Legislature(2013 - 2014)CAPITOL 106

02/07/2013 03:00 PM HEALTH & SOCIAL SERVICES


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03:04:35 PM Start
03:06:12 PM Overview: Children's Justice Act (cja) Task Force
04:44:26 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Overview: Children's Justice Act (CJA) Task Force TELECONFERENCED
*+ HB 54 PLACEMENT OF A CHILD IN NEED OF AID TELECONFERENCED
Scheduled But Not Heard
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                        February 7, 2013                                                                                        
                           3:04 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Pete Higgins, Chair                                                                                              
Representative Wes Keller, Vice Chair                                                                                           
Representative Benjamin Nageak                                                                                                  
Representative Lance Pruitt                                                                                                     
Representative Lora Reinbold                                                                                                    
Representative Paul Seaton                                                                                                      
Representative Geran Tarr                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
OVERVIEW: CHILDREN'S JUSTICE ACT (CJA) TASK FORCE                                                                               
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
HOUSE BILL NO. 54                                                                                                               
"An Act relating to the identification, location, and                                                                           
notification of specified family members of a child who is in                                                                   
state custody."                                                                                                                 
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
No previous action to record                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
JAN RUTHERDALE, Chair                                                                                                           
Alaska Children's Justice Act Task Force                                                                                        
Senior Assistant Attorney General                                                                                               
Child Protection Section                                                                                                        
Civil Division (Juneau)                                                                                                         
Department of Law (DOL)                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified and answered questions during the                                                              
Overview of the Children's Justice Act (CJA) Task Force.                                                                        
                                                                                                                                
CATHY BALDWIN-JOHNSON, Medical Director                                                                                         
Alaska CARES                                                                                                                    
The Children's Place                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:    Presented a  PowerPoint,  titled  "Alaska                                                             
Children's Justice Act Task Force."                                                                                             
                                                                                                                                
THOM JANIDLO, Vice-Chair                                                                                                        
Alaska Children's Justice Act Task Force                                                                                        
Attorney at Law                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:    Presented a  PowerPoint,  titled  "Alaska                                                             
Children's Justice Act Task Force."                                                                                             
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:04:35 PM                                                                                                                    
                                                                                                                                
CHAIR PETE  HIGGINS called the  House Health and  Social Services                                                             
Standing   Committee    meeting   to    order   at    3:04   p.m.                                                               
Representatives  Higgins,  Nageak,   Keller,  Tarr,  Seaton,  and                                                               
Reinbold  were present  at  the call  to  order.   Representative                                                               
Pruitt arrived as the meeting was in progress.                                                                                  
                                                                                                                                
^OVERVIEW: Children's Justice Act (CJA) Task Force                                                                            
       OVERVIEW: Children's Justice Act (CJA) Task Force                                                                    
                                                                                                                                
3:06:12 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS announced that the  only order of business would be                                                               
an Overview from the Children's Justice Act (CJA) Task Force.                                                                   
                                                                                                                                
3:06:37 PM                                                                                                                    
                                                                                                                                
JAN RUTHERDALE, Chair, Alaska Children's  Justice Act Task Force,                                                               
Senior  Assistant  Attorney  General, Child  Protection  Section,                                                               
Civil  Division  (Juneau),  Department  of  Law  (DOL),  directed                                                               
attention  to the  two packets,  "Alaska  Children's Justice  Act                                                               
Task Force"  and "Overview of  the Alaska Children's  Justice Act                                                               
Task Force"  [Included in members'  packets] and said  that these                                                               
described the  mission, the projects,  and the membership  of the                                                               
task force.   She noted that these also included  a more complete                                                               
description of  the Adverse Childhood Experiences  (ACE) project.                                                               
She said  that they  would first focus  on child  maltreatment in                                                               
Alaska and  why it mattered  to all of  us, and then  discuss the                                                               
legislative changes proposed by the  task force.  She noted that,                                                               
although  the task  force had  presented to  the Legislature  for                                                               
many years,  last year they  had also proposed legislation  to be                                                               
considered.                                                                                                                     
                                                                                                                                
3:11:58 PM                                                                                                                    
                                                                                                                                
CATHY  BALDWIN-JOHNSON,  Medical   Director,  Alaska  CARES,  The                                                               
Children's  Place,  introduced  slide  3,  "Alaskan  Children  in                                                               
Danger."   Moving on to  slide 4,  "Data Sources," she  said that                                                               
this  information  on the  Office  of  Children's Services  (OCS)                                                               
website  was  very  up  to  date.   She  moved  on  to  slide  5,                                                               
"Maltreatment- All Types,"  and shared that, in  2012, there were                                                               
more than  16,000 reports  of Alaskan children  as victims  of at                                                               
least one  incident of maltreatment.   She pointed out  that this                                                               
was  as many  as  44 children  a day,  which  would, on  average,                                                               
include  25  incidences  for  neglect, 7  for  mental  injury  or                                                               
exposure to  domestic violence, 5  for physical abuse, and  2 for                                                               
in-home  sexual abuse.   She  noted  that these  numbers did  not                                                               
include  out-of-home  sexual  abuse,   and  was  likely  a  gross                                                               
underestimation.                                                                                                                
                                                                                                                                
3:14:02 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  directed attention to slide  6, "Overall 171                                                               
% of National Average," and  said that, although still very high,                                                               
this was  an improvement over  prior years.  She  indicated slide                                                               
7,   "What  does   this  mean   for  Alaskans?"   and  slide   8,                                                               
"Consequences."     She  explained  that   maltreatment  included                                                               
physical  abuse,  sexual  abuse, neglect,  exposure  to  domestic                                                               
violence, and drug endangerment,  and that the consequences could                                                               
be physical, psychological, behavioral,  societal, both short and                                                               
long term, and could have effects throughout the lifespan.                                                                      
                                                                                                                                
3:14:52 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  stated that  a short  term impact  was child                                                               
death,  slide 9,  "Maltreatment-Related  Child  Deaths" and  said                                                               
that one in  five Alaskan child deaths  was maltreatment related,                                                               
either abuse or  neglect.  She presented slide 10,  "Child & Teen                                                               
death  in Alaska,"  a graph  which  depicted the  higher rate  in                                                               
Alaska, with  homicide being  the fourth  leading cause  of death                                                               
for  Alaskan  children.    In  response  to  Chair  Higgins,  she                                                               
clarified  that this  was solely  homicide, and  did not  include                                                               
suicide.                                                                                                                        
                                                                                                                                
3:15:55 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON,  indicating  slide 11,  "Violent  death  of                                                               
teens  in  Alaska,"  said  that   this  often  combined  suicide,                                                               
homicide,  and   violent  accidents,   and  that  the   rate  was                                                               
significantly  higher in  Alaska.   She relayed  that there  were                                                               
direct  and  indirect costs:    costs  for child  protection  and                                                               
criminal   justice  systems,   loss   of   future  earnings   and                                                               
productivity  during adulthood,  and  medical  and mental  health                                                               
care costs, slide 12, "What does this cost?"                                                                                    
                                                                                                                                
3:17:14 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON reported  that the  estimated cost  was $220                                                               
million a day, or $80 billion  each year, slide 13, "Total Annual                                                               
Cost of Child Abuse  and Neglect in the US."   She noted that the                                                               
struggle  to  pay for  increasing  health  care costs  needed  to                                                               
address the underlying causes, slide 14, "Health Care Costs."                                                                   
                                                                                                                                
3:17:53 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON moved on to  slide 15, "The Adverse Childhood                                                               
Experiences  (ACE)  Study,"  and  explained  that  this  landmark                                                               
research project  was a collaboration between  researchers at the                                                               
Centers  for  Disease  Control (CDC)  and  Kaiser  Permanente,  a                                                               
health maintenance  organization (HMO)  in California.   She said                                                               
that the first  published article was titled,  "Turning Gold into                                                               
Lead,"  as it  discussed the  lifelong adverse  effects from  the                                                               
abuse  of children.   She  explained  the study,  noting that  it                                                               
involved more than 17,000 employed  participants, almost the same                                                               
ratio  of men  to women,  with the  majority being  white, middle                                                               
aged, and college educated, slide 16, "ACE Study Description."                                                                  
                                                                                                                                
3:19:06 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  said that the  study asked questions  of the                                                               
participants regarding their life  growing up, slide 17, "Adverse                                                               
Childhood  Experiences  During 1st  18  years  of life."    These                                                               
included  questions regarding  any  history  of different  abuse,                                                               
family dysfunction,  substance abuse,  violence in the  home, and                                                               
neglect, and  asked if any of  these had happened at  least once,                                                               
slide 18,  "Adverse Childhood Experiences."   For every incident,                                                               
each participant was  given a score of one, so  that sexual abuse                                                               
and witnessing domestic violence would each have a score of one.                                                                
                                                                                                                                
3:19:59 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  observed that it  was not uncommon  for kids                                                               
to  be exposed  to  many  things, slide  19,  "ACEs are  common,"                                                               
noting that  28 percent had  been physically abused as  kids, and                                                               
an  astounding number  had been  sexually abused.   She  reported                                                               
that  only 36  percent of  the participants  had not  had any  of                                                               
these experiences,  while 12.5 percent had  experienced more than                                                               
four categories  of family dysfunction  or abuse, slide  20, "ACE                                                               
Scores."   She observed that the  higher the ACE score,  the more                                                               
likely  to suffer  from adverse  health  consequences, slide  21,                                                               
"Results."                                                                                                                      
                                                                                                                                
3:21:17 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  directed attention  to slide 22,  "ACE Score                                                               
vs. Smoking;"  slide 23,  "ACE Score  vs. Alcoholism;"  slide 24,                                                               
"ACE Score  vs. Ever  Ingested Drugs;" slide  25, "ACE  Score vs.                                                               
Depression;"  and  slide  26,  "ACE   Score  vs.  Ever  Attempted                                                               
Suicide."   She said that the  correlation of a higher  ACE score                                                               
with a higher incidence was true throughout.                                                                                    
                                                                                                                                
3:21:49 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON identified  slide  27, "ACE  Score vs  BMI;"                                                               
slide 28, "ACE Score vs  Sedentary Lifestyle;" and slide 29, "ACE                                                               
Score vs Chronic Disease," stating  that all of these reflected a                                                               
significant graded relationship.                                                                                                
                                                                                                                                
3:22:40 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON stated  that heart  disease was  the leading                                                               
cause of  death for men and  women in the United  States, and she                                                               
noted that the  significant correlation with ACE  created an even                                                               
stronger  relationship than  traditional  risk  factors, such  as                                                               
high blood pressure,  diabetes, or smoking, slide  30, "ACE Score                                                               
& Heart Disease."                                                                                                               
                                                                                                                                
3:23:14 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  shared that there were  links between higher                                                               
ACE  scores  and  reproductive  health  problems,  mental  health                                                               
problems,  auto-immune  diseases, fractures,  work  productivity,                                                               
and future victimization, slide 31, "More ACE links."                                                                           
                                                                                                                                
3:23:39 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON  cited  that   other  research  had  similar                                                               
findings, slide  32, "Sampling  of other  confirmatory research."                                                               
She  described  a  study of  adolescent  suicide  attempts  which                                                               
reported that children  who had been physically  abused were five                                                               
times  more  likely  to commit  suicide,  while  sexually  abused                                                               
children  were three  times more  likely,  slide 33,  "Adolescent                                                               
suicide attempts."  She  communicated the significant correlation                                                               
between bad  things happening in  childhood with more  bad things                                                               
happening in  adulthood, slide  34, "Revictimization  & substance                                                               
use."                                                                                                                           
                                                                                                                                
3:24:52 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON discussed  a  30 year  study  which found  a                                                               
correlation between  childhood physical abuse and  adult obesity,                                                               
even  when  other  factors  such   as  genetic  disposition  were                                                               
controlled,  slide 35,  "Adult obesity."   Summarizing  slide 36,                                                               
"Evidence  from  ACE study  suggests:"  she  stated that  adverse                                                               
childhood experiences  should be  considered as  one of  the most                                                               
basic causes  of health risk behavior,  illness, premature death,                                                               
and increased health care cost.                                                                                                 
                                                                                                                                
3:25:36 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON moved  on to slide 37,  "Next Questions:" and                                                               
said that this connection was  probably multi-factorial, as there                                                               
was the impact  of toxic stress on brain  development, impacts on                                                               
the immune system, and the  question of epigenetics, the study of                                                               
how genes are turned on or turned off, and expressed.                                                                           
                                                                                                                                
3:26:57 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON  presented  slide 38,  "Mechanisms..."  and,                                                               
pointing to  the top of  the pyramid graphic, explained  that the                                                               
traditional approach  for time and resources  was toward disease,                                                               
disability,  high  risk  behaviors,  and social  problems.    She                                                               
declared  that  the  concentration   of  efforts  would  be  more                                                               
effective  toward  the  outsized  base of  the  pyramid,  adverse                                                               
childhood experiences.   She  emphasized that  prevention through                                                               
earlier  identification  and  intervention   would  be  far  more                                                               
effective.                                                                                                                      
                                                                                                                                
3:27:39 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON  jumped  to  slide 40,  "Support  for  Child                                                               
Advocacy  Center  Funding" and  slide  41,  "Alaska CACs."    She                                                               
informed  the committee  that the  child advocacy  centers (CACs)                                                               
had been  an effective means  for providing services  and support                                                               
for  children and  their  families during  times  of concern  for                                                               
child physical  and sexual  abuse.  She  reported that  the first                                                               
CAC opened in  1996 in Alaska, first received  federal funding in                                                               
2001, and, beginning in 2008,  obtained funding from the State of                                                               
Alaska.    She stated  that  there  were  now  10 CACs,  with  an                                                               
additional 2  satellites, and  they had  served more  than 18,000                                                               
children.  She  pointed out that state funding  had remained flat                                                               
despite  the   significant  increase   in  CAC   utilization  and                                                               
expansion of services.                                                                                                          
                                                                                                                                
3:29:02 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON presented  slide 42,  "Recommendations," and                                                               
declared that  the CACs had  requested an increase in  funding to                                                               
$520,000, although  the Governor's current budget  allocation was                                                               
only  for $400,000.   She  considered slide  43, "Support  for HB                                                               
22/SB  73,"  and requested  support  for  these companion  bills,                                                               
which  included  stronger  provisions  against  sex  trafficking,                                                               
sentencing  provisions  for  investigations  of  exploitation  of                                                               
child abuse images,  expansion of admission of  evidence of prior                                                               
bad  acts,  and  a  statutory  revision  for  the  definition  of                                                               
mandatory reporter.                                                                                                             
                                                                                                                                
3:30:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  asked about the impacts  from adverse health                                                               
effects to performance in school.                                                                                               
                                                                                                                                
DR. BALDWIN-JOHNSON,  replying that most of  the slides reflected                                                               
health  consequences,  expressed  her agreement  that  there  was                                                               
clear evidence  that childhood stresses  affected the  ability to                                                               
learn.                                                                                                                          
                                                                                                                                
3:31:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  NAGEAK  asked  how   long  the  respondents  were                                                               
tracked for the ACE study.                                                                                                      
                                                                                                                                
DR.  BALDWIN-JOHNSON, in  response, said  that different  studies                                                               
had looked  at various age  groups.  She said  the aforementioned                                                               
ACE  study had  followed adults  for 20  years in  adulthood, but                                                               
that there had also been a range of other studies.                                                                              
                                                                                                                                
3:34:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  asked for  more information  regarding the                                                               
compilation  for  the ACE  score.    He questioned  whether  kids                                                               
attending a CAC  would have the same scores as  those who did not                                                               
receive this treatment.                                                                                                         
                                                                                                                                
3:35:34 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON pointed  out that CACs were  not in existence                                                               
until  the mid-1970s,  so  the  study was  done  on actions  from                                                               
decades earlier.  She agreed that  the impact from CACs was still                                                               
unknown,  though  she expressed  anecdotal  data  that kids  were                                                               
benefiting from the CACs.                                                                                                       
                                                                                                                                
3:37:00 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS  asked  to  receive a  budget  breakdown  for  the                                                               
funding request.                                                                                                                
                                                                                                                                
3:37:24 PM                                                                                                                    
                                                                                                                                
THOM  JANIDLO, Vice-Chair,  Alaska  Children's  Justice Act  Task                                                               
Force,  Attorney  at   Law,  said  there  were   not  many  child                                                               
protective laws in place until the late 1960s.                                                                                  
                                                                                                                                
3:38:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  expressed his concern that  it was unclear                                                               
whether  the CAC  services had  resulted  in a  reduction to  any                                                               
problems.                                                                                                                       
                                                                                                                                
3:39:53 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON replied  that  there were  fewer reports  of                                                               
child sexual  abuse for both  Alaska and  the nation, and  it was                                                               
theorized  that more  advocacy centers  similar to  CACs, coupled                                                               
with better laws, had resulted in a drop of abuse.                                                                              
                                                                                                                                
3:41:31 PM                                                                                                                    
                                                                                                                                
MR.   JANIDLO   directed   attention   to   slide   44,   "System                                                               
Improvement...",  slide 45,  "Recommendation #1,"  and slide  46,                                                               
"Mandatory Reporting: Background."   He declared that the mission                                                               
of  the  task  force  was  to  provide  recommendations,  and  he                                                               
clarified  that,  currently,  there  was  a  mandatory  reporting                                                               
statute in all the states.                                                                                                      
                                                                                                                                
3:43:07 PM                                                                                                                    
                                                                                                                                
MR.  JANIDLO  provided  slide 47,  "Problems:"  and  stated  that                                                               
research  showed that  child abuse  was still  underreported, and                                                               
that there was still confusion  about who was required to report.                                                               
He   noted   that,   although   Alaska   law   required   certain                                                               
professionals  to report,  it did  not include  many adults  with                                                               
daily contact  with children.   He  noted that  emergency medical                                                               
technicians  (EMT) did  not have  to report,  and yet,  they were                                                               
often the  first responder to  an incidence  of child abuse.   It                                                               
was often  unclear not only who  had to report, but  who they had                                                               
to report  to, and  that often people  were reluctant  to report.                                                               
He  shared that  almost 33  percent of  the states  required that                                                               
anyone  with  reasonable cause  to  suspect  child abuse  had  to                                                               
report.                                                                                                                         
                                                                                                                                
3:46:15 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS asked for a definition to a mandatory reporter.                                                                   
                                                                                                                                
MR. JANIDLO explained that, under  the current law, professionals                                                               
in  contact with  children had  a duty  to report  any reasonable                                                               
belief that a  child was being abused.  He  opined that in Alaska                                                               
everyone  was  responsible to  report  any  reasonable belief  of                                                               
child abuse, slide 48.                                                                                                          
                                                                                                                                
3:48:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER asked if there  was evidence that mandatory                                                               
reporting  had  significantly  lowered  the  incidence  of  child                                                               
abuse.                                                                                                                          
                                                                                                                                
MR. JANIDLO, in response to  Representative Keller, said that the                                                               
Children's Justice Act Task Force  was in support of all citizens                                                               
being responsible for mandatory reporting.                                                                                      
                                                                                                                                
3:48:43 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  asked if there  were any re-education  programs on                                                               
reporting for health professionals.                                                                                             
                                                                                                                                
DR. BALDWIN-JOHNSON replied that this was ongoing training.                                                                     
                                                                                                                                
3:49:25 PM                                                                                                                    
                                                                                                                                
MS.  RUTHERDALE   explained  that  the  task   force  budget  was                                                               
population based, and  it was necessary to  make project choices.                                                               
She declared  that, as understanding  mandatory reporting  was so                                                               
necessary, the task  force decided to create and  distribute a CD                                                               
about  the program.   She  added  that the  Office of  Children's                                                               
Services (OCS) also used and disseminated the CD.                                                                               
                                                                                                                                
3:50:52 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  shared some  professional anecdotal  incidences of                                                               
child dental neglect, and emphasized  the need for the continuing                                                               
education of health care professionals.                                                                                         
                                                                                                                                
3:51:41 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO said  that the goal was to protect  kids, and to take                                                               
responsibility as adults.                                                                                                       
                                                                                                                                
3:52:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  expressed  his  agreement  with  all  the                                                               
statements  regarding  abuse,  but  he pointed  out  that  Alaska                                                               
statutes referred to  "abuse or neglect," and  that "neglect" was                                                               
a  state-wide  standard  which  did   not  take  into  account  a                                                               
situation, such  as inadequate clothing.   He opined that  it was                                                               
necessary to advocate for mandatory  reporting of abuse, but that                                                               
there  needed  to be  definitions  for  levels  of neglect.    He                                                               
declared that  he did  not want  to have  unintended consequences                                                               
from a legal definition of neglect.                                                                                             
                                                                                                                                
3:54:18 PM                                                                                                                    
                                                                                                                                
MS. RUTHERDALE  explained to Representative  Seaton that  the law                                                               
clarified that poverty  was not neglect.  She  established that a                                                               
report  to OCS  for a  reasonable suspicion  of harm  allowed for                                                               
experienced  staff  to  determine whether  an  investigation  was                                                               
necessary.     She  said   that  a   very  small   percentage  of                                                               
investigations went to legal action.                                                                                            
                                                                                                                                
3:56:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON declared  that  the  question was  whether                                                               
people  were in  violation  for  not reporting  and  that it  was                                                               
necessary to better define the standard for neglect.                                                                            
                                                                                                                                
3:57:35 PM                                                                                                                    
                                                                                                                                
MS.  RUTHERDALE agreed  that it  was a  training issue  to better                                                               
understand  mandatory  reporting  for   a  "reasonable  cause  to                                                               
suspect."                                                                                                                       
                                                                                                                                
3:57:53 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  shared that he  had used the threat  for reporting                                                               
of neglect,  but he pointed  out that the definition  for neglect                                                               
and abuse was unclear to many health care professionals.                                                                        
                                                                                                                                
3:58:29 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO  declared that  Alaska still had  one of  the highest                                                               
rates of  child abuse in the  nation, 171 percent of  the rest of                                                               
the country.   He opined that  Alaska should be leading  the rest                                                               
of the country as the state did  not have so many of the old laws                                                               
to  deal  with.    He   endorsed  that  all  Alaskans  should  be                                                               
responsible for reporting child abuse, slide 49.                                                                                
                                                                                                                                
3:59:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  REINBOLD  commented  that  it  was  necessary  to                                                               
define abuse.   She declared that she did not  see any statistics                                                               
that  intervention  and mandatory  reporting  was  working.   She                                                               
considered that  abuse was  interpreted differently  in different                                                               
cultures.  She  offered her belief that it was  very important to                                                               
focus  on   the  serious  at-risk   cases,  and  that   the  best                                                               
intervention  was from  friends.   She  offered  her belief  that                                                               
government officials  could cause  more trauma, and  would demand                                                               
more reporting,  more exposure, and more  involvement, as opposed                                                               
to a  confidential, safe, gentle  intervention.  She  opined that                                                               
this gentle  intervention in  high risk areas  was "so  much more                                                               
effective  than  a  big  bureaucracy  that  really  doesn't  look                                                               
statistically like their doing much good."                                                                                      
                                                                                                                                
4:01:05 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO expressed his agreement  that if everyone watched out                                                               
for  their  neighbor,  then  many   of  the  laws  would  not  be                                                               
necessary.                                                                                                                      
                                                                                                                                
REPRESENTATIVE  REINBOLD replied,  "there's  a  lot of  wonderful                                                               
parents... we  do have wonderful  people all over the  place, and                                                               
interventions that are free all over."                                                                                          
                                                                                                                                
MR. JANIDLO expressed his agreement  that everyone wanted kids to                                                               
have  the necessary  safety  and protection.    He declared  that                                                               
intervention was only necessary  where there was reasonable cause                                                               
for concern for the child's safety.                                                                                             
                                                                                                                                
REPRESENTATIVE  REINBOLD  asked  if reporting  was  helping  with                                                               
positive outcomes, and not creating more problems.                                                                              
                                                                                                                                
4:03:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  asked to clarify that  mandatory reporting                                                               
was  for  seeing  abuse  or  neglect, and  that  there  would  be                                                               
violation of the statute, even if  you intervened, if you did not                                                               
report.                                                                                                                         
                                                                                                                                
4:04:19 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO  offered his  belief that  there were  fewer children                                                               
being  taken into  custody because  there were  more programs  to                                                               
help before there was abuse.                                                                                                    
                                                                                                                                
4:05:07 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO moved on to  slide 50, "Alternate Solution:" which he                                                               
described  as  an  addition  to  the patchwork  to  fill  in  the                                                               
reporting gaps.   He indicated slide 51,  "First Responders," and                                                               
listed  that  first  responders,  fire  fighters,  and  emergency                                                               
medical  personnel  should be  added  to  the mandatory  reporter                                                               
list.   He  listed  social workers,  juvenile justice  personnel,                                                               
court appointed  advocates, and guardian ad  litems, as mandatory                                                               
reporters, slide 52, "Social Services Personnel."                                                                               
                                                                                                                                
4:06:44 PM                                                                                                                    
                                                                                                                                
MR.  JANIDLO  indicated  slide   53,  "Veterinarians  and  animal                                                               
control officers,"  and shared that  studies linked  animal abuse                                                               
and  child  abuse, so  animal  control  officers should  also  be                                                               
included as mandatory reporters.                                                                                                
                                                                                                                                
4:07:30 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS   asked  what  were   the  consequences   for  not                                                               
reporting.                                                                                                                      
                                                                                                                                
MR.  JANIDLO   replied  that   not  reporting   was  a   Class  A                                                               
misdemeanor,  but he  clarified  that no  professionals had  been                                                               
prosecuted.  He stated that the  objective was as an incentive to                                                               
report.                                                                                                                         
                                                                                                                                
4:08:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR asked if there  had been previous legislation                                                               
for this.                                                                                                                       
                                                                                                                                
REPRESENTATIVE   SEATON  replied   that   he  remembered   debate                                                               
revolving around  the parameters of  neglect.  He said  that part                                                               
of  the perspective  was for  the legislature  to pass  laws that                                                               
people obey,  and there needed  to be consequences,  otherwise it                                                               
became a bad system.                                                                                                            
                                                                                                                                
4:10:07 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS opined  that the  rights and  liberties of  people                                                               
were taken away under the guise of safety.                                                                                      
                                                                                                                                
4:10:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE REINBOLD reflected  on successful interventions by                                                               
youth, and expressed her concern  for the unintended consequences                                                               
of adult  interventions, which raised  her concern  for mandatory                                                               
reporting.                                                                                                                      
                                                                                                                                
4:11:42 PM                                                                                                                    
                                                                                                                                
MR.  JANIDLO said  that  the  first child  abuse  came through  a                                                               
cruelty to animals'  case, because there were not  any laws about                                                               
abusing children  in the 1870s.   He declared that  clergy needed                                                               
to be  added to the list  for mandatory reporting, as  they often                                                               
had access  to information, slide 54,  "Clergy."  He moved  on to                                                               
slide  55,   "Persons  providing  instruction  and   coaching  to                                                               
children,"  and noted  that coaches,  music teachers,  and others                                                               
needed to help stop the abuse.                                                                                                  
                                                                                                                                
4:13:51 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO  declared that slide 56,  "Certain other volunteers,"                                                               
also needed to be added to  the mandatory reporters list, as they                                                               
often came  in frequent contact  with children.  He  reminded the                                                               
committee that  this addition to  the list was an  alternative to                                                               
making  it   mandatory  for  everyone   to  report  abuse.     He                                                               
established that  the second recommendation  from the  task force                                                               
was to update the current  statute concerning medical evaluations                                                               
of suspected child abuse, slide 57.                                                                                             
                                                                                                                                
4:14:53 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON reviewed slide  58, "Problem:", and explained                                                               
that  the law  for diagnostic  testing in  suspected child  abuse                                                               
cases was limited to x-rays  and photographs, and did not include                                                               
other tests, such as CT scans  and MRIs, which were more accurate                                                               
and  less invasive,  and could  help differentiate  between abuse                                                               
and non-abuse.  She noted  that parents were not always available                                                               
or cooperative.                                                                                                                 
                                                                                                                                
4:16:08 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO, slide 59, "Solution:"  suggested that modernizing AS                                                               
47.17.64  would allow  the necessary  testing of  abused children                                                               
with current  technologies.  He  moved on to  the "Recommendation                                                               
#3," slide  60, which  would add  a new  section to  the criminal                                                               
code  regarding children's  exposure  to domestic  violence.   He                                                               
explained that  the "Problem:", slide  61, was that  children who                                                               
were  exposed  to domestic  violence  were  subject to  the  same                                                               
outcomes as children directly experiencing  abuse, and it was not                                                               
a crime.   He suggested  to add and define  a new section  to the                                                               
Alaska  Criminal Code  making it  unlawful to  expose a  child to                                                               
domestic  violence,   slide  62,  "Solution:"     He  noted  that                                                               
Anchorage already had this in place.                                                                                            
                                                                                                                                
MR. JANIDLO announced  that the fourth recommendation  was to add                                                               
victim  protections to  the criminal  and child  protection laws,                                                               
slide 63,  "Recommendation #4."   He  explained that  the problem                                                               
was with  the information exchange during  the discovery process,                                                               
when mental  health interviews and forensic  interviews had ended                                                               
up in  the wrong  hands, slide  64, "Problem:"   He  suggested to                                                               
make  it  a crime  for  unauthorized  publication of  a  victim's                                                               
protected material, to modify the  rules of discovery in criminal                                                               
and child protection cases  regarding redistribution of protected                                                               
materials,  and to  protect mental  health records  of a  victim,                                                               
slide 65, "Solution:"                                                                                                           
                                                                                                                                
4:19:34 PM                                                                                                                    
                                                                                                                                
MR. JANIDLO  summarized and  said that  the task  force supported                                                               
increased    funding   for    CACs,   supported    the   proposed                                                               
aforementioned legislation,  HB 73 and SB  22, recommended making                                                               
all  Alaskans  responsible  to report  child  abuse,  recommended                                                               
modernizing  the statute  for medical  evaluation  and making  it                                                               
unlawful to expose  a child to domestic  violence, and protecting                                                               
children  from further  victimization in  the discovery  process,                                                               
slide 66,  "Summary of  Recommendations."   He declared  that the                                                               
task force  was looking  for champions  for Alaskan  children, as                                                               
everyone was responsible for them.                                                                                              
                                                                                                                                
4:21:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON, referring  to "CJATF Proposed Legislation"                                                               
[Included  in   members'  packets],  asked  about   the  proposed                                                               
legislation on  page 4, line  15.   He asked who  the financially                                                               
obligated party  was if  a doctor  decided to  have tests  on the                                                               
child.                                                                                                                          
                                                                                                                                
4:22:14 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON,  in response to Representative  Seaton, said                                                               
that  the responsible  payer could  be  the parent  or the  third                                                               
party payer,  insurance or  Medicaid; however,  if the  child was                                                               
taken into custody,  then the state would be  responsible, as the                                                               
guardian of the child.                                                                                                          
                                                                                                                                
DR.  BALDWIN-JOHNSON,  in   response  to  Representative  Seaton,                                                               
clarified that this  was only if the parent was  not available or                                                               
would not  supply consent if  the tests had  indicated reasonable                                                               
cause.                                                                                                                          
                                                                                                                                
4:23:07 PM                                                                                                                    
                                                                                                                                
MR.  JANIDLO pointed  out  that  this was  current  law, and  the                                                               
proposed  legislation   was  only  adding  imaging   studies  and                                                               
diagnostic testing to the existing law.                                                                                         
                                                                                                                                
REPRESENTATIVE SEATON pointed out  that this proposed legislation                                                               
was adding more expensive procedures.                                                                                           
                                                                                                                                
4:24:04 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  clarified that the proposed  legislation was                                                               
only updating to include current technology.                                                                                    
                                                                                                                                
4:24:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER  endorsed the membership list  for the task                                                               
force,  noting  that  it  was impressive  and  included  a  broad                                                               
spectrum of  knowledge which offered  an excellent resource.   He                                                               
offered his  assumption that there  were no salaries paid  to its                                                               
members.   He expressed his  appreciation for  the recommendation                                                               
to  expand the  CACs, although  he questioned  whether there  was                                                               
significant  data to  "really make  a really  hard core  case for                                                               
their success."   He expressed  his suspicions about  the vetting                                                               
process for the proposed legislation.   He asked who proposed the                                                               
legislation,  if  everyone  on   the  task  force  had  submitted                                                               
comments,  and if  it had  been influenced  by national  advocacy                                                               
groups.  He requested more background on the process.                                                                           
                                                                                                                                
4:25:52 PM                                                                                                                    
                                                                                                                                
MS. RUTHERDALE  replied that,  during brainstorming  sessions for                                                               
improvement to  the programs,  "mandatory reporting  always rises                                                               
to  the  top  of  the  list."    She  referenced  the  nationwide                                                               
awareness  and  discussion  for  mandatory  reporting  since  the                                                               
revelations about  child sexual abuse  by Jerry Sandusky  at Penn                                                               
State University.   She specified  that the majority of  the work                                                               
came  from   the  task  force's   review  of  the   statutes  and                                                               
discussions based  on personal experience  about "where  the gaps                                                               
lay."                                                                                                                           
                                                                                                                                
4:27:13 PM                                                                                                                    
                                                                                                                                
DR.  BALDWIN-JOHNSON pointed  out  that, as  the  task force  had                                                               
statewide  multi-disciplinary representation,  there were  others                                                               
who  offered information.   She  shared an  example from  the EMS                                                               
personnel,  who  had   disclosed  that  they  were   not  on  the                                                               
practitioners of the healing arts mandatory reporting list.                                                                     
                                                                                                                                
4:27:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER,  directing  attention to  the  $80-90,000                                                               
budget for  the task force  which included payment  for trainings                                                               
and part-time  staff, asked how often  the task force met  and if                                                               
it was  paid for from  "the meager budget  that you have  and the                                                               
grant."  He asked if the  meetings were broadcast and open to the                                                               
public.                                                                                                                         
                                                                                                                                
4:28:49 PM                                                                                                                    
                                                                                                                                
MS.  RUTHERDALE replied  that anyone  was welcome  to attend  the                                                               
meetings, and  that the task  force did invite  outside speakers.                                                               
She  pointed  out  that  there  were  subcommittee  meetings  and                                                               
teleconferences,  in addition  to  the quarterly  meetings.   She                                                               
disclosed that  the cost  for the  teleconferences was  also paid                                                               
from the budget.  She  reported that the committee which prepared                                                               
this presentation had been meeting weekly.                                                                                      
                                                                                                                                
4:29:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  directed  attention  to  page  3  of  the                                                               
Proposed CJATF  Alternative to  Universal Reporting  [Included in                                                               
members' packets], and  asked to clarify that the  intent was for                                                               
any  report to  be  submitted  to the  Department  of Health  and                                                               
Social Services.                                                                                                                
                                                                                                                                
MS. RUTHERDALE replied that this  was existing law, and that this                                                               
proposal merely  clarified that  the reporting had  to be  to the                                                               
Office of Children's Services (OCS),  in the Department of Health                                                               
and Social Services.                                                                                                            
                                                                                                                                
4:31:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON directed  attention  to  page 4,  proposed                                                               
Section 7, and  asked who was included as  "regular volunteers of                                                               
the church or religious body."                                                                                                  
                                                                                                                                
4:31:38 PM                                                                                                                    
                                                                                                                                
MS.  RUTHERDALE explained  that  this definition  was modeled  on                                                               
evidence  rules,  and she  could  research  further for  who  was                                                               
included.                                                                                                                       
                                                                                                                                
REPRESENTATIVE SEATON  surmised that  it could be  any volunteers                                                               
at a church.                                                                                                                    
                                                                                                                                
MS. RUTHERDALE expressed her agreement.                                                                                         
                                                                                                                                
REPRESENTATIVE  SEATON  asked  if  this was  the  intent  of  the                                                               
proposal.                                                                                                                       
                                                                                                                                
MS.  RUTHERDALE stated  that  this  was clarified  on  page 4  to                                                               
include those  who "supervise, educate, coach,  train, or counsel                                                               
children."                                                                                                                      
                                                                                                                                
REPRESENTATIVE  SEATON  asked  to clarify  whether  "and  persons                                                               
employed" also included the volunteers.                                                                                         
                                                                                                                                
MS.  RUTHERDALE  agreed  that  there would  need  to  be  further                                                               
legislative clarity,  even though  the task  force had  worked to                                                               
"make as shovel ready as possible."                                                                                             
                                                                                                                                
REPRESENTATIVE   SEATON  analyzed   that  the   intent  was   for                                                               
volunteers to  be analogous  with persons  employed, but  only to                                                               
include those  volunteers who  supervise, educate,  coach, train,                                                               
or counsel children.                                                                                                            
                                                                                                                                
MS. RUTHERDALE expressed her agreement with this analysis.                                                                      
                                                                                                                                
4:34:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR shared  a personal  anecdote, and  expressed                                                               
her   appreciation  to   the  task   force   presenters  and   to                                                               
Representative Reinbold  for her comments about  keeping families                                                               
together.  She asked for details to the CAC process.                                                                            
                                                                                                                                
4:35:16 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON  explained that  the CACs provided  a neutral                                                               
locale, when there  was an allegation of abuse,  for the agencies                                                               
involved with evaluation  of a child to bring  their resources to                                                               
the  child.   She  noted  that  most  children  at the  CAC  were                                                               
referred  by   Office  of  Children's  Services   (OCS),  medical                                                               
providers, or  law enforcement  when a  complaint had  been made.                                                               
She shared  that a child,  when old enough, would  be interviewed                                                               
by a person trained in  forensic interviews with children.  There                                                               
would  be a  medical  evaluation, if  appropriate,  by a  medical                                                               
provider specially  trained for evaluating children  for abuse; a                                                               
psycho-social  evaluation for  the child,  and an  evaluation for                                                               
the  needs of  the family;  and  ongoing support  for the  family                                                               
through the  follow up  process.  She  communicated that  the CAC                                                               
would coordinate the team for case review and ongoing tracking.                                                                 
                                                                                                                                
4:37:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR asked if a  parent could access the resources                                                               
of CAC  without a  complaint, in order  to better  understand any                                                               
cultural differences which could result in reported incidents.                                                                  
                                                                                                                                
DR. BALDWIN-JOHNSON  replied that this  was not part of  the core                                                               
services provided  by the  CAC program.   She offered  her belief                                                               
that  some  CACs  could  have   community  outreach  and  support                                                               
programs for parents.                                                                                                           
                                                                                                                                
4:38:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  REINBOLD asked  to clarify  her earlier  comments                                                               
about  organizations that  served youth.   She  noted that  youth                                                               
would share  with someone they  trusted, and if the  incident was                                                               
then reported, the  youth could be banned from  future outings by                                                               
their family for exposing these  abuses.  She declared her desire                                                               
to ensure that kids who were  not getting help were cared for and                                                               
given the  opportunity to  talk.  She  expressed her  concern for                                                               
doing more  damage than  good.   She asked  for the  effects from                                                               
this  proposed legislation  on the  Health Insurance  Portability                                                               
and Accountability Act (HIPAA) regulations.                                                                                     
                                                                                                                                
4:39:48 PM                                                                                                                    
                                                                                                                                
MS.  RUTHERDALE clarified  that  the  proposed legislation  would                                                               
restrict the  number of  people with  access to  the information,                                                               
which was compatible with HIPAA.                                                                                                
                                                                                                                                
MR. JANIDLO,  in response to  Representative Reinbold,  said that                                                               
medical  records  were already  being  released  to the  relevant                                                               
agencies,   but  remained   confidential  during   the  discovery                                                               
process, so this was all in compliance with HIPAA.                                                                              
                                                                                                                                
4:40:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  reported that  he had  visited the  CAC in                                                               
Homer,  and  he  declared  that  it  was  a  really  enlightening                                                               
experience.   He pointed  out that,  whereas most  state troopers                                                               
were  intimidating  and not  adequately  trained  to interview  a                                                               
child, the  CAC was  well trained  and very  child friendly.   He                                                               
questioned  whether  the  CAC became  directly  involved  when  a                                                               
medical provider  had a concern  for a  child abuse, and  if this                                                               
would bypass the Department of Health and Social Services.                                                                      
                                                                                                                                
4:42:40 PM                                                                                                                    
                                                                                                                                
DR. BALDWIN-JOHNSON explained that the  CAC notified OCS if there                                                               
was a  medical referral, and  then OCS and law  enforcement would                                                               
determine whether  to become immediately involved,  or, depending                                                               
on  the nature  of the  complaint, to  wait for  completion of  a                                                               
medical examination.   She noted  that this situation  most often                                                               
involved pre-verbal children.                                                                                                   
                                                                                                                                
4:43:38 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS  declared  that children  are  the  most  valuable                                                               
resource.                                                                                                                       
                                                                                                                                
4:44:26 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 4:44 p.m.                                                                                                          

Document Name Date/Time Subjects