Legislature(2007 - 2008)CAPITOL 106
05/03/2007 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB100 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 100 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
May 3, 2007
3:06 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Anna Fairclough
Representative Mark Neuman
Representative Paul Seaton
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
Representative Bob Roses, Vice Chair
COMMITTEE CALENDAR
SENATE BILL NO. 100
"An Act relating to substance abuse and mental health disorder
prevention and treatment programs; and relating to long-term
secure treatment programs for persons with substance abuse or
co-occurring substance abuse and mental health disorders."
- MOVED HCS SB 100(HES) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 100
SHORT TITLE: SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS
SPONSOR(s): SENATOR(s) ELLIS
02/28/07 (S) READ THE FIRST TIME - REFERRALS
02/28/07 (S) HES, STA, FIN
03/19/07 (S) HES AT 1:30 PM BUTROVICH 205
03/19/07 (S) Moved SB 100 Out of Committee
03/19/07 (S) MINUTE(HES)
03/21/07 (S) HES RPT 4DP 1NR
03/21/07 (S) DP: DAVIS, ELTON, THOMAS, DYSON
03/21/07 (S) NR: COWDERY
03/27/07 (S) STA AT 9:00 AM BELTZ 211
03/27/07 (S) Heard & Held
03/27/07 (S) MINUTE(STA)
03/29/07 (S) STA AT 9:00 AM BELTZ 211
03/29/07 (S) Moved CSSB 100(STA) Out of Committee
03/29/07 (S) MINUTE(STA)
03/30/07 (S) STA RPT CS 1DP 1DNP 3NR SAME TITLE
03/30/07 (S) DP: FRENCH
03/30/07 (S) DNP: BUNDE
03/30/07 (S) NR: MCGUIRE, STEVENS, GREEN
04/17/07 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/17/07 (S) Heard & Held
04/17/07 (S) MINUTE(FIN)
04/18/07 (S) FIN RPT CS 7DP SAME TITLE
04/18/07 (S) DP: HOFFMAN, STEDMAN, ELTON, THOMAS,
DYSON, HUGGINS, OLSON
04/18/07 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/18/07 (S) Moved CSSB 100(FIN) Out of Committee
04/18/07 (S) MINUTE(FIN)
04/25/07 (S) TRANSMITTED TO (H)
04/25/07 (S) VERSION: CSSB 100(FIN)
04/26/07 (H) READ THE FIRST TIME - REFERRALS
04/26/07 (H) HES
05/03/07 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
SENATOR JOHNNY ELLIS
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SB 100 as the prime sponsor.
KATE HERRING, staff to Senator Johnny Ellis
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on SB
100.
BILL HOGAN, Deputy Commissioner
Office of the Commissioner
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on SB
100.
MARGARET LOWE, Trustee
Alaska Mental Health Trust Authority (AMHTA)
Department of Revenue (DOR)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 100.
JEFF JESSEE, Chief Executive Officer
Alaska Mental Trust Health Authority (AMHTA)
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 100.
MIKE FORD, Representative
Alaska Native Health Board
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 100.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:06:17 PM.
Representatives Seaton, Fairclough, Cissna, and Wilson were
present at the call to order. Representatives Neuman and
Gardner arrived as the meeting was in progress.
SB 100-SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS
3:06:50 PM
CHAIR WILSON announced that the only order of business would be
SENATE BILL NO. 100, "An Act relating to substance abuse and
mental health disorder prevention and treatment programs; and
relating to long-term secure treatment programs for persons with
substance abuse or co-occurring substance abuse and mental
health disorders."
3:07:00 PM
SENATOR JOHNNY ELLIS, Alaska State Legislature, as prime
sponsor, paraphrased from a prepared statement, which read as
follows [original punctuation provided]:
Addiction is taking a heavy toll on Alaska's people,
culture and economy. Alaska ranks #l in the nation in
alcohol-related deaths and Alaskans with substance
abuse problems, or co-occurring mental and substance
abuse disorders, are more likely to be homeless, spend
time in correctional facilities, and become involved
in child protective service proceedings. Substance
abuse tears apart families; in 2004, 81% of all
reported harm against a child cases involved illicit
drugs. The financial impact of addition is
staggering, costing the state an estimated $738
million a year in health care cost, accidents, lost
productivity, criminal justice and correctional
facilities. Something must change.
At the same time, Alaska is falling behind in
providing treatment to those who need help in
overcoming their addition. According to the 2002
Integrated Substance Abuse Treatment Needs Assessment
for Alaska, only 15.6% of Alaskans in need of
substance abuse treatment received it. We can, and
must do better.
Senate Bill 100 proposes several common sense changes
to Alaska's statutes regarding drug and alcohol abuse
in order to improve the quality of an access to
treatment and prevention. The legislation:
Mandates priority treatment for pregnant women seeking
help in overcoming addition. Reducing the incidence
of Fetal Alcohol Spectrum disorders will save large
sums of money.
Gives priority to state grantees who utilize evidence-
based programming, as well as programs that address
substance abuse prevention, addiction within prisons,
among youths and in rural Alaska.
Supports the Department of Health and Social Services
in their efforts to identify people with co-occurring
mental and substance abuse disorders, so that this
population can be better served.
Ensures that effective faith-based strategies for
treating substance abuse are not discriminated against
in statute.
Most Alaskans have been touched by substance abuse,
whether it is a personal struggle with addiction, or
watching a friend or relative battle with this deadly
condition. I ask you to support ... SB 100 and its
common-sense steps to strengthen the fight against
drugs and alcohol abuse in our state.
3:10:31 PM
SENATOR ELLIS pointed out the three updates to existing law that
are a part of SB 100: mandating that pregnant women receive
priority treatment; use of evidence based treatment programs for
substance abuse and the unification of co-occurring mental and
substance abuse disorders; and the prohibition on discrimination
against faith based programs. He stressed the value of the
inclusion of all types of effective programs in substance abuse
treatment.
3:13:17 PM
CHAIR WILSON recalled that the committee has previously
identified the priority of treatment for pregnant women as an
important recommendation.
3:13:47 PM
REPRESENTATIVE GARDNER reminded the committee of its previous
pledge to address the alcohol problems in the state. She stated
her hope that, with the bill's priority for evidence based
programming, there will still be room for experimental
treatment. She stated that different programs do work for
different people and there is much that is not known about the
effective treatment of substance abuse.
3:14:45 PM
KATE HERRING, staff to Senator Johnny Ellis, Alaska State
Legislature, explained the different approaches to treatment
which are included in the definitions of this bill; evidence
based, research based, consensus based, and promising practices
treatments.
3:15:24 PM
REPRESENTATIVE SEATON referred to page 7, line 27, of the bill
and read:
The department may not fund a proposed program or
project that has been previously funded under this
section unless the applicant provides satisfactory
evidence of success of the program or project.
REPRESENTATIVE SEATON stated his concern that the success of a
program may not be evident in the first year and this statement
appears to limit the opportunity for a program to become
successful.
MS. HERRING stated that the sponsor will work through
regulations to make sure this is not a problem.
REPRESENTATIVE SEATON pointed out that a statute that states
"may not fund" would limit the program's ability to legally fund
a program for a second year.
3:17:12 PM
SENATOR ELLIS stated that he had not read this language with
that strict interpretation. He presumed that the DHSS will
allow sufficient time through regulation.
3:17:41 PM
REPRESENTATIVE GARDNER asked whether programs are funded on an
annual basis; for example, could funding for a pilot program be
authorized for a period of five years.
CHAIR WILSON noted that the bill says "may" and not "shall."
3:18:06 PM
REPRESENTATIVE FAIRCLOUGH informed the committee that grants
usually are awarded for multiple years. However, she opined
that the DHSS would not want to be limited by this statement and
real success may not be demonstrated after one year.
3:18:47 PM
BILL HOGAN, Deputy Commissioner, Office of the Commissioner,
Department of Health and Social Services (DHSS), stated that the
language does not say "shall." He opined that the word "may"
provides the DHSS with some flexibility about funding a program.
He stressed that DHSS is moving towards performance based
contracting or funding, and supported the language of the bill
as it stands.
3:19:42 PM
REPRESENTATIVE CISSNA offered her interpretation, that "unless
the applicant ..." appears to mean that if the program is not
keeping records and adhering to a model, it would not receive
continued funding.
3:21:08 PM
SENATOR ELLIS opined that this language is necessary in order to
build support and funding for the bill. He recalled that
previous legislatures have cut funds for treatment systems due
to the lack of missions and measures that are standard
requirements for significant state government investments.
Senator Ellis said that he felt that the application of
missions, measures and performance standards by DHSS will ensure
that treatment programs measure up and have a reasonable chance
of success.
3:22:25 PM
REPRESENTATIVE FAIRCLOUGH asked whether the intent of page 7,
line 27, is to preclude funding if measurements are not being
met.
SENATOR ELLIS said, "Well, um, in a single year. Is that, is
that a condition that your ...."
REPRESENTATIVE FAIRCLOUGH said:
Just as it states, if a project ... because a grant
can be awarded for one year, so if it's not
successful, is your intent not to allow them to have
funding. Or is it, you want the department to have
latitude and that is a condition that they can
consider.
SENATOR ELLIS expressed his belief that this language is to be
directive, but not too restrictive.
REPRESENTATIVE FAIRCLOUGH suggested insertion of the word
"consider" so line 27 will read, "the department may consider
not funding a program ...."
SENATOR ELLIS concurred.
3:24:09 PM
REPRESENTATIVE FAIRCLOUGH offered Conceptual Amendment 1, so
that line 27 will read, "The department may consider not funding
a proposed program or project that has been previously funded
under this section unless the applicant provides satisfactory
evidence of success of the program or project."
3:24:29 PM
CHAIR WILSON announced that, hearing no objection, Conceptual
Amendment 1 was adopted. She then opened the hearing to public
testimony.
3:24:50 PM
MARGARET LOWE, Trustee, Alaska Mental Health Trust Authority
(AMHTA), Department of Revenue (DOR), stated her support for SB
100, paraphrasing from a prepared statement, which read as
follows [original punctuation provided]:
Thank you for the opportunity to talk with you about
SB 100. I have lived in Alaska for a very long time
and I have seen the problem of substance abuse and
alcohol addiction continue to increase and devastate
lives of Alaskans. I have had a personal research
project going for the past 15 years and of all of the
instances of child abuse and neglect I have known, I
have not found one that does not have substance abuse
as part of the problem, and frequently, the whole
problem. Improving life for children is cost
effective and is a moral responsibility for all of us.
When I was Commissioner of HSS we were beginning to be
aware of the commonality of mental illness and
substance abuse, and now we have established the
Division of Behavioral Health to provide state of the
art treatment. We are in great need of much more
treatment availability and treatment that is
appropriate to each person and their personal
situation - circumstances of mothers of young
children, pregnant women, etc.
I remember testifying before legislative committees
and being asked why, with more money being spent the
data showed the problem was growing. I will say today
what I said then: we need to spend far more than we
are currently spending: we need to spend the money on
treatment facilities and personnel as our basic
approach to prevention. With treatment available we
will have parents and young adults in recovery,
modeling health and wellness for our children and
parenting children appropriately so that they learn to
make good choices.
3:27:33 PM
REPRESENTATIVE GARDNER commented that, even with unlimited funds
and programs available for all who wish to participate, other
avenues would still be needed to address this problem. This is
because treating an existing problem is only part of the issue;
finding the source of the problem and prevention is the rest of
the answer.
3:28:21 PM
MS. LOWE suggested that prevention will mean that children are
raised with good role models and treatment of parents leads to
increased security and stability in children's lives. Children
of parents under the influence are abused and neglected,
generating problems for the future.
3:29:38 PM
JEFF JESSEE, Chief Executive Officer, Alaska Mental Trust Health
Authority (AMHTA), Department of Revenue, stated his support for
SB 100. He then pointed out that this bill takes a similar
direction as the AMHTA does now, which is toward evidence based
treatment programs. He stated that evidence based practices are
critical to allow the evaluation of data from the substance
abuse and mental health programs so that more intelligent
allocations of funding are made. He cautioned that measurement
brings a complexity into a program, and care must be taken that
a program does not manipulate data for a favorable outcome.
Mr. Jessee said that the work on co-occurring disorders is also
critical to address continuing resistance, in the substance
abuse field, to integrating substance abuse and mental health
into a behavioral health system. He opined that the intent of
this legislation is as important as policy guidance from the
legislature that follows the changes made by the executive
branch.
3:31:54 PM
REPRESENTATIVE FAIRCLOUGH expressed her concern about the
stipulation in the bill that prioritizes treatment for pregnant
women. She asked whether this will encourage a women, who may
be suffering from co-existing disorders, to become pregnant in
order to receive services.
3:33:01 PM
MR. JESSEE said that this is an interesting problem; in fact, he
gave an example of parents allowing the Division of Family and
Youth Services (DFYS) to take custody of their child in order to
acquire needed psychiatric care. He agreed that the creation
of a priority can create an incentive for misuse. However, he
said that he is not overly concerned because a motivated client
can get treatment without extreme measures. In fact, most
programs already prioritize this population.
3:34:29 PM
REPRESENTATIVE CISSNA relayed that, in her experience working in
this field, the effect of alcohol on the brain would preclude a
woman's ability to make that decision.
3:35:27 PM
REPRESENTATIVE SEATON recalled that previous testimony has
identified that Fetal Alcohol Spectrum Disorder (FASD) damage
can happen before a woman is aware of her pregnancy. He pointed
out that the priority in SB 100 will not address the problem of
pre-pregnancy treatment and awareness that is needed to prevent
FASD. He reminded members that prevention of FASD is a concern
of the committee.
3:36:57 PM
CHAIR WILSON asked whether pregnancy screening is a routine part
of substance abuse treatment.
MR. JESSEE said he did not know.
3:37:51 PM
REPRESENTATIVE GARDNER stated that intake forms for some
programs ask if a woman may be pregnant.
MR. JESSEE observed that this discussion points out that alcohol
addiction is treated differently than any other health
condition, despite the fact that it is the most socially
damaging health problem. Society initially treated alcoholism
as a moral issue. Today, one still hears the argument that
treatment doesn't work, or it is not effective. In fact, many
treatment programs can realize a 40 percent success rate of
clients who maintain abstinence after one year. Mr. Jessee
compared this to other health issues, such as diabetes, and said
that rates of success for other health problems may not be any
higher. Nevertheless, no one would suggest that the treatment
for diabetes should be restricted. The argument continues that
people choose to drink and it is not up to the state to provide
funds for treatment. However, insurance coverage for lung
cancer treatment will always be funded, even though people
choose to smoke. Mr. Jessee concluded that there needs to be a
fundamental review of how society and policy makers view
substance abuse. It is known that alcohol treatment can make a
difference in society, yet, funding for treatment is limited.
3:41:56 PM
CHAIR WILSON agreed that society collectively supports the
consumption of alcohol. Smoking has been accepted by society as
a health concern, but drinking is still acceptable.
3:42:59 PM
MR. JESSEE opined that people may have the freedom to drink. It
does not mean that those who are affected by alcoholism should
not be assisted and supported by treatment that has now been
determined to be effective.
3:44:09 PM
CHAIR WILSON opined that smoking does not cause people to harm
others, but drinking does.
3:44:42 PM
MIKE FORD, Representative, Alaska Native Health Board, stated
his organization's support for SB 100, and said that it is hard
to find anyone who has not been touched by one of these two
issues: substance abuse and mental health disorders. He stated
that this bill is a necessary small step in order to create
infrastructure. Statewide clinics fight these two problems and
need additional support.
3:46:09 PM
CHAIR WILSON closed public testimony.
3:46:15 PM
REPRESENTATIVE GARDNER moved to report SB 100, as amended, out
of committee with individual recommendations and attached fiscal
notes. There being no objection, HCS SB 100(HES) was reported
out of the House Health, Education and Social Services Standing
Committee.
3:46:52 PM
CHAIR WILSON provided instruction to the committee concerning
the interim meeting schedule. The first meeting will be a
discussion on the uninsured of Alaska.
3:48:15 PM
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 3:48 p.m.
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