Legislature(2019 - 2020)ADAMS ROOM 519
04/12/2019 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB25 | |
| HB22 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 25 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 22 | TELECONFERENCED | |
HOUSE FINANCE COMMITTEE
April 12, 2019
1:30 p.m.
1:30:33 PM
CALL TO ORDER
Co-Chair Wilson called the House Finance Committee meeting
to order at 1:30 p.m.
MEMBERS PRESENT
Representative Neal Foster, Co-Chair
Representative Tammie Wilson, Co-Chair
Representative Jennifer Johnston, Vice-Chair
Representative Dan Ortiz, Vice-Chair
Representative Ben Carpenter
Representative Andy Josephson
Representative Gary Knopp
Representative Bart LeBon
Representative Kelly Merrick
Representative Colleen Sullivan-Leonard
Representative Cathy Tilton
MEMBERS ABSENT
None
ALSO PRESENT
Senator David Wilson, Bill Sponsor; Kris Curtis,
Legislative Auditor, Alaska Division of Legislative Audit;
Representative Geran Tarr, Bill Sponsor; Linda Brazak,
Administrative Operations Manager, Division of Behavioral
Health, Department of Health and Social Services; Eric
Morrison, Project Assistant, Division of Behavioral Health,
Department of Health and Social Services.
PRESENT VIA TELECONFERENCE
Dr. David Neilson, Member, Alaska Board of Dental
Examiners; David Logan, Alaska Dental Society, Anchorage;
Sara Chambers, Director, Division of Corporations, Business
and Professional Licensing, Department of Commerce,
Community and Economic Development; Sharon Fishel,
Education Specialist II, Department of Education; Barbara
Franks, Chair, Alaska Suicide Prevention Council,
Ninilchik; James Biela, American Foundation for Suicide
Prevention, Bethel; Lily Wertz, Self, Anchorage; Tina
Walsh, Self, Anchorage; Sam Trivette, Juneau Suicide
Prevention Coalition, Juneau.
SUMMARY
HB 22 EXTEND SUICIDE PREVENTION COUNCIL
HB 22 was HEARD and HELD in committee for further
consideration.
SB 25 EXTEND BOARD OF DENTAL EXAMINERS
SB 25 was HEARD and HELD in committee for further
consideration.
SENATE BILL NO. 25
"An Act extending the termination date of the Board of
Dental Examiners; and providing for an effective
date."
1:31:52 PM
SENATOR DAVID WILSON, BILL SPONSOR, thanked the committee
and apologized for being held up with other state business.
He reviewed the bill sponsor statement:
Senate Bill 25 extends the termination date for the
Board of Dental Examiners until June 30th, 2027. The
Board of Dental Examiners is composed of nine members:
six dentists, two dental hygienists, and one public
member.
Legislative Audit conducted their review of this board
and determined that "The audit concludes that the
board operated in the public's interest by effectively
licensing and regulating dentists, dental hygienists,
and dental assistants. The board monitored licensees
and worked to ensure only qualified individuals
practiced in Alaska. Furthermore, the board was active
in amending regulations to improve the industry. In
accordance with AS 08.03.010(c)(7), the board is
scheduled to terminate on June 30, 2019. We recommend
that the legislature extend the board's termination
date eight years to June 30, 2027."
The Board of Dental Examiners serves an important role
in adopting regulations to carry out the laws
governing the practice of dentistry and dental hygiene
in Alaska. The continuation of this board plays an
important role in ensuring high standards of dental
care are offered throughout the state.
Senator Wilson reported that Legislative Audit made 2
recommendations to the board. He read the recommendations
from the sunset review:
Recommendation 1:
The Board of Dental Examiners (board) president should
take steps to correct a regulation error.
A 2016 change to a dental radiological equipment
regulation resulted in regulations referring to a
repealed section of regulations.
Specifically, 12 AAC 28.965 states:
(b) The inspection of dental radiological
equipment must
(1) be performed by an inspector who is on the
list
maintained under (d) of this section;
However, section 12 AAC 28.965(d) was repealed March
2016.
Senator Wilson reported that the board had corrected the
error.
Recommendation 2:
Division of Corporations, Business and Professional
Licensing's chief investigator, in consultation with
the board, should implement controls to ensure the
appropriate entities are notified when a licensee's
prescription authority is suspended or revoked.
Senator Wilson explained that although the investigations
were done in a timely manner, Legislative Audit found that
there were no procedures and notified the Board of Pharmacy
or the Federal Drug Enforcement Administration when a
licensees prescription authority had been suspended or
revoked. The Division had immediately addressed the issue
by implementing controls to ensure that the entities were
appropriately notified.
Senator Wilson drew members' attention to the fiscal note.
The note reflected a spend of $35,100 which paid for
expenses for board travel, attending meetings, advertising,
and board and conference fees. Professional licensing
programs within the Division of Corporations, Business and
Professional Licensing were funded by Receipt Supported
Services with designated general funds. Licensing fees were
covered by the costs of the board.
Senator Wilson reviewed the sectional analysis:
Section 1. AS 08.03.010(c)(7) is amended to read:
(7) Board of Dental Examiners (AS 08.36.010) -
June 30, 2027 [2019];
Sec. 2. This Act takes effect immediately under AS
01.10.070(c).
Senator Wilson reviewed the available testifiers and urged
members support.
Co-Chair Wilson invited Kris Curtis to the table.
1:35:59 PM
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, indicated the purpose of the sunset
audit, dated April 2018 (copy on file), was to determine
whether a board or commission was serving the public's
interest and whether it should be extended. She read from
the audit report:
The audit concludes that the board operated in the
public's interest by effectively licensing and
regulating dentists, dental hygienists, and dental
assistants. The board monitored licensees and worked
to ensure only qualified individuals practiced in
Alaska.
Furthermore, the board was active in amending
regulations to improve the industry.
In accordance with AS 08.03.010(c)(7), the board is
scheduled to terminate on June 30, 2019. We recommend
that the legislature extend the board's termination
date eight years to June 30, 2027.
Ms. Curtis directed members to turn to page 6 regarding
licensing activity. She relayed that as of January 2018
there were 2,399 active licenses. On page 7 there was a
schedule of board revenues and expenditures. It showed that
as of March 2018 the board had a deficit of $36,000. She
reported that there was a fee analysis planned for 2018.
The schedule of fees was on page 8.
Ms. Curtis continued that the audit had two recommendations
administrative in nature. The first recommendation was a
regulation error which should be easy to address. A 2016
regulation change resulted in one regulation referencing a
repealed recommendation. The second recommendation was an
issue the auditor also found with the Board of Nursing. She
explained that when a licensee's prescription authority was
suspended or revoked, there were no procedures to notify
the Board of Pharmacy or the Federal Drug Enforcement
Administration (DEA). In the audit period she found two
licensed dentists that had their prescription authority
revoked and the information was not communicated to the
proper entities.
Ms. Curtis reported that the response to the audit was on
page 21. The board agreed with both recommendations and
planned to take corrective action.
Representative LeBon mentioned there had been discussion
about a level of dental practice that would allow a
practitioner to serve the public in rural areas providing
basic dental services. He asked if a discussion had ensued.
Ms. Curtis responded that the audit did not look at the
issue. However, she thought Dr. Neilson, the chairman of
the board, could field the question.
1:39:21 PM
DR. DAVID NEILSON, MEMBER, ALASKA BOARD OF DENTAL EXAMINERS
(via teleconference), thought Representative LeBon was
referencing the Dental Health Aide Therapist. He wondered
if he was right. Representative LeBon responded in the
affirmative.
Dr. Neilson relayed that the particular provider was not
regulated by the state or the board. They were regulated by
Indian Health Service and supervised by dentists that work
in the villages. It was difficult for him to comment except
to say that it seemed to be working.
Representative LeBon asked how common the program was
throughout the state. He wonder how many practitioners were
in the state. Dr. Neilson did not have the information. The
best way to obtain the information would be through Alaska
Native Tribal Health Consortium (ANTHC) or the tribes.
Since the board did not license them, he did not know the
numbers or where they were practicing.
Co-Chair Wilson asked if Mr. Neilson had additional
testimony. Dr. Neilson was available for questions. He
supported the extension.
Co-Chair Wilson asked if any regulations had been brought
forward to make it easier for out-of-state dentists to
provide service in Alaska. Dr. Neilson responded
affirmatively. The board's goal was to accept all generally
equivalent regional licensing exams. The board had a
current regulation project that addressed the issue. He
reported that it was just signed by the Lieutenant
Governor's Office and should be in effect approximately by
May 1, 2019. It should be in effect for the upcoming exam
season. Co-Chair Wilson appreciated the information he
provide over the interim.
1:42:31 PM
DAVID LOGAN, ALASKA DENTAL SOCIETY, ANCHORAGE (via
teleconference), reported that the Alaska Dental Society
had worked with the board for several years to bring a
change in place where dentists graduating from U.S. schools
could take any regional board and apply for an Alaska
dental license. The society was very glad to see the
project come to an end. He conveyed that the Alaska Dental
Society supported the board extension.
1:43:36 PM
Co-Chair Wilson OPENED Public Testimony.
1:43:50 PM
Co-Chair Wilson CLOSED Public Testimony. Co-Chair Wilson
asked Ms. Chambers to review the fiscal note associated
with the bill.
SARA CHAMBERS, DIRECTOR, DIVISION OF CORPORATIONS, BUSINESS
AND PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE,
COMMUNITY AND ECONOMIC DEVELOPMENT (via teleconference),
reported that the fiscal note reflected all receipt
supported services to continue the work of the board if
extended through the recommended amount of time. All
expenses were paid through license fees. There were no
undesignated general funds. If the board was sunset there
would not be expenses for maintaining the activity of the
board. If the board was extended expenses would be
incurred. She estimated about $35,000 per year for the
activities of the board. If the bill was not successful and
the board were not to continue, the division would assume
all the responsibilities for the licensing program without
the benefit of the wisdom of the board.
Co-Chair Wilson understood the fiscal note reflected what
the department would incur if the board was not in place.
She wondered if the fees would drop down without the
infrastructure of the board in place. Ms. Chambers
responded that it was unlikely that the division would see
a significant savings by simply discontinuing the board.
The board was a group of experienced volunteers that
provided service at no salary cost to the division. The
division would likely have to obtain expert witnesses at a
much higher cost to provide the expertise in regulations
and advising regarding investigations. The real benefit
went far beyond $35,000 per year to gather the board
together to meet.
Co-Chair Wilson did not object to the extension of the
board. Rather, she was trying to be transparent with the
fiscal note. She referred to page 7 of the audit which
showed the state's direct expenditures for the board and
the money collected. She thought the fiscal note should
include the amount if board was extended. She thought the
fiscal note currently reflected the amount if the board was
not extended. Ms. Chambers replied that if the bill passed,
the division would require $35,000 to continue the
activities of the board. If the bill did not pass, the
expense would not be part of the division's expenditures
for the fiscal year.
Co-Chair Wilson asked why the board was being given
$145,216 in program receipts to do its business, but it was
not reflected in the fiscal note. Ms. Chambers responded
that the only thing that changed with the bill was the
existence of the board. The rest of the program did not
change. The division would continue to perform all
licensing and investigative functions for the program. The
fiscal note, per the legislature, reflected what the bill
accomplished, not all of the expenses associated with the
entire licensing program.
Co-Chair Wilson suggested that if the board no longer
existed there would still be fees incurred to regulate the
profession. She asked if she was correct. Ms. Chambers
responded positively. Co-Chair Wilson suggested that the
fiscal note needed work.
Representative Knopp tried to clarify Co-Chair Wilson's
comment. He wondered if he understood correctly. Ms.
Chambers responded in the affirmative.
Co-Chair Wilson wanted to make sure when people were
looking at the fiscal note they did not think the amount
listed was all that the program was spending.
SB 25 was HEARD and HELD in committee for further
consideration.
HOUSE BILL NO. 22
"An Act extending the termination date of the
Statewide Suicide Prevention Council; and providing
for an effective date."
1:49:38 PM
Co-Chair Wilson thanked Representative Tarr for quickly
running through the bill earlier in the week.
REPRESENTATIVE GERAN TARR, BILL SPONSOR, reviewed the bill
which reauthorized the suicide prevention council through
2027, an 8-year extension. The extension came following the
successful audit recommending the extension. She indicated
the committee would hear from the auditor about a couple of
recommendations later in the meeting. She had talked about
her experience serving on the board previously. She spoke
of a couple of key reasons why the membership was so
important. She had mentioned in a previous meeting about
the diverse membership and the statutory requirement that
there be a Veteran or military representative, a person
from the Alaska Federation of Natives (AFN), and a person
from a faith-based organization in addition to other more
expected membership representing agencies and legislators.
Representative Tarr discussed the importance of the Veteran
and military connection. Alaska had the highest number of
Veterans per capita in the country, and suicide was a major
problem with Veterans. She referenced in members' packets,
"Suicide Facts and Figures" (copy on file). She pointed to
the Alaskan Veteran suicide rate which was much higher than
the Western Region and the national Veteran suicide rate.
She reiterated the importance of having representation from
military and Veteran affiliation. She reported other data
that suggested someone who served in the military was twice
as likely to commit suicide.
Representative Tarr talked about the importance of having
representation from AFN. A member from AFN had knowledge
and connections to tribal organizations and the Alaska
Native community. Suicide was an issue that affected rural
communities harder than anywhere else in the state. She
reported that the group of individuals who were dying the
most from suicide were Alaska Native males between the ages
of 19 to 25. The council had partnered with AFN at all of
the recent meetings to provide information, training,
prevention work, and healing. She spoke of a suicide at an
AFN conference a few years prior. The incident made it even
more clear the importance of continuing to work on the
issue and how impactful it was to communities and families.
Representative Tarr stressed the importance of having
someone with a faith-based background on the board.
Churches and schools, especially in small communities, were
some of the more stable organizations. They were good
organizations to partner with. Also, an important part of
healing from trauma or abuse was a person's faith. Over the
years the council had worked with members in the faith
community to offer training for people who were leaders.
Often times people went to their faith leaders for advise
when they were experiencing a challenging time in their
life.
1:53:57 PM
Representative Tarr suggested that the state's suicide
rates were rising. She referred to the suicide fact sheet
again. She thought another piece of data which was
important to consider in relation to the number of suicides
which was the number of calls to the Care Line. The number
of calls had jumped substantially. In 2012 there were 6,956
contacts for the entire year. In 2018 there were 20,976
calls. Even though the suicide rates had increased, the
call line numbers were very large. She thought both data
points should be taken into consideration together. There
was no way of knowing whether the outcome could have been
different if those individuals had not called the Care
Line. The calls to the careline cemented the idea that it
was essential to provide resources for people in crisis.
Representative Tarr spoke about the recommendations from
the audit. She wanted to talk about an additional piece she
hoped members would consider. The council produced an
annual report - the third report was recently released
recasting the net. She highlighted a checklist found at the
end of the report of things that individuals, families, and
communities could do. The council always tried to
incorporate things that it learned into its work. The list
reflected some of the data the council knew was working.
She suggested to legislators to provide information in
their newsletters and talk about the council's resources at
constituent meetings. She thought having a diverse group,
coordinating and designing a plan and sharing it with
communities, organizations, and churches would be how the
state would achieve the desired change.
Representative Tarr relayed that the fiscal note would be
addressed in the committee and the funding was included in
the base for the Department of Health and Social Services
(DHSS). She noted funding for the related grant which was
incorporated into the work of the council 5 years ago. She
reported that the grants went through the council and out
through the Department of Education and Early Development
(DEED) to schools for primary prevention (very promising
early intervention type of work with young people). The
money was in the budget, however, the legislature needed to
pass the bill extending the council.
1:57:42 PM
Representative Carpenter was looking at the findings and
recommendations of the audit and the prior 2012 sunset
audit recommendations. He asked about the recommendation
for the council to develop performance measures. He
wondered how the council was measuring success with the
program. He saw a chart that showed 2007 to 2016 with
categories of Alaska Native, Alaska Non-Native, Alaska, and
U.S. and with a rate per 100,000. Co-Chair Wilson asked
Representative Carpenter to identify the page he was
looking at.
Representative Carpenter was looking at page 7 of the audit
report, Exhibit 3. He knew it was difficult to quantify how
many people did not commit suicide but wondered how the
council was measuring the effectiveness of the program.
Representative Tarr indicated it was difficult to measure
success. It was unknown who might have been thinking about
committing suicide. She brought up the number of calls to
the Care Line as a way of measuring success. The Care Line
reported quarterly to the suicide prevention council
meetings. She encouraged people to contact the council to
find out more about the work performed by the council. She
could not provide an answer to the representative's
question. However, the council looked to the numbers from
the Care Line as an indication that the demand and need was
growing for individuals looking for services to address
when they were feeling in a crisis situation. She added
that when looking at the grants, some of them did work that
involved a training program. She used iTalk Assist as an
example of a program used in high schools and taught
students to speak up if they saw something. It allowed
students to be a part of a support network for people. She
thought looking at metrics geared towards how providing
services and training could be achieved would be more
quantifiable. She did not think it was possible to track
the number of deaths that were prevented.
Representative Carpenter relayed that there were 39 per
100,000 in 2007, and in 2016 the number was 42 per 100,000.
Over the time span the numbers had not changed much. There
was a marginal increase. The state was spending over
$500,000 per year without apparent results. He wondered how
to know the council's effectiveness.
2:02:42 PM
Representative Tarr responded that most people thought the
number would be much higher without the program. She noted
the village of Hooper Bay and the contagion of suicide a
few years back. She noted that when looking at the smaller
segment of population sometimes an event, such as the one
in Hooper Bay, influenced the date significantly.
Representative Carpenter asked what the suicide prevention
council did in the instance of the deaths in Hooper Bay.
Representative Tarr responded that after the event the
council got people from the community connected with
resources for the postvention. The council sent resources
to the community and tried to provide the support necessary
for a small community to respond to such tragic events that
happened in close succession. She noted that the council
wanted to do more of the postvention training. In terms of
the training, none of it was happening previously. More of
the training had been offered in the past 5 years because
money was more available currently. It was reported to the
council that the training had been critical to the crisis
response after the incidents.
2:05:46 PM
Representative Sullivan-Leonard asked for examples of the
work done through the council regarding the grants and how
the grants were dispersed. She also about what was actually
happening out in the communities.
Representative Tarr replied that earlier the council had
been working on setting up framework. The framework had
been a coalition model. There was a Juneau Coalition and
two coalitions in Anchorage. There were others around the
state as well. Some had been more successful than others.
One of the things the council noticed was that in the urban
centers, in churches and schools, it had been easier for
the sustainability and longevity of the coalitions. In some
of Alaska's smaller communities it had been more difficult
to sustain the coalitions over time. The council was trying
to build and strengthen the coalitions in the communities.
The coalitions often included people from the council or
people who were working closely with JAMI in Juneau or NAMI
in Anchorage. For example, Juneau Suicide Prevention
Coalition conducted training events and held conferences
getting out into communities. NAMI focused on supporting
families.
Representative Tarr continued that the grants awarded to
schools were geared towards primary prevention programs and
teaching. Much of the work recently was focused on being
trauma-informed. They recently completed some training
models that could be used for education professionals and
was accessible online by dedication a certain number of
slots for the public. The funds were used to produce the
training which had longevity because it was done in a
webinar format. She was hoping that individuals that worked
with children, such as individuals working at childcare
centers, could potentially go online to use the resource.
She noted there was prevention and postvention work
occurring in communities as well.
2:09:54 PM
Co-Chair Wilson invited Ms. Fishel to comment.
SHARON FISHEL, EDUCATION SPECIALIST II, DEPARTMENT OF
EDUCATION (via teleconference), responded that the grant
program saved lives including the lives of children and
teachers. There was a tremendous effort in training staff.
She reported that in 2012 there was a law passed, SB 137,
that required all educators to receive suicide prevention
training. Since then, through the department's e-Learning
system there had been over 18,000 of DEED's 23,000 users
that have taken 1 of 4 suicide prevention courses developed
by the department in collaboration with the suicide
prevention council. The depart also developed several
trauma courses.
Ms. Fishel continued that over the 5 years that the
department had the grants, there had been 20 grants that
had gone out to different school districts and some
particular schools. School districts were moving to a peer-
to-peer model training students how to recognize signs of
suicide. They were teaching students how to encourage
individuals by letting them know they were not alone. She
mentioned several school districts that were utilizing the
funds. She spoke highly of the program. She provided some
examples of school districts and how they were making
efforts to educate students about suicide prevention. She
noted that a federal grant manager commented that the small
grant for suicide prevention saved lives and had the
largest impact of all of the millions of dollars he
managed. Every 3 years districts were asked to apply for
the grants. They were all required to use an evidence-based
practice. She reported that over 137,000 Alaskans had been
touched or were part of the program in the previous two
grant cycles.
2:14:37 PM
Co-Chair Wilson asked for information regarding the
allocation of grants.
Representative Carpenter asked if the department kept any
non-attributable statistics on suicide ideation, attempted
suicide, or successful interventions. He was looking for
verification that the program was saving lives.
Ms. Fishel reported the information would point to specific
individuals and would break privacy provisions. She
mentioned the youth risk behavior survey done every 2 years
included questions about depression, whether a person
considered suicide, and whether a person attempted suicide.
The last statistics the department had were from 2017. The
information was currently being administered, and she was
unsure of the trend line. The survey was collected from
students. However, the data the representative was asking
for was not collected by DEED.
Representative Carpenter thought, going forward, the
department should keep non-attributable information in
order facilitate a conversation about the program's
success. He did not approve the measure that was currently
in place. He thought measures of effectiveness were
necessary in managing a program.
Co-Chair Wilson asked if there was a fee attached to any of
the courses being offered.
Ms. Chambers responded in the negative. All the courses
were free.
2:18:48 PM
Vice-Chair Ortiz asked about the issue of suicide
prevention and awareness. He wondered if it was possible
that the state had more documented suicides because people
were paying more attention to the issue. He thought it was
possible that previously suicides might not have been
documented prior to the new level of awareness in the
state.
Co-Chair Wilson thought Vice-Chair Ortiz's question was
valid. However, Representative Tarr already testified on
the difficulty of measuring success of the program.
Representative Tarr added that DHSS could provide
additional information. Sometimes suicide was not listed on
a death certificate as the cause of death. She provided
additional Care Line numbers. The numbers reflected a jump
at each measure taken. There continued to be an increase.
People were finding out about the service. She believed the
care line might have more information.
Representative Tilton asked for a list of grantees of the
past history of the program. She wondered if most of the
grantees were going out to government agencies or
faith-based organizations. Co-Chair Wilson asked if a 2-
year look back was a large enough timeframe.
2:22:57 PM
Representative Tilton responded in the affirmative. She
mentioned that in the fiscal note it stated that the
Statewide Prevention Council was developing and
implementing a plan, the council's most significant
statutory duty. There was a new revised plan that moved
away from an intervention plan to more of a prevention and
promotion plan. She asked Representative Tarr to talk about
the change.
Representative Tarr replied that it was essentially
recasting the net. It was available online, and a checklist
was provided. In her work in public health, she had seen a
shift from a crisis response model - the costliest point of
intervention - to an earlier intervention and prevention
model. The grants were awarded to a promising or
evidence-based practice. People wanted to use
evidence-based models to know for sure that the model was
effective. She reported that evidence-based models showed
that the earlier intervention and prevention was the most
effective and cost-effective model. She suggested that in
working with young people it helped them to develop skills
for themselves in how they experienced and addressed a
personal crisis as well as being a resource for others. She
mentioned the vulnerable group of young men, ages 19-25 and
the hope of reaching them and providing tools to them that
would help them to be resilient.
Representative LeBon wondered if the history of the funding
for the program had been static. Representative Tarr
responded that it had been static. She reported that in the
earlier years there had been just one staff person. Once
the grants were factored in, the funding had been pretty
consistent over the prior 5 years. The funding covered the
cost of staff, travel, and the grants. During her time on
the council she had visited multiple sites which provided
significant insight. There were travel funds and grant
monies. She indicated the fiscal note estimated the cost of
the position, travel, and the grants. Under Governor Walker
there had been a travel freeze. For a couple of years it
appeared that travel came under budget, but it was the
freeze that influenced the number.
2:27:33 PM
Representative LeBon pointed to the graph on page 7 that
confirmed that Alaska had a real problem with suicide in
the state. However, the graph did not specify the number of
suicides prevented by the state's actions. He suggested
that one option would be to zero out the program and see
how many suicides occurred, however he did not believe it
was a good strategy.
Representative Josephson thought that in a failed attempt
there could be great costs borne by the public in degree,
far greater than the fiscal note. He asked Representative
Tarr if he was correct.
Representative Tarr responded affirmatively. She
highlighted the handout regarding suicide facts and figures
which spoke to Representative's question. She read from the
handout:
Suicide cost Alaska a total of $226,875,000 combined
lifetime medical and work loss cost in 2010, or an
average of $1,383,382 per suicide death.
Representative Tarr relayed that the cost of someone dying
at a young age was very costly. Beyond the dollar, she
conveyed losing her brother to suicide and the personal
impact to family and friends.
2:29:47 PM
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, read a portion of the audit dated,
August 3, 2018 (copy on file):
The audit found the council operated in the public's
interest by actively broadening the public's awareness
of suicide prevention and coordinating the efforts of
other suicide prevention entities including State
agencies, regional groups, coalitions, and local
communities. Additionally, the council fulfilled its
statutory duty by issuing the 2018-2022 Suicide
Prevention Plan and working closely with stakeholders
to add and refine the plan's strategies, resources,
and indicators. The audit also concluded that
administrative improvements were needed to ensure
council meetings are adequately public noticed and the
executive director is consistently evaluated on an
annual basis.
In accordance with AS 44.66.010(a)(7), the council is
scheduled to terminate on June 30, 2019. We recommend
that the legislature extend the council's termination
date to June 30, 2027.
Ms. Curtis directed members to turn to page 4 of the audit
showing expenditures and funding sources. It showed that
the council was funded entirely by general fund
appropriations and that in FY 18 the council spent just
under $600,000. She referred to a detailed list of council
activities conducted during the audit period on pages 9 and
10. She reported there were two minor recommendations as a
result of the audit beginning on page 12. Both were
administrative in nature and easily addressed:
The council's executive director should develop and
implement procedures to ensure public notices for
meetings are published timely and accurately.
From July 2014 through March 2018, 5 of the 18
meetings held (28 percent) were not public noticed or
not public noticed properly. Specifically, two were
not published on the State's Online Public Notices
system, two were published with incorrect meeting
dates, and one was published one day prior to the
meeting. The deficiencies were caused by a lack of
written procedures to ensure notices are posted timely
and contain accurate meeting dates.
Ms. Curtis reviewed the second recommendation:
The council chair should develop and implement
written procedures to ensure performance evaluations
are completed annually for the council's executive
director.
Between July 2014 and March 2018, two evaluations were
completed for the executive director; however, two
more should have been completed. Specifically, there
were no evaluations for the period of November 2014 to
November 2015, and November 2015 to June 2016. Per
discussion with council staff and the previous council
chair, it is unclear why the evaluations were not
completed for the executive director.
Ms. Curtis restated that the recommendations were easy to
address. She indicated the responses to the audit could be
found on page 23. She reported that the commissioner of
DHSS and the counsel chair agreed and concurred with the
report conclusions and recommendations.
Representative Josephson asked if it was true that in all
of the cost saving measures the administration proposed,
they wanted the council untouched. Ms. Curtis did not know.
Co-Chair Wilson indicated the committee would ask someone
from DHSS.
2:32:46 PM
Co-Chair Johnston asked about how the division audited the
coordination between the suicide groups and the state
agency. She thought Ms. Curtis had seen improvement.
Ms. Curtis clarified Vice-Chair Johnston's question.
Vice-Chair Johnston restated her query.
Ms. Curtis explained that as part of the audit her division
sampled, reviewed, and read the board meeting minutes,
reviewed annual reports, and conducted interviews of
stakeholders and council members to reach their conclusions
about coordinating. The council served in an advisory
position to the legislature and the governor. Legislative
Audit looked at whether the council had been accomplishing
its statutory mandate, which she thought they had. Another
statutory duty was to develop a statewide plan which had
been done in a timely fashion. Legislative Audit had been
looking at the council since inception. Initially the
council had a rough start. At one point the division might
have recommended termination in the council's early stages.
The current audit and the prior audit were very
complimentary of the council in how it conducted business
and coordinated throughout the state.
Co-Chair Wilson asked Vice-Chair Johnston to comment on
Representative Josephson's question regarding the money
that was put back in the budget that was originally removed
in the governor's version of the budget.
Vice-Chair Johnston responded that she had better not
answer the question.
Representative Josephson commented that the governor wanted
to keep the monies in place.
Vice-Chair Johnston commented that it was interesting to
listen to the governor's report because they were listing
the priorities of the departments. On a scale of 1 to 5 the
item had a 1, the lowest number on the scale. She commented
that it was interesting that the governor wanted it funded.
2:36:14 PM
Co-Chair Wilson turned to page 3 of the audit report. She
wondered about item 13 under public member:
13. one public member.
The council is staff ed by a program assistant and an
executive director. The council's executive director
also serves as the executive director for AMHB and
ABADA. The co-location is formalized by a memorandum
of agreement between the three entities and
facilitates collaboration through shared resources.
Per the agreement, AMHB and ABADA pay the personal
services and travel costs for the executive director
until such time as the council has the resources to
contribute.
Co-Chair Wilson asked if they were looking for other funds
outside of general funds at the time the council was put
together.
Ms. Curtis responded that in the prior sunset audit the
division had a recommendation of a co-location that had
been put together and working well. There was nothing
documented between the three entities. The person was just
serving. The auditor indicated an agreement was needed. In
the current audit there was an agreement in place. She
assumed they meant general funds. Legislative Audit did not
look at what the three entities were thinking when the
agreement was made.
Co-Chair Wilson asked if Ms. Curtis knew whether the mental
health board had ever participated in funding any of the
program since they were a benefactor. Ms. Curtis replied
that she knew that the suicide council was not paying the
cost of personal services. Per the agreement, the other two
entities paid the personal services and travel costs. She
clarified that the personal services on page 4 was not the
executive director, rather, it was a staff person to the
executive director.
Co-Chair Wilson was trying to figure out who else would be
contributing based on the way things were written. Ms.
Curtis reported that the other two entities were paying for
the executive director. She thought they assumed that the
suicide prevention council would help contribute at some
point when monies became available.
Co-Chair Wilson indicated there were invited testifiers
online.
2:39:09 PM
BARBARA FRANKS, CHAIR, ALASKA SUICIDE PREVENTION COUNCIL,
NINILCHIK (via teleconference), was a mother of a child who
died by suicide. She provided a personal story as it
related to the death of her family member. The suicide
prevention program helped her tremendously when her son
committed suicide and her husband died of cancer. She had
lived in Juneau for over 30 years. While she was visiting
she had found out about someone she knew who had jumped off
the Douglas Bridge. She spoke of the coalition built
through the council. The Juneau Suicide Prevention was
there and would be at the gentleman's funeral in the
following week. She spoke of the need for young people to
know how to talk about suicide. She advocated not waiting
for a crisis to happen to call the suicide prevention
number. She spoke of the benefits of the tool of the
program. She thanked the committee.
2:43:35 PM
JAMES BIELA, AMERICAN FOUNDATION FOR SUICIDE PREVENTION,
BETHEL (via teleconference), reported that for the previous
4 years the Alaska chapter had drastically improved on
working with the Statewide Suicide Prevention Council by
sharing information provided by trainings. The council had
also assisted him at the elder and youth conference the
previous 6 years. He had the pleasure of doing chapter
presentations on suicide loss, lived experience, and
surviving after a suicide. The council had also increased
their participation in the International Suicide Loss Day,
which was held the Saturday before Thanksgiving. He talked
about the benefits of the council and being able to have
access to suicide prevention. He spoke in support of HB 22.
Mr. Biela was aware the nation had reported a 30 percent
increase in suicides in the previous year. Alaska rates had
risen by 13 percent. The state did not have any statistics
for the number of lives that had been saved. He spoke of
the Statewide Suicide Prevention Council assisting him in
responding to suicides in the Southwest Region. Regarding
fiscal goals, he worked full-time as an itinerant school
social worker. In 2017 he had been trained in suicide
prevention and had trained roughly 1,395 students. There
had been 222 requests from people to take the course. He
reported that of the 119 requests 89 kids had entertained
thoughts of suicide. He highly recommended extending the
Statewide Suicide Prevention Council.
2:47:06 PM
Co-Chair Wilson OPENED Public Testimony.
2:47:20 PM
LILY WERTZ, SELF, ANCHORAGE (via teleconference), was a
lifelong resident of Anchorage. She was bipolar and had
been saved through the suicide hotline. She provided some
suicide statistics. She urged support for HB 22 to extend
the council until 2027 and beyond.
2:48:26 PM
TINA WALSH, SELF, ANCHORAGE (via teleconference), [Note:
Testimony was inaudible].
2:51:20 PM
AT EASE
2:54:02 PM
RECONVENED
Co-Chair Wilson thanked the previous testifier for calling
in.
SAM TRIVETTE, JUNEAU SUICIDE PREVENTION COALITION, JUNEAU
(via teleconference), had been a member of the coalition
for 11 years. He thanked the sponsors for introducing HB 22
which would extent the Statewide Suicide Prevention Council
for 8 years. He reported it being the third session that he
had testified on behalf of the council extension in the
previous decade. He was a survivor of suicide loss. He and
his wife lost their son to suicide on June 28, 2007. He and
his wife had utilized the resources available of the
program and had been involved with the council for the
prior 10 years. He had participated in a number of the
statewide conferences, regional conferences, and trainings.
The council had linked him to some national experts and
resources to help him tackle the major public health
problem.
Mr. Trivette opined that the council was the glue that kept
everyone together and kept people working on suicide
issues. He noted positive changes happening constantly
because of the work of the council. He provided a couple of
examples of the work done by the council. He spoke of a
recent council meeting in Juneau. A group had trained high
school students about suicide prevention. Those high school
students were then going into the middle schools and
elementary schools talking about suicide prevention,
delivering tools on a peer-to-peer basis. He noted that
suicides would continue. However, with more information
getting out into the public was resulting in more calls to
the Care Center. All of the calls went to Fairbanks where
there were folks answering calls. He continued with his
testimony. He personally was aware there were no stats
available with the exception of the number of calls on the
Care Line. He thought the council had helped make an
impact. He appreciated the committee's time.
3:02:04 PM
Co-Chair Wilson CLOSED Public Testimony.
Co-Chair Wilson commented that it was the job of the House
Finance Committee to question where dollars were spent. She
asked Ms. Brazak to review the fiscal note.
3:02:49 PM
LINDA BRAZAK, ADMINISTRATIVE OPERATIONS MANAGER, DIVISION
OF BEHAVIORAL HEALTH, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, reviewed the fiscal note. The note represented
one position; a classified, full-time, range 16 position.
She mentioned travel funds used to bring board members to
meetings. The services represented department-wide and
statewide charge back costs. Commodities represented
materials for the council and the grant.
Co-Chair Wilson asked about the cost to keep the Care Line
going. Ms. Brazak could provide the information in writing.
Representative Tilton asked about previous reductions to
travel costs affecting the council. Ms. Brazak deferred to
Mr. Morrison.
3:04:42 PM
ERIC MORRISON, PROJECT ASSISTANT, DIVISION OF BEHAVIORAL
HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES,
introduced himself.
Representative Tilton restated her question.
Mr. Morrison replied that originally the council tried to
meet on a quarterly basis across the state. Several years
ago it had not been feasible with the funding the council
had. Instead, the council had gone to having video
conferences in the summer. The travel freeze became
effective in 2015 or 2016. The council went to two
quarterly meetings, then down to one quarterly meeting in
communities. Going to the sites was the largest outreach in
communities each year. He mentioned a number of places the
council had met in and around the state. There were key
partnerships started at the site visits. Teleconferences
were not as effective when it came to building
relationships.
Co-Chair Wilson announced amendments were due for HB 22 and
SB 35 by 5:00 P.M. on the following Monday.
HB 22 was HEARD and HELD in committee for further
consideration.
Co-Chair Wilson reviewed the agenda for the following week.
ADJOURNMENT
3:07:08 PM
The meeting was adjourned at 3:07 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 25 Board of Dental Examiners Sunset Review.pdf |
HFIN 4/12/2019 1:30:00 PM |
SB 25 |
| SB 25 HFIN Hearing Request 4.3.2019.pdf |
HFIN 4/12/2019 1:30:00 PM |
SB 25 |
| SB 25 Letters of Support.pdf |
HFIN 4/12/2019 1:30:00 PM |
SB 25 |
| SB 25 Sponsor Statement.pdf |
HFIN 4/12/2019 1:30:00 PM |
SB 25 |
| HB 22 Supporting Documents-Suicide Facts.pdf |
HFIN 4/12/2019 1:30:00 PM |
HB 22 |