Legislature(2005 - 2006)CAPITOL 106
01/17/2006 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
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| Start | |
| Overview: Petersburg Mental Health Services | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
January 17, 2006
3:09 p.m.
MEMBERS PRESENT
Representative Paul Seaton, Vice Chair
Representative Tom Anderson
Representative Carl Gatto
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
Representative Peggy Wilson, Chair
Representative Vic Kohring
OTHER LEGISLATORS PRESENT
Senator Charlie Huggins
COMMITTEE CALENDAR
OVERVIEW: PETERSBURG MENTAL HEALTH SERVICES - ADOLESCENTS IN
TREATMENT FOR CHRONIC MENTAL ILLNESS OR ADDICTION
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
SUSAN OHMER, Licensed Clinical Social Worker (LCSW), Chemical
Dependency Counselor I (CDC I), Executive Director
Petersburg Mental Health Services (PMHS)
Petersburg, Alaska
POSITION STATEMENT: Presented the overview of PMHS and
introduced client witnesses.
REPRESENTATIVE NANCY DAHLSTROM
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Asked questions of the testifying
witnesses.
MICHAEL BOSEMAN
Petersburg, Alaska
POSITION STATEMENT: Presented an oral memoir and answered
questions regarding services received from Petersburg Mental
Health Services.
JESSICA GREENE
Petersburg, Alaska
POSITION STATEMENT: Presented a digital memoir and answered
questions regarding services received from Petersburg Mental
Health Services.
MICHAEL BIGGERS
Petersburg, Alaska
POSITION STATEMENT: Presented a digital memoir and answered
questions regarding services received from Petersburg Mental
Health Services.
KATIE EDFELT
Petersburg, Alaska
POSITION STATEMENT: Her digital memoir was presented by Susan
Ohmer.
ACTION NARRATIVE
VICE-CHAIR PAUL SEATON called the House Health, Education and
Social Services Standing Committee meeting to order at 3:09:12
PM. Present at the call to order were Representatives Gatto,
Cissna, Gardner, and Anderson. Representative Wilson was
excused. Senator Huggins was also in attendance.
^OVERVIEW: PETERSBURG MENTAL HEALTH SERVICES
3:10:12 PM
VICE-CHAIR SEATON announced that the only order of business
would be the overview from Petersburg Mental Health Services.
SUSAN OHMER, Licensed Clinical Social Worker (LCSW), Chemical
Dependency Counselor I (CDC I) Executive Director, Petersburg
Mental Health Services (PMHS), presented the overview from a
seven-page document, available in the committee packet. Ms.
Ohmer described Petersburg, Alaska: location, industry, ethnic
makeup, and approximate population of 3,400. Ms. Ohmer provided
a history of the mental health care versus the current
activities and services available in Petersburg at PMHS.
MS. OHMER spoke from her document stating:
You [the legislature] help fund our center, and
Petersburg Mental Health [Services] belongs in part to
you, ... we wanted to come up here today and let you
know the difference your investment makes, ... not to
ask you for anything other than to listen, and
basically hear what our stories are. ... We're funded
at the base rate of a center in a rural Alaska
setting. This means that we're one of the lower-
funded centers in Alaska, but we are not complaining.
We want you to know what kind of bang for your buck
that you get, when you send money down to our
community.
MS. OHMER outlined the disposition of the PMHS office and
caseload, contrasting how it has evolved during her twelve-year
tenure.
MS. OHMER went on to describe how stigmas are attached to mental
health care recipients. However, she stated that by servicing a
large percentage of the community, stigmas are dispelled.
3:16:02 PM
MS. OHMER described the center's cross training efforts, the "no
wrong door policy", PMHS's community relationships, the center's
joint work with local law enforcement, and PMHS' goal mandate to
do "whatever works."
MS. OHMER highlighted the programs offered at PMHS: Connecting
Threads Crafts program; Wellness program; Community Garden
program; Buprenorphine program; Prime of Life Prevention and
Education program; Fully-Connected program; and programs
categorized as "Other".
MS. OHMER said she attributes the keys to PMHS's success to
innovative staffing efforts, and effective outreach programs.
She commended each staff member as being dedicated to the goal
of keeping clients out of prison, from being hospitalized, and
from committing suicide.
3:21:46 PM
VICE-CHAIR SEATON requested a more in-depth description of the
buprenorphine program.
MS. OHMER detailed this opiate drug addiction program, it's
development, and application. Further, she stated that clients,
who might otherwise be institutionalized in jail, hospitalized,
or admitted to a long-term care facility, are not due to this
program's effectiveness.
MS. OHMER introduced the day's presentations, describing them as
an example of the Fully-Connected program, which allows clients
to illustrate their experiences, learn a computer skill, and
create an artistic/educational presentation. She warned the
committee about the graphic nature of the presentation, which
consists of three, client-produced, two-minute videos; a fourth
client will present oral testimony.
3:24:21 PM
MS. OHMER named PMHS's eight current staff members, their hours,
and the hours of operation for the center. Many hours, evenings
and weekends, are "investment hours" volunteered by the staff,
she noted. She then thanked the presenters for forfeiting their
confidentiality, for their courage, and for their work with
PMHS.
3:25:53 PM
MS. OHMER, in response to questions, said fishing is the
predominate industry; that the economy is also supported by
Alaska Department of Fish & Game (ADF&G), and United States
Forest Service (USFS) offices; and that Petersburg has one
elementary school, a middle school, and a high school. In
response to further questions, she explained that students must
leave the community if they want to obtain a college education;
that alcohol and addiction problems exist in Petersburg schools;
and that there is a methamphetamine ("meth") presence in
Petersburg.
3:28:43 PM
VICE-CHAIR SEATON asked if the forthcoming presentation has been
circulated in Petersburg and used there to any benefit.
MS. OHMER answered that only the governing board of PMHS has had
the opportunity to view the productions, and so this would be
their premier presentation. She then introduced the first
presenter.
MICHAEL BOSEMAN gave an oral presentation regarding difficulties
he experienced while growing up; the eight-page transcript was
made part of the committee packet. He concluded his delivery by
crediting Petersburg Mental Health with saving his life, despite
his attempts to avoid being helped.
3:40:37 PM
REPRESENTATIVE GATTO asked whether if Mr. Boseman had written
the presentation himself, and whether he considers himself to be
a good student and a good influence on other students.
MR. BOSEMAN replied that he had written the presentation
himself, that he has been clean for two and a half months and no
longer deals in drugs, and that he hopes that he is a good
influence on those around him.
3:42:52 PM
REPRESENTATIVE GARDNER asked Mr. Boseman whether earlier
intervention [in Utah] might have had a beneficial effect on his
life.
MR. BOSEMAN credited the Petersburg police with doing their job;
that is how he arrived at PMHS and, and then proceeded to change
his life.
3:44:08 PM
REPRESENTATIVE ANDERSON asked Mr. Boseman whether he could see
PMHS being of help to other high school students; and whether
expanding the PMHS facility would be of service to the
community.
MR. BOSEMAN stated, "Definitely."
3:46:12 PM
REPRESENTATIVE GATTO inquired if it is possible for incorrigible
children to be helped by the experiences of others.
MR. BOSEMAN opined that everyone has to go through his/her own
experiences.
3:48:08 PM
VICE-CHAIR SEATON referred to Mr. Boseman's statement regarding
the acceptance of drug and alcohol use in Petersburg compared to
Utah, and asked Mr. Boseman to describe any differences that he
experienced.
MR. BOSEMAN said he had experienced underage alcohol use to be
widely accepted in [Petersburg] Alaska, and that although in
use, drugs are not spoken about or seem to be ignored. He said
he recalls hearing adults justify and accept juvenile drinking
parties by rationalizing that "it's going to happen any way, it
might as well be now" and that "kids will be kids"; however if
drugs are involved, not much is said.
3:50:45 PM
MR. BOSEMAN, in response to more questions, confirmed that he
primarily received his drugs and alcohol from adults, and that
suppliers whom he has known are still in operation. He went on
to say that he has made no attempts to identify these suppliers
for law enforcement, stating, "I'm not out to get anyone in
trouble".
3:53:20 PM
REPRESENTATIVE GATTO returned to Mr. Boseman's earlier statement
that in regards to alcohol, adults justify the issue by saying,
"it's going to happen anyway, and it might as well be now". He
asked whether this statement applies to underage sexual
activity.
MR. BOSEMAN noted that in his experience, it is a statement
commonly made by adults rationalizing underage drinking. He is
not able to speak to the point of whether it translates as a
pressure statement for young girls to have sex.
3:55:26 PM
MS. OHMER informed the committee that under age sexual activity,
particularly as it relates to substance abuse and young girls,
is a concern in the community. Also, PMHS works hard to
intervene in substance abuse situations as early as possible.
In response to questions, she offered her belief that when a
teen is found to be in possession of an illegal substance it
would indicate a history of use.
MS. OHMER, in response to another question, offered her
understanding that schools do have policies regarding drug use
incidents, and that if a student is caught, suspension from an
athletic team may occur. She opined, however, that many are
using who are not being caught, and that athletic involvement is
no longer the deterrent that it once was.
3:59:39 PM
MICHAEL BIGGERS indicated that the basis for his [digital]
presentation centered around divorce and the damage that it can
cause to those involved; the presentation consisted of a slide
show entitled "Goodbye Asshole". [Some technical difficulties
with part of the visual aspect of the presentation occurred,
providing audio only.]
4:03:22 PM
JESSICA GREENE introduced her digital presentation, which she
indicated focused on a drug program that she attended in Burien,
Washington, and the help that she has received from PMHS as an
outpatient. In response to a question she said that things are
going [well] for her now.
4:07:49 PM
REPRESENTATIVE ANDERSON said he would like to see these
presentations made available as part of a deterrent program for
other students.
4:10:33 PM
VICE-CHAIR SEATON asked Ms. Greene about substance abuse in
Petersburg, and the focus of the rehabilitation center she
attended. He also said he was interested in what she had
experienced as being the accepted drug(s) of choice in
Petersburg.
MS. GREENE said that the treatment center in Burien was for drug
and alcohol rehabilitation, and that according to her
experience, painkillers and alcohol are the drugs of choice, and
that juvenile use of alcohol is widely accepted. In response to
further questions she said that adults with relationships to
minors buy alcohol for them, or often an unknown adult would be
asked to do it.
4:13:49 PM
VICE-CHAIR SEATON asked Ms. Greene what was "in it" for the
suppliers.
MS. GREENE answered that regarding alcohol, most suppliers hang
around for a while and just share a couple of drinks. Regarding
prescription painkillers, the dealers receive money for finding
the requested drugs. She went on to say that with regard to
prescription drugs, they have become available via extensions of
refill authorizations, prescriptions given for minor ailments,
and stealing from the elders.
MR. BIGGERS, in response to questions, reported that he is no
longer angry with his father, and that he has learned effective
coping skills with the help of PMHS staff. In a follow up
response he described how anger episodes effect his life today
versus when he first began receiving services from PMHS.
4:23:41 PM
REPRESENTATIVE GATTO hypothesized moving the Petersburg
community to the Seattle area. If given the various choices of
a more cosmopolitan location, he asked, would Mr. Biggers still
have utilized, and stayed with, the program at PMHS.
MR. BIGGERS praised the Petersburg staff, and stated that the
support he has found at PMHS could not easily be replaced.
4:24:43 PM
KATIE EDFELT had her [digital] presentation shown by Ms. Ohmer.
4:27:30 PM
VICE-CHAIR SEATON expressed his appreciation for the work being
done in Petersburg by PMHS.
REPRESENTATIVE DAHLSTROM asked if statistics could be provided
focusing on the points that were brought up today, including any
available statistics regarding [underage] sexual activity.
MS. OHMER indicated that she would get that information to the
committee.
4:29:26 PM
VICE-CHAIR SEATON requested that Ms. Ohmer identify areas of the
current system that could be altered to help PMHS be more
effective in dealing with the identified community problems. He
asked if she could specify any constraints or overbearing
requirements.
MS. OHMER identified the administrative and documentation
requirements that have increased in the last two years to the
point of becoming burdensome. These prevent her from having the
client contact hours that she normally carries which in turn
creates a reduction in client services. She stated that due to
the time consumed fulfilling documentation requirements, the
number of clients served at PMHS this year will be reduced from
400 to 200. She then outlined, and provided examples of, the
documentation that is necessary to secure funding, indicating
how the requirement hampers day-to-day operations. Ms. Ohmer
asked that a streamlined system be developed to certify and
record the casework.
VICE-CHAIR SEATON acknowledged that attempts to streamline can
often, as in this case, go in the opposite direction. However,
he said he is appalled that the documentation requirement would
so drastically reduce the number of clients served.
4:34:28 PM
MS. OHMER went on to describe what she considers to be a very
disturbing requisite, that being the state-imposed requirement
of entering personal client information onto a database. Due to
the accessibility of this database, Ms. Ohmer said she considers
this requirement to be in violation of patient confidentiality,
and a breach of doctor-client trust. In addition to being
objectionable, she remarked, the requirement has also proven to
be extremely time consuming, given what she characterized as the
current dysfunctional computer system.
VICE-CHAIR SEATON wondered if this requirement is intended to
maintain compliance with the Health Insurance Portability and
Accountability Act, (HIPAA).
MS. OHMER replied that whether it is for HIPAA compliance or
not, it is her understanding that the database entry must be
done in order to receive funding and to keep PMHS's doors open.
4:35:52 PM
REPRESENTATIVE CISSNA said she would like to understand from
which direction the mandate for documentation is most demanding:
federal or state.
MS. OHMER characterized the federal requirements as being
manageable. She said that according to her experience, the
State of Alaska mandates are the biggest problem. Ms. Ohmer in
response to a question explained why the majority of the federal
information cannot be interfaced with the state requirements.
Additionally, federal funds funneled through the state are held
up, awaiting additional statistical information prior to being
released to the center; this serves to slow down the funding
process.
4:39:31 PM
MS. OHMER in response to a question, stepped through the details
of dealing with involuntary commitments in the Petersburg
community, where patients may [ultimately] be transported to
Juneau, or, if space is not available, moved north to the Alaska
Psychiatric Institute (API) in Anchorage. She also outlined the
impacts on the budget of dealing with "ex parte" patients.
4:45:26 PM
VICE-CHAIR SEATON asked Ms. Ohmer if there are any other issues
that are "dragging down the system of providing mental health
treatment" in Petersburg.
MS. OHMER said she expects that the lifting of the
aforementioned burdens and stressors would rejuvenate PMHS and
other similar centers statewide. She reported that for the
first time in her twelve-year tenure, the perception in
Petersburg is that the legislature would like to discontinue the
PMHS funding. Although Ms. Ohmer said she sees this as a
possibly skewed perception, the support for these services, as
experienced in the past, is not currently evident, nor does it
seem that an appreciation exists for what PMHS offers. In
summary she stated:
I do believe that this type of service doesn't just
save lives, but it saves money. We keep people out of
hospitals and we keep people out of prison. ... That
was one of the reasons that we wanted to communicate
that the dollars you send us, and they are a
significant amount of dollars, make a difference.
Because of that I believe that [PMHS] belongs to each
of you as well as to those of us on the front lines.
...
4:47:06 PM
REPRESENTATIVE CISSNA asked whether payroll issues are still a
problem. Going on, she called for her colleagues on the
committee to join with her in viewing non-profits as partners to
the state. Representative Cissna said she would expect such a
view to maximize the best, quality service from non-profits.
She asked Ms. Ohmer how the legislature could further that image
with PMHS.
MS. OHMER stated that the sense of partnership PMHS previously
established with the state has dissolved over time, and said
that she looks forward to receiving whatever support the
legislature deems possible.
4:49:47 PM
VICE-CHAIR SEATON admitted that the committee does not
necessarily have a way to identify the most effective programs.
He encouraged Ms. Ohmer, and directors of centers who may be
listening throughout the state, to speak with committee members
and other representatives on an individual basis to inform them
about effective and ineffective programs.
MS. OHMER reiterated that she "would love to see more people and
do less paperwork", if that's possible.
4:52:04 PM
REPRESENTATIVE GATTO queried whether paper records are a
requirement, and whether digital records might be more expedient
and helpful.
MS. OHMER confirmed that paper records are required and, in her
office, preferred. She went on to express her concern for
confidentiality when utilizing digital records. Other problems
arise as well, when entering digital records: computer
glitches, database crashes, and lengthy hours of work lost due
to a dysfunctional computer system.
VICE-CHAIR SEATON said he has been aware of computer problems at
API. He asked if PMHS's computer system has been improved and
if high-speed access is available.
4:53:32 PM
MS. OHMER specified that a "T-1" line would be required for PMHS
to be on high speed and there is not currently a subsidy to make
it affordable. She described how it can take an hour to load a
page of documentation. She said she does understand the need
for accurate, detailed documentation.
VICE-CHAIR SEATON expressed his understanding that these
computer problems had been solved in Homer and elsewhere, but
acknowledged that perhaps they have not been solved. He
expressed his appreciation for the presentations, and relayed
apologies from Representative Wilson for her absence.
ADJOURNMENT
4:55:57 PM
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:55 p.m.
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