Legislature(2005 - 2006)CAPITOL 106
01/25/2005 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Overview: Division of Public Health: the Three Main Causes of Death in Alaska | |
| Division of Public Assistance: General Overview with Report on the Food Stamp Program | |
| 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 25, 2005
3:04 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Paul Seaton
Representative Tom Anderson
Representative Berta Gardner
Representative Sharon Cissna
MEMBERS ABSENT
Representative Vic Kohring
Representative Lesil McGuire
COMMITTEE CALENDAR
OVERVIEWS: DIVISION OF PUBLIC HEALTH: THE THREE MAIN CAUSES OF
DEATH IN ALASKA; DIVISION OF PUBLIC ASSISTANCE: GENERAL
OVERVIEW WITH REPORT ON THE FOOD STAMP PROGRAM
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
DICK MANDSAGER, M.D., Director
Division of Public Health
Department of Health and Social Services, DHSS
Juneau, Alaska
POSITION STATEMENT: Presented the overview of the Division of
Public Health.
KATHERINE FARNHAM, Director
Division of Public Assistance
Department of Health and Social Services, DHSS
Juneau, Alaska
POSITION STATEMENT: Presented the overview of the Division of
Public Assistance.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:04:58 PM.
Representatives Seaton, Cissna, and Gardner were present at the
call to order. Representative Anderson arrived as the meeting
was in progress. Representatives Kohring and McGuire were
excused.
^OVERVIEW: DIVISION OF PUBLIC HEALTH: THE THREE MAIN CAUSES OF
DEATH IN ALASKA
3:05:53 PM
DR. MANDSAGER, M.D., Director, Division of Public Health,
Department of Health and Social Services, described how the
division prevents deaths in Alaska. He referred to the Division
of Public Health's handout, entitled "PUBLIC HEALTH: Protecting
and Promoting the Health of all Alaskans - The Three Leading
Causes of Death in Alaska" and highlighted the leading causes:
cancer, heart disease, and unintentional injuries. He explained
that Alaska has a higher percentage of deaths due to
unintentional injuries than other states. He explained that
this type of death causes a greater loss for society -
economically, and socially.
3:09:14 PM
REPRESENTATIVE SEATON inquired as to child mortality rates in
Alaska.
DR. MANDSAGER said that he is unsure as to how children are
represented within the statistics and will address the question
in the future.
DR. MANDSAGER described the major causes of death, nationally,
and listed: diet, tobacco, decreased activity, and alcohol.
3:11:14 PM
DR. MANDSAGER stated that the effects and burdens of these
causes increase over time. He emphasized that society pays for
this through government funded Medicare and Medicaid programs.
He announced that chronic diseases, which are related to diet,
tobacco use, and activity, cause the majority of deaths in
America.
3:13:54 PM
DR. MANDSAGER said that diet is an enormous contributor to
issues of obesity. He commented on the shift throughout America
toward larger portion sizes. He stated that increased caloric
densities and larger portion sizes are contributors to the
problem of obesity.
3:15:51 PM
REPRESENTATIVE ANDERSON brought up the issue of soda in schools
and questioned about the effects of soda on the body.
DR. MANDSAGER responded that the caloric intake of soda in
schools has increased. He explained that one, 20 ounce soda per
day, over the course of one year, would cause a person to gain
seven or eight pounds. He discussed the complexity interacting
with schools and addressing vending machine issues. He
explained that high schools in Anchorage, Alaska are making
large profits off of their vending machines.
3:20:18 PM
DR. MANDSAGER responded to Representative Seaton's question
regarding youth caloric output estimates and offered his opinion
that both schools and communities can help increase activity for
children. He then referred to the handout and highlighted the
issue of Alaska's growing elderly population and the associated
health costs for the future.
3:24:20 PM
DR. MANDSAGER described increasing weight gain and obesity
trends of Alaskan adults. He stated that over 35 percent of
kids at age 18 are overweight or obese and discussed the future
health implications for these children and the associated costs
for society.
3:26:07 PM
REPRESENTATIVE SEATON inquired as to current body mass index
definitions set by the Center for Disease Control, (CDC).
DR. MANDSAGER stated that he would research the changes set by
the CDC and email his findings to each committee member.
3:31:02 PM
DR. MANDSAGER discussed lung, colon, breast, and cervical
cancer. He described the prevention programs specific to each
illness. He stated that Alaska screening data for colon cancer
is available through the American Cancer Society, and he would
obtain that information for the committee. He stated that risk
factors related to colon cancer include poor diet, tobacco use
and genetics.
DR. MANDSAGER turned to heart disease. He stated that Alaska's
heart disease death rate is below America's. He attributed this
to prevention, technology, and medicine. Dr. Mandsager
discussed tobacco use as a contributor and cause for death.
Fortunately, Alaska has had a reduction in teenage smoking and
data shows that people are smoking less, he informed.
3:39:21 PM
DR. MANDSAGER explained that Alaska has high death rates related
to unintentional injuries and defined what types of injuries are
unintentional. He referred to the handout, and showed that, in
Alaska, one person a day (between the ages of 15 and 55) dies
from unintentional injuries. He stated that falls are a
significant injury for elderly populations and are extremely
costly for the individual and the State of Alaska.
3:46:57 PM
DR. MANDSAGER explained that the division has a proposal in to
the CDC about improving fall prevention education with elders.
He highlighted the division's prevention programs that have been
successful in Alaska over the past year.
3:50:39 PM
REPRESENTATIVE GARDNER inquired as to the role of alcohol in
relation to the major causes of death in Alaska.
DR. MANDSAGER emphasized that, according to the division,
alcohol is a very significant contributor to unintentional
injuries in Alaska.
3:54:23 PM
DR. MANDSAGER discussed chronic disease prevention. He
explained that this prevention is funded by the federal
government and that those funds are not reliable year to year.
He stated his belief that chronic disease work should focus on
three areas: surveillance data collection, primary prevention,
and secondary prevention. He advocated using prevention models
to improve people's self-management techniques. He discussed
new strategies and programs that are available to the State of
Alaska for chronic disease management, prevention and education.
DR. MANDSAGER explained that what Alaskans need to do in order
to achieve greater, overall health. He described the difficulty
of instituting these changes as they contradict the modern
American lifestyle.
4:02:45 PM
REPRESENTATIVE GARDNER inquired as to alcoholism and whether it
is considered a chronic disease.
DR. MANDSAGER said that alcoholism is not considered a chronic
disease and, as a result, has caused debate within the division.
CHAIR WILSON stated that she would like a total cost of
corrections, related to alcohol, from state departments. She
said that using this, the House Health, Education and Social
Services Standing Committee could make a recommendation, as a
committee, to the HESS finance chairman.
4:08:13 PM
DR. MANDSAGER said that the breast and cervical screening
program has been utilized throughout the state. He explained
that the number of women who took advantage of free screenings
surpassed the division's estimates. He then explained that
poison control centers have been regionalized for cost,
efficiency and quality and are no longer federally funded. He
commented on the importance and value of the hotline and the
necessary funding to keep it active.
DR. MANDSAGER concluded with remarks on the success of seat belt
usage in Alaska. He stated that Alaska is now in range with the
rest of the United States.
^DIVISION OF PUBLIC ASSISTANCE: GENERAL OVERVIEW WITH REPORT ON
THE FOOD STAMP PROGRAM
4:12:52 PM
KATHERINE FARNHAM, Director, Division of Public Assistance,
Department of Health and Social Services, described the mission
of the division as promoting and providing basic benefits to
Alaskans in need. She explained what the division's core
services were and included temporary assistance in cash
benefits, support in the form of food stamps, nutrition
programs, childcare assistance, and providing eligibility for
medical services. She stated that the division attempts to knit
together offices around the State of Alaska and help clients
access programs. She announced that the division has placed a
high emphasis on accurate and timely benefits but has also added
extra missions and measures that would promote self-sufficiency.
4:16:08 PM
CHAIR WILSON inquired as to welfare assistance programs in
Alaskan villages and their specific time frame limits.
KATHERINE FARNHAM clarified that the federal law allows
exemption from the 60-month time limit for native villages where
more than 50 percent of the population report being unemployed.
4:18:30 PM
KATHERINE FARNHAM stated that caseload reduction strategies are
successful because of the new emphasis on employment as an
outcome and a changed expectation of clients' current skills.
She explained that the support of these skills, provided by the
division, helps bridge the gap toward self-sufficiency.
4:20:56 PM
REPRESENTATIVE CISSNA inquired as to the "Welfare-to-Work"
program's success and the co-occurrence of specific job
openings. She commented that she would like to be informed as
to what types of legislation could benefit Alaskans in seeking
employment.
4:23:41 PM
KATHERINE FARNHAM said that the tribal TANF systems can define
subsistence activity as a work-related activity. She continued:
Part of the requirement for obtaining public
assistance benefits is...adhering to some work
participation rates that are established by the
federal government...and so we, with all of our
clients, and our contractors, and the tribal
organizations ... utilize that participation rate ...
in whether it be training, job preparation,
subsistence ... we've even got a tribe that wants to
include attending your children's parent-teacher
conferences as ... responsibility that you have to
your society ... those, the definition of work
participation, can be set by the tribal organizations
and, I believe, they do, if not all of them, I know
some of them include subsistence as a work activity
... I do not believe that at a statewide level we do,
but that's, again, why the rural, regionally operated
programs are good because they're more attuned to the
specific economic activities out there.
And, if I may address the question raised by
Representative Cissna ... we are trying to increase
our linkage to economic development priorities in each
region through the emerging regional advisory councils
and ... I will share some data I recently saw, for
example, that showed entrepreneurism in Alaska is
actually alive and well and what we're seeing is that
services are being provided closer to home ... and I
was surprised by the data to see that about 80 percent
of all of the self reported new entrepreneurs getting
going are outside of Anchorage ... but then, it's not
surprising when you realize in a small community we
need our own services delivered by our own people ...
many of our training opportunities have been geared
towards promoting that kind of self-sufficiency
through one's own means, maybe training of skills that
are locally delivered ... Alaska is, I think, less
flying outside or flying maybe to hubbs for services
and we're seeing more robust ... economic activities
in villages.
CHAIR WILSON inquired as to merging the food stamp program with
other [assistance] programs and using the money saved as a means
to fund apprenticeships.
MS. FARNHAM explained a similar program within the division as,
"subsidized employment as a transition in partnership with the
local employers." She also stated that the division is working
with the Department of Labor to create "job carving" which would
suit people with very special, specific abilities.
4:28:15 PM
KATHERINE FARNHAM explained that the division is attempting to
increase the percentage of temporary assistance families leaving
with earnings and not returning to the program for six months.
She provided the percentages of families reaching goals set by
the division and explained that the division has had to develop
more creative family plans with partner agencies. She stated
that the division has met federal rates consistently and has
achieved a high performance bonus of $9.5 million. This money
will be used to support new programs for the division, she said.
4:31:43 PM
MS. FARNHAM reported that the State of Alaska, in fiscal year
2003, was the worst in the nation for food stamp accuracy. She
stated that the Department of Health and Social Services
organized a campaign to increase accuracy rates. She said that
rates are now, as of fiscal year 2004, on par nationally and
described how this was accomplished. As a result of this
success, she said, Alaska will receive a high performance bonus
for being the most improved state. She highlighted how benefits
accrued from increasing accuracy with food stamps improved the
performance and quality of other programs.
4:36:07 PM
MS. FARNHAM said that the division has been able to reduce costs
for direct cash benefits and transfer those resources into
better, integrated services and prevention programs. The
division has used its partnership with the Alaska Job Center
Network as a key part of the solution, she said. She related
that the division attempts to increase investments in
communities in ways that prevent poverty and the need for public
assistance.
4:39:35 PM
MS. FARNHAM stated that [the division] supports domestic
violence shelters and other agencies on substance abuse
prevention. She added that, "the possibility of improving the
health and well-being in a family or in a community through
these preventative techniques, with the community organization,
is really a key part of our current strategies."
She concluded and remarked on the importance of the childcare
assistance program and its new placement within the division of
public assistance.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:45:51 PM.
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