Legislature(2007 - 2008)HOUSE FINANCE 519
02/05/2008 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Alaska Mental Health Trust Authority | |
| HB315 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | HB 315 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE FINANCE COMMITTEE
February 5, 2008
1:44 p.m.
CALL TO ORDER
Co-Chair Meyer called the House Finance Committee meeting to
order at 1:44:25 PM.
MEMBERS PRESENT
Representative Mike Chenault, Co-Chair
Representative Kevin Meyer, Co-Chair
Representative Bill Stoltze, Vice-Chair
Representative Harry Crawford
Representative Les Gara
Representative Mike Hawker
Representative Reggie Joule
Representative Mike Kelly
Representative Mary Nelson
Representative Bill Thomas Jr.
MEMBERS ABSENT
Representative Richard Foster
ALSO PRESENT
Jeff Jesse, Chief Executive Office, Alaska Mental Health
Trust Authority; Dr. William Doolittle, Chair, Board of
Trustees, Alaska Mental Health Trust Authority; Linda Hay,
Staff, Representative Ralph Samuels; Pat Davidson,
Legislative Auditor, Legislative Audit Division, Legislative
Affairs Agency; Paul Johnson, President, Big Game Commercial
Services Board; Jennifer Strickler, Licensing Chief,
Division of Corporations, Business and Professional
Licensing, Department of Commerce, Community and Economic
Development.
PRESENT VIA TELECONFERENCE
Robert Fithian, Executive Director, Alaska Professional
Hunters' Association.
SUMMARY
Presentation: Alaska Mental Health Trust Authority
Housing Trust, Bringing the Kids Home Initiative,
Crime, and Recidivism
HB315 "An Act extending the termination date of the Big
Game Commercial Services Board; and providing for
an effective date."
HB 315 was reported out of Committee with a "no
recommendation" and with a new fiscal note by the
Department of Commerce, Community and Economic
Development.
^Presentation: Alaska Mental Health Trust Authority
Housing Trust, Bringing the Kids Home Initiative,
Crime, and Recidivism
[This relates to House Bill 312]
1:44:44 PM
DR. WILLIAM DOOLITTLE, CHAIR, BOARD OF TRUSTEES, ALASKA
MENTAL HEALTH TRUST AUTHORITY (AMHTA), introduced the
trustees in the audience and sketched the historical
background of AMHTA.
1:46:17 PM
Dr. Doolittle described AMHTA beneficiaries as people with
mental illness, developmental disabilities, alcoholism,
Alzheimer's, and brain injury. He listed the various trust
advisors.
1:48:12 PM
JEFF JESSE, CHIEF EXECUTIVE OFFICER, ALASKA MENTAL HEALTH
TRUST AUTHORITY presented the FY 09 Mental Health Budget
(copy of slide presentation on file). He referred to slide 5
and explained that AMHTA expects to have nearly $29 million
available for spending in FY 09. Slide 6 shows the breakdown
of revenue from Trust land. He said that AMHTA was about to
come to the end of many of the timber sales, which may
affect the numbers.
1:51:20 PM
Mr. Jesse turned to slide 8 and explained that the
Governor's FY 08 budget had a number of increments to fund
behavioral health grants. The AMHTA was left short about $3
million in behavioral health grants, $2 million of which was
replaced through legislative action.
Mr. Jesse talked about AMHTA treatment and services work,
including brain injury training. He said that as more
veterans return home from overseas, the Trust will be
collaborating with the Veterans Administration and the
Department of Defense to develop an integrative system of
brain injury care. The Trust will invest in community health
centers. AMHTA integrates behavioral health into primary
care centers.
Mr. Jesse recalled that AMHTA partnered with the Legislature
to expand dental coverage. Cost containment measures are
working, but he stated concerns about difficulties getting
sufficient dental services to the Native health community.
Mr. Jesse pointed out that the Governor is coming forward
with underage drinking and suicide prevention programs as
well as partnering with the Trusts to provide autism
services.
1:53:55 PM
Representative Hawker commented on the role of the Trust in
relation to the State. As chair of the Department of Health
and Social Services sub-committee, he has seen the amount
committed to the Department double. In the beginning the
Trust would use a relatively small amount of money to
partner a program to get it going, with the presumption that
the State would then take fiscal responsibility for the
program. Representative Hawker urged re-evaluating the role
of the Trust in relation to leveraging increases in general
fund spending. He thought part of the Trust's money should
be dedicated to sustaining services already established.
Mr. Jesse answered that in addition to the mini-grants the
Trust now provides significant on-going support to the
planning and advocacy boards. He acknowledged controversy
over whether on-going support is a proper role for the
Trust; those are generally seen as State responsibilities.
Mr. Jesse agreed the Trust is now more able to look at other
avenues of supporting the overall State budget. Currently
40% of Trust income goes to on-going support of projects.
Representative Hawker reiterated his concerns.
1:58:00 PM
Mr. Jesse turned the Committee to the pamphlet "Creating a
Formula for Success" (On File). He said the Trust has
developed an approach with four steps (slide 9): (1)
identify the problem; (2) collaborate with the players that
will participate in the solution; (3) develop strategic,
sharply focused solutions rather than throwing money at the
problem; and (4) make lasting system improvements.
Mr. Jesse described five focus areas, starting with the
"Bring the Kids Home" (BTKH) initiative (slides 11-15). The
Trust realized that over 700 Alaskan children were placed in
out-of-state residential psychiatric treatment centers, at a
yearly cost of $40 million. The Trust then developed
partnerships with agencies and with them strategized how to
change the situation. The result of BTKH has been a 40%
decrease in number of kids in out-of-state facilities and a
72% increase in residential treatment capacity in Alaska.
Mr. Jesse thought the most effective way to help children
would be to start with the home, to put resource in home
communities and only move up the continuum of care when that
fails: however, that approach would not have secured
funding. Instead the Trust started by building residential
housing and then put resource into home and community based
services, which could, over time, lessen the need for
residential care.
2:01:56 PM
Representative Hawker added that Residential Psychiatric
Treatment Centers (RPTC) are regulated by Certificate of
Need (CON) statutes and wondered if the Trust had a position
on the blanket repeal of CON as proposed by the
Administration.
Mr. Jesse stated that the Trust is absolutely opposed to
repeal of CON for RPTC. At one point in the BTKH initiative
there were over 500 RPTC beds proposed. If there had been no
CON process, the result would have been one of the most
expensive institutionally based systems of care in the
country. He understood the Administration was proposing
amendments.
2:04:05 PM
Mr. Jesse directed the Committee to the graph on slide 13
showing the steady decline in out-of-state expenditures as a
result of the BTKH initiative. He pointed out that when the
initiative started, the graph was going in the opposite
direction at about the same slope. The Trust is reinvesting
the saved funds into the community, which will leave the
State with a more effective continuum of care for kids and
communities. The Trust believes the Legislature could use a
similar strategy of reinvestment in other places such as the
Department of Corrections.
2:06:21 PM
Representative Kelly observed that the model moves towards a
public-private partnering in the community. Mr. Jesse agreed
there is a public-private partnership in that the public
pays and the private receives; the difference is the State
will be investing in-state rather than out-of-state.
Mr. Doolittle added that in other aspects of the trust
programs there has been a successful effort to bring
behavioral health management and treatment closer to home,
which is less expensive.
Mr. Jesse highlighted requested amendments related to
community behavioral health capacity development (slide 14).
2:09:17 PM
Representative Kelly expressed interest in the model Mr.
Jesse described, which was of to him related to corrections.
He noted the criminal equation is different but there are
common elements that could translate.
Mr. Jesse continued to talk about the Trust's five year plan
(slide 15). He admitted the numbers are substantial: $17.5
million over five years for capacity infrastructure
development. He reminded the Committee that if the State
doesn't continue to make the investment, the costs will rise
in the long term. The five year plan focuses on managing the
system of care.
Representative Hawker emphasized that until the State gets a
ten year planning horizon, decisions will be made in a
vacuum. He appreciated Mr. Jesse for taking the lead in
"truth in budgeting efforts."
2:12:16 PM
Representative Kelly thought hard numbers related to what
the State saves when spending in-state would help the
Legislature make budget decisions.
Mr. Jesse proposed that honesty in budgeting encourages
collaboration. He credited the Department with working hard
in developing the projections.
2:14:42 PM
Representative Joule, referring to the downward sloping
chart (slide 13), wondered what the Trust had seen when
looking forward at the beginning of the project. Mr. Jesse
replied that about a year and half into the project the
Department started to get a handle on the situation and knew
they were going to make a difference. The Trust was not as
confident until the Department got the data.
2:17:13 PM
Mr. Jesse moved to slides 16-22, describing the Housing
Initiative. The Trust wondered what drove the chronic nature
of homelessness in the state and discovered two reasons.
Many low-income housing projects are focused on people with
relatively higher incomes, 70% of median income and above,
even though the homeless are at 50% and below. The second
reason is that people who are at 50% and below are there for
good reasons, such as substance abuse, mental health and
domestic abuse. The Trust looked around the country to see
how others were dealing with homeless issues. The Gates
Foundation testified in Alaska about their experience in the
Seattle area. Out of those discussions came a recommendation
now on its way to the Legislature in the form of an enabling
bill and a capital appropriation to create a housing trust
for Alaska (slide 17). The Gates Foundation learned that to
get support partners invested there must be five to ten
years of support service funding with the first year's
money.
2:20:15 PM
Mr. Jesse assured the Committee that there would be
mechanisms to fund the housing initiative regardless of oil
prices and that the Legislature wouldn't be caught funding a
five to ten year project.
Vice-Chair Stoltze supported the idea of affordable decent
housing. There was a discussion about what constituted
reasonable housing. Mr. Jesse re-assured the Committee that
the Housing Trust would spend money carefully.
2:24:03 PM
Mr. Doolittle commented that the AMHTA has recognized a
theme in every focus area. The goal is to bring mental and
behavioral healthcare to those who need it at an earlier
age.
2:26:29 PM
Mr. Jesse gave an overview of what the Legislature could
expect during the rest of the session (slide 22), including
the $10 million capital appropriation and enabling
legislation in HB 324.
Mr. Jesse emphasized that the Housing Trust is essential to
maintain current housing, which the State is losing
steadily, as well as to create additional housing.
Representative Hawker pointed out that three-quarters of the
money listed on slide 22 consists of public funds. He wanted
to know the long-term plan for the housing trust development
and how long AMHTA wants the State to continue spending at
that level. Mr. Jesse answered that the Council on the
Homeless had estimated that to address the current homeless
needs would take about $15 million per year for ten years.
Representative Kelly felt there have been many failures in
the effort to solve homelessness. He was both nervous and
about and encouraged by the Housing Initiative.
2:30:51 PM
Mr. Jesse agreed that the old system of putting people in
housing without support did not work. He cited examples of
successfully combining housing with support services and
believed similar strategies would work in Alaska.
Representative Kelly talked about the pride of ownership and
the importance of responsibility. Representative Hawker
wondered what additional money would be needed for support
services to augment the $10-15 million a year for ten years.
2:33:11 PM
Mr. Jesse answered that it costs more to support people who
are homeless than to support and train people while they are
in long-term housing. Representative Hawker voiced concerns
about unanticipated costs. Mr. Jesse was confident the
Housing Trust would be as fiscally successful as the BTKH
initiative and encouraged the passage of the enabling
legislation.
Mr. Jesse addressed Disability Justice (slide 23). He
recommended the study conducted by the AMHTA in the
Department of Corrections ("A Study of Trust Beneficiaries
in the Alaska Department of Corrections," On File). He
indicated that 42% of those incarcerated in the DOC are
Trust beneficiaries. He emphasized that a major effort led
by the Administration was needed to address the issue of
overcrowded prisons and provided examples of public policy
options to reduce recidivism.
Mr. Jesse said the Trust has been working on a plan to
provide a workforce development strategy for Alaska. He
described a plan to pay student loans for health-care
professionals who stay in Alaska and supporting increments
to the University of Alaska to further develop health
programs. He referred to the Trust Beneficiary Projects
Initiative, which helps people integrate recovery into their
lives.
Mr. Jesse addressed Medicaid, which provides funding for
Alaska's mental health programs. He emphasized the need
support rate adjustments and fund increments to replace Pro
Share.
Representative Hawker spoke regarding rate re-basing. He
noted the $20 million placeholder in the budget for home and
community based services that have not been addressed.
Vice-Chair Stoltze acknowledged the inherent problem of paid
lobbyists versus citizen lobbyists.
Mr. Jesse appreciated Vice-Chair Stoltze comments and
underlined that small community-based programs are the best
places to put dollars.
Vice-Chair Stoltze clarified that Mr. Jesse was opposed to
CONs only on the point of residential psychiatric treatment.
Representative Kelly noted that many of the beneficiaries of
the AMHTA use the services that the CON supports.
2:48:38 PM
Representative Kelly believed the growth in the social
services budget is unsustainable. He worried about when oil
prices came down and urged the Trust to prioritize. Vice-
Chair Stoltze looked forward to the debate in subcommittee.
2:51:42 PM AT EASE
2:54:41 PM RECONVENE
HOUSE BILL NO. 315
"An Act extending the termination date of the Big Game
Commercial Services Board; and providing for an
effective date."
LINDA HAY, STAFF, REPRESENTATIVE RALPH SAMUELS, described
House Bill 315 as an extension of the Big Game Commercial
Services Board to June 30, 2012, at the recommendation of
the Legislative Audit Division.
PAT DAVIDSON, LEGISLATIVE AUDITOR, LEGISLATIVE AFFAIRS
AGENCY, explained that the Big Game Commercial Services
Board was reconstituted approximately two years ago.
Normally sunset extensions are around eight years. The Board
had only two years of activity under their belt at the time
of the review.
2:55:53 PM
Legislative Audit recommended a four-year extension. Most of
the other recommendations were administrative. Legislative
Audit recommended that fees be increased to cover the costs
generated by the Board.
2:57:48 PM
PAUL JOHNSON, PRESIDENT, BIG GAME COMMERCIAL SERVICES BOARD,
spoke in favor of the bill. He reported that the Board spent
the past two years getting up and running, and that its
members are volunteers.
Mr. Johnson said in response to a query by Representative
Kelly that his biggest concern was addressing complaints
that have come in after a ten-year lapse. He reported that
the Board now has a good investigator, great support from
the Department of Commerce and have been working on their
image.
ROBERT FITHIAN, EXECUTIVE DIRECTOR, ALASKA PROFESSIONAL
HUNTERS' ASSOCIATION (TESTIFIED VIA TELECONFERENCE) spoke in
support of HB 315. He believes the oversight board is vital
to the integrity of Alaska's guide and transporter
industries, to prudent wildlife conservation, and to
sustainable economy in rural Alaska. The Board also
represents a much needed buffer between Alaska's public
resources of wildlife and wild lands, and exploitation by
the professional guide and transporter industries.
Mr. Fithian said that six years ago Alaska had a blemished
image in relation to how the State managed guide industries
and wildlife, and the lack of consumer protection. He
described the three years of hard work re-creating the
Board. In a recent meeting with a worldwide group of guide
and outfitter association representatives, people from all
over the world requested the footprint for how Alaska
established the current guide and outfitting licensing
standards. He said the Board is working exceptionally well,
supported by all affiliated state and federal agencies. The
Board carries its own weight financially.
3:03:10 PM
Vice-Chair Stoltze observed that the United States
Department of Agriculture is in favor of this bill. He
wondered why the federal government is interested in the
issue.
Mr. Johnson explained that the Board has learned from
experience that cooperating with the federal agencies on
land use and other issues, then the State can make its own
laws and regulations with local input.
3:05:14 PM
Co-Chair Meyer opened discussion of the new fiscal note.
JENNIFER STRICKLER, LICENSING CHIEF, DIVISION OF
CORPORATIONS BUSINESS AND PROFESSIONAL LICENSING,
DEPTARTMENT OF COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT,
pointed out that the fiscal note before the Committee
reflects both direct and indirect costs to the Big Game
Commercial Services Board. She explained that all
professional licensing programs are responsible by statute
for covering costs through licensing fees. The Board's costs
are built into the standard operating budget.
Ms. Strickler explained that the Board is staffed by two
full-time occupational examiner positions. One of the
positions is currently vacant due to difficulties in
recruiting because of the pay ranges. The Board is receiving
the support of a dedicated investigator. Other costs are
indirect costs, for example, the supervisors that have been
sitting in with the licensing examiners to help staff the
Board and the regulations specialists that have helped to
promulgate the regulations and other management costs.
3:07:19 PM
Co-Chair Chenault wanted clarification regarding travel
costs which he thought looked high.
Ms. Strickler indicated that the Board meets twice a year.
Licensing examinations are given during the meeting because
the presence Board members and staff are necessary to
conduct examinations. The meeting lasts for a week and costs
around $35,000. Sometimes members are required to fly exam
proctors (professional licensees) to come and help with the
exams. If the proctors can drive, their mileage is covered.
Co-Chair Chenault asked if all the other costs were covered
in the $108,000 for contractual services. Ms. Strickler
answered that the contractual costs cover legal fees, expert
witnesses and also re-writes of the guide licensing
examinations. The examination is currently being re-written,
which is a major undertaking. Co-Chair Chenault asked if the
examinations would be re-written every year. Ms. Strickler
hoped not, but explained that the examination is extensive.
Co-Chair Chenault pointed out that the cost was projected
out through the length of the extension. He noted the Board
has nine board members.
3:10:11 PM
Co-Chair Meyer had further questions about travel costs. He
pointed out that if the Board meets twice each year, at a
cost of $35,000 each meeting, the total would be $70,000. He
asked what the other $30,000 on the fiscal note was used
for.
Ms. Strickler answered that the Board sends investigators to
conferences outside Alaska. The investigators also work with
other law enforcement agencies, such as Fish and Wildlife
Protection, and need to travel to hearings.
Co-Chair Meyer thought the justification sounded weak. Co-
Chair Chenault wanted to know how many investigators the
Board utilized. Ms. Strickler answered one there was one
investigator, with one position for investigator still open.
Representative Kelly wondered if the position that hasn't
been filled could be eliminated since the Board is
performing so well without it. Ms. Strickler answered that
currently a supervisor is filling in as much as she can.
However, there are major projects require much staff time,
including the guide scanning project. The Board is always
behind with requests from enforcement officers for these
records. Once that process is completed, she thought one
staff position to the Board could be reduced.
3:13:16 PM
Representative Kelly thought more information was needed and
that the vacancy rate was a budget issue. Co-Chair Meyer
thought the bill could be passed out of committee with the
current fiscal note and then changes could still be made in
the budget. Representative Hawker observed that as a
statutory board, the Board is separately accounted and not
part of the Department's general fund budget.
Representative Joule added that the absence of the Board for
about ten years created significant problems. He referred to
the effort taken to get the Board running again and noted
that part of the Board's success will depend on how well it
is maintained. He understood the need to scrutinize but did
not want the Board to fall behind again. Representative
Kelly thought any problems could be handled in committee.
3:16:07 PM
Representative Hawker asked if the fiscal note reflects the
increase in fee rates. He wondered how personal services
positions are acquired. Ms. Strickler answered that personal
services positions are not listed on the fiscal note because
they are not exclusively authorized through the budget
process. Occupational licensing examiner positions are
authorized through the Division's budget. Management assigns
the various licensing programs to the positions.
Representative Hawker discussed the difference between
contractual services to an agency and personal services.
3:18:42 PM
Co-Chair Chenault MOVED to REPORT HB 315 out of Committee
with individual recommendations and the new attached fiscal
note dated 2/4/08. There being NO OBJECTION, it was so
ordered.
HB 315 was reported out of Committee with a "no
recommendation" and with a new fiscal note by the Department
of Commerce, Community and Economic Development.
#
ADJOURNMENT
The meeting was adjourned at 3:19 PM.
| Document Name | Date/Time | Subjects |
|---|