Legislature(2007 - 2008)SENATE FINANCE 532
04/17/2007 09:00 AM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB89 | |
| HB168 | |
| SB100 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 100 | TELECONFERENCED | |
| + | SB 76 | TELECONFERENCED | |
| + | SB 137 | TELECONFERENCED | |
| + | HB 168 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | SB 89 | ||
MINUTES
SENATE FINANCE COMMITTEE
April 17, 2007
9:05 a.m.
CALL TO ORDER
Co-Chair Bert Stedman convened the meeting at approximately
9:05:44 AM.
PRESENT
Senator Lyman Hoffman, Co-Chair
Senator Bert Stedman, Co-Chair
Senator Charlie Huggins, Vice Chair
Senator Kim Elton
Senator Joe Thomas
Senator Fred Dyson
Senator Donny Olson
Also Attending: SENATOR BILL WIELECHOSWKI; SENATOR JOHNNY ELLIS;
DWAYNE PEEPLES, Deputy Commissioner, Department of Corrections;
DAVID SCOTT, Staff to Representative Kyle Johansen; MARY SIROKY,
Special Assistant to the Commissioner, Department of
Transportation and Public Facilities; WENDY LINDSKOOG, Assistant
Vice President, Corporate Affairs, Alaska Railroad Corporation,
Department of Commerce, Community and Economic Development; JEFF
JESSEE, Chief Executive Officer, Alaska Mental Health Trust
Authority, Department of Revenue; KATE HERRING, Staff to Senator
Ellis; LONNIE WALTERS, Chair, Governor's Advisory Board on
Alcoholism & Drug Abuse; SUEY LINZMEIER; VERNER STILLNER,
Psychiatrist, Bartlett Regional Hospital and Member, Governor's
Advisory Board on Alcohol & Drug Abuse
Attending via Teleconference: From Offnet Locations: FRAN
ZIMMERMAN, Central Region, Department of Transportation and
Public Facilities; JOHN BENNETT, Right-of-Way Chief, Northern
Region, Department of Transportation and Public Facilities;
PHYLISS JOHNSON, Vice President, General Counsel, Alaska
Railroad, Department of Commerce, Community and Economic
Development; Dr. MARC PELLICCIARO, Medical Director, Psychiatric
Emergency Room, Providence Hospital; MARGARET LOWE, Trustee,
Alaska Mental Health Trust Authority
SUMMARY INFORMATION
SB 89-ELECTRONIC MONITORING OF GANG PROBATIONER
The Committee heard from the bill's sponsor and the Department
of Corrections. The bill reported from Committee.
HB 168-LAND TRANSFERS ALASKA RR & Department of Transportation
and Public Facilities
The Committee heard from the bill's sponsor, the Alaska
Railroad, the Department of Transportation and Public
Facilities, and the Department of Commerce, Community and
Economic Development. The bill reported from Committee.
SB 100-SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS
The Committee heard from the bill's sponsor, the Alaska Mental
Health Trust Authority, and took public testimony. A committee
substitute was adopted and the bill was held in Committee.
SB 76-TUITION FOR CERTAIN CHILDREN
This bill was scheduled but not heard.
9:07:09 AM
CS FOR SENATE BILL NO. 89(JUD)
"An Act relating to requiring electronic monitoring as a
special condition of probation for offenders whose offense
was related to a criminal street gang."
This was the third hearing for this bill in the Senate Finance
Committee.
Co-Chair Stedman noted the bill had been held in Committee in
order to further review the fiscal impact of the bill on the
Department of Corrections.
9:07:51 AM
SENATOR BILL WIELECHOWSKI, the bill's sponsor, informed the
Committee that a new fiscal note, dated April 16, 2007, has been
provided. The determination was that the program would not incur
any expense in FY 2008 (FY 08). The anticipated costs of the
program from FY 2009 through FY 2012 were depicted on the fiscal
note.
9:08:56 AM
DWAYNE PEEPLES, Deputy Commissioner, Department of Corrections,
addressed the new fiscal note. While the Department anticipates
a substantial number of people might qualify for this electronic
monitoring (EM) program in the future, the immediate fiscal
impact would be delayed as a result of the US Supreme Court's
decision in Blakely v. Washington. That decision would slow the
process involved in subjecting people to the probation program.
Therefore, the fiscal note was developed with the understanding
that the earliest date anticipated for admitting someone to this
EM program might be the last quarter of FY 08; it is more likely
that no one would be monitored until early FY 09. This is the
reason no expenses are reflected for FY 08.
Mr. Peeples stated that if only a few participate in the EM
program in FY 08, the expense would be absorbed within the
Department's Intensive Supervision and Surveillance Probation
Program (ISSPP). The Finance Committee would be alerted if the
program experienced a large unexpected influx of participants in
FY 08.
Co-Chair Stedman asked regarding the indeterminate fiscal impact
specified for FY 12 and FY 13.
Mr. Peeples informed that the program being addressed by this
fiscal note is one monitor for each 40 probationers. Projections
are that the program's caseload would increase to approximately
40 over the next three years, as reflected in the $168,400 FY 09
expense, the $208,300 FY 10 expense, and the $258,900 FY 11
expense. Expenses after FY 12 are indeterminate; they would be
affected by actions of the Department of Law, the Alaska Court
System, and police departments.
9:11:13 AM
Senator Dyson recalled that some categories of prisoners had
paid for the expenses associated with their monitoring devices.
9:11:38 AM
Mr. Peeples reminded the Committee that in the 1980s an effort
had been undertaken to charge probationers the cost of their
probation services. He characterized that effort as "a bust"; it
did not work, and the associated statutes were ultimately
rescinded.
Mr. Peeples further noted that electronic monitoring is
currently utilized "for sentenced prisoners on furlough". Those
individuals pay $17 per day. This revenue "provides most of our
contract fees".
9:12:21 AM
Senator Dyson asked whether individuals in this program would be
subjected to a fee.
Mr. Peeples responded in the affirmative. Language in the
committee substitute would provide the Department the authority
"to collect for probationers under this program".
Senator Dyson asked for further information about the Blakely v.
Washington decision.
Mr. Peeples explained that a case in the State of Washington had
been appealed to the United States Supreme Court. The Supreme
Court ruled in the so-called Blakely Decision that a two step
process must occur "when you are imposing extra standards".
First, there must be a conviction and second, a separate hearing
must occur "to prove the circumstances for the higher level of
surveillance under probation".
Co-Chair Hoffman moved to report the Version "L" committee
substitute from Committee with individual recommendations and
accompanying fiscal notes.
There being no objection, CSSB 89(FIN) was REPORTED from
Committee with new zero Department of Corrections fiscal note
dated April 16, 2007; previous zero fiscal note #1 from the
Department of Law' previous indeterminate fiscal note #2 from
the Alaska Court System; previous indeterminate fiscal note #3
from the Department of Administration, Office of Public
Advocacy; and previous indeterminate fiscal note #4 from the
Department of Administration, Public Defender Agency.
AT EASE 9:14:14 AM / 9:14:57 AM
HOUSE BILL NO. 168
"An Act authorizing two exchanges of land between the
Alaska Railroad Corporation and the Department of
Transportation and Public Facilities; and providing for an
effective date."
This was the first hearing for this bill in the Senate Finance
Committee.
Co-Chair Stedman pointed out that this is the House of
Representatives companion bill for SB 137, which is in
Committee, but has not been heard.
DAVID SCOTT, Staff to Representative Kyle Johansen, Chair, House
Transportation which sponsors this bill, read from the sponsor's
statement as follows.
House Bill 168 would authorize the Alaska Railroad
Corporation (ARRC) to exchange approximately ten acres of
land with the Department of Transportation and Public
Facilities (DOTPF) to accommodate two DOTPF projects. The
Parks Highway Improvement project in Wasilla and the Heavy
Aircraft Cargo Apron project at the Fairbanks International
Airport both require an adjustment to the Alaska Railroad's
track and right-of-way lands. This legislation ensures that
all the appropriate titles to property can be in place for
both of these important DOTPF projects.
The Alaska Railroad Corporation Act, Alaska Statute
42.40.285, requires Legislative approval for the ARRC to
"exchange, donate, sell or otherwise convey its entire
interest in land".
Mr. Scott noted that this bill was reviewed by three House
Committees. Its Senate companion bill, SB 137, was reviewed by
the Senate Transportation Committee.
9:17:19 AM
MARY SIROKY, Special Assistant to the Commissioner, Department
of Transportation and Public Facilities, identified this as an
important bill to the Department. Receipt of these fee simple
titles would satisfy the projects' fund sources, specifically
federal agencies.
9:18:28 AM
Senator Thomas understood that the land in question had
originally been owned by the State. The State had conveyed it to
the Railroad.
Ms. Siroky affirmed.
9:18:51 AM
WENDY LINDSKOOG, Assistant Vice President, Corporate Affairs,
Alaska Railroad Corporation, Department of Commerce, Community
and Economic Development, specified that this legislation would
"clean up" matters of title as these projects move forward.
Co-Chair Stedman considered the action proposed in the bill "a
fairly straight forward land exchange" that would clean up the
land titles.
Co-Chair Hoffman asked how the expense of relocating the
railroad tracks would be addressed.
9:19:52 AM
Ms. Siroky pointed out that the Parks Highway track relocation
project had already been completed.
Co-Chair Hoffman thus asked why the title transfer for that
project was being requested.
Ms. Siroky communicated that when the Department began the
construction process, "it entered into lease arrangements" with
the ARRC. This legislation would allow the State "to get the fee
simple title where it's available for the land".
Co-Chair Hoffman questioned the reason for pursuing a title
transfer since "the lease arrangement had been adequate" to
allow for the track relocation.
Ms. Siroky expressed that "it is always in the State's best
interest to have fee simple title wherever possible so that we
don't have to go back" and renegotiate a lease. In this case, it
would be difficult to move the highway and the railroad back to
its original location in the event the lease renegotiation
faltered.
Co-Chair Hoffman asked the cost of the lease.
Ms. Siroky did not have that information and deferred to other
Department of Transportation and Public Facilities (DOT)
personnel.
9:21:31 AM
FRAN ZIMMERMAN, Central Region, Department of Transportation and
Public Facilities, testified via teleconference from an offnet
location. One of the conditions of the temporary construction
permit that permitted the Parks Highway project to commence was
that the State would initiate the process to acquire the title.
She also noted that the project was supported by federal highway
funding.
In response to a question from Co-Chair Hoffman, Ms. Zimmerman
explained that moving the railroad tracks had been an integral
component of the Parks Highway project.
Co-Chair Hoffman again asked the State's cost for the right-of-
way lease with ARRC.
Ms. Zimmerman did not have the exact information but assured the
Committee it was a "nominal fee".
9:22:49 AM
JOHN BENNETT, Right-of-Way Chief, Northern Region, Department of
Transportation and Public Facilities, testified via
teleconference from an offnet location to speak to the Fairbanks
Heavy Cargo Apron Relocation project. The right-of-entry
contract the State signed with ARRC allowed DOT's contractor to
enter ARRC's railroad right-of-way "and relocate it in
anticipation that we will eventually transfer title".
Mr. Bennett informed the Committee that this title transfer
process had begun the previous year; however, the Legislature
adjourned before the action could be addressed. That situation
prompted the Department to enter into the right-of-entry
agreement with ARRC.
Mr. Bennett communicated that because the acreages being
transferred were considered to be of equal value, no exchange of
money would be required. He also noted that federal aviation
funding would provide for the cost of relocating the rail track.
Co-Chair Hoffman asked whether the land was valued in terms of
acreage or dollar amount.
Mr. Bennett specified that the acreages were equal, and, since
the parcels were in close proximity to each other, an appraisal
was not deemed necessary. The values of the land would be
similar.
9:24:31 AM
In response to a question from Co-Chair Stedman, Mr. Bennett
affirmed the lands had not been appraised.
Co-Chair Stedman asked whether not conducting an appraisal was
standard operating procedure in Department right-of-way land
transfers.
Mr. Bennett responded in the negative. When properties are
geographically distant, an appraisal would be conducted as
different values would be expected. However, that is not the
case with the lands in question.
9:25:21 AM
PHYLISS JOHNSON, Vice President, General Counsel, Alaska
Railroad, Department of Commerce, Community and Economic
Development testified via teleconference from an offnet location
and advised she was available to answer questions.
Co-Chair Stedman asked whether she, as a representative of ARRC,
deemed the value of these properties to be equal, and thus,
would not warrant an appraisal.
Ms. Johnson expressed that ARRC "is getting equivalent value in
the sense of having an operating route covering the same
stretch" from one point to another. Therefore, even were the
acreage or the value to vary slightly, ARRC would consider the
transfer "status quo" in that ARRC would be able to move traffic
in a similar fashion as before.
9:26:22 AM
Co-Chair Stedman, observing that neither of two ARRC land issues
being considered by the Legislature have had appraisals done,
asked whether this was the norm for ARRC.
Ms. Johnson specified that both issues concerned exchanges. The
land in this bill would be transferred to another State entity
and thus, the land would not "be leaving the umbrella of State
ownership". In addition, the land parcels were in close
proximity to each other and would be "operationally very
equivalent".
Ms. Johnson considered ARRC's other land issue to be a "unique
land transfer … it stands on its own two feet for other reasons
other than an appraised value". The president of ARRC has
expanded on the circumstances involved in that land transfer
issue several times before the Legislature.
9:27:38 AM
Co-Chair Stedman asked whether ARRC's decision not to have these
parcels of land appraised was an anomaly or regular operating
procedure.
Ms. Johnson advised that an appraisal is conducted in the
majority of ARRC's land transactions, including lease
transactions.
Ms. Johnson noted that an appraisal would have been conducted on
the land identified in this bill were the transactions to have
involved a private party rather than a State entity. Thus, this
situation is an anomaly.
9:28:43 AM
Co-Chair Hoffman moved to report the bill from Committee with
individual recommendations and accompanying fiscal notes.
There being no objection, the HB 168 was REPORTED from Committee
with previous zero fiscal note #1 from the Department of
Commerce, Community and Economic Development and previous zero
fiscal note #2 from the Department of Transportation and Public
Facilities.
AT EASE 9:29:24 AM \ 9:30:09 AM
CS FOR SENATE BILL NO. 100(STA)
"An Act relating to substance abuse and mental health
disorder prevention and treatment programs; and relating to
long-term secure treatment programs for persons with
substance abuse or co-occurring substance abuse and mental
health disorders."
This was the first hearing for this bill in the Senate Finance
Committee.
Co-Chair Stedman expressed that substance abuse and mental
health issues are a statewide concern. Since this is the first
hearing for this bill in Committee, the intent would be to
discuss it and then hold it for further consideration.
9:31:00 AM
SENATOR JOHNNY ELLIS, the bill's sponsor, noted that, while
Members' packets contain a plethora of information and
statistics attesting to the "enormous human tragedy and negative
budget impacts of untreated … substance abuse and addiction" on
the State, his remarks would concentrate on the remedies
proposed in this legislation as "there must be a better way" to
address these issues than what is currently being done.
Senator Ellis noted that the efforts proposed in this bill are
supported by the Department of Health and Social Services.
Senator Ellis cited there being two major components to the
bill. The first component consists of three parts. The first of
those would modernize State Statutes pertaining to substance
abuse programs. The effort would mirror nationwide endeavors
spurred by the fact that many policy and budget writers "are
tired of funding treatment programs that may not work". The goal
is to achieve results by developing "evidence-based, research-
based treatment programs".
Senator Ellis assured the Committee that even though he would
like to see these treatment programs expanded in the future,
this bill did not include such action. It simply specifies that
the programs be evidence and research based.
Senator Ellis stated that the second part of the first component
would require programs to give priority to pregnant women. Since
the majority of these programs have long waiting lists, giving
pregnant women priority would assist in negating the impact of
fetal alcohol syndrome (FAS) on the State. Efforts to mitigate
FAS disorders have long been touted by Senator Dyson. FAS "is
totally preventable, wildedly expensive, tragic human
consequences".
9:34:28 AM
Senator Ellis identified the third part of the first component
as being the inclusion of a non-discriminatory clause that would
allow "faith-based approaches to treatment". There is evidence
that faith-based approaches have been "very effective" in
treating some people. They should be allowed "as long as they
can compete on the same basis of being evidence and research
based". This would be akin to "secular programs for treatment in
our public facilities". The inclusion of this non-discrimination
clause is supported by the Office of Faith-based and Community
Initiatives.
Senator Ellis noted that a copy of a memorandum [copy on file]
he received from Jean Mischel, Legislative Council, Division of
Legal and Research Services, Legislative Affairs Agency, dated
April 2, 2007, speaks to the inclusion of this non-
discriminatory clause. The Attorney General has also indicated
this would be "a positive thing, it's constitutional, and
actually improves our Statutes" by protecting the State "from
any challenges in the future".
Senator Ellis characterized these three parts of the first
component as "easy, non-controversial," and necessary updates to
State Statutes.
Senator Ellis advised that the second component of the bill
would be the implementation of a pilot project that would allow
between ten and twelve secure beds in a detoxification (detox)
center for individuals who were involuntarily committed by
judges for substance abuse treatment. The State currently has an
involuntary commitment statute through which judges could commit
people who have co-occurring mental disorders and substance
abuse problems". This component should be thoroughly considered
as it would require an annual commitment of approximately
$2,000,000 for six years.
Senator Ellis advised that following the discussion on the bill,
he would present a proposal on this issue for their
consideration. He noted having already discussed the proposal
with Co-Chairs Stedman and Hoffman.
Senator Ellis stressed that "it is absolutely true" that some
people are "very very expensive" to the State: they cycle
through the system repeatedly "at great public expense". These
are the people who "wind up dead in snow banks or [are] the
suspect at the scene of a murder". Other states have developed
"more cost effective and humane way to deal with this".
9:36:51 AM
Co-Chair Hoffman understood that the pilot project would be
operated in one location. Thus, he asked whether the program
would be available to individuals throughout the State or
limited to the area in which it was administered.
Senator Ellis stated that the intent would be to allow a judge
to place a person in the program regardless of where they reside
in the State. Even though the proposal would be to have this
program "co-exist" in an area with an existing detox" center, he
would support providing one in both an urban and rural setting.
Senator Ellis expected that there would be considerable demand
for this program. It would also produce significant savings to
the State.
9:38:12 AM
JEFF JESSEE, Chief Executive Officer, Alaska Mental Health Trust
Authority, Department of Revenue, spoke in support of the bill.
The actions being proposed would be "a significant step forward,
both in overall policy for substance abuse treatment, but also
taking an innovative approach to really trying to get some push
on some of the people that are having the most difficulty
overcoming their alcohol addiction".
Mr. Jessee communicated that the Trust is "very supportive" of
implementing evidence-based practices "across the board";
specifically as this approach analyses "the science behind what
we do and rigorously" evaluates a program's results.
Mr. Jessee concluded that mental health treatment programs have
not "traditionally" done "a very adequate job" in this regard.
Therefore, "emphasizing, through legislation, the expectation
that we are going to use evidence-based practices; that we are
going to rigorously evaluate our outcomes is really crucial in
the long-run, not only to the effectiveness of our program, but
in cost-containment".
Mr. Jessee stated that any money supporting a non-effective
treatment program should be moved to support those demonstrating
proven effectiveness.
Mr. Jessee characterized the directive to provide priority
treatment for pregnant women with substance abuse problems as a
"huge" step forward. FAS/Fetal Alcohol Effects (FAE) "is the
most preventable mental health condition that we deal with at
the Mental Health Trust. It's hugely expensive for every one of
those cases. Anything that we can do to get a handle on those
problems I think is to the good".
9:40:35 AM
Mr. Jessee next addressed the pilot involuntary commitment
component of the bill. For the majority of the 28 years he has
represented the civil rights of people, his position was that
involuntary commitment did not work and "was an infringement on
people's liberties". However, after reviewing literature and
witnessing the positive results of involuntary commitment
efforts, he has now changed his mind. Evidence does support
"that involuntary treatment and treatment while in Corrections
is, in fact effective, and it does reduce the incidence of abuse
when somebody is no longer confined."
Mr. Jessee also realized that many individuals with substance
abuse issues "consume so much of our other resources in cycling
through emergency rooms, and the jails, and API (Alaska
Psychiatric Institute), and all of our other systems, that
frankly, it's just not fair. We need to be more efficient and
effective in our use of resources and that means these people
that are high utilizers of these other services, frankly need to
get a handle put on them. They need to get put into treatment.
We need to follow up on that with after-care, which is something
that we'll be looking at working with Senator Ellis and the
Department on as we move along. But, we're very supportive of
looking at this for Alaska. There is good data from other
jurisdictions that it's effective, and we will certainly
participate and collaborate with you in evaluating the results
to ensure that you are making the kind of investment that you're
hoping to make."
9:42:42 AM
Senator Olson, after hearing Mr. Jessee's testimony on the
merits of the program, asked why this effort had not been
undertaken earlier.
9:43:01 AM
Mr. Jessee responded that the effort had been curtailed by the
fact that "two different commitment statutes and structures have
evolved". Individuals who are subject to mental health civil
commitments are in "the care and custody of the Department of
Health and Social Services", and the State is required to treat
these individuals. The alcohol commitment process however, is
"very different". A petition in this regard could be initiated
by anyone, and the individual would be committed to a facility
that is not operated by the State.
Mr. Jessee disclosed that these facilities are often incapable
of providing the "security aspects of that kind of a
commitment". In addition, "many judges have been reluctant … to
use the State's police power to commit someone to a non-profit
entity". The differences in these two processes, combined with
"the thinking and understanding of addictions and what kind of
treatments are effective have evolved … the pendulum is swinging
on this issue of civil liberties". People such as himself have
concluded "that there has to be a different balance struck, and
that we have to hold people more accountable for their behavior
even if we believe it's an addiction that they need to be
treated for".
9:45:01 AM
Co-Chair Hoffman, observing that the pilot program would be
limited to ten beds, asked how many people could be served by
the program each year. He also asked to the length of time an
individual could be involuntary committed.
9:45:26 AM
KATE HERRING, Staff to Senator Ellis, communicated that people
are initially committed for a 30 day period. At that point,
their progress is evaluated, and if necessary they would
continue in the program another 30 days. This case-by-case
evaluation would be conducted every 30 days thereafter, up to a
maximum commitment of 180 days.
9:46:17 AM
Senator Thomas voiced being "generally supportive of this bill".
One concern however was the recognition of there being two types
of people with alcohol substance abuse. In Fairbanks, for
example, the experience is that there "are drunks", who, while
bothersome to downtown businesses, might be doing harm to
themselves but not to society. In contrast, there are other
inebriates "who are a danger to society as well as themselves".
Requiring that these individuals be the first addressed by this
legislation, would further the success of this program, in
addition, to garnering more public support.
Senator Thomas acknowledged that some of these individuals might
also suffer from a mental disorder in addition to having an
alcohol or substance abuse problem.
9:47:35 AM
Senator Ellis clarified that the focus of this legislation is to
those individuals "who were, under a judge's discretion and
judgment", considered a danger to themselves and to society.
Data would indicate that these people are typically both
"substance abusers and mentally ill". The involuntary commitment
statute proposed in this legislation would target the "most
severe cases that are the most expensive and the most dangerous
folks".
Mr. Jessee stressed that the results of this endeavor would be
thoroughly reviewed. This would include comparing the
individual's behavior after being released from the program to
their prior history, their prior utilization of resources, and
the social consequences of their behavior. "Only by that kind of
rigorous evaluation can you really tell whether you are
achieving the results that you set out to accomplish".
9:48:48 AM
Co-Chair Hoffman asked whether the priority treatment status
given to pregnant women would also apply to the involuntary
commitment program.
Senator Ellis affirmed that pregnant women would be given
priority in each component.
Senator Elton recommended that the involuntary commitment
program evaluation include a comparison of its costs to the
costs that otherwise might be incurred by the Department of
Public Safety, the Alaska Court System, and the Department of
Corrections.
Mr. Jessee considered the cost comparison to be of utmost
importance. There is not much doubt that a sober person's
quality of life is happier and safer than that of a person "who
is drinking themselves to death under a bridge".
Mr. Jessee anticipated that the cost of the program would be of
interest to the Finance Committee, and he did not consider
viewing the legislation in that light to be "cold hearted".
Money that is spent "inappropriately or unnecessarily on people
in these other systems is money that is not available for other
services that we really need. We need to look at those numbers.
The public inebriate under the bridge is not free. There are
huge costs centered around those individuals." For example, the
experience in Fairbanks is that the cost associated with some
public inebriates is between $45,000 and $50,000 a year. A study
in New York found that services provided to one such person
there cost that state in excess of one million dollars over a
ten-year period. "That is intolerable, and we have to look at
the numbers and we have to get a handle on these people that are
creating this huge, huge cost centers."
Co-Chair Hoffman asked what benchmarks would be established to
gauge the success of the program; specifically whether a dollar
amount of savings per individual might be a determining factor.
Mr. Jessee expressed that information regarding the cost of
treating these individuals before entering the program, the
actual costs of treating them in the program, and the costs of
aftercare would be provided to the Legislature. The Legislature
would make the final determination as to whether this approach
is a good investment. "Other jurisdictions have information that
leads them to believe it has been a good investment"; however he
advised that the costs must be available before a determination
to the success of the program could be made.
9:53:33 AM
Co-Chair Hoffman communicated that the Legislature's
determination would also depend on whether professionals'
"expectations" on the program were met. "The delivery of
services" as well as program costs should be a consideration.
Mr. Jessee agreed. Developing "performance benchmarks" is one of
the components that would be undertaken in "the program
development phase". There must be "a target" to aim for.
9:54:38 AM
Senator Huggins expressed that, while the answer to homelessness
and other "things that cost our society money", is evasive,
"intuitively, this makes me very very nervous". Even through he
has participated in such things as Operation Stand-down and
programs for homeless veterans, he continues to be unable to
understand the homeless syndrome.
Senator Huggins cited the expense of dealing with the people
identified in this legislation as being one part of the
discussion. The second part was the treatment aspect. He had
previously participated on a board that "dispose[d] of people"
by placing them in such things as in-home treatment facilities.
Senator Huggins recalled professionals stating that the success
rate of such programs was based on the fact that there had to be
"consequences". He did not believe it possible that any program
could protect people from themselves. Thus, while he
acknowledged "the passion" in the supporting testimony, he was
not convinced it would work.
9:56:20 AM
LONNIE WALTERS, Chair, Governor's Advisory Board on Alcohol &
Drug Abuse and co-executive director of a small substance abuse
and mental health facility in Craig Alaska, shared with the
Committee that he was a 26-year recovering alcoholic who had
been involuntarily committed to an alcohol treatment center when
he was in the military. "That saved my life."
Mr. Walters also stated that prior to moving to Alaska, he had
served as an involuntary commitment specialist in the State of
Washington. He had personally committed people to programs such
as that being proposed in this legislation.
Mr. Walters was disturbed to find that while Alaska had an
involuntary commitment law, there was no place to commit people
to. The two people he had committed in this State, both simply
walked out of the facility they were placed in because it was
not a secured facility.
Mr. Walters committed approximately 30 individuals when he lived
in Washington. The program in Washington had approximately an 80
percent success rate. The people committed to the program had an
extensive history of intoxication. Some had upwards of 50
arrests and numerous emergency services visits.
Mr. Walters declared that all of the people he knew who were
admitted to the involuntary commitment program thanked those who
were responsible for placing them there. "We saved their life."
He firmly believed that "every alcoholic wants to quit
drinking".
9:58:50 AM
Senator Olson asked Mr. Walters to respond to some of the
concerns voiced by Senator Huggins; particularly in regards to
how "the effectiveness of the program eventually curtails, or is
to the degree" where its benefits to society would become
apparent.
Mr. Walters responded that the benefits of an involuntary
commitment program would take time. "The more promiscuity" is
present the more time is required to recover. A "normal 30-day
program would not work for these people … their brain doesn't
even clear up in 30 days. They need time, they need length."
Mr. Walters disclosed that of every drug and alcohol program he
has been affiliated with, "involuntary commitment gives you the
biggest bang for your dollar".
10:00:37 AM
Dr. MARC PELLICCIARO, Medical Director, Psychiatric Emergency
Room, Providence Hospital, testified via teleconference from an
offnet location in support of the bill. It would provide
"increased energy and resources and attention to people
suffering from chemical dependency"; particularly those who also
suffer from a mental illness. Approximately 30 percent of the
4,000 patients served by the Psychiatric Emergency Room are
referred by police. Approximately 70 percent of the 4,000
patients have some "chemical dependency issue associated with
their current situation". Each patient is evaluated, diagnosed,
treated, and then referred "to the next best place to continue
the road to recovery so they don't end up back involved with the
police or back in the emergency room".
Dr. Pellicciaro informed the Committee that, of the multitude of
services he has access to, the resource most lacking is "detox
or treatment options for the duel-diagnoses patient". This is a
person with "a legitimate mental illness plus a significant
substance abuse chemical dependency problem". There are only
eight beds in Anchorage to which his and other emergency
services in Anchorage can refer such patients to.
Dr. Pellicciaro declared that "the first step" in getting these
patients better "is get them to a detox program and the
surroundings of sobriety that both identify the chemical
dependency issues and the mental heath issues".
10:03:21 AM
MARGARET LOWE, Trustee, Alaska Mental Health Trust Authority,
testified via teleconference from an offnet location and
informed the Committee that alcohol addiction and substance
abuse problems in the State are increasing and are devastating
the lives of many Alaskans.
Ms. Lowe shared that "virtually all of the child abuse" and
child neglect cases reviewed in a 15-year research project she
conducted, included "substance abuse as a part of" or "the basis
of the problem". Improving the lives of children whose "parents
or caregivers who are unable to manage well and be reliable
parents for their children" … "is cost effective and is a moral
responsibility."
Ms. Lowe recounted that at the time she was commissioner of the
Department of Health and Social Services, the Department was
just becoming aware "of the commonality of mental illness and
substance abuse". Since that time, the Department has
established the Division of Behavioral Health to provide "state
of the art treatment". However, the availability of treatment
programs must be increased; specifically programs for pregnant
women and mothers of young children.
Ms. Lowe also recalled that in her role as commissioner, she had
been asked why the problem was increasing even as more money was
being appropriated to the Department. Her response continues to
be that far more money than is being spent is required. More
"treatment facilities and personnel and personnel training" is
necessary to provide "the basic approach to prevention".
Ms. Lowe asserted that educating children about the negatives of
substance abuse must begin earlier than middle school. "One of
the best ways to do that kind of prevention is that children are
in homes where parents have received appropriate treatment and
are able to model the kind of wellness and appropriate
behavior…"
10:06:50 AM
Senator Olson agreed there was merit to the program being
proposed. To that point, he asked Ms. Lowe why such a program
had not been implemented earlier.
Ms. Lowe communicated that treatment programs have been in place
for several years. While evidence-based methodologies and
effective treatments are key elements, an adequate level of
funding must be provided "to deal with an overwhelming problem".
Even thought Alaska has done a good job providing "state-of-the-
art professionals" and advancements in how to address the
problem are occurring, the State has "unique problems". For
example, no follow-up support is available to people when they
return to their village after receiving treatment is a "hub
village" or larger city. Providing that level of support is an
expensive proposition.
10:08:44 AM
Senator Elton surmised that increasing funding to a level that
would adequately support programs would generate savings in
other service areas.
Ms. Lowe agreed. Savings would result from such things as fewer
children being placed in foster homes, fewer visits to emergency
rooms, and even fewer house fires.
10:10:56 AM
SUEY LINZMEIER, mother of an alcohol and drug addicted son,
testified in Juneau in support of the bill. "It's a really good
starting place for this State." Alcohol is everywhere, across
all boundaries of society. Her son began experimenting with
drugs when he was 13, and now, seven years later, he is
struggling against both drugs and alcohol. He is one of many
young people experiencing this struggle, as evidenced by a
recent incident in Anchorage where an intoxicated 17-year old
youth allegedly committed a serious crime.
Ms. Linzmeier informed the Committee that her son sought help
two months ago and luckily, the family's health insurance
circumstances allowed him to enroll in a 21-day non-profit
treatment program in the State of Washington that cost $4,200.
There is no similar in-state program. A person who commits a
crime while under the influence of alcohol or drugs or who is
charged with Driving Under the Influence (DUI) could choose to
either go to jail or enter a treatment program. Many of the
people attending the Washington program were there because they
realized they had a problem.
Ms. Linzmeier communicated that prior to her son's entering the
program she blamed him, the school district, and others for
contributing to the problem. She now believes that "alcoholism
and addiction are a disease", and the program teaches people to
address these issues as such.
Ms. Linzmeier stated that in addition to providing her son the
tools he required to return to Alaska and to continue getting
the help he required, it also taught the family how to deal with
his addiction. The program convinced her son "he had a condition
that he cannot help". He now attends counseling and daily
Alcoholics Anonymous (AA) meetings.
Ms. Linzmeier stressed that her son and other AA participants
are very "committed"; they do not want to be a burden on their
family, their friends, or their employer. They are the people
that this legislation would help, as "some sort of a treatment
plan" is required.
Ms. Linzmeier also noted that most of the programs available to
her son have a "sliding scale" fee structure. This enables him
to get those services. Her son chose to enter treatment rather
than going to jail.
Ms. Linzmeier contended that had her son instead gone to jail
for 90 days, upon release, he would have continued to drink and
use drugs. The treatment program enlightened him to the fact
that he, like many people, had mental and emotional problems
that he needed to address. "Mental illness is huge;" many people
have social anxiety disorder, depression, post-traumatic stress
syndrome. For many, "drinking and doing drugs is a way to kind
of take the edge off that".
Ms. Linzmeier urged the Committee to acknowledge the fact that
this problem is far-reaching. This legislation "would be good
for all Alaskans and all families".
Co-Chair Stedman assured Ms. Linzmeier that her paraphrasing her
written remarks and then providing the written remarks to
Members was a very effective way to communicate her message.
10:15:54 AM
VERNER STILLNER, Psychiatrist, Bartlett Regional Hospital and
Member, Governor's Advisory Board on Alcohol & Drug Abuse,
shared that he had personally lost two relatives to alcoholism.
Dr. Stillner, speaking from a professional viewpoint, deemed
"the weakness in the current system" to be that "if we want to
involuntarily commit someone through" the State's current
alcohol statutes, "virtually all facilities will say no,
especially for something that is a 30 day or longer commitment".
In addition, a person, who has "a co-occurring disorder" such as
an alcoholic with a diagnosed bi-polar disorder, is not eligible
for an alcohol treatment program under existing statutes. In
contrast, medical hospitals do not similarly discriminate
against someone who might have, for example, diabetes and
hypertension.
Dr. Stillner also informed the Committee that the current system
does not function well 24 hours a day, seven days a week. This
concern is addressed in this legislation.
Dr. Stillner described a detox center as a facility which
prepares someone for treatment. "Drying someone out does not
really contribute much". It could however, prepare someone for
the next course of treatment.
Dr. Stillner contended that the status quo system does not
appropriately address people who are "rapid recyclers or
repeaters" who "simply take up a good deal of time" from police,
emergency rooms, ambulance service, and hospital beds.
Dr. Stillner voiced support for the bill with one modification
which he would address later in his testimony.
Dr. Stillner next addressed "the notion of involuntary
treatment". Alaska's mental health statutes allow a person to be
committed because they are "gravely disabled. I think the
alcoholic or the chemically dependent is, at the time of
addiction or intoxication, gravely disabled and as eligible for
commitment as the mentally ill".
Dr. Stillner disagreed with the "false notion" that treatment is
only effective if the person wanted to be there. "Treatment is
as effective for voluntary patients as it is for involuntary
patients". This determination is based on his 35 years of
experience as a psychologist. It is also supported by research.
Few people enter treatment programs voluntarily; most are forced
to enter a program for some reason.
Dr. Stillner specified that this legislation would result in
there being secured detox centers, intense case management, and
treatment for those with co-occurring disorders and the chronic
repeater.
Dr. Stillner concluded that the legislation would "divert people
from emergency services, hospital beds, [and] the criminal
justice system". It would have an immediate affect. While it
might be impossible to quantify the amount of money that would
be saved, a person undergoing treatment for 30 days would be
consuming fewer services from a variety of agencies.
Dr. Stillner next addressed the lone concern he has with the
bill. That being that it would operate a single pilot project as
opposed to multiple pilot projects. A lot of time would be lost
were the State to wait for the results of this program to be
evaluated before establishing the program in other places and
adequately addressing the State's "number one public health
problem".
Dr. Stillner suggested that the bill be expanded to allow three
regional pilot programs. "They could compete against each other,
learn from each other, and improve our entire systems".
Dr. Stillner thanked Senator Ellis for presenting the
legislation.
10:20:52 AM
Senator Olson asked Dr. Stillner to comment on a situation in
Bethel where a pregnant woman was involuntary committed to
treatment. He understood that the judge who committed her was
criticized for his action.
While Dr. Stillner could not comment on the specifics of that
case, he observed that there could be "times when involuntary
treatment is the best treatment available". The traditional
argument against involuntary treating pregnant women has been
the concern that making this a criminal offense might discourage
other people from seeking treatment. He contended otherwise:
consideration should be given to the fact that the behavior is
affecting the life of the baby as well as the mother.
Senator Olson asked whether a person involuntarily committed to
treatment ever "challenged" Dr. Stillner after their treatment
ended.
Dr. Stillner responded "never". Many individuals have thanked
him for committing them to treatment.
Senator Ellis thanked the Committee for the opportunity to
present this legislation. He noted that during the bill's
progress through committees, many people have come forward,
unsolicited, to testify on its merits. "This is really a public
health emergency in our State." While civil liberty concerns
deterred him from proposing this action in the past, he
contended that it is now time to move forward with a new
approach.
Senator Ellis stated that, after discussions with the Co-chairs
of this Committee and other Legislators, he has decided to
separate the two components of the bill. This would allow "the
popular, free, non-controversial portions" of the bill to
advance. To that point, he asked that the Committee adopt a new
committee substitute which would not include the pilot program
language. This would allow that component to be further analyzed
by the Administration, the Legislature, the Department of Health
and Social Services, the Alaska Mental Health Trust Authority,
and other affected parties. The program could be re-introduced
at a later time.
AT EASE 10:25:44 AM \ 10:29:08 AM
10:26:13 AM
Co-Chair Hoffman moved to adopt committee substitute, Version
25-LS015\R as the working document.
Senator Elton objected to comment.
Senator Elton appreciated the intent of separating the two
components, but raised concern to the fact that "this is a
public health crisis". While furthering the bill without the
pilot program would be taking a first step in addressing the
crisis, he thought a bigger step should be taken. He was "more
compelled" to expand the pilot project than to eliminate it.
Nonetheless, Senator Elton acceded to the wishes of the sponsor.
Work on the pilot project should continue during the Legislative
Interim. Furthermore, the discussion should be expanded to
address other parts of the system. For example, it is "criminal
that we have people … in our prison system that are there
because of crimes" they committed when they were addicted or
under the influence, in light of the fact that "we've reduced
the substance abuse programs within the prison system."
Senator Elton considered the problem to be "systemic and I think
that the demonstration projects, such as the Therapeutic and
Wellness Courts have demonstrated success and have demonstrated
that the money being spent on them does result in savings".
Senator Elton had felt compelled to object to the adoption of
Version "R" because the need to address this issue is real. No
one on the Committee could disagree with that.
Senator Elton removed his objection and noted that further
discussions on the pilot program might assist in persuading
others to its merits.
There being no further objection, the Version "R" committee
substitute was ADOPTED.
Co-Chair Stedman agreed with Senator Elton that a cooperative
effort during the Interim would assist in determining the most
appropriate way to implement, and even expand, the pilot program
component.
Co-Chair Stedman advised that a new fiscal note, relevant to
Version "R", was being developed.
The bill was HELD in Committee.
ADJOURNMENT
Co-Chair Bert Stedman adjourned the meeting at 10:32:24 AM.
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