03/01/2018 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB290 | |
| HB336 | |
| Presentation: Key Coalition | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 290 | TELECONFERENCED | |
| *+ | HB 336 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 1, 2018
3:03 p.m.
MEMBERS PRESENT
Representative Geran Tarr
Representative David Eastman
Representative Jennifer Johnston
Representative Colleen Sullivan-Leonard
Representative Matt Claman (alternate)
Representative Dan Saddler (alternate)
MEMBERS ABSENT
Representative Ivy Spohnholz, Chair
Representative Bryce Edgmon, Vice Chair
Representative Sam Kito
COMMITTEE CALENDAR
HOUSE BILL NO. 290
"An Act relating to the membership of the Alaska Criminal
Justice Commission; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 336
"An Act relating to supported decision-making agreements to
provide for decision- making assistance; and amending Rule 402,
Alaska Rules of Evidence."
- HEARD & HELD
PRESENTATION: KEY COALITION
- HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 290
SHORT TITLE: CRIMINAL JUSTICE COMMISSION: MEMBERSHIP
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
01/19/18 (H) READ THE FIRST TIME - REFERRALS
01/19/18 (H) HSS, JUD
03/01/18 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 336
SHORT TITLE: SUPPORTIVE DECISION-MAKING AGREEMENTS
SPONSOR(s): MILLETT
02/07/18 (H) READ THE FIRST TIME - REFERRALS
02/07/18 (H) HSS, JUD
03/01/18 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
VALERIE DAVIDSON, Commissioner
Office of the Commissioner
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Presented HB 290 on behalf of the sponsor.
HANS RODVIK, Staff
Representative Charisse Millett
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 336 on behalf of the bill
sponsor, Representative Millett.
ANNE APPLEGATE, Program Coordinator
Governor's Council on Disabilities and Special Education
Juneau, Alaska
POSITION STATEMENT: Testified during discussion of HB 336.
RICK BENJAMIN, Director of Organizational and Spiritual Wellness
Hope Community Resources
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 336.
IAN MINER
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 336.
JEANNE GERHARDT-CYRUS
Governor's Council on Disabilities and Special Education
Kiana, Alaska
POSITION STATEMENT: Testified during discussion of HB 336.
LINDA GOHL
AARP
Juneau, Alaska
POSITION STATEMENT: Testified during discussion of HB 336.
ART DELAUNE
Fairbanks, Alaska
POSITION STATEMENT: Testified during discussion of HB 336.
HEIDI KELLY, Executive Director
Governor's Council on Disabilities and Special Education
Juneau, Alaska
POSITION STATEMENT: Testified during discussion of HB 336.
MILLIE RYAN, Board Member
Key Coalition of Alaska
Juneau, Alaska
POSITION STATEMENT: Presented a PowerPoint titled "Welcome to
Key Campaign 2018."
SHELLY VENDETTI VUKOVICH
Key Coalition of Alaska
Anchorage, Alaska
POSITION STATEMENT: Shared her personal experiences with the
Key Coalition.
ACTION NARRATIVE
3:03:25 PM
REPRESENTATIVE GERON TARR called the House Health and Social
Services Standing Committee meeting to order at 3:03 p.m.
Representatives Tarr, Johnston, Saddler (alternate), and Claman
(alternate) were present at the call to order. Representatives
Sullivan-Leonard and Eastman arrived as the meeting was in
progress. [Representative Tarr was the acting chair in the
absence of Chair Spohnholz]
HB 290-CRIMINAL JUSTICE COMMISSION: MEMBERSHIP
3:04:18 PM
REPRESENTATIVE TARR announced that the first order of business
would be HOUSE BILL NO. 290, "An Act relating to the membership
of the Alaska Criminal Justice Commission; and providing for an
effective date."
3:04:34 PM
VALERIE DAVIDSON, Commissioner, Office of the Commissioner,
Department of Health and Social Services (DHSS), stated that HB
290 had been introduced by the governor's office, and she
paraphrased from the Sectional Analysis [Included in members'
packets], which read:
Section 1: This section amends AS 44.19.642(a) to
increase the number of members of the Alaska Criminal
Justice Commission from 14 to 15 by adding as a member
a resident of the state who has been the victim of a
felony crime under AS 11. The governor will appoint
this individual for a three-year term. This bill
further amends this section to include the
Commissioner of Health and Social Services on the
Alaska Criminal Justice Commission as a voting member.
Section 2: This is a conforming amendment to recognize
that the member of the Commission who is the victim of
a felony crime serves at the pleasure of the governor
and may be reappointed, as is currently the case for
the municipal law enforcement and victims' rights
advocate members.
Section 3: Allows for an immediate effective date
under AS 01.10.070(c).
COMMISSIONER DAVIDSON explained that the addition of the
Commissioner of the Department of Health and Social Services
(DHSS) as a voting member on the commission was necessary as
there was influence and correlation between the DHSS and
Criminal Justice. She pointed out that the Division of Juvenile
Justice was within the purview of the DHSS, and not within the
Department of Corrections (DOC). She stated that law
enforcement worked closely with the division and that any
changes to criminal justice laws would have an impact on
juvenile justice practices, needs, and resources, particularly
for discretionary waivers.
COMMISSIONER DAVIDSON added that changes in juvenile justice
laws could have an impact on the likelihood of juveniles
entering the adult criminal system. She stated that experience
in Alaska, as well as other states, had shown that a key aspect
for reducing recidivism was the availability of treatment
services for substance use disorders. Both the Division of
Behavioral Health with behavioral health grants and the Medicaid
program with payments for behavioral health were sources for
treatment funding. She reported that the Alaska Criminal
Justice Commission was required by statute to consider treatment
and rehabilitation programs during its deliberations. She
shared that when people left the criminal justice system, the
opportunity for access to medically assisted treatment or health
care had a significant impact on the reduction of recidivism.
3:08:27 PM
REPRESENTATIVE SADDLER asked if the Commissioner of DHSS had
recently been added to the commission as a non-voting member.
COMMISSIONER DAVIDSON offered her belief that this had been a
result of Senate Bill 54 during the special session.
REPRESENTATIVE SADDLER asked on how many boards Commissioner
Davidson currently served.
COMMISSIONER DAVIDSON said that she currently served on the
Alaska Housing Finance Corporation board and on the Council for
Domestic Violence and Sexual Assault, as well as the Alaska
Criminal Justice Commission board. She reported that a designee
would attend when she was unable.
REPRESENTATIVE SADDLER asked if this was all the boards.
COMMISSIONER DAVIDSON reported that DHSS had the Suicide
Prevention Council, and that others participated on that
council.
REPRESENTATIVE SADDLER said that he wanted to make sure that
this additional responsibility was not adding too many more
duties. He asked which meetings she attended and which meetings
she had a designee attend.
COMMISSIONER DAVIDSON said that she would provide that
information.
3:10:25 PM
REPRESENTATIVE EASTMAN asked for clarification on the victims.
COMMISSIONER DAVIDSON replied that victim was defined under AS
12.55.185, a person against whom an offense has perpetrated, or
a person who is a minor, incompetent, or incapacitated that is
living in a spousal relationship, a parent, an adult child, a
guardian or a custodian. If the victim is deceased, then it is
the person living in the spousal relationship, an adult child, a
parent, a sibling, or a grandparent or grandchild of the
deceased.
REPRESENTATIVE SADDLER asked if criminal activity was a
behavioral issue or a moral issue.
COMMISSIONER DAVIDSON offered her belief that criminal activity
was both, and she directed attention to the corrections system
in Alaska where individuals were dealing with behavioral health
issues and substance use issues.
3:13:05 PM
REPRESENTATIVE SADDLER suggested the addition of someone from
the faith-based community to the commission in order to share a
moral perspective.
REPRESENTATIVE TARR asked if this had been considered. She
pointed out that the suggestion to have the Commissioner of DHSS
on the board had been a recommendation from the Criminal Justice
Commission.
COMMISSIONER DAVIDSON expressed her agreement that the
Commissioner of DHSS be added as a voting member.
REPRESENTATIVE TARR asked if there were any other
recommendations.
COMMISSIONER DAVIDSON said that was the only recommendation to
add members to the commission.
3:14:15 PM
REPRESENTATIVE SADDLER asked if there was anyone from the
commission to testify regarding the intent. He questioned the
decision to move the Commissioner from a non-voting to a voting
member in such a short time.
REPRESENTATIVE TARR said that there was not anyone on-line but
it could be suggested as a follow-up request.
REPRESENTATIVE SADDLER expressed his agreement.
COMMISSIONER DAVIDSON offered that the recommendation to become
a voting member had been forwarded at the request of the
Behavioral Health Sub-Committee to the Alaska Criminal Justice
Commission.
COMMISSIONER DAVIDSON, in response to Representative Tarr,
reported that the Chair of the Commission was Greg Razo, and the
Chair of the Behavioral Health Sub-Committee was Steve Williams.
REPRESENTATIVE TARR said that there should be public minutes
from the commission meeting.
COMMISSIONER DAVIDSON expressed her agreement, although the
minutes from the meeting at which this was discussed may not
have yet been approved.
3:16:15 PM
REPRESENTATIVE EASTMAN directed attention to page 2, line 25,
which specifically stated that the new position being created
would serve at the pleasure of the governor, and he asked if
this was duplicative language and would it still be the case
even if this language was deleted.
COMMISSIONER DAVIDSON replied that, typically with boards and
commission, those positions were nominated and appointed by the
governor's office unless specifically outlined as designated by
positions or other appointment.
3:17:27 PM
REPRESENTATIVE EASTMAN offered his belief that this language
would allow the government to terminate the position if
displeased.
COMMISSIONER DAVIDSON read from the proposed bill, page 2, line
13: "a resident of the state who has been the victim of a
felony crime under AS 11 appointed by the governor for a three-
year term." She allowed that most governors recognized that
reasonable people can disagree, and she pointed out that there
had been instances in which members of a commission voted
differently than the governor, but that she had not seen this
governor replace people "willy-nilly." She declared that the
benefit of a state-wide commission or advisory committee was to
get a balanced perspective from across the state.
3:19:13 PM
REPRESENTATIVE EASTMAN suggested that, when serving at the
pleasure of the governor, an appointee would vote with the
Governor's desires.
COMMISSIONER DAVIDSON asked whether she was referring to a
different version of the bill, and she read: "appointed by the
governor for a three-year term."
3:19:55 PM
REPRESENTATIVE TARR offered her belief that Representative
Eastman's reference to page 2, line 25 of the proposed bill
referenced the existing statute which created the Alaska
Criminal Justice Commission and was not what was being addressed
by the proposed bill. She relayed that during her work with the
commission, one of the representatives had been very independent
with their positions.
3:21:16 PM
REPRESENTATIVE EASTMAN directed attention to the position
described on page 2, line 13, and stated that this position was
characterized on page 2, line 25, as one that "serves at the
pleasure of the governor."
REPRESENTATIVE TARR opined that, as this was part of the
executive branch, the legislature could not be involved in
executive branch appointments. She suggested that
Representative Eastman contact Legislative Legal Services for
advice.
REPRESENTATIVE EASTMAN asked if this was duplicative language.
He offered his belief that the governor "could just swap them
out with somebody that he likes more."
3:22:54 PM
REPRESENTATIVE JOHNSTON opined that this was standard in all the
advisory commissions. She suggested that he discuss this with
Legislative Legal Services to determine the reason for this
language.
3:23:19 PM
REPRESENTATIVE SADDLER said that, according to the State
Constitution, the governor had the right to replace any person
on a board or commission for any reason. He said that there
were very few boards or commissions with specific rights to
membership.
3:24:21 PM
REPRESENTATIVE JOHNSTON pointed out that the public members of
the permanent fund were protected.
REPRESENTATIVE TARR asked if Representative Eastman was
satisfied.
REPRESENTATIVE EASTMAN mused that it could be open for
discussion for change in the future.
3:24:39 PM
REPRESENTATIVE SADDLER asked what Commissioner Davidson could
contribute to the board as a voting member that she would not be
able to accomplish as an ex-officio non-voting member.
COMMISSIONER DAVIDSON explained that the state should have a
vote for the direction to the role of treatment for recidivism
and criminal justice. She declared that a voting position was
worthwhile. She pointed out that she would choose to attend any
meetings in which she was statutorily required to participate.
She pointed out that, as the topic of treatment was discussed at
"every, single Criminal Justice Commission meeting" and the
recidivism reduction funds had been directed to the DHSS, it
would be a missed opportunity not to have the Commissioner of
DHSS as a voting member.
REPRESENTATIVE SADDLER asked if she was aware that the intent
was to make her a voting member when she was appointed as a non-
voting member.
COMMISSIONER DAVIDSON said that the recommendation to be a
voting member of the commission happened before Senate Bill 54
designated her as a non-voting member of the commission. She
noted that prior to that, she was not even a member of the
commission. She reported that the role of treatment for
reducing recidivism in criminal justice endorsed her
participation in those meetings. She offered her belief that
the change in language to add the Commissioner of DHSS was the
result of a vote on the House floor.
REPRESENTATIVE SADDLER reiterated that she was involved prior to
becoming even a non-voting member. He asked when she became
aware that the intent was for her to become a voting member.
COMMISSIONER DAVIDSON offered to review the notes of the
commission, and she opined that there was a vote in August 2016
to add the Commissioner of DHSS as a voting member of the
commission.
REPRESENTATIVE SADDLER asked if there had been the intention all
along for the Commissioner of DHSS to become a voting member of
the commission.
COMMISSIONER DAVIDSON stated that she would not speculate on the
legislative intent throughout the process. She reiterated the
facts.
REPRESENTATIVE SADDLER recapped that she believed it was good to
be involved as a voting member.
COMMISSIONER DAVIDSON stated that, as a voting member, the
Commissioner of DHSS would be able to vote on the deliberations
before the Criminal Justice Commission.
REPRESENTATIVE SADDLER asked if she intended to attend
personally or would she designate someone to attend and vote in
her place.
COMMISSIONER DAVIDSON declared that she had been participating
in the meetings and expected to attend all the meetings although
she did not anticipate going to meetings if she was
incapacitated.
3:31:01 PM
REPRESENTATIVE JOHNSTON asked if the meetings were
teleconferenced.
COMMISSIONER DAVIDSON said that options for both personal and
teleconference attendance were available.
3:31:25 PM
REPRESENTATIVE TARR declared that the addition of a member who
was the victim of a felony crime was very important. She
expressed her hope that this would increase the collaboration
between departments, an efficient and effective use of dollars.
REPRESENTATIVE EASTMAN offered his belief that the reasons
stated by Commissioner Davidson for becoming a voting member of
the commission were equally valid for the other non-voting
members of the commission. He asked if there was an objection
to making those voting members, as well.
COMMISSIONER DAVIDSON replied that the other non-voting members
were appointed by the Speaker of the House and the Senate
President. She expressed confidence in the Alaska State
Legislature to make that determination.
3:33:19 PM
REPRESENTATIVE TARR opined that, as this was an executive branch
commission and there was a separation of powers, the legislators
could not be voting members.
REPRESENTATIVE EASTMAN said that, if it was put in statute,
"then it is so."
REPRESENTATIVE TARR said that this could be reviewed. She
pointed out that members appointed by the legislature, in
statute, as opposed to the governor, created this separation of
powers.
3:34:51 PM
REPRESENTATIVE SADDLER offered his belief that the Alaska
Criminal Justice Commission was a creation of the legislature,
and he reiterated his earlier question for the increased
effectiveness as a voting member of the commission. He
suggested that she had said she would be more powerful and her
opinions would carry more weight.
COMMISSIONER DAVIDSON, in response to Representative Saddler,
emphasized that she had not used the word "powerful," as this
was a word that she generally did not use when she described
herself. She declared that having a vote "gets your position on
the record and you're able to actively take a stand on a
position in a way that a non-voting member does not."
3:36:01 PM
REPRESENTATIVE TARR opened public testimony and after first
determining no one wished to testify, closed public testimony on
HB 290.
3:36:44 PM
REPRESENTATIVE TARR announced that HB 290 would be held over.
HB 336-SUPPORTIVE DECISION-MAKING AGREEMENTS
3:36:54 PM
REPRESENTATIVE TARR announced that the next order of business
would be HOUSE BILL NO. 336, "An Act relating to supported
decision-making agreements to provide for decision- making
assistance; and amending Rule 402, Alaska Rules of Evidence."
3:38:18 PM
REPRESENTATIVE CLAMAN moved to adopt the proposed committee
substitute (CS) for HB 336, labeled 30-LS1239\J, Bannister,
2/26/18, as the working draft.
3:38:37 PM
REPRESENTATIVE TARR objected for discussion.
3:38:44 PM
HANS RODVIK, Staff, Representative Charisse Millett, Alaska
State Legislature, paraphrased from the Sponsor Statement
[Included in members' packets], which read:
With over 100 wards per public guardian Alaska has one
of the highest rates of full guardianship in the
nation. Studies concerning individuals under full
guardianship have found that such individuals were
significantly less likely to have any kind of paid
employment and are less likely to be integrated into
their community, than people provided less restrictive
options to full guardianship.
Policy makers should engage in efforts to provide
adults with intellectual and developmental
disabilities (IDD) the needed tools to experience
lives with the most autonomy, freedom and independence
as possible. The Supported Decision-Making Agreements
Act does just that.
Designed as a mechanism to enable adults with IDD to
enter into newly created legal structures called
supported decision-making agreements (SDMA), House
Bill 336 will provide a less restrictive alternative
to full guardianship for adults with IDD. Guided by
the experience of other states, HB 336 will enable
adults with disabilities to maintain their rights to
make decisions currently being taken away from them by
guardianship orders.
The philosophy underpinning HB 336 contends that
adults with IDD do have and should retain their
constitutional and civil rights to live as freely and
autonomously as possible. HB 336 will help change the
current system in which one person tends makes every
decision for adults with IDD, even though those adults
have capacity to make many decisions on their own; to
a system where adults who can make life decisions with
support from others no longer have the right to make
those decisions taken away from them by the
government.
HB 336 will enable OPA to focus its efforts on adults
who truly need full guardianship, while providing
Alaskans experiencing varying levels of IDD an avenue
to live happier and healthier lives.
MR. RODVIK pointed out that Alaska had one of the highest rates
of full guardianship in the nation, as currently, the Office of
Public Advocacy was overwhelmed with a ratio of about 100 wards
to 1 guardian. He reported that there were more than 1500 wards
in Alaska. He explained that, under full guardianship with a
such a high caseload, there was a potential for failure to meet
monthly with the ward, potential for abuse, and loss of
independence, ambition and self-expression on behalf of the
ward. He stated that these concerns were compounded, reporting
that individuals with intellectual and developmental
disabilities (IDD) under full guardianship experienced
significantly less paid employment than those who were
independent. In Alaska, he added, there were very few options
for those adults who did not need full guardianship to receive
any other support in their lives. He declared that the proposed
bill would help Alaskans with IDD and the elderly to retain
their inherent right to make decisions for themselves and would
ensure that the Office of Public Advocacy would be able to spend
its time with those who needed the full guardianship.
3:41:25 PM
MR. RODVIK paraphrased the changes to the proposed committee
substitute (CS), Version J [Included in members' packets]
[original punctuation provided], which read:
Section 13.56.010, Page 1, Line 9: Deleted "another
adult" and added "one or more adults"
Section 13.56.010(c), Page 2, Line 1-4: Changed
language to clarify that an adult cannot enter into a
SDMA if that agreement infringes on the authority of
any guardian or conservator but still gives
principal the ability to enter a SDMA IF the
guardian/conservator approves of it in writing
3:42:28 PM
REPRESENTATIVE SADDLER asked that one term be used consistently.
MR. RODVIK replied that he would use the word "principal" and he
continued to paraphrase from the changes to Version J, which
read:
Section 13.56.030(a)(2), Page 2, Line 18: Changed the
word "the" after "assistance that" to "each" to
clarify that a SDMA may have multiple supporters
Section 13.56.030(b), Page 2, Line 20-22: Inserted
this new subsection to mandate that SDMAs contain 3rd
party notification of the rights and obligations of
supporters in SMDAs
Section 13.56.030(c), Page 2, Line 23-27: Renumbered
the section, following insertion of subsection b
Section 13.56.040, Page 2, Line 30-31: Removed
subsection 3 referencing a form provided by the
Department of Health and Human Services. DHSS will not
be required to create SDMA forms. Governor's Council
on Disabilities and Special Education has agreed to
take this on. Also, under subsection 2, line 31 added
language "the agreement?"
3:44:13 PM
REPRESENTATIVE SULLIVAN-LEONARD asked for clarification on
Section 13.56.030(b) that SDMA referred to supported decision
making agreements.
MR. RODVIK said that was correct.
3:45:04 PM
MR. RODVIK returned to the explanation of changes, which read:
Section 13.56.040, Page 3, line 2-6: Renumbered
subsection "4", to subsection "3."
Section 13.56.040, Page 3, line 8-9: Added new
subsection "4," which provides safeguards by ensuring
that a principal who also has a guardian or
conservator must notify them of the SDMA for the
agreement to be valid
Section 13.56.060(b), Page 3, line 22-24: Added
"supported decision-making" before "agreement"
Section 13.56.070, Page 3, Line 25-30: Grammar edits
in this section. Keeping consistency throughout bill,
by adding "supported decision-making" before
"agreement"
Section 13.56.080, Subsections A-D, Page 3, Line 31-
Page 4, Line 14:
Removed subsection "c" referencing the superior
court's ability to terminate or limit a SDMA, as these
are private agreements and decision-making right are
retained by the principal. Capacity is inherently
retained by principals under SDMAs. SMDAs do not grant
decision making authority away. Superior Court doesn't
have authority over these agreements
a) Clarifies that either a principal or supporter
may terminate all, or a portion of a SDMA at any
time
b) Termination process of all or part of a SDMA
must be in writing, signed, and such signing must be
presence of two witnesses who also sign the
termination paperwork, or the signature must be
notarized
c) Renumbered as subsection "c" from "b
includes language noting that a principal or supporter
can terminate all or a portion of a SDMA
d) New subsection. If certain parts of a SDMA are
terminated, the entire SDMA is not terminated, and the
untouched parts remain in effect
Section 13.56.100(2), Page 4, Line 24-25: Strikes out
"to manage the principal's affairs", replaced with
"for the principal to manage the principal's affairs".
Supporter isn't managing principal's affairs
principal is managing their own affairs with
assistance by supporter is specific areas
Section 13.56.110, Page 5, Line 11: Inserted new
subsection "3." Prohibits a supporter from signing or
providing an electronic signature for the principal.
Renumber other subsections accordingly
Section 13.56.140(3), Page 6, Line 14-15: Removed the
language "conscience or" on concerns that this
language might have been
unconstitutional/discriminatory
3:48:30 PM
REPRESENTATIVE TARR asked to describe the changes on page 6,
line 12.
MR. RODVIK read the language in the original bill, "declining to
comply with an authorization related to health care in a
supported decision-making agreement if the person is declining
because the action proposed to be taken under the agreement is
contrary to the conscience or good faith medical judgement," and
he shared that "to the conscience" was removed.
REPRESENTATIVE TARR asked why this was removed.
MR. RODVIK replied that there were concerns that this might
create avenues of discrimination and some constitutional
questions.
3:50:29 PM
MR. RODVIK returned to the explanation of changes, which read:
Removed Section 13.56.150 "Principles for providing
decision-making assistance," Page 6 of original bill
(Version D), Line 11-24 and renumbered sections
accordingly. This language is stated better in the
Shared Vision bill and shouldn't have to be stated --
we are talking about people with full agency, so these
are already inherent rights
3:51:18 PM
ANNE APPLEGATE, Program Coordinator, Governor's Council on
Disabilities and Special Education, offered her belief that this
section was about stating some general principles for the
underlying mission for this change of direction. She reported
that this was better stated in the shared vision and that it was
determined to be unnecessary and overly burdensome to be written
into the proposed bill.
REPRESENTATIVE TARR stated that this was removed in Version J.
MR. RODVIK returned to the explanation of changes, which read:
Section 13.56.150, Page 6, Line 19-27: Removed
subsection "a" referencing the superior court for same
reasons state previously, and renumbered subsections
accordingly
MS. APPLEGATE, in response to Representative Tarr, explained
that this resulted from a conversation with Nancy Meade, General
Counsel for the Alaska Court System, and it was decided to
remove it as this was a private agreement and the court would
not supervise the relationships involved.
REPRESENTATIVE SULLIVAN-LEONARD suggested that this "opens up
the question then if something does happen where there's a
certain sense of liability or maybe injury to a principal, that
does not exclude then the Superior Court's involvement with
judicial oversight." She asked if this was correct.
MS. APPLEGATE said that it did not because the opinion after
analysis of other statutes was that there could be a tort action
for negligence on the part of a supporter, if there were damages
that resulted to a principal from a failure to comply with what
they had agreed to and declared to support in that agreement.
She opined that would be a standard, ordinary negligence, and
would have to be determined by a court. She added that,
although there was not a legal opinion, this was the direction
it would go. She acknowledged that, although the court would
have authority, that authority did not need to be stated in this
proposed bill as it was well established in other places.
3:54:47 PM
MR. RODVIK returned attention to the explanation of changes,
which read:
Removed Section 13.56.185 "Regulatory authority;
forms," Page 8 of original bill (Version D), Line 9-
11: Deleted this section as DHSS won't be necessary to
create forms or regulate these private capacity
agreements. Governor's Council on Disabilities has
offered to produce SDMA forms
REPRESENTATIVE TARR directed attention to page 6, line 28, and
asked for discussion.
MR. RODVIK replied that that no changes were made, that this
section dealt with the affairs of a principal that an SDMA could
cover, and anything related to work, health care, support
services, education, finances, living arrangements and more were
all discussed.
REPRESENTATIVE TARR said that this was important to the proposed
legislation. She asked how this became the comprehensive list
for an SDMA.
MR. RODVIK explained that this list had been compiled from
examples from other states and successful SDMA projects.
3:57:20 PM
MS. APPLEGATE clarified that this list had come from the
Delaware statute and that Massachusetts had created an agreement
in the absence of a statute authorizing it. She said that the
Delaware statute was based on a non-profit study and was now
used as a template. This was a description to offer suggestions
for what might be included, and she declared that none of the
agreements had to include any or all of these, as they were
individualized to the needs, preferences, and circumstances of
the person in the center. She compared this to a laundry list
or menu for choice.
3:58:38 PM
REPRESENTATIVE SADDLER said that he did have some general
questions about the proposed bill once the changes were
discussed.
3:59:04 PM
REPRESENTATIVE TARR asked about Section 13.56.170 [page 7, line
14 of Version J].
MR. RODVIK explained that this contained the list of support
services, as referenced in the previous section, that supporters
may provide the principal as agreed upon by the SDMA. He
pointed out that this was not a fully inclusive or exclusive
list, but individualized agreements which could be narrow or
broad in scope.
3:59:52 PM
MR. RODVIK, in response to Representative Tarr, said that
Section 13.156.185 was removed in Version J. He explained that
Department of Health and Social Services was not needed to
create the forms or regulate the private capacity agreements.
REPRESENTATIVE SADDLER directed attention to page 7, line 14,
and asked for clarification that these were not exclusive, and
the list could be expanded.
MR. RODVIK said, "that is correct."
REPRESENTATIVE TARR mused that the regulations were not
necessary because there was a sample form available.
4:01:07 PM
MR. RODVIK returned attention to the proposed changes, which
read:
Section 13.56.190 (4), Page 8, Line 7-8: Added new
definition of "conservator" to include a conservator
in another state
Section 13.56.190(6), Page 8, Line 10-11: Added new
definition of "decision-making assistance"
Section 13.56.190(7), page 8, Line 12-13: Added new
definition of "guardian" to include a guardian in
another state
4:02:16 PM
MR. RODVIK directed attention to page 8, line 28, the short
title of the proposed bill, the Supported Decision-Making
Agreements Act. He discussed page 8, line 30, and the Alaska
Rules of Evidence to clarify that the execution of a supported
decision-making agreement cannot be used as evidence of a
principal's incapacity. Moving on to page 9, line 6 of Version
J, he stated that it was necessary to receive a two-thirds vote
of each house to go into effect.
REPRESENTATIVE TARR pointed out that everything in the proposed
bill was found in Section 1, and that none of the provisions
could be adopted without the two-thirds majority vote.
4:03:49 PM
REPRESENTATIVE TARR removed her objection. There being no
further objection, Version J was adopted as the working draft.
4:04:06 PM
REPRESENTATIVE SULLIVAN-LEONARD asked about the effective
changes in [Court] Rule 402.
MR. RODVIK explained that Court Rule 402 was a five-paragraph
information piece related to exceptions and admissible evidence
[Included in members' packets].
REPRESENTATIVE SULLIVAN-LEONARD said that she would continue her
review and that she supported the intent of the proposed bill.
She declared that it was "pretty convoluted between the two
bills, between the initial one and the committee substitute."
4:05:22 PM
REPRESENTATIVE SADDLER asked about the universe of Alaskans who
would qualify for SDMAs.
4:05:38 PM
MS. APPLEGATE replied that there were two discreet categories.
The first was people who did not have any guardianship, limited
guardianship, or conservative order that they were the ward
under. This group of people could create an agreement with one
or more supporters which described in detail, specific to their
circumstance, what kind of help they may desire. She explained
that the second category were people who had "some kind of
order, whether it's a guardianship order or a conservatorship
order." She stated that these people, with the signed
authorization of their guardian, could engage in the process of
creating the document and experience the process of decision
making although in a shared decision-making encounter and under
the oversight of that guardian.
REPRESENTATIVE SADDLER offered his belief that the "thrust of
the bill is to provide support for those who are not in a
position to make every decision for themselves." He stated that
inclusion in the proposed bill for people with no guardianship
issues raised it to "a very interesting level." He suggested
that this might be a lot to do.
MS. APPLEGATE explained that they did not want to exclude the
senior trying to plan for advancing age, while trying not to
rely on a single individual; but, to instead, plan their process
of needing more support as they aged. She opined that the
requirement of verification of disability put people in the
position of validating their needs. She stated that this was
"not extending any additional rights to some protected group"
and should not require any proof of that need.
4:08:43 PM
REPRESENTATIVE SADDLER asked if other states, jurisdictions, or
countries were employing this type of agreement.
MS. APPLEGATE replied that Texas has had a supported decision-
making agreement act since 2015 with no criminal or civil
actions, and no full guardianships. She added that Delaware,
British Columbia, and Australia also used this program. She
pointed out that, in Australia, there was a second tier of
supporters.
REPRESENTATIVE SADDLER asked if these all included people
without any guardianship or conservatorship.
MS. APPLEGATE offered her belief that this was the case in
Texas, and, even if the statute articulated for people with
disabilities, people were using them prior to diagnosis and as a
part of planning for the aging process.
4:10:21 PM
REPRESENTATIVE SADDLER asked if this would be difficult for
people to understand who were already having a difficult time
assessing and making decisions.
MS. APPLEGATE opined that it was necessary to educate families
and other supporters, while describing the process for support.
She shared that this process would begin by articulating long
term goals and helping someone understand what was currently
being done for the decision making. This would lead to a
creation of a statement in conjunction with a personal centered
plan. She offered her belief that, as people knew what help
they needed and wanted, it was just a matter of helping them
articulate that.
REPRESENTATIVE SADDLER suggested that, as the legislature would
need annual feedback to see how it could be made better, he
might offer an amendment to include that requirement.
4:12:44 PM
REPRESENTATIVE SULLIVAN-LEONARD shared that the proposed bill
offers a sense of ease for family members to aid in gathering
information for their loved one and the extra set of hands to
assist in the stages of their loved one. She asked Ms.
Applegate to offer examples.
4:13:45 PM
MS. APPLEGATE explained that in some government processes the
interview process was deemed confidential and, in that
circumstance, the only accompanying people were a guardian or a
formal interpreter. If someone merely needed help articulating
or sequencing a set of events, this could create obstacles for
many government processes.
REPRESENTATIVE SULLIVAN-LEONARD asked if someone could opt in or
opt out as a supporter.
MS. APPLEGATE said that she was not sure, but she offered her
belief that it would be necessary to give notice for termination
of obligation.
REPRESENTATIVE SULLIVAN-LEONARD mused that there would be a
provision for multiple caregivers in the proposed bill.
MS. APPLEGATE stated that there was a provision for a substitute
supporter.
MS. APPLEGATE said that the majority of members of the
Governor's Council either experienced disabilities or were
parent guardians of people with disabilities.
4:18:42 PM
RICK BENJAMIN, Director of Organizational and Spiritual
Wellness, Hope Community Resources, explained that Hope
Community Resources was doing a pilot project in collaboration
with the Governor's Council and the Disability Law Center. He
stated that supported decision making was based on the simple
concept that everyone had people we trusted for medical,
financial, and other advice. He stated that these agreements
just made it formal, official, and legal. He opined that,
although Alaskans liked to be independent, we did rely on others
that we trust. He shared that Hope Community Resources had
chosen the Massachusetts model, and he read a few supportive
quotes for that model. He declared that he was very excited for
this proposed bill.
4:21:40 PM
IAN MINER shared a personal anecdote about his parents taking
guardianship for him when he turned 18 years of age. He
reported that, when he attempted to remove the guardianship
order when he turned 23 years of age, it took more than 2 years
of hearings to accomplish. He shared that, had the option for
supported decision-making agreements been available when he was
age 18, he would have chosen it. This would have given him both
the help and advice he wanted as well as the rights when he
wanted them back at age 23. He stated that he now recognized
that he had not needed a full guardianship, only some guidance.
4:24:28 PM
JEANNE GERHARDT-CYRUS, Governor's Council on Disabilities and
Special Education, shared a personal anecdote, stating that she
was the parent of multiple children with pre-natal exposure to
alcohol. She relayed the story of her 19-year-old daughter,
Ivy. She reported that her daughter had some decision-making
instances for which she was not comfortable or did not currently
have the skills, related to major financial purchases, health,
benefits, and her future. She noted that her daughter consulted
with others having more knowledge to receive their input and did
not have the need for a full guardian. She pointed out that she
could not participate in some of these discussions, or act in
her daughter's behalf, without legally sanctioned, supported
decision making. She noted that with this sanction, she could
help her daughter to remain calm, reduce her anxiety, and
effectively articulate her desires and needs. She explained
that, although her daughter did not require a full guardian, she
was not yet totally independent. She declared that there should
be an option "to flex her support as she matures, and her
independence increases" as currently the option was all or
nothing. She explained that there should be the option for her
daughter to decide what she needs, and this should be adaptable
to her needs as she matures.
4:27:42 PM
LINDA GOHL, AARP, said that the proposed bill could be
beneficial to older Alaskans and their family members, as it
would allow the principal person to have a choice for whom they
designate to support and assist them. She pointed out that a
family member may not always be the one selected, as this
decision was based on trust. She shared some anecdotes. She
clarified that the proposed bill did not replace a durable power
of attorney. She noted that the principal person could also
have a team of people for support. She pointed out that an
older person who never married may be in a situation of needing
help and the public guardianship system "may not be exactly
appropriate and this would give them some other options."
4:31:42 PM
ART DELAUNE shared a personal anecdote and expressed his concern
that, as he aged, his son with fetal alcohol spectrum disorder
would not have the opportunities for a supported decision-making
process. He declared his support for a team of advocates. He
stated his support for the proposed bill.
4:36:16 PM
REPRESENTATIVE SADDLER asked if there was any downside to a
supported decision-making agreement.
MR. DELAUNE offered his belief that it was important for his son
to choose the right people to be on his team.
4:37:31 PM
HEIDI KELLY, Governor's Council on Disabilities and Special
Education, stated that she, her son, and her daughter were all
on the autism spectrum. She declared that autism did not define
who she was or who she would continue to become, and that she
used her voice on the Governor's Council as an autistic speaker
advocate. She shared her accomplishments, stating that she
hoped these would inspire others. She pointed out that, as full
guardianship takes away your voice and would not have allowed
her to make her own decisions with proper education, she would
not be who she had become. She stated that full guardianship
did not work for her family, but a supported decision-making
agreement allowed them to have a voice over their own lives.
She declared that they deserved a community that helped with
everything possible to achieve their very best. She stated her
support for the proposed bill. She emphasized that it was
"illogical to not use the power you have to do the job you
signed up for, which is to make a difference for all Alaskan
people."
4:41:21 PM
REPRESENTATIVE TARR opened public testimony on HB 336 and stated
that she would keep it open.
REPRESENTATIVE TARR announced that HB 336 would be held over.
^PRESENTATION: KEY COALITION
PRESENTATION: KEY COALITION
4:42:50 PM
REPRESENTATIVE TARR announced that the final order of business
would be a presentation by the Key Coalition.
4:42:51 PM
MILLIE RYAN, Board Member, Key Coalition of Alaska, presented a
PowerPoint titled "Welcome to Key Campaign 2018." She directed
attention to slide 1, "Thanks for your support," and thanked the
legislature for increasing the day habilitation "soft cap" from
an average of 8 hours weekly to an average of 12 hours weekly.
She stated that this service got people out into the community
to contribute. She shared slide 2, "Priority 1, Pass SB 174"
which she described as a shared vision bill that laid out a
flexible system in which individuals were able to direct their
support based on their strengths and abilities to allow for a
more meaningful life. She added that it was important to
support family, have a professional staff, and have services
available into the future. She noted that SB 174 was on its way
to the House after passing out of the Senate.
MS. RYAN moved on to slide 3, "Priority II, "Put in Place a
Stable and Sustainable Fiscal Plan." She emphasized that a
stable, sustainable fiscal plan was necessary to ensure that
those with intellectual and developmental disabilities received
the necessary services to be productive, contributing members of
the community, as this would reactivate the commitment by the
state to reduce the waitlist by 200 people each year, instead of
the current 50 people. She pointed out that when waiver
services outstripped the available resources, Medicaid would
allow states to maintain a waitlist. She reported that there
were 652 Alaskans waiting for services. She addressed slide 4,
"BENEFITS," and explained that when benefits were provided prior
to a crisis, there was a reduced cost to the state and it
increased the probability for a family to remain together. She
shared a personal anecdote about the loss of a younger sister in
an institution without any services.
MS. RYAN directed attention to slides 5 and 6, "WHY," and
reported that the Key Campaign had provided the legislature with
recommendations to reduce the costs of home and community-based
waivers and for the use of technology to allow greater
independence. She reported that the State of Kansas had a
return of $3.15 on every $1 spent on its re-use program. She
declared that individuals with intellectual disabilities and
their families had already contributed to efforts to reduce the
State budget. She pointed to research which showed that the
out-of-pocket expenses for a family to care for a child with
developmental disabilities was estimated at $8,000 annually
beyond the cost to raise a child without a disability.
4:49:33 PM
SHELLY VENDETTI VUKOVICH, Key Coalition, introduced her
daughter, Claire, and she shared anecdotes of her work with
Claire in support of Key. She directed attention to slide 8,
"WHAT," and stated that waiver services for families allowed the
opportunity to become more independent. She declared that she
wanted children to stay with families, and there was a need to
take care of this population. She shared that, although the
types of therapy were not covered by insurance or Medicaid, they
brought so much improvement that the family paid out of pocket.
She listed special equipment and summer programs as other needs
from out-of-pocket expenses, and she estimated that these
expenses were closer to $20,000 each year.
4:56:15 PM
MS. RYAN directed attention to slide 8, "WHAT:" and spoke about
the two bills supported by the Key Campaign, SB 80, a
telecommunication bill that would require telephone utilities to
provide services for those who were deaf, hard of hearing, or
speech impaired and HB 336, the bill heard by the committee
earlier in the day.
REPRESENTATIVE SADDLER stated that the Key Campaign focused on a
few things and was willing to work with the legislature to
attain achievable goals.
5:00:32 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:00 p.m.