Legislature(2017 - 2018)BUTROVICH 205

02/21/2018 01:30 PM HEALTH & SOCIAL SERVICES

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Audio Topic
01:58:42 PM Start
01:59:08 PM SB174
02:25:15 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 174 PROGRAMS FOR PERSONS WITH DISABILITIES TELECONFERENCED
Moved SB 174 Out of Committee
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
         SB 174-PROGRAMS FOR PERSONS WITH DISABILITIES                                                                      
                                                                                                                                
CHAIR WILSON announced the consideration of SB 174.                                                                             
                                                                                                                                
1:59:23 PM                                                                                                                    
SENATOR MICCICHE said the bill  is about philosophy. There is not                                                               
a  fiscal  note.  It  is  about  identity.  People  used  to  say                                                               
physically and  mentally disabled  Alaskans. It changes  the tone                                                               
to say Alaskans with physical  and mental disabilities. This bill                                                               
is  about  their active  participation  in  decisions related  to                                                               
their  own care.  There are  efficiencies  associated with  that.                                                               
There  are  improvements  to  their quality  of  life  for  those                                                               
individuals. That is the basic philosophy of the bill.                                                                          
                                                                                                                                
2:00:29 PM                                                                                                                    
KAITLYNN  STANSBERRY,  Intern,  Senator  Peter  Micciche,  Alaska                                                               
State Legislature,  presented SB 174  on behalf of  bill sponsor.                                                               
She said  SB 174  is the  product of input  from over  200 people                                                               
across  Alaska, including  the Alaska  Mental  Health Trust,  the                                                               
Governor's  Council on  Disabilities and  Special Education,  and                                                               
the Key  Coalition of Alaska.  All persons deserve to  be treated                                                               
with  respect  and  dignity. Persons  with  physical  and  mental                                                               
disabilities  actively participating  in  the  programs they  use                                                               
enhances their  quality of life  and treatment. They  thrive when                                                               
participating  in the  social and  economic environment  of their                                                               
homes, communities, and Alaska. SB  174 enables the Department of                                                               
Health  and  Social  Services  (DHSS) to  take  a  more  flexible                                                               
approach to  the application of programs,  allowing Alaskans with                                                               
physical and  mental disabilities to participate  actively in the                                                               
systems of  their care.  These systems of  care are  the programs                                                               
they use daily. SB 174 provides  a unifying vision to assure that                                                               
available resources,  whether great  or small, are  allocated and                                                               
applied in a manner that  maximizes the contributions of Alaskans                                                               
experiencing disabilities in their communities.                                                                                 
                                                                                                                                
2:02:24 PM                                                                                                                    
SENATOR BEGICH said he is very  pleased to see the bill. He asked                                                               
what the phrase flexibility means so  that it could be put on the                                                               
record and encourage employers to take advantage of it.                                                                         
                                                                                                                                
2:03:01 PM                                                                                                                    
SENATOR MICCICHE said  he could say what it means  to him, but it                                                               
will  be more  meaningful coming  from  people who  are going  to                                                               
testify.                                                                                                                        
                                                                                                                                
2:03:18 PM                                                                                                                    
SENATOR  BEGICH said  then they  will answer  his next  question,                                                               
which  is   the  different  ways  this   will  increase  economic                                                               
opportunity for the State of Alaska.                                                                                            
                                                                                                                                
2:03:29 PM                                                                                                                    
CHAIR WILSON opened public testimony.                                                                                           
                                                                                                                                
2:03:50 PM                                                                                                                    
LIZETTE  STIEHR,   Executive  Director,  Alaska   Association  on                                                               
Developmental  Disabilities (AADD),  supported SB  174. She  said                                                               
the Alaska  Association on Developmental Disabilities  is a trade                                                               
association, a professional association that represents 47 dues-                                                                
paying  organizations, all  of whom  provide home  and community-                                                               
based  services for  individuals who  experience intellectual  or                                                               
developmental disabilities.  The association  has been  an active                                                               
and  strong  supporter of  this  shared  vision, which  brings  a                                                               
renewed  energy  and  excitement  to the  work  of  the  provider                                                               
community. The shared  vision reminds them of  why they dedicated                                                               
their professional lives to this  field. She mentioned that it is                                                               
a challenging time  for legislators, who are  dealing with fiscal                                                               
constraints,  which roll  down into  the field  and the  services                                                               
offered in  Alaska. The provider  world is feeling  many changes,                                                               
including SB  74, Medicaid  reform. It seems  so many  things are                                                               
going away or  being reduced. It has been a  trying time, but the                                                               
shared vision  work has  been a  ray of sunshine  and a  place of                                                               
excitement and  enthusiasm. She loves  the question of  what does                                                               
flexible mean.  It means people  have a right to  direct services                                                               
they would  like to  have, not just  what has  been traditionally                                                               
offered or has  been a system of support. The  economic impact is                                                               
that  they work  with what  people would  like to  have in  their                                                               
lives,  they want  to  be  in the  community.  One way  inclusion                                                               
happens  is   through  unpaid  or  natural   supports  that  then                                                               
economically helps the community  through inclusion and the price                                                               
of  services. She  thanked Senator  Micciche  for sponsoring  the                                                               
bill. She said they in the field are very excited about it.                                                                     
                                                                                                                                
2:07:50 PM                                                                                                                    
MICHELE  GIRAULT,   Board  Member,   Key  Coalition   of  Alaska,                                                               
supported SB 174.  She said she is a guardian  of two individuals                                                               
who  experience disabilities.  She  appreciated Senator  Micciche                                                               
reaching  out  to  create  a value-driven  bill  that  puts  into                                                               
statute their  vision of what life  should be like for  those who                                                               
experience disabilities.  It is  really people  first. Regardless                                                               
of fiscal  impact, the idea  is that Alaskans will  support those                                                               
among  them who  experience  disabilities in  a  way that  honors                                                               
their  desire and  right to  have  meaningful lives.  Flexibility                                                               
means that in  these dynamic times all  the different departments                                                               
of the  state work  together to  support people,  whether someone                                                               
has  intellectual,  behavioral,   or  mental  health  challenges.                                                               
People  might need  more  of  one kind  of  support  and less  of                                                               
another. From  a consumer's  point of  view, flexibility  means a                                                               
person may  need a support in  one moment and then  can later let                                                               
go of that  support. The bill puts into statute  a framework that                                                               
allows departments  and stakeholders  to come together  to assure                                                               
individuals will  have opportunities  to create  meaningful lives                                                               
for  themselves. This  is  one  of the  platform  issues for  Key                                                               
Coalition in their planned visit next week.                                                                                     
                                                                                                                                
2:10:40 PM                                                                                                                    
JIMAEL  JOHNSON,  Program  Officer, Alaska  Mental  Health  Trust                                                               
Authority,  supported  SB  174.  She said  the  trust  exists  to                                                               
advocate  on  behalf of  trust  beneficiaries  and to  prioritize                                                               
policies,  practices,  and  funding   for  strategies  that  help                                                               
improve the  lives of  beneficiaries. The  beneficiary population                                                               
includes  Alaskans with  mental illness,  addiction, Alzheimer's,                                                               
dementia,   traumatic   brain   injury,  and   individuals   with                                                               
intellectual or  developmental disabilities. The  trust advocates                                                               
for crucial  services for the most  vulnerable population through                                                               
community-based  services.  Community-based services,  especially                                                               
when person centered  and directed, reduce the level  of need for                                                               
costlier institutional  care. The goal  of the  trust is to  be a                                                               
catalyst for change  and improvement in the  state's continuum of                                                               
care. SB  174 is  a visionary  framework to  increase opportunity                                                               
and improve the quality of  life for individuals, their families,                                                               
and  full  communities.  It   elevates  the  person  experiencing                                                               
disability to  more actively participate and  determine their own                                                               
community-based care and  thus more fully direct  their lives and                                                               
wellness.                                                                                                                       
                                                                                                                                
2:13:06 PM                                                                                                                    
MAGGIE  WINSTON, Chair,  Governor's Council  on Disabilities  and                                                               
Special  Education, supported  SB 174.  She said  she works  at a                                                               
center  for independent  living and  most importantly,  she is  a                                                               
person  who  experiences  a significant  disability.  A  flexible                                                               
system can literally  mean the difference for her  getting out of                                                               
bed  in the  morning or  being able  to go  to work.  This vision                                                               
enables  person-directed   care  and   culture.  This   is  super                                                               
important,    especially   for    individuals   who    experience                                                               
disabilities.  It  gives more  control  in  living the  life  she                                                               
directs and she  chooses. They have in statute  the verbiage that                                                               
enables them to be flexible and live a normal, autonomous life.                                                                 
                                                                                                                                
2:14:54 PM                                                                                                                    
SENATOR MICCICHE noted  that Maggie was before  the committee two                                                               
weeks  ago. She  is the  inspiration for  the bill  Some physical                                                               
limitations  may   seem  debilitating,   but  they  are   not  an                                                               
impediment  to  absolute success  in  one's  life. They  are  not                                                               
asking  for  more  resources.  They are  asking  for  more  self-                                                               
directions  so people  like  Maggie can  continue  to thrive  and                                                               
inspire the rest of Alaskans.                                                                                                   
                                                                                                                                
2:15:48 PM                                                                                                                    
DAVE   LEWIS,  System   Advocate,   Independent  Living   Center,                                                               
supported  SB  174.  He  said  they support  the  bill  and  what                                                               
everyone else said previously.                                                                                                  
                                                                                                                                
2:16:27 PM                                                                                                                    
MICHEAL   BAILEY,  Chief   Financial   Officer,  Hope   Community                                                               
Resources,  supported SB  174. He  said the  systems and  service                                                               
delivery  are often  siloed, specialized,  and governed  by their                                                               
own  regulations. This  limits flexibility.  This unified  vision                                                               
engages a  collaborative system  of paid  and unpaid  supports to                                                               
enhance abilities,  not just to  address disabilities.  This bill                                                               
allows flexibility in  being able to adjust  without a regulation                                                               
rewrite.  As they  do  that  they are  better  stewards of  state                                                               
funds.  His daughter's  team won  the  Anchorage School  District                                                               
middle school  Battle of the  Books competition. A member  of the                                                               
team has a physical disability  and listens to audio books. She's                                                               
a  valuable  member of  the  team  and  an inspiration  to  other                                                               
people. Her  team members were  her natural supports. That  is an                                                               
example of  what they  want to  promote. The  approach in  SB 174                                                               
moves  away   from  some  traditional  medical   models  to  more                                                               
integrated,   meaningful   lives  and   upholds   person-centered                                                               
directives  from the  federal government  that  are necessary  to                                                               
access Medicaid  funds. This  bill benefits  everyone, regardless                                                               
of  the  level  of  financial  support  available,  by  promoting                                                               
partnerships and new  models of support guided  by a value-driven                                                               
philosophy. People  have heard the  saying it takes a  village to                                                               
raise  a  child. It  takes  a  community  to help  Alaskans  with                                                               
disabilities lead meaningful lives.                                                                                             
                                                                                                                                
2:19:08 PM                                                                                                                    
PATRICK  REINHART,  Executive  Director,  Governor's  Council  on                                                               
Disabilities  and Special  Education, supported  SB 174.  He said                                                               
they view this as a culture  change. A few years ago, they pushed                                                               
through   similar  aspirational   language   in  statute   around                                                               
employment first.  They wanted people  with disabilities  and the                                                               
people who  support them to look  at the opportunities to  lead a                                                               
meaningful life  through employment.  It takes a  long to  make a                                                               
culture  change and  shift  in  a large  system  of services  and                                                               
supports like  they have in Alaska.  A few years later,  they are                                                               
starting  to see  a  cultural shift  occurring.  When people  are                                                               
making plans  of care for  people with  significant disabilities,                                                               
the question "What do  you want to do when you  grow up" is asked                                                               
more often.  This also  is a cultural  shift--more and  more they                                                               
are looking  to the individual  about their hopes and  dreams and                                                               
desires,  which also  means  allowing them  to  take some  risks.                                                               
People   with   developmental    disabilities   need   the   same                                                               
opportunities  to  take risks.  The  bill  puts  it back  on  the                                                               
individual's  plate  and  that  comes  with  responsibilities  to                                                               
direct their own care and lives.                                                                                                
                                                                                                                                
2:21:29 PM                                                                                                                    
CHAIR WILSON closed public testimony.                                                                                           
                                                                                                                                
2:21:43 PM                                                                                                                    
SENATOR  GIESSEL thanked  Senator Micciche.  She said  he's moved                                                               
the dial for Alaskans with  disabilities. Patrick Reinhart talked                                                               
about the  challenge of  self-determination and  decision making,                                                               
but also the  gratification of being able to do  that. It reminds                                                               
her  of  the house  bill  a  few  years  that let  Alaskans  with                                                               
disabilities  participate   in  the   federal  program   of  ABLE                                                               
accounts. They can  save their own money to use  as they see fit.                                                               
The bill is  another step in that direction, so  bravo to Senator                                                               
Micciche.                                                                                                                       
                                                                                                                                
2:22:41 PM                                                                                                                    
SENATOR MICCICHE said  folks are thanking him, but  he knows they                                                               
will pile on as cosponsors  in recognition of the capabilities of                                                               
those who have challenges.                                                                                                      
                                                                                                                                
2:23:12 PM                                                                                                                    
CHAIR  WILSON asked  if  there were  amendments.  There being  no                                                               
amendments,  he  entertained a  motion  to  move  SB 174  out  of                                                               
committee.                                                                                                                      
                                                                                                                                
2:23:21 PM                                                                                                                    
SENATOR  VON  IMHOF  moved  SB  174,  version  30-LS1258\D,  from                                                               
committee  with individual  recommendations  and attached  fiscal                                                               
notes.                                                                                                                          
                                                                                                                                
2:23:35 PM                                                                                                                    
There  being no  objection, CHAIR  WILSON SB  174 moved  from the                                                               
committee  with  the  understanding  that  Legislative  Legal  is                                                               
authorized  to make  any  necessary  technical and/or  conforming                                                               
adjustments.                                                                                                                    

Document Name Date/Time Subjects
SB 174 30-LS1258 D.pdf HHSS 3/29/2018 3:00:00 PM
SHSS 2/21/2018 1:30:00 PM
SB 174
SB 174 Sponsor Statement.pdf HHSS 3/29/2018 3:00:00 PM
SHSS 2/21/2018 1:30:00 PM
SB 174
SB 174 Fiscal Note.pdf HHSS 3/29/2018 3:00:00 PM
SHSS 2/21/2018 1:30:00 PM
SB 174
SB 174 Supporting Documents.pdf HHSS 3/29/2018 3:00:00 PM
SHSS 2/21/2018 1:30:00 PM
SB 174
SB 174 Public Input.pdf HHSS 3/29/2018 3:00:00 PM
SHSS 2/21/2018 1:30:00 PM
SB 174