Legislature(2005 - 2006)CAPITOL 106
01/18/2005 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
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| Start | |
| Overview: Commissioner of Dept of Health and Social Services Joel Gilbertson | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
January 18, 2005
3:02 p.m.
MEMBERS PRESENT
Representative Peggy Wilson
Representative Paul Seaton
Representative Vic Kohring
Representative Berta Gardner
MEMBERS ABSENT
Representative Lesil Mcguire
Representative Tom Anderson
Representative Sharon Cissna
OTHER LEGISLATORS PRESENT
Representative Mike Kelly
Representative Mike Hawker
Representative John Coghill
COMMITTEE CALENDAR
OVERVIEW: COMMISSIONER JOEL GILBERTSON OF THE DEPARTMENT OF
HEALTH AND SOCIAL SERVICES
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
JOEL GILBERTSON, Commissioner
Department of Health and Social Services, DHSS
Juneau, Alaska
POSITION STATEMENT: Presented the overview of the Department of
Health and Social Services.
JANET CLARKE, Deputy Commissioner
Division of Finance and Management Services
Department of Health and Social Services, DHSS
Juneau, Alaska
POSITION STATEMENT: Offered additional information regarding
DHSS technology.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:02:05 PM.
Representatives Seaton, Kohring, and Gardner were present at the
call to order. Representatives McGuire and Anderson were
excused. Also in attendance were Representatives Kelly, Hawker,
and Coghill.
^Overview: Commissioner of Dept of Health and Social Services
Joel Gilbertson
3:03:14 PM
COMMISSIONER GILBERTSON stated that the mission of the
Department of Health and Social Services is to promote and
protect the health and well being of all Alaskans.
3:05:25 PM
COMMISSIONER GILBERTSON described three principles that guide
the department and its agencies. He explained that the
principles center on empowerment of the individuals being served
and their shift toward self-sufficiency. He also discussed
issues specific to the State of Alaska. He mentioned core
services provided by the department, including safe assisted
living programs, integrated behavioral health systems, and
managed health care for Alaskans in need. He stated that the
department creates public value and helps to assure that
Alaskans are healthy and productive.
3:09:10 PM
COMMISSIONER GILBERTSON stated that the department has 3,200
full-time budgeted positions and of those, 1,600 are direct
field workers. He highlighted specific agencies and the numbers
of employees working for them. He said that the department
provides services to 100,000 Alaskans every month, and the total
budget in the governor's fiscal year (FY) 2006 budget submission
is $1.8 billion. He emphasized the size and importance of the
Department of Health and Social Services.
3:14:27 PM
COMMISSIONER GILBERTSON described the eight agencies and their
directors within the Department of Health and Social Services.
He stated that these agencies aim to accomplish the main goal of
the department, which is promoting the health and well being of
all Alaskans.
3:15:08 PM
COMMISSIONER GILBERTSON explained that his discussion will
highlight the agencies that are within the department. He began
by describing the Alaska Pioneers' Homes and stated that there
are six pioneers' homes throughout Alaska. He discussed their
expensive annual maintenance needs. He said that a major
challenge for the Alaska Pioneers' Homes is Alzheimer's disease
and its increasing prevalence.
3:21:38 PM
COMMISSIONER GILBERTSON described the Division of Behavioral
Health as the second major agency within the department. He
stated that this division is an integrated agency that has
combined the services of the Division of Alcohol and Drug Abuse,
the Division of Mental Health and Developmental Disabilities,
and the Office of Fetal Alcohol Syndrome. He explained that
this is the first integrated behavioral health system in the
state and it recognizes that a significant amount of the
consumers in these programs have co-occurring disorders.
3:25:35 PM
COMMISSIONER GILBERTSON stated that integrated community
agencies are successfully functioning in several areas of
Alaska. He offered examples of integrated systems that were
able to deliver more services without requiring an increase of
funding.
3:27:47 PM
CHAIR WILSON inquired as to the department's integrated agencies
that have been established and their structure.
COMMISSIONER GILBERTSON responded that integrated models are
often community-specific.
3:30:12 PM
COMMISSIONER GILBERTSON mentioned Synar enforcement. He
explained that Synar is federal legislation that mandates states
to reduce the illegal sale of tobacco to minors. He described
using confidential informants and collaborating with retailers
in Alaska. He elaborated on the penalty for an illegal sale
rate that is higher than 20 percent. He concluded that the
department has successfully brought the illegal tobacco sale
rate down below the 20 percent mark and conserved funding grants
dependent on a low illegal sale rate.
3:35:24 PM
REPRESENTATIVE GARDNER inquired as to the department's ability
to predict where illegal tobacco sales will occur and about how
confidential informants are chosen.
COMMISSIONER GILBERTSON responded that informants are chosen
randomly. He described rural communities as having higher
illegal tobacco sale rates.
3:38:04 PM
COMMISSIONER GILBERTSON addressed the issue of Alaskan children
obtaining health and social services out of state. He referred
to the "Bring the Kids Home" campaign and clarified that this
program will utilize a gate keeping system to make sure that
when a child enters Alaska's Behavioral Health System, at a
young age, it can direct that child to a local service in
his/her community. He mentioned the Alaska Psychiatric
Institute (API). He explained the changes associated with the
new API building and the shift in the treatment paradigm toward
recovery. He discussed API technology advancements that offer
behavioral health services to remote communities lacking
[behavioral health] facilities.
3:42:43 PM
COMMISSIONER GILBERTSON described the third agency within the
department as the Office of Children's Services. He described
this as an integrated agency. He emphasized that this agency's
planning is built around a prevention model.
3:46:43 PM
CHAIR WILSON inquired as to how the department deals with
program wait lists.
COMMISSIONER GILBERTSON explained the program improvement plan
of the child protection system. He stated that this program is
driven by negotiated performance measures. He discussed
upcoming budget requests that would fund new positions within
the Office of Children's Services.
3:51:44 PM
REPRESENTATIVE SEATON inquired as to the department's budget
allowance for information technology.
3:52:34 PM
JANET CLARKE, Deputy Commissioner, Division of Finance and
Management Services, Department of Health and Social Services,
responded that there is a budget request for the purchase of
specific hardware. The department is planning to see how it can
make improvements on the technology now in use.
3:53:07 PM
REPRESENTATIVE SEATON described a situation in Homer in which
there are delays with the department's technology. He requested
that this situation be addressed further at another time.
COMMISSIONER GILBERTSON said that situation will be addressed at
a later date. He described the difficulty of working with
outdated systems and talked about future replacements where
information will be integrated around a common database. He
introduced the concept of using an integrated dataset from which
the department has access to each agency's data. The
aforementioned would empower field workers with relevant
background information and provide better services to
individuals being served.
3:58:12 PM
REPRESENTATIVE GARDNER inquired as to the likelihood of
obtaining archived information from this future database.
COMMISSIONER GILBERTSON explained that although the goal is to
move away from paper, it's a huge undertaking involving massive
amounts of data.
4:00:11 PM
REPRESENTATIVE SEATON inquired as to how the legislature could
update missions and measures and enable programs to move
forward.
COMMISSIONER GILBERTSON stated his belief that missions and
measures should be annually updated. He explained the
department's commitment towards performance measures.
4:04:37 PM
REPRESENTATIVE SEATON expressed concern that the department
could be following outdated missions and measures because
updated [missions and measures] have not been adopted by the
legislature. He stated his belief that the department should
notify the legislature regarding any necessary changes.
COMMISSIONER GILBERTSON turned to Health Care Services, which is
the agency that administers the Medicaid Program. He referred
to the handout, entitled "Fiscal Year 2006 Executive Summary."
He explained that legislation is required in order to halt the
growth of the state's Medicaid program. He said that the
department controls Medicaid reimbursements.
4:09:25 PM
COMMISSIONER GILBERTSON described the Juvenile Justice System
Agency, which follows a restorative justice model. He described
youth facilities within Alaska. Commissioner Gilbertson
commented on the need to use data effectively. He described the
Detention Assessment Instrument, (DAI), a system the department
uses in juvenile justice facilities.
The department has implemented the use of an inventory data
system that looks at risk factors for youth offense, he related.
4:16:08 PM
COMMISSIONER GILBERTSON moved on to the Division of Public
Assistance, which promotes self-sufficiency.
Welfare reform has been a huge success. He explained that
Alaska continues to decrease caseloads and increase clients
entering the workforce. He described the immediate benefit as
monetary savings [for the state] and future benefits as families
who are an integral part of the workforce.
4:20:45 PM
COMMISSIONER GILBERTSON turned to the Division of Public Health,
and pointed out that Alaska is the only state without quarantine
authority. The aforementioned and other Public Health issues
will come before the legislature, he noted.
4:22:11 PM
COMMISSIONER GILBERTSON described the "Kids don't float
campaign" and highlighted its successes in Alaskan waterfront
areas. He also described the Senior and Disabilities Services
Agency. He stated that the rapid growth of the personal care
attendant program is a challenge for this agency. Furthermore,
the department's goal of keeping seniors in their homes
receiving services is challenging.
4:25:26 PM
REPRESENTATIVE GARDNER inquired as to alcoholism and any
specific programs existing that deal with Fetal Alcohol Syndrome
(FAS).
COMMISSIONER GILBERTSON explained that the Division of
Behavioral Health deals with alcoholism issues. He stated that
Governor Murkowski has requested more funding for substance
abuse programs. He addressed the need for prevention programs.
4:30:30 PM
CHAIR WILSON commented on the benefit and value of prevention
programs.
4:31:13 PM
COMMISSIONER GILBERTSON talked about delivering services to
improve health outcomes. He discussed the expense involved in
the treatment of chronic health problems. He also talked about
treatment methods and promoted case management as a means of
necessary follow-up treatment.
4:34:07 PM
REPRESENTATIVE SEATON inquired as to Medicaid-based programs and
the difficulty of finding participating dentists.
COMMISSIONER GILBERTSON elaborated on Governor Murkowski's
proposal to expand dental services and provide preventative
services for Medicaid clients.
4:38:16 PM
CHAIR WILSON commented on patients neglecting to honor their
appointments with dental providers.
COMMISSIONER GILBERTSON agreed that there are many barriers for
providers to work through. He stated that Medicaid provider
agreements are a challenge for dentists and DHSS has to work
with them to find appropriate solutions.
4:40:10 PM
REPRESENTATIVE KOHRING stated that he would prefer to see less
emphasis on success measurements based on the amount of money
spent on programs providing services for Alaskans. He related
his preference on focusing on serving people
who truly need assistance, including low-income seniors and
disabled people who cannot fend for themselves. He opined that
the number of Alaskans being served is astounding. Therefore,
he respectfully requested that the department demonstrate to the
legislature that its programs are serving people who truly need
services.
4:41:55 PM
COMMISSIONER GILBERTSON clarified that performance measures are
not based on the amount spent for programs. He explained that
the department focuses on services delivered and the benefit to
society. Eligibility is defined by statute, which is determined
by the legislature. He agreed caseloads are incredibly high and
emphasized that the department promotes self-sufficiency and
actively works to enable people to move off of programs. He
said that since he has been commissioner, general fund
expenditures have been reduced by $160 million dollars. He
explained that the department implements the statutes passed by
the legislature and will continue to make sure programs are
tailored toward self-sufficiency. He related his commitment to
the mission of the department, which is the development of
healthy and safe communities. He emphasized his willingness to
work constructively with the legislature to address issues and
provide the level of service needed by the population.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:46:21 PM.
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