Legislature(2013 - 2014)CAPITOL 106
04/01/2014 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SCR13 | |
| SCR14 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SCR 13 | TELECONFERENCED | |
| + | SCR 14 | TELECONFERENCED | |
| + | TELECONFERENCED |
SCR 13-FETAL ALCOHOL SPECTRUM DISORDERS
3:10:27 PM
CHAIR HIGGINS announced that the first order of business would
be CS FOR SENATE CONCURRENT RESOLUTION NO. 13(HSS), Urging the
governor to establish and support programs designed to eradicate
the occurrence of fetal alcohol spectrum disorder from the
state.
3:11:10 PM
HEATHER SHADDUCK, Staff, Senator Pete Kelly, Alaska State
Legislature, explained that the idea for this proposed
resolution had been initiated after a presentation by the Alaska
Mental Health Trust Authority in the previous year, which
described the lack of progress toward eradication of fetal
alcohol spectrum disorder (FASD).
3:12:12 PM
RYAN RAY, Staff, Senator Pete Kelly, Alaska State Legislature,
paraphrased from the sponsor statement, which read:
Senate Concurrent Resolution 13 calls for a focused,
statewide effort to prevent further occurrence of
fetal alcohol spectrum disorder in Alaska. Fetal
alcohol spectrum disorder (FASD) has been identified
as a driver of numerous social challenges in our
state. The tragedy of fetal exposure to alcohol
continues to negatively impact Alaska's families,
communities, and government agencies.
Due to its teratogenic effects, Alcohol creates more
damage to the brain of a fetus than cocaine, heroin,
or methamphetamine. Unfortunately, the brain damage
created by alcohol is irreversible. The state of
Alaska currently has the highest documented prevalence
of fetal alcohol spectrum disorders in the United
States. According to the Alaska Maternal and Child
Health Data Book, 112.9 children in 10,000 births in
Alaska are born with FASD. The financial cost to the
State is tremendous. Best estimates from the Alaska
Department of Health and Social Services place the
cost per child born with FASD in the range of $860,000
to $4.2 million dollars.
However, fetal alcohol spectrum disorder is completely
preventable. This fact highlights the moral and
ethical responsibility to take action that all
Alaskans share. SCR 13 urges the Governor to
establish and support programs designed to eradicate
the occurrence of FASD and resolves that the Alaska
State Legislature will support programs that will
minimize the risk of pre-natal exposure to alcohol.
In addition, SCR 13 encourages increasing the State's
capability to conduct rapid FASD screening in order to
ensure that those experiencing the challenges of
living with FASD receive the care and support they
rightly deserve as early as possible. Far too often,
alcohol addiction and personal trauma fuel the
incidence of fetal exposure to alcohol. For this
reason, SCR 13 appeals to the Governor to take actions
to expand residential substance abuse treatment
services for women who are pregnant and concurrently
experiencing alcohol and drug addiction challenges.
Thus ensuring mother and child receive the care,
protection, and healthy environment they both need in
order to thrive.
As Alaskans, we all share in the responsibility of
ensuring our future generations are healthy and
vibrant. The horrible tragedy of fetal alcohol
spectrum disorder in Alaska is totally preventable.
SCR 13 stands against FASD in Alaska and resolves that
the leadership of our State will take actions
necessary to safeguard future children from fetal
alcohol spectrum disorder.
3:16:19 PM
MS. SHADDUCK explained that there were not enough diagnostic
screening tools for FASD throughout Alaska, and it took a long
time to observe a child. She stated that there was not a
uniform screening tool in the nation. She expressed a desire to
find and implement a screening tool for nationwide use.
CHAIR HIGGINS asked for clarification that the disorder was not
recognized by the federal government and that there was not a
screening tool.
MS. SHADDUCK deferred to others for an answer. She noted that
other screenings could be combined for many disorders, but that
there were no other screenings similar to FASD.
3:17:58 PM
CHAIR HIGGINS asked about the definition for a screening tool.
MS. SHADDUCK replied that conversations with the Department of
Corrections had indicated that, although FASD was a mitigating
factor in sentencing, there was not any screening tool for
diagnosis. This diagnostic process needed to be started by a
screening to flag FASD, which would help with placement and
support.
3:19:13 PM
MR. RAY explained that the point of highest risk for fetal
exposure to alcohol was between conception and the knowledge of
pregnancy. It was critical for a woman to quickly find out that
she was pregnant before she consumed alcohol. He reported that
research conducted by the Substance Abuse and Mental Health
Service Administration (SAMSA) stated that, although 90 percent
of women stopped drinking at pregnancy, the remaining 10 percent
struggled with addiction challenges. He declared that men and
women should be aware if their partner was pregnant before
consumption of alcohol. He stated that the State of Alaska
"must enhance residential substance abuse treatment services for
women who are pregnant and concurrently suffering from
addiction." He declared that it was vital to ensure that women
received the treatment they needed, while living in a "healthy,
enriching, and trauma free environment." He reported that Dr.
Mark Sloane, a professor at the University of Michigan, was
studying the comparison of fetus development when exposed to
alcohol with that of a fetus whose mother was living in a
traumatic, abusive environment. The findings were showing a
similarity between the two. He stated that the Alaska State
Legislature "urges the governor to establish and support
programs designed to eradicate the occurrence of fetal alcohol
spectrum disorder from the state." He said that the legislature
supported a strong public awareness campaign designed to inform,
move, and motivate state residents in an effort to prevent the
occurrence of fetal alcohol spectrum disorder in the state; that
the legislature supported programs that minimized the risk of
fetal exposure to alcohol; and that the legislature encouraged
the governor to increase the capability for rapid screening of
fetal alcohol spectrum disorder with the Department of
Corrections and the Department of Health and Social Services.
He reported that the Alaska State Legislature encouraged the
governor to take action to expand residential substance
treatment services for women. He stated that FASD was
completely preventable, and that it was a societal problem to
ensure that no child was born with this disability.
MR. RAY, in response to Representative Nageak, explained that
fetal alcohol effect (FAE) had been grouped with fetal alcohol
syndrome (FAS) to identify fetal alcohol spectrum disorder
(FASD).
3:24:56 PM
CHAIR HIGGINS opened public testimony.
3:25:07 PM
DEB EVENSEN declared that it was time to take a bold step
forward to find solutions to eradicate FASD in Alaska. She
expressed her support for the proposed resolution. She offered
an anecdote about her observations of an FASD three-year-old
child, and the difference between him and other kids his age.
She expressed her hope that this is the last generation of FASD
kids.
3:28:49 PM
JEFF JESSEE, Chief Executive Officer, Alaska Mental Health Trust
Authority, Department of Revenue, stated his support of the
proposed resolution, and pointed to the lack of understanding
for the prevalence of FASD and the loss of potential for many
children through the exposure to alcohol. He reported that, as
50 percent of pregnancies were unplanned and there was no safe
level of alcohol consumption during pregnancy, this raised the
necessity for many social norm issues to be addressed in the
community. Although 90 percent of women stopped drinking when
they became pregnant, there was the need for a new social norm
to stop drinking until it was known. He relayed that this
involved both the women and their partners, and the importance
of engaging men in the conversation. He stated that it was a
big step to quit drinking until sureness regarding pregnancies.
He said the two biggest risks to having an FAS child were the
mother already having an FASD diagnosis, or already having an
FASD child. He explained that residential treatment was about
helping women deal with addiction and giving them employment and
parenting skills to live a healthy life and be a productive
member of the community. He lauded the need for the legislature
to take a stand.
CHAIR HIGGINS opined that it was necessary to change the
culture, and that it was not possible to legislate pride or
value.
3:33:45 PM
REPRESENTATIVE SEATON reflected that the number one risk factor
of an FASD child was the mother having a diagnosis of FASD. He
offered his understanding that the big problem with FASD was the
brain disconnects between cause and effect. He suggested the
voluntary offering of implants for long term pregnancy control
to women with FASD, as a support for the lack of capacity for
understanding cause and effect. He asked if the Alaska Mental
Health Trust Authority had a position.
3:35:32 PM
MR. JESSEE replied that birth control would work for some
people, but not for others. He opined that the use of birth
control as a strategy to prevent FASD and pregnancy was an
option, and that strategies under the proposed initiative would
evolve. He stated that it was necessary to provide basic
information to people.
REPRESENTATIVE SEATON reiterated that he had suggested the birth
control be voluntary, and that it should be a choice. He stated
his full support of the resolution while continuing to review
all the available strategies.
3:36:58 PM
REPRESENTATIVE REINBOLD asked if the State of Alaska or the
Alaska Mental Health Trust Authority did enough to prevent
drinking by underage women and to protect them from FASD. She
asked if there was there a plan of action.
MR. JESSEE replied that not enough was done, and that it was
always difficult to monitor a legal product that was promoted
nationally, while convincing youth that it should not be used.
He relayed that there was a tight nexus between sports and
alcohol consumption, although a strategy to keep youth "on the
straight and narrow" was for participation in sports. He stated
that this was delivering youth to the [alcohol] industry for
inculcation of the mindset for consumption. He shared that he
was involved with the statutory review process for alcoholic
beverage control, and that underage drinking issues were being
discussed. He said that there was no real check on underage
drinking parties, and this was being reviewed. He offered his
belief that there were ways to protect youth.
3:40:37 PM
REPRESENTATIVE REINBOLD expressed her amazement and asked if
there was anything that could be done to better educate and
protect youth.
3:41:42 PM
PATRICIA SENNER, Professional Practice Director, Alaska Nurses
Association, relayed that she was also a family nurse
practitioner, and had been on the staff of the Governor's
Council for the Handicapped and Gifted, which encouraged women
not to drink when pregnant. She shared that many of the youth
at Covenant House had FASD and were graduates from the foster
care system. She suggested the need of a better strategy for
the discharge planning of affected youth in foster care. She
reported that many youth with mental disabilities had difficulty
finding gainful employment and were "picked up by the sex trade"
or "picked up as part of the drug trade." She encouraged a
requirement that youth put in residential treatment be tested
for FASD, and then social supports could be developed instead of
medication. She opined that almost all of the young girls with
FASD became pregnant, and she offered agreement with
Representative Seaton regarding the disconnect between actions
and consequences. She encouraged long acting reversible birth
control. She relayed that some fellow health care
professionals, usually not nurses, would still tell patients
that small amounts of alcohol while pregnant would not cause
harm. She stated that women without substance issues did not
ask if it was okay to drink when pregnant, they just quit
immediately. She declared the need for more in-house supportive
programs for pregnant women.
3:46:22 PM
JERRY JOHN reported that he grew up with FASD and that, while he
could do some things just fine, he needed "an external brain
every day to keep me on track," as he needed daily reminders for
everyday tasks. He offered his belief that the most important
thing was to prevent FASD and educate people about it. He
declared that people with FASD needed lifelong support.
3:48:01 PM
K. C. LOWE, Nurse Anthropologist, shared that she worked with
Mr. John as his "external brain." She reported that she had
known him since his birth, and had become his medical foster
mom, in a program to see if medical foster parenting was an
appropriate solution for FASD children. She shared his story
after he returned to his village and scavenged with the village
dogs to survive. She reported on a "remarkable intervention"
from 2001 to 2004, which made it possible to assist him with
attendance at Job Corps. She declared that that this had been a
relatively successful alternative for him, although the staff
were not educated or prepared to deal with FASD and the
cognitive disconnect. She reported that he had spent 4 years at
a community resources ranch; however, the lack of educational
understanding and experiential awareness by the staff for the
limitations caused by FASD resulted in a lack of success. She
explained that there were limitations to the functional
abilities, and these functional irregularities caused by the
physical damage to the mind from the alcohol made traditional
behavioral remediation unsuccessful. He was currently living in
Anchorage with some independence and with 24 hour support.
Although he had very few role models for success, he had been
successful in his own way. He plays five instruments, speaks
two languages fluently, and was teaching himself Spanish. He
had cognitive ability but no organizational ability, and he
could be dangerous to himself. She testified in support of
efforts toward prevention and education, and especially for
substantial, in-depth education, health and social services, and
recognition. The need for lifelong 24 hour-a-day support was
critical and essential.
REPRESENTATIVE TARR acknowledged that support and celebration of
success was necessary.
3:55:08 PM
CHAIR HIGGINS closed public testimony.
3:55:17 PM
REPRESENTATIVE KELLER commented that the proposed resolution was
frustrating, as this was not new information, and yet it was not
possible to write a law to fix it. He shared the need for more
advocates and activity to remind the legislature to spend the
money on education programs and to organize a task force. He
reflected on the challenge to social norms, although it was
"messing with people's choice and autonomy and that's why
government can't fix this one." He lamented that "it is insane
that we have this totally preventable situation and we have so
little we can really do."
3:57:18 PM
REPRESENTATIVE NAGEAK shared that something had to be done, as
this impacted a lot of people, especially in rural Alaska. He
stated that the new social networks offered hope and support,
and a place to tell people that it was not okay to drink when
you were pregnant.
4:00:04 PM
REPRESENTATIVE SEATON expressed support to the need for
prevention, and he referenced earlier discussion for voluntary
access to long term, reversible birth control. He addressed the
need to deal with the mental disconnect of cause and effect for
women with FASD, as there was no way to cure this most
significant risk factor, but it was possible to make birth
control available.
4:03:16 PM
REPRESENTATIVE KELLER moved to report CSSCR 13(HSS), Version 28-
LS1398\C, out of committee with individual recommendations.
There being no objection, CSSCR 13(HSS) was moved from the House
Health and Social Services Standing Committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| CS SCR13 Ver C.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 13 Sponsor Statement.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 13 - Summary of Changes.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR013-1-2-030314-LEG-N.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 13 - A call to Action Alaska white paper.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 13 - Alaska FAS Fact Sheet.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 13 - Circumpolar Health Study.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 13 - MCHDataBook2012.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| CS SCR 14 Ver C.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 14 - Sponsor Statement.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 14 - Summary of Changes.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR014-1-2-030314-LEG-N.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 14 - EconomicCostofAlcoholandDrugAbuse2012.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 14 - CDVSAAnnualReport2012.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 14 - AMHTA Scorecard2013.pdf |
HHSS 4/1/2014 3:00:00 PM |
|
| SCR 14 - 2012 Annual Drug Report.pdf |
HHSS 4/1/2014 3:00:00 PM |