Legislature(2023 - 2024)DAVIS 106
01/23/2024 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Presentation(s): Update from the Department of Family and Community 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 AND SOCIAL SERVICES STANDING COMMITTEE
January 23, 2024
3:03 p.m.
DRAFT
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Dan Saddler
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
Representative Jesse Sumner
COMMITTEE CALENDAR
PRESENTATION(S): UPDATE FROM THE DEPARTMENT OF FAMILY AND
COMMUNITY SERVICES
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
KIM KOVOL, Commissioner
Department of Family and Community Services
Anchorage, Alaska
POSITION STATEMENT: Co-presented the update from the Department
of Family and Community Services presentation.
MARIAN SWEET Assistant Commissioner
Department of Family and Community Services
Juneau, Alaska
POSITION STATEMENT: Co-presented the update from the Department
of Family and Community Services presentation.
CLINTON LASLEY, Deputy Commissioner
Department of Family and Community Services
Juneau, Alaska
POSITION STATEMENT: Co-presented the update from the Department
of Family and Community Services presentation.
ACTION NARRATIVE
3:03:04 PM
CHAIR PRAX called the House Health and Social Services Standing
Committee meeting to order at 3:03 p.m. Representatives
McCormick, Ruffrdige, Saddler, Fields, Mina, and Prax were
present at the call to order.
^PRESENTATION(S): UPDATE FROM THE DEPARTMENT OF FAMILY AND
COMMUNITY SERVICES
PRESENTATION(S): UPDATE FROM THE DEPARTMENT OF FAMILY AND
COMMUNITY SERVICES
3:04:22 PM
CHAIR PRAX announced that the only order of business would be
the update from the Department of Family and Community Services
presentation.
3:05:06 PM
KIM KOVOL, Commissioner, Department of Family and Community
Services (DFCS), as co-presenter, began a PowerPoint
presentation, titled "Department of Family and Community
Services, Department Legislative Overview." Commissioner Koval
presented slide 2, titled "To provide support, safety, and
personal well-being for vulnerable Alaskans," which specified
the following divisions as follows [original punctuation
provided]:
Alaska Pioneer Homes
Division of Juvenile Justice
Alaska Psychiatric Institute
Office of Children's Services
Coordinated Health & Complex Care
3:05:52 PM
COMMISSIONER KOVOL moved to slide 3, "At DFCS we will," and
explained the four guiding principles for the department's work,
which read as follows [original punctuation provided]:
• Strengthen lives through meaningful connections with
families, communities, Tribes, and providers.
• Provide safe, person-centered care with integrity
and dignity to the Alaskans we serve.
• Advance an agency culture that prioritizes the well-
being of our workforce.
• Mobilize innovative solutions to complex challenges
3:06:13 PM
COMMISSIONER KOVOL advanced to slide 4, titled "Talent
Acquisition Team," which read as follows [original punctuation
provided]:
Dedicated human resources team to improve recruitment
and retention
logicalnot Expedited recruitment and hiring
logicalnot Personal engagement with candidates throughout
process
logicalnot Specialized on-boarding support and orientation
training
logicalnot Phased implementation - started with Office of
Children's Services
COMMISSIONER KOVOL briefly explained the points on slide 4 and
then introduced Assistant Commissioner Marian Sweet.
3:06:32 PM
MARIAN SWEET, Assistant Commissioner, Department of Family and
Community Services, asked the committee members to recall
testimony from last year regarding the issue of recruitment and
retention. After trying numerous solutions, DFCS decided to
look at the actual recruitment process. The department found it
to be very administrative with too many steps; a duplication of
work; with multiple touch points between steps; and an overall
process that was cumbersome, redundant, and too long.
Applicants were either taking other jobs or losing interest due
to delays between application submissions and first contact.
With those deficiencies in mind, the department developed a plan
for recruitment and onboarding. After creating the Talent
Acquisition Team, the time between candidate application and
referral to the hiring team is cut in half. The talent
acquisition team has weekly touch points with all candidates,
allowing the team to stay engaged with candidates. The team
will provide day one onboarding. The department will phase in
this candidate-centric model starting with the Office of
Children's Services (OCS). The department plans to complete the
phasing process by 2026.
3:11:43 PM
REPRESENTATIVE MINA asked where most recruits were coming from.
MS. SWEET explained that the talent acquisition team just
started on December first, so it is too early to have data
points.
3:12:30 PM
MS. SWEET continued her presentation with slide 5, "Talent
Acquisition Team, Days from Referral to Approval to Hire." She
explained the time from referral to job offer is down from 34
days in June, 2023, to 10 days in December, 2023.
3:14:33 PM
CHAIR PRAX asked for clarification concerning what comprised the
approval process.
MS. SWEET explained the process from referring the candidates to
the hiring team to actually making a job offer.
CHAIR PRAX asked whether this was all within the department or
did it include the department of administration.
MS. SWEET replied that DFCS reviewed personnel rules, statutes,
and regulations to ensure it followed all state required
processes and policies. The improvements were due to removing
redundancies and having a centralized service with the talent
acquisition team. This is a pilot program.
3:16:33 PM
CHAIR PRAX commented that if this continues to work well, other
departments might follow suit.
3:16:55 PM
COMMISSIONER KOVOL presented the slide 6, "Workforce
Innovations," which read as follows [original punctuation
provided]:
Internships and Practicum Placements
.notdef 35 student interns and practicum placements across
the department
.notdef 11 different colleges and universities
.notdef Pharmacy interns at Pioneer Homes
.notdef Doctoral and Masters clinical interns at Alaska
Psychiatric Institute
.notdef Bachelors and Masters in Social Work practicum
students in Commissioners Office, Office of Children's
Services, and Division of Juvenile Justice
COMMISSIONER KOVOL explained the department has expanded efforts
to serve as a training ground with internships and practicum
placements including bachelors and masters level students. The
hope is the interns will become future employees.
3:18:00 PM
REPRESENTATIVE FIELDS asked whether the department has looked at
apprenticeships as well.
COMMISSIONER KOVOL replied that they were looking at entry level
apprenticeships. They also work with Skill Bridge, an
apprenticeship program with veterans.
3:18:34 PM
REPRESENTATIVE FIELDS pointed out the Alaska Native Tribal
Health Consortium (ANTHC) has a fairly new PHD program as well
as several other programs.
3:18:54 PM
COMMISSIONER KOVOL continued with slide 7, "Complex Care." She
described a situation concerning a youth and all the barriers to
the child's progress and the obstacles to getting services. The
parents contacted the department and said they were
contemplating giving up the child to OCS custody. This would
have led to a barrier crime for the parents. In response to
questions, she defined barrier crimes as federal crimes with
degrees. She then continued her description of the scenario.
She described how cross-departmental collaboration secured
funding to maintain the youth in a group home. The
collaboration, creative problem solving, and effective
communication resulted in a positive outcome. She explained
this is just one of numerous complex situations that demonstrate
the evolving landscape of Alaska's needs.
3:22:36 PM
COMMISSIONER KOVOL moved to slide 8, "Complex Care Unit," which
read as follows [original punctuation provided]:
Complex Care Unit
.notdef Identifying solutions to address systemic gaps in
care for individuals with complex needs
.notdef Data-informed decisions, streamline state system
processes, and improve case outcomes
Transitional Youth Pilot Program
.notdef Limited step-down options for youth discharged from
API
.notdef Home-like setting staffed to support successful
transition
.notdef FY25 budget request
COMMISSIONER KOVOL described the work of the Complex Care Unit
(CCU) and the department's approach to finding solutions. She
also discussed the Transitional Youth Pilot Program. The
department is collaborating with the Department of Health to
find a transitional program tailored to youth with complex
issues. The goal is to create small home-like settings with a
client-centered care plan. She explained that the complex case
unit was created in response to the heightened barriers facing
the most vulnerable Alaskans. The CCU partners with the
Department of Health to propose changes in policy, regulation,
and processes to better serve complex Alaska cases. She
discussed the CCU structure and the work it does with other
agencies and departments to identify gaps in service and find
the least restrictive placements. She also discussed the
Transitional Youth pilot program. There is a lack of step-down
options for individuals who are at their base line. In
collaboration with the Department of Health, the CCU is looking
at small home-like settings with client-centered care plans.
3:26:18 PM
REPRESENTATIVE SADDLER asked about their level of confidence in
finding staff for the transitional pilot program.
COMMISSIONER KOVOL, in response to a series of questions, said
the department felt confident because it was starting with a
small population, identifying providers, then ramping up. She
relayed that the two vacant positions in the complex care unit
were for administrative support and coordination with the
Department of Health. She indicated that recruitment would be
done by contracting with the provider, and positions are filled
by licensed professionals.
3:28:07 PM
MS. SWEET moved to slide 9, "Technical Innovations." She
explained that the department is committed to using data to
drive decisions, increasing collaboration both internally and
with stakeholders, and creating efficient processes. The
department is working with Microsoft to pilot the OneLink
program for CCU so they can pool analytics to find service gaps.
In addition, the Image Source programs have gone live for the
Pioneer Home, the Office of Children's Services, and department
support services. Additional applications are being considered
for human resources, procurement, and grants.
3:30:13 PM
REPRESENTATIVE SADDLER asked whether Image Source was a document
management system.
MS. SWEET responded to questions from committee members. She
said Image Source serves as a document management system, but it
also has other aspects including using artificial intelligence
(AI). She gave an example of its use at Pioneer Homes. In
addition, the department is implementing mobile device
management (MDM) which gives secure access to mobile devices and
will change the way the department does field work because case
workers can remotely access client information. The department
is also implementing electronic health records for the Pioneer
Homes and Alaska Psychiatric Institute (API) as well as using
technology for facilities management. She explained that DFCS
has a very robust security requirement, following Health
Insurance Portability and Accountability Act (HIPAA) and keeping
alert for cyber attacks
MS. SWEET continued her presentation with a description of Tiger
Connect, a program being utilized by API, Pioneer Homes, and
CCU. This HIPAA-secure application provides communication
between external and internal partners and allows coordinated
care. In response to further questions, she explained that
Tiger Care is a HIPAA-compliant mobile and desktop clinical
collaboration software with the ability to transfer health
information securely, and it interfaces with electronic health
records at API and pioneer homes
3:37:59 PM
CHAIR PRAX questioned how the department anticipated using AI.
COMMISSIONER KOVOL, in response to Chair Prax, offered examples
of case management using AI such as using projections in case
management in children's services; looking at intakes and report
status; and optimizing travel and meeting schedules.
3:39:15 PM
CLINTON LASLEY, Deputy Commissioner, Department of Family and
Community Services, reviewed ways the department has worked to
improve services. He moved to slide 10, "Pioneer Homes," which
read as follows [original punctuation provided]:
.notdef Alzheimer's Disease and Dementia Services
.notdef Safety and Wellness
.notdef Wi-Fi in Facilities
.notdef Electronic Health Record
.notdef Online Admission and Waitlist Enrollment
MR. LASLEY pointed out that individuals now entering the
pioneers homes are older and have more needs than previously.
About fifty percent of the residents are diagnosed with
dementia, and others are showing signs. The Division of Alaska
Pioneer Homes has worked on staff training and a positive
approach to care following a national model. In addition to
training which improves skills, it has a dementia specialty
apprenticeship program. Those who go through the training get a
step increase in the pay scale. Most of the staff who went
through the apprenticeship program have stayed on. Image Source
does document management, but it also covers an array of
services that allow the department to improve processes across
the system.
3:44:15 PM
MR. LASLEY, in response to questions from Representative Fields,
reported on the success or a memory care unit and said the
department is looking at how to expand that program into other
Pioneer Homes. He spoke about a study done regarding the
Fairbanks Pioneer Home to determine feasibility and cost of
either a staged renovation or an entire rebuild of the facility.
REPRESENTATIVE FIELDS theorized that a new build would be a
better and more modern facility than a phased renovation.
MR. LASLEY responded that there were plusses for both and
described some of the differences.
3:47:04 PM
MR. LASLEY responded to questions from the committee members.
He explained that the Fairbanks Pioneer Home was hit harder than
most places in Alaska post-pandemic, specifically in terms of
staffing, and the department is looking at innovative solutions,
so they can offer the highest level of care for the elders.
These include job fairs and talking to people in the community.
He pointed out that there are many postings requesting health
care workers, but the pool of potential candidates is small.
3:49:09 PM
COMMISSIONER KOVOL explained that staff spend a significant
amount of time with elders that may not be family members or
have family members, and they become family. During recruitment
the department is building on the stories of the relationships
the staff have with the elders and the connections they are
creating. She affirmed that Certified Nursing Assistants (CNA),
Registered Nurses, and other positions are in high demand. She
said she would find out whether some individuals could not be
employed because of barrier crimes.
COMMISSIONER KOVOL replied that she could get that information
for the committee.
3:51:52 PM
REPRESENTATIVE FIELDS wanted to know whether the department
compares their wages and benefits with other similar facilities
in Anchorage such as Prestige Care.
COMMISSIONER KOVOL confirmed that the department does unofficial
surveys comparing data with other similar facilities; however,
the private agencies can refuse certain populations, and the
pioneer homes are accepting some of the most challenging clients
with dementia-related diseases.
3:52:44 PM
MR. LASLEY moved to slide 11, "Alaska Psychiatric Institute,"
which read as follows [original punctuation provided]:
logicalnot Community and Jail Based Restoration Programs
logicalnot Discharge Planning and Support
logicalnot Automatic Medication Dispensing Machines
logicalnot Electronic Health Record and Wireless Internet
logicalnot Beacon Award- Alaska Hospital and Healthcare
Association
MR. LASLEY said API has made significant improvements over the
past few years. It has recently launched the community and
jail-based restoration program. This program originally offered
only 10 beds for those individuals who had been charged with a
felony. API just launched a 10-seat outpatient program for
those awaiting trial. In addition, there is a 10-space forensic
program in the jail setting.
REPRESENTATIVE MINA asked whether there has been.
MR. LASLEY responded to questions from committee members. He
said it is too early to have data regarding any difference in
the length of competency restorations between the outpatient
process and API, but the department will share that data next
session. He discussed the work API has been doing regarding
discharge planning. Early data showed about twenty-five percent
of those discharged had failed discharges. As of this meeting,
the number was down to zero. The number of those who returned
within 30 days has been reduced to one. Several innovations
have been implemented to reduce inefficiencies, behavioral
emergencies, and medication errors. He said API has received
awards for its work. Regarding a mechanism for involuntarily
detaining individuals as well as treating people with co-
occurring substance abuse disorders and mental health issues, he
explained that the department is looking at various innovations
to improve care to individuals and the community. The
Department of Health is working on the Crisis Now model and
crisis residential centers which can provide support and care
for up to seven days. He spoke about teaming with community
partners to create a behavioral health roadmap, working on how
to solve these problems in communities throughout the state.
The administration is putting a lot of emphasis on how to
address these problems.
COMMISSIONER KOVOL talked about the work the department is doing
with local crisis response partners in response to diversion, so
individuals are not necessarily entering custodial care but are
still getting treatment and getting their needs met without
crowding out the mercy rooms. He described the specific number
of beds in API, the types of beds, how many are being used, and
the number on the wait list. He agreed that there need to be
more community step-down services. When clients are being
discharged, staff are now helping the individual or the
caregiver to find payer sources.
4:07:22 PM
MR. LASLEY moved to slide 12, "Division of Juvenile Justice,"
which read as follows [original punctuation provided]:
logicalnot Traumatic Brain Injury Project
logicalnot Job Training and Traditional Skill Building
logicalnot Community Engagement
logicalnot Employee Wellness Program
He praised the work of the Juvenile Justice Division, saying the
staff were doing a great job and providing excellent service to
the youth around the state. Evidence shows that about forty
percent of the youth involved in juvenile justice have a history
of brain injury. The division is collaborating with public
health and Southeast Regional Resource Center (SERRC) and are
working on a traumatic brain injury project.
MR. LASLEY, in response to questions, identified several reasons
for traumatic brain injuries including fetal alcohol syndrome.
He then moved to a description of the types of skill training
and programs being implemented in the juvenile justice system.
He emphasized how these programs give opportunities for success.
In addition, the division has been partnering with Pioneer Homes
and has found the youth are learning a lot and enjoying the time
spent with the elders. He moved on to a description of the
Employee Wellness Program. He offered to get information to the
committee regarding a peer support specialist structure model
for youth at Juvenile Justice.
4:11:35 PM
MR. LASLEY moved to slide 13, "Office of Childrens Services,"
which read as follows [original punctuation provided]:
logicalnotFoster Care Base Rate
logicalnotTribal Compact Expansion
logicalnotAdoption File Modernization
logicalnotTeams App for Youth
logicalnotCarePortal
logicalnotPlacement Search and Support
Mr. Lasley stated that this year the governor's budget shows an
increase in the base rate for foster care to keep up with foster
care standards and bring in more foster parents. He noted that
OCS is also expanding their work with tribal programs. In
addition, OCS is working on prevention with its tribal partners.
The office is also modernizing and digitizing the adoption
files, as well as implementing a Teams app for youth so case
workers can work directly with families and the needs of
resource parents when they have them. The department continues
to look at innovations in how to meet the needs of people.
4:15:37 PM
COMMISSIONER KOVOL concluded the presentation with slide 14
which provided contact information. She responded to committee
questions. Regarding litigation, she noted that there is only
one tort case at this time, and it is in the beginning of
beginning the discovery phase. She confirmed that the
department interfaces with many organizations that assist with
services for youth and is currently doing an internal review of
The Door. Regarding grants that have been awarded to nonprofits
but which have not been paid out, she assured the committee that
the divisions are quite good at getting those payments issued.
She talked briefly about a trip to the Western Region sponsored
by the Alaska Mental Health Trust Authority (AMHTA) and
commented that it was well-attended. Regarding the foster
parent program, she talked about what was and was not working
and remarked that it is trending in the right direction.
Regarding the timeline of a U.S. Department of Justice (DOJ)
settlement concerned with improving communities and an in-state
and out-of-state issue, she replied that the talks with DOJ are
progressing positively. The department is working in
conjunction with the Department of Health, and they have
presented action items. All parties hope to see settlement
terms in the near future.
4:23:21 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services meeting was adjourned at 4:23 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| DFCS HHSS Overview (1-23-24).pdf |
HHSS 1/23/2024 3:00:00 PM |
DFCS |
| HHSS 1-23-24 Presentation DFCS follow up.pdf |
HHSS 1/23/2024 3:00:00 PM |
DFCS Overview 1.23.24 |