Legislature(2017 - 2018)CAPITOL 106

02/13/2018 03:00 PM HEALTH & SOCIAL SERVICES

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Audio Topic
03:06:32 PM Start
03:07:21 PM Presentation: Alaska Children's Justice Act Task Force
04:03:22 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation: Alaska Children's Justice Act Task TELECONFERENCED
Force by Jared Parish, PhD & BJ Coopes, MD
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                       February 13, 2018                                                                                        
                           3:06 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Sam Kito                                                                                                         
Representative Geran Tarr                                                                                                       
Representative Jennifer Johnston                                                                                                
Representative Colleen Sullivan-Leonard                                                                                         
Representative Matt Claman (alternate)                                                                                          
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Bryce Edgmon, Vice Chair                                                                                         
Representative David Eastman                                                                                                    
Representative Dan Saddler (alternate)                                                                                          
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
PRESENTATION: ALASKA CHILDREN'S JUSTICE ACT TASK FORCE                                                                          
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
No previous action to record                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
B.J. COOPES, Medical Director                                                                                                   
Inpatient Pediatrics                                                                                                            
The Children's Hospital at Providence                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Presented a PowerPoint on the Alaska                                                                     
Children's Justice Act Task Force.                                                                                              
                                                                                                                                
JARED PARRISH, PhD, Senior Epidemiologist                                                                                       
Alaska Division of Public Health                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Presented a PowerPoint on the Alaska                                                                     
Children's Justice Act Task Force.                                                                                              
                                                                                                                                
KIM GUAY, Child Welfare Administrator                                                                                           
Central Office                                                                                                                  
Office of Children's Services                                                                                                   
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified and  answered questions during the                                                             
presentation by the Alaska Children's Justice Act Task Force.                                                                   
                                                                                                                                
JOSH LAWRES, Covenant House International                                                                                       
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during the presentation.                                                                       
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:06:32 PM                                                                                                                    
                                                                                                                                
CHAIR  GERAN TARR  called the  House Health  and Social  Services                                                             
Standing   Committee    meeting   to    order   at    3:06   p.m.                                                               
Representatives  Tarr,  Kito,  Johnston, and  Claman  (alternate)                                                               
were  present at  the call  to order.   Representative  Sullivan-                                                               
Leonard  arrived as  the  meeting  was in  progress.   [As  Chair                                                               
Spohnholz  and Vice  Chair Edgmon  were not  able to  be present,                                                               
Representative Tarr was acting Chair]                                                                                           
                                                                                                                                
^Presentation: Alaska Children's Justice Act Task Force                                                                       
     Presentation: Alaska Children's Justice Act Task Force                                                                 
                                                                                                                                
3:07:21 PM                                                                                                                    
                                                                                                                                
CHAIR TARR announced  that the only order of business  would be a                                                               
presentation by the Alaska Children's Justice Act Task Force.                                                                   
                                                                                                                                
3:07:47 PM                                                                                                                    
                                                                                                                                
B.J.   COOPES,  Medical   Director,  Inpatient   Pediatrics,  The                                                               
Children's  Hospital at  Providence, shared  her background  as a                                                               
pediatrician,  a pediatric  intensivist, and  palliative care  in                                                               
Hospice  physician.   She noted  that  she was  also the  Medical                                                               
Director  at the  Matanuska-Susitna Paramedic  College and  other                                                               
outreach programs.  She offered  her background for work with the                                                               
Alaska Children's Justice  Act Task Force, stating  that her role                                                               
as  a pediatric  ICU [intensive  care unit]  doctor included  the                                                               
responsibility  to  look  at  illness  and  cause  of  death  for                                                               
children.  She reported that, upon  review, she had found that 30                                                               
- 40 percent of the children  who died in the intensive care unit                                                               
at Providence [Alaska  Medical Center] were under the  age of two                                                               
years  and had  been beaten  to  death.   She acknowledged  that,                                                               
although this did not mean that  40 percent of children in Alaska                                                               
were dying from  abuse, she was looking  for preventative factors                                                               
to help  minimize the injuries and  death rate.  This  led to her                                                               
involvement with  the Alaska Children's  Justice Act  Task Force.                                                               
She shared an overview of  the agenda, which included an overview                                                               
of the child  abuse data, as well as some  options and needs when                                                               
addressing  these   issues.    She   declared  that   the  Alaska                                                               
Children's Justice  Act Task Force  was a federally  mandated and                                                               
funded  committee   with  a  mission  to   identify  areas  where                                                               
improvement  was   needed  in  a  statewide   response  to  child                                                               
maltreatment,   particularly    child   sex   abuse,    to   make                                                               
recommendations,  and  to  take  actions to  improve  the  entire                                                               
system.   She  pointed out  that  the task  force membership  was                                                               
statewide  and multidisciplinary.   She  introduced  many of  the                                                               
members of the task force, slide 4.                                                                                             
                                                                                                                                
3:11:23 PM                                                                                                                    
                                                                                                                                
JARED PARRISH,  Senior Epidemiologist, Alaska Division  of Public                                                               
Health,  introduced   slide  6,  "Perception,   observation,  and                                                               
statistics."     He   acknowledged   that,  as   data  could   be                                                               
overwhelming, it  was best to provide  a few numbers to  get some                                                               
context  with our  personal experiences  and  understanding.   He                                                               
said  that statistics  were used  to  summarize observations,  to                                                               
confirm,  inform,   re-frame  or   dispute  our   own  individual                                                               
perceptions,   and  then   gain  knowledge   and  formulate   our                                                               
understandings.   He shared  an anecdote  of explaining  hikes to                                                               
friends  as an  example of  perception.   He  offered to  provide                                                               
multiple  images  for  the  context   of  child  maltreatment  to                                                               
"potentially see it for what it  is in our state."  He introduced                                                               
slide  7, "Annual  prevalence -  3 estimates,"  which listed  the                                                               
prevalence of  child maltreatment for  children from ages 0  - 17                                                               
years,  as  evidenced by  reports  to  the Office  of  Children's                                                               
Services (OCS).   He explained that  "reports" were a call  for a                                                               
suspicion of  harm, "screened in"  were the reports that  met the                                                               
OCS classification  for investigation, and  that "substantiation"                                                               
met  certain  parameters.   He  pointed  out that,  although  the                                                               
contacts to  OCS and the  screen ins had  significantly increased                                                               
since 2008,  the substantiated  rate had  remained constant.   He                                                               
allowed  that there  was  not a  known reason  for  why this  had                                                               
remained constant,  but he offered some  hypotheses including OCS                                                               
work load  capacity and  its ability to  investigate, as  well as                                                               
other challenges  due to the size  of the state.   He lauded that                                                               
the  numbers  generated  hypothesis,  and "gets  you  hungry  for                                                               
another number to  start answering that."  He added  that, in any                                                               
given year, about 10 percent  of the child population had contact                                                               
with child welfare.                                                                                                             
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD referenced  the average of 15,000                                                               
children  reported for  possible child  maltreatment on  slide 7,                                                               
followed by  the screening process, and  then the substantiation.                                                               
She  asked, as  this  reporting was  a high  number,  how it  was                                                               
possible to ascertain what was really happening.                                                                                
                                                                                                                                
3:16:14 PM                                                                                                                    
                                                                                                                                
DR. PARRISH pointed  out that he was in public  health and not in                                                               
child  welfare.    He  explained   that  he  did  not  have  this                                                               
information.                                                                                                                    
                                                                                                                                
CHAIR TARR reported  that there had been about  20,000 reports of                                                               
harm, for 15,000 individual children.                                                                                           
                                                                                                                                
3:17:28 PM                                                                                                                    
                                                                                                                                
KIM GUAY, Child Welfare Administrator,  Central Office, Office of                                                               
Children's Services,  Department of  Health and  Social Services,                                                               
in response  to Representative Sullivan-Leonard, said  that there                                                               
was a  matrix to  screen the information  during the  call-ins of                                                               
child  abuse reports.   She  added that  family history  was also                                                               
considered.  She  explained that OCS took all  the information to                                                               
make   a  determination   for  whether   it  met   the  statutory                                                               
requirement  for  abuse.   If  so,  a  worker would  recommend  a                                                               
screen-in,   and  then   a  supervisor   would  make   the  final                                                               
determination for an investigation.                                                                                             
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked to  clarify that every call                                                               
was recorded.                                                                                                                   
                                                                                                                                
MS. GUAY said that was correct,  and noted that in the last year,                                                               
21,000 reports had been called in.                                                                                              
                                                                                                                                
3:19:24 PM                                                                                                                    
                                                                                                                                
DR.   PARRISH  stated   that  they   were   most  interested   in                                                               
understanding a sentinel event.   He reported that, from a Public                                                               
Health aspect,  nationwide and  international research  had shown                                                               
that  kids experiencing  at least  one report  had outcomes  more                                                               
similar  to those  kids with  a substantiated  report than  those                                                               
with  no report.    He stated  that this  showed  that there  was                                                               
something  potentially  going  on  in  that  child's  life  where                                                               
optimal  health and  development  was not  being  supported.   He                                                               
compared this  research to  the challenge  of putting  together a                                                               
puzzle without all  the pieces.  He  moved on to slides  8 and 9,                                                               
"Adverse  Childhood  Experiences  (ACEs)," and  offered  a  brief                                                               
overview.   He reported  that this study,  conducted in  the late                                                               
1990s,  was a  joint venture  between Kaiser  Permanente and  the                                                               
Centers for Disease  Control and Prevention.  He  added that this                                                               
group  of about  17,000  participants was  very homogeneous,  was                                                               
older, and  about 75  percent had some  college education.   They                                                               
were asked to recall or reflect  on a series of questions related                                                               
to  physical, emotional,  or sexual  abuse or  neglect and  their                                                               
experiences as children up to age  17 years.  He added that there                                                               
was also  a series of questions  regarding household dysfunction:                                                               
mental  illness,  mother  treated violently,  divorce,  substance                                                               
abuse,  or incarceration  of a  relative  or family  member.   He                                                               
reported that  two-thirds of the  group had experienced  at least                                                               
one of  those "adverse childhood  experiences."  He  stated that,                                                               
although the sheer volume of  this was shocking, the relationship                                                               
between accumulation  of these adverse childhood  experiences and                                                               
multiple  negative health  consequences was  even more  shocking.                                                               
He shared  that emerging  research had  started to  formulate the                                                               
causal  etiology  between  experiencing  some  of  these  adverse                                                               
childhood experiences  and the connection  with cancer  and other                                                               
health issues.   Continuing research  had affirmed that  the more                                                               
of these  adverse experiences accumulated in  childhood, the more                                                               
likely to experience negative life events.                                                                                      
                                                                                                                                
3:23:09 PM                                                                                                                    
                                                                                                                                
DR. PARRISH  moved on  to slide 10,  "Alaska ACEs  snapshot," and                                                               
reported  that   the  information  was  drawn   from  the  Alaska                                                               
Behavioral  Risk Factor  Surveillance System  in the  Division of                                                               
Public Health.  He pointed out  those people who reported four or                                                               
more of these adverse childhood  experiences were 50 percent more                                                               
likely to be unemployed, 274 percent  more likely to be unable to                                                               
work, 92 percent more likely  to earn less than $20,000 annually,                                                               
and significantly more likely to  report poor physical and mental                                                               
health.   He  pointed to  the association  between more  of these                                                               
adverse  childhood experiences  and the  increased likelihood  to                                                               
have  poor health  outcomes and  limited economic  attainability.                                                               
He explained  that there was  now research "looking up  stream to                                                               
your  early  childhood  experiences"  to  better  understand  and                                                               
prevent  chronic  diseases.   He  pointed  out  that  appropriate                                                               
intervention turned into prevention for the next generation.                                                                    
                                                                                                                                
3:25:30 PM                                                                                                                    
                                                                                                                                
DR.  PARRISH shared  slide  11, "Life  course  perspective."   He                                                               
shared  that  he  had  no  memory  of  being  one  year  old  and                                                               
acknowledged  that "there  could be  some fogginess"  when adults                                                               
were asked to remember their  childhood.  He reported that things                                                               
that  occur early  on during  the developmental  trajectory could                                                               
impact the overall trajectory.   He offered an analogy for flying                                                               
a plane,  pointing out that being  off one degree would  not make                                                               
that large a difference on a  short flight relative to the impact                                                               
on a  long-distance flight.   He stated that a  course correction                                                               
early on  could mitigate the  negative consequences.   He pointed                                                               
out that toxic stress, related  to adverse childhood experiences,                                                               
could  have adverse  effects on  health.   He  reported that  the                                                               
Alaska  Division  of Public  Health  was  now trying  to  measure                                                               
things as  they were occurring  in children over time,  to better                                                               
inform the decisions for how they target the interventions.                                                                     
                                                                                                                                
3:27:25 PM                                                                                                                    
                                                                                                                                
DR. PARRISH  introduced slide 12, "New  emerging data resources,"                                                               
and  directed attention  to the  Alaska Longitudinal  Child Abuse                                                               
and Neglect Linkage  Project (ALCANLink).  He said  that this was                                                               
a new measure  and he directed attention to  the Alaska Pregnancy                                                               
Risk  Assessment Monitoring  System  (Alaska  PRAMS), a  complex,                                                               
federally funded survey  representative of all the  births in the                                                               
state each year,  even though it only sampled  about 1500 mothers                                                               
each year,  and it had been  conducted since the late  1980s.  He                                                               
reported  that  the mothers  answered  questions  related to  the                                                               
maternal  experience and  gave consent  to have  this information                                                               
integrated  with  other  information.    He  explained  that  the                                                               
information from the  2009, 2010, and 2011 Alaska  PRAMS was used                                                               
to develop the ALCANLink.  He  pointed out that ALCANLink was now                                                               
connected  to  the  Child   Protective  Services  records,  which                                                               
offered a  better life time  risk report.   He moved on  to slide                                                               
13, "ALCANLink - lifetime risk,"  and reported that 32 percent of                                                               
kids born between 2009 and 2011  would experience a report to the                                                               
OCS, 27 percent  would experience a report that  was screened in,                                                               
and 10  percent would experience  a substantiated report  to OCS.                                                               
He pointed out that this  eliminated duplicative reports from the                                                               
first report and projected something  potentially going on in the                                                               
home that would lead to a report of harm.                                                                                       
                                                                                                                                
3:31:10 PM                                                                                                                    
                                                                                                                                
DR. PARRISH addressed slide 14,  "ALCANLink - crude proportion by                                                               
birth  cohort," which  linked  all the  children  born in  Alaska                                                               
between 2008  and 2015,  who had  contact with  OCS before  age 2                                                               
years.  He  reported that the lifetime burden  for being reported                                                               
to  OCS  had  not  changed  and  had  the  same  probability  for                                                               
experiencing contact with  child welfare.  He  declared that this                                                               
was  another  piece  of  information  to  better  understand  the                                                               
potential  burden   that  children   in  Alaska   were  currently                                                               
experiencing.                                                                                                                   
                                                                                                                                
CHAIR TARR  relayed that  the number of  children in  foster care                                                               
had  been rising,  although  with a  small dip  in  the last  two                                                               
years.   She asked if  this suggested  a constant with  the first                                                               
report to OCS.                                                                                                                  
                                                                                                                                
DR.  PARRISH  said   there  was  now  a  data   source  to  start                                                               
investigation for  the answers  to some of  these questions.   He                                                               
declared that  there was a  challenge for "continually  trying to                                                               
do  less with  more."   He declared  that more  partnerships were                                                               
being formulated to answer some of these questions.                                                                             
                                                                                                                                
3:33:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD referenced  the 15,000 reports of                                                               
child abuse  to OCS  and asked if  a phone call  would be  a data                                                               
marker, regardless of whether it was determined to be abuse.                                                                    
                                                                                                                                
DR.  PARRISH stated  that the  contact  with OCS  was a  sentinel                                                               
event,  even though  it was  not  clearly defined  for which  age                                                               
group was reported.                                                                                                             
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked if  it was possible to have                                                               
contact with OCS without a need for services because of abuse.                                                                  
                                                                                                                                
3:35:59 PM                                                                                                                    
                                                                                                                                
DR.  COOPES explained  that these  reports  were considered  risk                                                               
factors with an indication of  a potential problem in the future.                                                               
She pointed  out that  statisticians did  not think  about guilt,                                                               
they just determined  an association.  Any report to  OCS had the                                                               
same risk factor whether substantiated or not.                                                                                  
                                                                                                                                
REPRESENTATIVE  SULLIVAN-LEONARD mused  that it  would be  a risk                                                               
factor regardless of the outcome.                                                                                               
                                                                                                                                
DR. COOPES  reiterated that  a report  to OCS  was simply  a risk                                                               
factor, not a judgement.                                                                                                        
                                                                                                                                
DR.  PARRISH   said  that  a   lot  of  national   research  used                                                               
measurements based on the first  report of child abuse because of                                                               
the  association and  similarities  with the  risk  factors.   He                                                               
noted  that a  researcher  in North  Carolina  was reviewing  the                                                               
chronicity of  these reports, and he  acknowledged the difficulty                                                               
for measurement  of something that "usually  occurs behind closed                                                               
doors,  whatever  maltreatment or  abuse  or  neglect might  look                                                               
like."  He  added that any support to  families could potentially                                                               
reduce the reports to child welfare  and allow a greater focus on                                                               
abuse.                                                                                                                          
                                                                                                                                
3:39:18 PM                                                                                                                    
                                                                                                                                
DR.  PARRISH  directed  attention   to  slide  15,  "Maltreatment                                                               
burden."   He  shared the  annual prevalence  of reports  to OCS,                                                               
which  averaged about  10 percent  of the  child population.   He                                                               
then  spoke about  the cumulative  incidence measure,  a lifetime                                                               
measure  which indicated  that  32 percent  of  children will  be                                                               
reported  to  child welfare  before  the  age  of  8 years.    He                                                               
reported  that 34  percent of  adults reported  an experience  of                                                               
physical or sexual abuse, physical  neglect, or emotional neglect                                                               
before the age  of 17 years.   He pointed out that  this was very                                                               
close to  the estimates for  the lifetime burden, similar  to the                                                               
contacts with child  welfare.  He said these  estimates were much                                                               
closer than with  an annual prevalence estimate.  He  moved on to                                                               
slide  16, "Household  dysfunction,"  and addressed  the 13  life                                                               
event experiences  asked of  mothers prior  to childbirth  in the                                                               
Alaska PRAMS study, pointing out  the similarity to the household                                                               
dysfunction questions  in the  ACEs study.   He relayed  that the                                                               
more  stressors reported  by a  mother prior  to childbirth,  the                                                               
more  likely the  child  would have  contact  with child  welfare                                                               
before the age of 8 years.   He stated that this would allow them                                                               
to  begin  interventions and  preventions  prior  to birth.    He                                                               
pointed out that 21 percent  of the mothers reported experiencing                                                               
4 or more  of these events, and  that 1 out of every  2 births in                                                               
that group had  contact with child welfare.  He  stated that this                                                               
offered  potential  areas for  focused  prevention  efforts.   He                                                               
lauded the collection  of data to more  adequately evaluate "what                                                               
we are doing."                                                                                                                  
                                                                                                                                
3:42:42 PM                                                                                                                    
                                                                                                                                
DR.  PARRISH  addressed slide  17,  "It's  usually not  just  one                                                               
thing!"   He  spoke about  protective factors  and risk  factors,                                                               
those  things that  supported health  and  development and  those                                                               
things that  detracted.  He reported  that for a child  born to a                                                               
mother with less than 12 years  of education, there was 3.5 times                                                               
the likelihood for a report to  child welfare prior to the age of                                                               
8 years.   He declared that  education appeared to be  one of the                                                               
protective  factors  for offspring.    He  pointed out  that,  if                                                               
intimate  partner violence  was interjected  into the  lower risk                                                               
group  of mothers  with  at  least 12  years  of education,  that                                                               
protective  factor  was  "obliterated"  and the  risk  for  those                                                               
offspring became 3.9  times as likely to be reported.   He stated                                                               
that a focus on one protective  factor would not solve the issue,                                                               
as it needed a comprehensive understanding.                                                                                     
                                                                                                                                
3:44:41 PM                                                                                                                    
                                                                                                                                
DR.  PARRISH spoke  about slide  18,  "Disparity and  risk."   He                                                               
shared  that there  was a  distinction between  a risk  factor, a                                                               
protective factor,  and a population at  risk.  He stated  that a                                                               
population  at risk  was  a group  of people  that  could not  be                                                               
changed,  with  a  disproportionate  burden  of  these  risk  and                                                               
protective  factors that  were out  of  balance.   He offered  an                                                               
example  of white  children and  Alaska Native  children and  the                                                               
relative risks that  could be modified to  reduce the independent                                                               
association  for race.   He  declared that  "race doesn't  define                                                               
risk,  rather  the  disproportionate  load of  factors  that  are                                                               
modifiable  and  preventable."    He  pointed  out  that  it  was                                                               
important  to not  misinterpret or  misrepresent the  information                                                               
for risk and protective factors as it could do more harm.                                                                       
                                                                                                                                
3:46:44 PM                                                                                                                    
                                                                                                                                
DR. COOPES shared  slide 19, "Addressing this  issue," and lauded                                                               
the work being  done and the resources available  for the public.                                                               
She  moved  on  to  slide  20,  "Costs  to  Alaska:  $82  million                                                               
ANNUALLY,"  the  substantiated cost  of  child  abuse in  Alaska,                                                               
which included the  economic impact for taking  care of children.                                                               
She  acknowledged how  frustrating it  appeared, slide  21, "What                                                               
can  we do?"  but  emphasized  that it  was  not  hopeless.   She                                                               
explained  that the  purpose of  the ACEs  study was  to identify                                                               
risk  factors very  early  in life.   She  pointed  out that  the                                                               
changes  needed  to  "go  through the  life  trajectory"  and  be                                                               
continually brought  back in line.   She reported that  the toxic                                                               
stresses of child abuse really did affect child brains.                                                                         
                                                                                                                                
3:50:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked if  this was the adrenaline                                                               
process that caused this toxic stress.                                                                                          
                                                                                                                                
DR. COOPES said that, although  there was not any direct evidence                                                               
in  children, this  was the  case  in adults  for heart  disease,                                                               
colon cancer, breast cancer, and others from toxic stresses.                                                                    
                                                                                                                                
                                                                                                                                
3:51:38 PM                                                                                                                    
                                                                                                                                
DR. COOPES reported  that the Alaska Children's  Justice Act Task                                                               
Force had  drafted and improved  laws to protect  children, slide                                                               
22.    She  stated  that the  multidisciplinary  guidelines  were                                                               
indispensable for  statewide reform  and the standards  for child                                                               
advocacy centers, slide 23 "Prior  Projects."  She noted that the                                                               
task force  supported education with  scholarships, sponsorships,                                                               
and on-line programs, slide 24, "Ongoing Projects: Education."                                                                  
                                                                                                                                
3:53:50 PM                                                                                                                    
                                                                                                                                
DR.  COOPES addressed  slide 25,  "Advocacy &  Partnerships," and                                                               
lauded the  child advocacy  centers (CACs).   She pointed  to the                                                               
data on  slide 26, "Children  seen at Alaska CACs,"  which listed                                                               
the CACs  around the  state, noting that  although this  data was                                                               
for kids  of all ages,  more than  two-thirds of them  were under                                                               
the age of  12 years.  She  moved on to slide 27,  "Labor and Sex                                                               
Trafficking Among Homeless Youth," and  reported that one in four                                                               
homeless youth in  Alaska were sex or  labor trafficked, pointing                                                               
out  that boys  were also  sexually abused.   She  referenced the                                                               
studies  through  Covenant  House International,  a  service  for                                                               
homeless youth and  teens which helped them with  jobs, homes and                                                               
services, slide 28, "Results of Loyola University Study:"                                                                       
                                                                                                                                
3:56:04 PM                                                                                                                    
                                                                                                                                
DR.  COOPES  said  that  the system  needed  multiple  people  to                                                               
evaluate kids  and get them  help, slide  30, "What can  you do?"                                                               
She  declared  that "redundancy  is  critical!"   She  emphasized                                                               
that, although  the culture tends  to blame victims,  that needed                                                               
to  be mitigated  to  help  change the  trajectory.   She  listed                                                               
programs that were doing excellent  work, slide 31, "What can you                                                               
do?"  She spoke in favor  of HCR 2, Adverse Childhood Experiences                                                               
resolution,  and in  favor of  HB  151, training  on foster  care                                                               
licensing and sibling contact, slide 32,  "What can you do?"  She                                                               
declared that it was necessary to keep siblings together.                                                                       
                                                                                                                                
3:58:32 PM                                                                                                                    
                                                                                                                                
DR.  COOPES discussed  slide  34, "CJATF  focus  this year,"  and                                                               
reported  that  there  was  a focus  on  exploring  barriers  for                                                               
information  sharing to  initiate  services earlier.   She  noted                                                               
that they were  working with communities to  arrive at individual                                                               
programs.     She   addressed  the   unintended  consequence   of                                                               
overloading  a  system  when   reporting  possible  child  abuse,                                                               
stating  that it  was  necessary  to build  a  system that  would                                                               
accommodate the  kids.  She  declared that they would  also focus                                                               
on trafficking and  safe harbor laws in  collaboration with other                                                               
national groups.                                                                                                                
                                                                                                                                
3:59:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  referenced presentations  in her                                                               
community about child trafficking,  which revealed that kids were                                                               
being brought  in to the Port  of Anchorage.  She  asked if there                                                               
had been any discussion about this.                                                                                             
                                                                                                                                
DR. COOPES  said that it  was very hard  to get the  data because                                                               
the kids  hide.   She pointed  out that  putting a  prostitute in                                                               
jail  was punishing  the victim,  and that  much of  this started                                                               
with child trafficking.                                                                                                         
                                                                                                                                
4:01:19 PM                                                                                                                    
                                                                                                                                
JOSH  LAWRES,  Covenant  House  International,  spoke  about  sex                                                               
trafficking.  He  said they had partnered  with JOY International                                                               
and   that   both  sex   and   labor   trafficking  were   large,                                                               
underreported issues in Alaska.                                                                                                 
                                                                                                                                
4:03:22 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 4:03 p.m.                                                                                                          

Document Name Date/Time Subjects
CJATF 2018 Presentation to House H&SS REVISED.pdf HHSS 2/13/2018 3:00:00 PM
Children's Justice Act Task Force