Legislature(2015 - 2016)HOUSE FINANCE 519
03/17/2015 07:30 AM LEGISLATIVE BUDGET & AUDIT
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|Hearing: Public Input on the Department of Health and Social Services Performance Review.|
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE LEGISLATIVE BUDGET AND AUDIT COMMITTEE March 17, 2015 7:37 a.m. MEMBERS PRESENT Representative Mike Hawker, Chair Representative Lance Pruitt Representative Sam Kito Senator Cathy Giessel MEMBERS ABSENT Senator Anna MacKinnon, Vice Chair Senator Lyman Hoffman Senator Bert Stedman Senator Click Bishop Senator Pete Kelly (alternate) Representative Kurt Olson Representative Steve Thompson Representative Mark Neuman (alternate) OTHER LEGISLATORS PRESENT Representative Lora Reinbold COMMITTEE CALENDAR HEARING: PUBLIC INPUT ON THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES PERFORMANCE REVIEW. PREVIOUS COMMITTEE ACTION No previous action to record WITNESS REGISTER JIM WALDINGER, Manager Public Consulting Group (PCG) Boston, Massachusetts POSITION STATEMENT: Introduced his group during the public comments on the Department of Health and Social Services performance review. SHARI HOLLAND Public Works Austin, Texas POSITION STATEMENT: Introduced her group during the public comments on the Department of Health and Social Services performance review. GAYLE TRIVETTE Juneau, Alaska POSITION STATEMENT: Testified during the public comments on the Department of Health and Social Services performance review. SAM TRIVETTE Juneau, Alaska POSITION STATEMENT: Testified during the public comments on the Department of Health and Social Services performance review. PATRICK CUNNINGHAM, Chair Denali Family Services Anchorage, Alaska POSITION STATEMENT: Testified during the public comments on the Department of Health and Social Services performance review. ACTION NARRATIVE 7:37:30 AM CHAIR MIKE HAWKER called the Legislative Budget and Audit Committee meeting to order at 7:37 a.m. Representatives Hawker and Kito were present at the call to order. Representative Pruitt and Senator Giessel arrived as the meeting was in progress. Also in attendance was Representative Reinbold. ^HEARING: Public Input on the Department of Health and Social Services Performance Review. HEARING: Public Input on the Department of Health and Social Services Performance Review. 7:37:54 AM CHAIR HAWKER announced that the only order of business would be a hearing for public input on the Department of Health and Social Services performance review of behavioral health services, long-term care services, and the department's overall organizational and administrative structure. He pointed out that it was not required for the committee to have a quorum to conduct this testimony, as it was not taking any formal legislative action. CHAIR HAWKER explained that the passage of House Bill 30 a few years prior had placed into statute a provision that the Division of Legislative Audit shall conduct performance reviews of appropriate programs and agencies of state government on a recurring basis. He noted that the statute provided for a cycle of the state agencies, with the first being the Department of Corrections, which had been reviewed in 2014. He reported that the current performance review would be for the Department of Health and Social Services, and in 2016, the Department of Education and Early Development would be reviewed. He explained that the process for these performance reviews as provided in AS 44.66.020(b) was for the Division of Legislative Audit to hire individuals and contract with individuals or firms to form a review team or teams to complete these reviews. He shared that the legislative auditor had arranged for two organizations to work on the review of the Department of Health and Social Services. He directed attention to AS 44.66.040(a)(2) which detailed the duties of the review team, that through the Legislative Budget and Audit Committee, the Senate Finance Committee, or the House Finance Committee public hearings shall be scheduled in Juneau, Fairbanks, Anchorage, and other locations as determined by the committees to review agency activities and identify problems and concerns. He reported that this meeting had been noticed a few weeks prior in order to satisfy the statutory requirement for a public hearing in Juneau to allow the opportunity to comment on activities, problems, or concerns with the Department of Health and Social Services. He stated that similar public hearings would be conducted in Anchorage and Fairbanks sometime shortly after the end of this current legislative session. 7:41:39 AM JIM WALDINGER, Manager, Public Consulting Group (PCG), shared (via teleconference) that his consulting firm had been "around for about 28 years now focusing almost exclusively on government work, mostly in the health and human services arena." He reported that his group worked closely with Medicaid, behavioral health, and long term care systems. He reported that both the long term care and the behavioral health system teams were also participating in the meeting today, via teleconference. He reported that his consulting group had been travelling around Alaska for the past month, meeting with state staff and providers in urban, rural, and remote rural areas, in order to get a good cross section analysis of these systems. He stated that the group had more trips planned for late March and April to meet with additional staff and providers. He explained that the group would then take this information and formulate its recommendations. He shared that the state staff and providers had been "extremely co-operative with us both in scheduling and meetings and they've been quite forthcoming with information about the programs." 7:44:39 AM SHARI HOLLAND, Public Works, shared that her group had been hired to do a review on the administrative and organizational structure of the Department of Health and Social Services. She stated that Public Works worked exclusively with state and local governments throughout the country doing these types of performance reviews. She reported that they had "extensive experience with health and human services" and they were also in the process of conducting its field work, interviewing staff throughout the department and reviewing this information. 7:45:37 AM CHAIR HAWKER clarified that this was a performance review of the organization, activities, quality of services, and ability to deliver the expected services by the Department of Health and Social Services, and it was not a budget hearing. He offered for anyone to submit written testimony regarding the Department of Health and Social Services. 7:47:16 AM CHAIR HAWKER opened public testimony. 7:47:59 AM GAYLE TRIVETTE reported that, although she was representing herself, she was a volunteer member of the Juneau Suicide Prevention Coalition. She stated that she was "a survivor of Alaska suicide," and had participated in the coalition since its formation as a voluntary, grass roots organization, in 2008. She declared it to be a vibrant coalition dedicated to suicide prevention, and its participants included Juneau Youth Services, Juneau Alliance for Mental Health, Inc. (JAMHI), Catholic Community Services, Rotary Club, Tlingit & Haida Central Council, and Bartlett Hospital. She shared her experiences with grant and technical support from the Division of Behavioral Health. She said that the first three years of funding for the coalition were supported by a prevention grant from the division, and administered by the Juneau School District with a primary goal for establishing and administering the signs of suicide, education, and screening programs which were considered to be the most effective program of its type. She pointed to the website developed by the coalition, JuneauSuicidePrevention.org, which educated the public about suicide and the local resources, followed by a broader website, generalmentalhealth.org, which included a comprehensive list of information regarding mental illness, as well as all the mental health providers in Juneau. She stated that the volume of traffic on these websites had increased dramatically. She reported that a wide array of public service advertisements and the Alaska Careline phone number had been distributed on city buses, in activity booklets, on theater screens, and on brochures, pins, wallet cards, and sport bags. She relayed that the council had developed and offered free public suicide education and prevention training and collaborated with the SEARCC suicide prevention coalition. She shared that they had helped develop an extensive process for a community plan for effective response following a suicide. She reported that the group had published a brochure, Surviving After a Sudden Loss. She explained that their second three-year prevention grant had been administered by the Juneau Youth Services, and had helped continue the work started under the first grant, while adding the Sources of Strength Youth Resilience Building program, work in the middle schools, and increasing its training programs and advertising. She lauded the excellent help and advice which the coalition had received from the Division of Behavioral Health. She shared that the coalition had been recognized statewide for its widespread community collaboration and its creative and effective suicide prevention efforts. She expressed shock for the latest prevention grant parameters, which did not allow the use of grant funds to support the ongoing suicide prevention initiatives, until a complex and time consuming community wide research project was completed. She reported that the work had been submitted and the coalition was waiting for a response from the division. She noted that the coalition had been able to secure private, one-time funding to keep the Sources of Strength program going in the high schools, although currently there was not a presence in the middle schools or any financial support for the Signs of Suicide program. She concluded that these once thriving initiatives were "languishing and limping along with volunteer efforts." SAM TRIVETTE shared that he was also a survivor of suicide and, although he was an active participant in the coalition, he was speaking on his own behalf and not as a representative of the coalition. He reported that, as he had worked for more than 10 years as a manager in the Department of Health and Social Services, he was quite familiar with the department. He lauded the successful collaboration with the Division of Behavioral Health for the past six years, but he expressed his frustration with the management to the current 2015 prevention grant program. He reported that his requests for information had brought him very little satisfaction. He explained that there were about 20 different grantees during this funding cycle, and there had not been any distinction between new grantees and those who had functioned for many years at a high level. He stated that the coalition, even with its extensive successful history, had to start at ground zero for this grant funding. He reported that his request for acknowledgement of the prior work by the council and allowance to move forward had been refused. He expressed understanding that new information and research would become available from time to time, and that it would be necessary to modify services using this new information. He pointed out that this had been a regular system for the past six years. He declared that the group applauded performance based management and funding, but opined that the division had not been utilizing the data submitted by the coalition over the past six years in making an evaluation for its current work. He suggested that the current requirements by the division were for process, and not progress or outcomes. He offered an example of a required memorandum of agreement with the Careline, a suicide prevention telephone hot line, which the coalition had successfully worked with for many years. He relayed some background regarding the five step planning process for grant applications, and the seven month lag in receiving a copy of the process. He offered his belief that the imposition of a management structure that did not reflect a daily reality set up the suicide prevention coalition for failure. He reminded that the coalition was staffed by volunteers from the community, and that roadblocks would lead to its collapse. He stated that support and treatment as a mature coalition would allow for continuance of quality prevention and support services to Alaskans. In response to Chair Hawker, he acknowledged that the anecdotal paperwork he offered for exhibit did not need to be entered into the public record. 7:58:20 AM PATRICK CUNNINGHAM, Chair, Denali Family Services, explained that Denali Family Services provided services to mentally ill children and their families. He shared that he was also the president of the Narcotic Drug Treatment Center, which provided services to individuals addicted to opium or heroin. He relayed that both of his agencies worked very closely with the Division of Behavioral Health. He declared that the relationship with the division had always been "outstanding," with excellent cooperation in the award of numerous grants. He shared that he was also a professor of social work at University of Alaska Anchorage (UAA). He explained that there was an issue for the reimbursement for services. He stated that Xerox had created havoc within the agencies, noting that his agency had $1.5 million in accounts receivable, and that there were constant requests by Xerox to resubmit and send additional information. He expressed hope that money from the supplemental budget would allow Xerox to catch up, while sharing that many smaller agencies had been forced to close. He stated that his agencies also had waiting lists. He reported that his agency could serve "a great deal more people that are addicted to opium that want treatment, that are on our list for treatment, but can't afford the services." He declared that it would be wonderful if they could be covered under Medicaid, noting that current support for their habit was most likely from illegal activity. He said that almost 60 percent of the people in the methadone program were also working full time jobs because the methadone helped them become functional. He allowed that it would be very beneficial if the reimbursement could be improved. He stated that, although it was improving a little bit, it was still problematic for both of his agencies. He noted, as both of the agencies provided state of the art services, it would be most beneficial for them to continue. 8:02:20 AM CHAIR HAWKER closed public testimony. 8:03:01 AM ADJOURNMENT There being no further business before the committee, the Legislative Budget and Audit Committee meeting was adjourned at 8:03 a.m.
JBUD 3/17/2015 7:30:00 AM