was a high priority not readily evidenced in the budget, he noted. Number 162 MS. CARTER reported that HCRA had originally looked at language that would include goals and measurable performance indicators. She noted that the response from Legislative Legal and Research Services was that this was not a standard procedure for a grant not established by a state agency. She added that individual clubs would modify the general program. Number 176 REPRESENTATIVE STEVENS asked about a budget page for the grant. Number 183 MS. CARTER drew members' attention to lines 8 and 9 of the bill and stated that the funds were "for a youth suicide prevention program that includes drug, alcohol, and teen pregnancy prevention, education, career development, leadership and character development, conflict resolution, and violence prevention, and fitness and social [recreation] programs." Number 193 REPRESENTATIVE STEVENS clarified that he was seeking a more thorough breakdown [of the budget]. Number 194 REPRESENTATIVE COGHILL observed that this is "quite a broad spectrum" covered in the bill's language. He asked whether suicide prevention necessitated inclusion of all of those [topics]. Number 212 MS. CARTER indicated that HB 338 would not include a fiscal note because there would be no fiscal impact to the department; it is general fund money. Number 215 JOHN OATES, Chief Executive Officer, Boys & Girls Clubs of Southcentral Alaska, testified in favor of HB 338. He noted that three [Boys & Girls Clubs] organizations in Alaska - Fairbanks, Kenai, and Southcentral - are recognized by the national organization. The Southcentral organization was asked by the national one to expand the clubs throughout Alaska; it has opened clubs from Metlakatla to Barrow. He noted that 16 new clubs have been established in the last three years. Number 245 CHAIR DYSON said he was pleased that new clubs have been started in Western and Southeast Alaska. He asked how Boys & Girls Clubs work in predominantly Native villages. Number 250 MR. OATES replied that the "Indian country" movement in the Lower 48 started [in the Boys & Girls Clubs] approximately five years ago. He said, "First of all, we weren't Indian country, and [we] explained the situation here with ... Alaska Natives." He stated that the needs in rural Alaska were outlined for the national organization. [United States] Senator Stevens became a Boys & Girls Clubs "fanatic" after he "took over the chairmanship of the appropriations committee," Mr. Oates commented. Boys & Girls Clubs' expansion appropriations, explained Mr. Oates, went from $15 million to $70 million in five or six years. Alaska is receiving approximately $5 million in federal monies for the statewide expansion into Alaskan Native communities, he stated. Number 277 MR. OATES indicated that much of this [federal appropriation] is due to the high suicide rate among children and the lack of activities before and after school. Boys & Girls Clubs has over 40 programs designed collaboratively with sponsors. Most clubs, he noted, run 8 to 12 programs. When going into a rural community, Boys & Girls Clubs looks for a facility, local leadership, and some type of local funding - be it cash or an in-kind contribution. He emphasized that "the heart and soul" of Boys & Girls Clubs is the clubhouse. Mr. Oates explained that most clubs begin small and then grow in staff and programs as resources allow. Number 310 MR. OATES pointed out that in Bush communities, Boys & Girls Clubs expands its normal age range to include younger children. Number 315 CHAIR DYSON inquired whether Boys & Girls Clubs places staff in new clubhouses or hires and trains local people. Number 320 MR. OATES replied that Boys & Girls Clubs has done it both ways. He noted that the most success occurs when staff is hired locally; the organization endeavors to hire locally whenever possible. Number 330 CHAIR DYSON queried if local staff were free to adapt programs to fit the local situation. Number 332 MR. OATES responded that this was indeed the case. He gave the example of Tyonek, where the clubhouse is used by parents and elders to teach children their culture. He indicated that the school was too formal of a setting and the home too informal for teaching culture. In Tyonek, members drum, sing, and dance in the clubhouse, he pointed out. In Metlakatla, he said, "spirit camp" takes place each summer, and in Hydaburg, members are carving totem poles. He said the clubhouses run Boys & Girls Clubs' programs as well as cultural programs. He noted that the clubhouse is "a terrific opportunity and facility." Number 364 CHAIR DYSON asked whether the Boys & Girls Clubs had a suicide prevention program that had been in place long enough in North America to establish its effectiveness. Number 370 MR. OATES responded by acknowledging that outcomes are very important. He stressed that he was pleased that more grantors are holding the recipients of funding more accountable for outcomes. He noted that this was not always true in the past. Mr. Oates described how one measurable outcome, used in the Spenard club, is attendance at events that is monitored by magnetic swipe cards. He recounted that [measurable outcome] language had been planned for inclusion in HB 338 and was subsequently rejected as a result of advice from Legislative Legal and Research Services. He stated, "The plan is to work with the state health folks to come up with some guidelines." Number 398 CHAIR DYSON asked if Boys & Girls Clubs was implementing a suicide prevention program elsewhere. Number 401 MR. OATES responded that he was unaware of a program that fell "under the suicide prevention umbrella." He indicated that the results [of club programs] existed, but not results specific to suicide prevention. Number 404 CHAIR DYSON noted that his understanding was that this "hasn't been done exactly this way somewhere else before," so members cannot look at another club's experience [on which to base their decision]. Number 406 REPRESENTATIVE WILSON queried whether volunteers were ever used [to run clubs]. Number 411 MR. OATES replied that the facilities and professionally trained staff are the elements which make Boys & Girls Clubs work. He noted that staff training is expensive. Using paid staff to run clubhouses gives a greater measure of control and accountability than volunteers alone would provide, he noted. Boys & Girls Clubs utilizes hundreds of volunteers to run athletic programs in Alaska. Number 428 REPRESENTATIVE CISSNA asked whether Mr. Oates had any outcome measurements on any Boys & Girls Clubs' programs [to furnish to members]. Number 437 MR. OATES answered that studies had been done, but that he couldn't readily cite them. He did note that Boys & Girls Clubs is "becoming more and more sophisticated all the time at measuring outcomes." He gave the example of Tyonek, which has about 65 children; it was averaging 2 youth suicides a year. Since Boys & Girls Clubs has been in Tyonek, he said, not one child suicide has occurred. He acknowledged that there were other [positive influences] in addition to the club, but that Boys & Girls Clubs helped to impact that trend. He suggested it was easier to measure outcomes in the "finite area" of a small community, where there is less transience. He explained that the statewide expansion of the clubs is in "its embryo stage." Number 464 REPRESENTATIVE CISSNA stated that problems are increasing [including the incidence of suicide and alcoholism in the Bush] while revenues are running out. She noted that the only way to change [that trend] is by using a guide and measurement. The state is going to do poorly if it doesn't make this change, she predicted. Representative Cissna requested that some "commitment" to [measurable outcomes] be added to the bill. Number 474 REPRESENTATIVE CISSNA pointed out that [a youth's] first support is his/her family. She acknowledged, "Boys & Girls Clubs probably [has] one of the best opportunities to get into families in a way that nobody else can." She asked if the suicide prevention program includes a [family component]. Number 481 MR. OATES responded that Boys & Girls Clubs does work with families. He said, "It is a bigger challenge for us in the Native villages, and I wish that I could say otherwise." He explained that many of the adults in the community are reluctant to become involved in the club, but they want their children to be taught to "make better choices than [they] did." He related that it is difficult to do this tactfully. It takes time to establish trust in a community, he explained. Number 503 MR. OATES indicated that when parents are involved in club programs, it is because their children have brought them. He speculated that in time, the clubs could have more influence with the adults. Number 510 REPRESENTATIVE CISSNA sympathized with Mr. Oates regarding the difficult task of involving parents. She pointed out, however, that if this was established as one of the organization's primary goals, then this goal might be met more quickly. Number 516 MR. OATES offered that he might not be giving staff their due credit [for involving parents]. He described how the club in Tyonek might sometimes remain open all night, enabling parents and youth to avoid a community drinking party. This gives parents, who might otherwise be ostracized for not drinking, an excuse for not attending the party. He stressed that Boys & Girls Clubs' staff must use caution when taking steps to [include parents]. He disclosed that some communities are "pleading for help." Number 545 REPRESENTATIVE STEVENS noted the many other organizations providing youth-oriented programs around the state. "Why you?" he asked. "Why should we give you a million dollars and not the Boy Scouts or 4-H?" He requested clarification regarding the proposed suicide prevention program - whether a specific prevention program would be offered or simply more programs offered to provide [healthy activities] that would, in turn, prevent suicide. He asked, "What are you doing specifically about suicide?" Representative Stevens concluded by asking, "How are you spending the money?" Number 565 MR. OATES replied that clubs with 250 members or more would receive approximately $37,000; clubs with less than 250 members would receive approximately $29,000. The larger clubs would be enabled to hire an additional full-time senior instructor and a part-time teen aide. The smaller clubs would have just the additional full-time senior instructor. He added that this would affect 10 large clubs and 22 small clubs. Mr. Oates explained that the allocations might change if more clubs were to be added. TAPE 02-3, SIDE B Number 565 MR. OATES stated that the Matanuska-Susitna area is considered a "cluster area" for suicide. An 8,000-square-foot clubhouse had been built there recently, he remarked. He described that some of the reasons for suicide are the lack of hope, the lack of school success, and the lack of expectations. He stated that Boys & Girls Clubs can help "raise the bar of expectation," improve self-esteem, and assist in college or job readiness. He related that Boys & Girls Clubs give children a place to go after school, a time when there is typically a lack of supervision. Number 554 MR. OATES answered, "We're there," in response to Representative Stevens' question regarding why should Boys & Girls Clubs get this money. He noted that this facility-based organization is aggressively expanding in Alaska. He added that the organization's eventual goal is to have 65 clubs in the state. He suggested, however, that if committee members identified a facility-based, professionally staffed organization serving youth more effectively than Boys & Girls Clubs, he'd "be the first one to vote to move your money over to them." Mr. Oates added, "You need to put your money where you're going to get a return on it." Oftentimes, he offered, government invests in a "newfangled, whiz-bang thing" without much return. He furnished that Boys & Girls Clubs has been around for 140 years; it is adding a new club every day. "There's a reason for that," he concluded. Number 534 REPRESENTATIVE WILSON asked what Boys & Girls Clubs Southcentral was going to do with this additional money that it was not already doing. Number 529 MR. OATES replied that Boys & Girls Clubs will add to existing programs. Clubhouses provide basic programs now, he said, which include the "Smartmoves" program. Number 524 REPRESENTATIVE WILSON asked which programs would be added. MR. OATES answered they would add "POWER HOUR," a homework help and tutoring program; "Goals For Graduation," [a career and education goal-setting program]; "TEENSupreme Keystone Club," a leadership and community service skills program; and the "NIKE SWOOSH Club," an athletic-based careers program. Number 513 REPRESENTATIVE WILSON inquired whether these programs were specifically [designed to be] suicide prevention programs, or if the organization's implementation of more programs would result in fewer troubled kids. MR. OATES answered, "Yes." He explained that Boys & Girls Clubs does not have a program specifically targeting suicide prevention; the "Smart Moves" program, however, does address it. Generally, Boys & Girls Clubs' programs teach abstention, he said. He stated that the severity of Alaska's suicide problem is not faced elsewhere in the nation. He added that Boys & Girls Clubs "can have a very positive impact on that." Number 496 REPRESENTATIVE WILSON referred to the map in the committee members' packets and asked which club sites were proposed for this year. Number 493 MR. OATES replied that the following clubhouses already exist: Metlakatla, Hydaburg, Kake, Angoon, Juneau, Seldovia, Homer, Soldotna, Kenai, Mountain View, Spenard, Eagle River, Muldoon, Mat-Su, Tyonek, Bonnie Cusack, South Naknek, King Salmon, Bristol Bay, Dillingham, New Stuyahok, Elim, Nome, Kotzebue, Barrow, Fairbanks, North Pole, Two Rivers, and Tok. He indicated that the following clubhouses would open this year: Sitka, Kodiak, Delta Junction, Akiachak, Akiak, Bethel, Tuluksak, Yupiit Schools, Stebbins, Saint Michael, Koyuk, Atqasuk, Nuiqsut, and Kaktovik. Number 480 REPRESENTATIVE JOULE asked if membership fees are required to join Boys & Girls Clubs. Number 477 MR. OATES responded that membership fees range in each community from no fees to $5; this fee is determined by the individual clubhouse. Number 470 REPRESENTATIVE JOULE said he wondered if some children were excluded because they were unable to pay the membership fee. MR. OATES said that has never been a problem "because we scholarship kids in" when they are unable to pay. Number 463 REPRESENTATIVE JOULE asked if Boys & Girls Clubs was partnering with school districts to use school facilities. MR. OATES responded, "In some areas we are." In some communities, he added, the school is the only facility that will work. He expressed his opinion that "kids get sick of school," so they tire of being in the school facility. Nevertheless, Boys & Girls Clubs is partnering with districts in communities where the school is the only available facility. Number 446 REPRESENTATIVE JOULE asked for verification that Boys & Girls Clubs was "incorporating the local values" when it established a new club. Number 438 MR. OATES answered, "I'm not sure that ... is measurable, but I think the short answer is yes." Boys & Girls Clubs does not go into a community without local leadership, he pointed out. This leadership, Mr. Oates said, brings the local values and culture [to the process of establishing a new club]. Number 421 REPRESENTATIVE COGHILL commended Mr. Oates for his work [with youth]. He stressed that HB 338 is a one-time allocation that will create an expansion. He asked: How will Boys & Girls Clubs [maintain this expansion after the grant cycle ends]? He also asked what funding sources are available to Boys & Girls Clubs. Number 411 MR. OATES explained that Boys & Girls Clubs is fee-based in many places. Childcare also provides revenue, he noted; athletic and other programs are self-supporting and, in some cases, contribute to the clubhouse. Grants are available to Boys & Girls Clubs, he noted. He offered that the Boys & Girls Clubs' board raises funds through an auction and other fundraisers. Each community raises funds for its clubhouse, he added. Number 393 MR. OATES said, "Everything you can think of, we've done" [to raise money]. He offered, "If this is successful, who's to say that the state isn't going to want to fund this again?" Number 390 REPRESENTATIVE COGHILL explained that this [appropriation], if granted, would set a precedent for the legislature. Number 378 SHARRON O'DELL stated that she is a volunteer at the Mat-Su Valley club. The club has grown since its inception two and one-half years ago from 35 members to over 350 members. Volunteers spend time with kids in various activities, she stated; they provide another adult with whom a youth can form a one-on-one relationship. She has observed outcomes that include children [gaining social confidence and skills] as a result of club membership, she noted. Ms. O'Dell took note of the Mat-Su Valley's high suicide rate. She pointed out that members view the adults at the clubhouse as friends [not authority figures]; the club belongs to the kids. MS. O'DELL said Boys & Girls Clubs also offers opportunities for youth to develop peer relationships. She highlighted the Torch Club, which performs skits in the clubhouse, in schools, and in the community that delve into teen problems such as pregnancy and suicide. She closed by recounting the story of a Torch Club president who had lost her friend to suicide; the president had said, "If he had been a member of Boys & Girls Club[s], he would not have taken his life." Number 317 REPRESENTATIVE STEVENS asked Ms. O'Dell how she would spend $20,000 to $30,000 at the Mat-Su club to mitigate suicide. MS. O'DELL responded that she was not a staff member and therefore unable to answer his question. She noted that she was a founder of the Mat-Su club, and she thought that increasing the number of programs offered would be appropriate. Number 304 ELMER LINDSTROM, Deputy Commissioner, Department of Health & Social Services, testified regarding the suicide prevention council established last year by the legislature. This council, he noted, was established to prepare suicide prevention recommendations for the executive and legislative branches. Recommendations from this council are not yet available because the council has just begun to meet, he stated. He said the department would be looking to the council for direction in addressing the problem of suicide. He said, "I'm willing to go out on a limb and predict that that $1 million would very ... easily be used productively to address this problem. I can't imagine that ... this would be overkill in terms of the magnitude of the problem." Number 283 MR. LINDSTROM pointed out that in the budget pending before the House and Senate finance committees there is, he believes, a half-million-dollar increment in the governor's budget for suicide prevention activities, [which would be spent] in consultation with the suicide prevention council. He acknowledged that he was impressed with the Boys & Girls Clubs' presentation, but reiterated that the department would look to the council for recommendations for suicide prevention. He closed by saying that he thought it would be a useful recommendation from the House Health, Education and Social Services Standing Committee to the finance committees that additional resources are needed in the area of suicide prevention. He said, "I'm certainly not testifying in opposition to the bill and the need for resources." Number 276 CHAIR DYSON asked when members could expect recommendations from the council. MR. LINDSTROM replied that he would speak to the commissioner, who is on the council. He said he thought that the council would have had a representative at the hearing, but he presumed that the council was still meeting. Mr. Lindstrom added that he did not believe the council had yet established a work plan. Number 268 CHAIR DYSON inquired whether it might be reasonable to expect [a recommendation] from the council within a couple of months. MR. LINDSTROM answered that the commissioner is aware of the governor's increment in the budget, and that he couldn't imagine the council not making a recommendation during this year's budget process. Number 263 CHAIR DYSON asked if Mr. Lindstrom thought it reasonable to assume that the council is unlikely to recommend that the entire $500,000 be designated for the Boys & Girls Clubs. MR. LINDSTROM replied that he couldn't speak to that. Number 259 REPRESENTATIVE JOULE related his impression that Alaska is "small enough" for most present at the hearing to have been affected by suicide in some way. He noted that within the family [context], suicide is an especially important issue. He commended the Boys & Girls Clubs for "stepping up to the plate." One of the biggest [factors] in suicide is "not having somebody there ... at that ... moment," he said. Representative Joule continued, "That abyss of hopelessness ... will exist where there seems to be no other alternatives." Number 237 REPRESENTATIVE JOULE indicated that if the members wished to move this bill to the House Finance Standing Committee, that would be fine with him; he was going to raise the issue with the suicide council. "I think we need to see what those many minds ... come up with," he said. He noted his hope for more community partnerships that could be forged by, perhaps, Boys & Girls Clubs or other community entities such as schools and businesses. Often parents won't attend [activities] but employees will, he offered. He stated that recreation is an important facet of [suicide prevention], especially in smaller communities. "We also need to find a way to show individuals that they can become part of the workforce ... and be in their communities," he said. He added that working with regional nonprofits, village corporations, and regional corporations would facilitate the provision of additional jobs. He stated that he thought these community resources were underutilized. People are able to make better and healthier choices when they have access to more information, he concluded. Number 198 REPRESENTATIVE CISSNA commented that she had witnessed the creation of many health programs over the years and that she still saw Alaska's problems increasing. She noted that her own hesitation [in endorsing HB 338] was founded in the modicum of measurable returns from the large amounts of money spent on these programs. "We don't know what we're doing," she emphasized. She admonished the members to refrain from spending "one more cent" [without the use of measurable goals and objectives]. She expressed her hope that the new council would include measurement [as a component of its recommendations]. REPRESENTATIVE CISSNA noted that other states are "doing some great stuff ... with measurement." She expressed her belief that Alaska could do the same. She said, "It's hard, but it's not impossible" to include measurement in the state's efforts to address health issues. She offered that the federal government had implemented results-based [funding] seven or eight years ago. "Are we going there?" she queried. Number 157 MR. LINDSTROM responded that he was less involved in budget activities than others. He noted that he was encouraged by the missions-and-measures activity. He added that some skepticism existed regarding how seriously the missions and measures would be taken. He pointed to "steadfast interest" by the finance committees; missions and measures discussions are "becoming institutionalized." He noted that his department is "poised for what is a needed 'second iteration' on what ... missions and measures really ought to be." He recognized that the first effort may not have measured the right things and that some of the selected measures didn't have data on which to base them. MR. LINDSTROM stated that he is "moderately encouraged" that agencies and the legislature are utilizing missions and measures. This can develop into a useful tool to identify progress and failure in many of these "very difficult and intractable problems," he said. Number 125 REPRESENTATIVE CISSNA asked whether "building a requirement for data" or some kind of measurement is useful. MR. LINDSTROM responded, "Generally, the answer is yes." He added that it is now a rare circumstance in which he does not have a discussion about measurement when working on any bill. He noted that the process needs more work and attention from the executive and legislative branches; it remains an imperfect process. It will be "an incremental process of improvements," he said; the questions and answers will become more refined over time. Number 075 CHAIR DYSON called for an at-ease at 4:28 p.m. TAPE 02-4, SIDE A Number 001 CHAIR DYSON reconvened the hearing at 4:34 p.m. He closed the public hearing on HB 338. He announced that the committee would hold over HB 338.
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