03/10/2009 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HJR10 | |
| Presentation: Alaska Brain Injury Network: Traumatic Brain Injury | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | HJR 10 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 10, 2009
3:07 p.m.
MEMBERS PRESENT
Representative Bob Herron, Co-Chair
Representative Wes Keller, Co-Chair
Representative John Coghill
Representative Bob Lynn
Representative Paul Seaton
Representative Sharon Cissna
Representative Lindsey Holmes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE JOINT RESOLUTION NO. 10
Urging the United States Congress to improve health care for
veterans.
- MOVED CSHJR 10 (HSS) OUT OF COMMITTEE
Presentation: Alaska Brain Injury Network: Traumatic Brain
Injury
- HEARD
PREVIOUS COMMITTEE ACTION
BILL: HJR 10
SHORT TITLE: VETERANS' HEALTH CARE
SPONSOR(s): REPRESENTATIVE(s) GUTTENBERG
01/30/09 (H) READ THE FIRST TIME - REFERRALS
01/30/09 (H) MLV, STA, HSS
02/24/09 (H) MLV AT 1:00 PM BARNES 124
02/24/09 (H) Moved CSHJR 10(MLV) Out of Committee
02/24/09 (H) MINUTE(MLV)
02/25/09 (H) MLV RPT CS(MLV) 6DP
02/25/09 (H) DP: KAWASAKI, OLSON, HARRIS, LYNN,
BUCH, GATTO
03/02/09 (H) STA REFERRAL WAIVED
03/10/09 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
HOWARD COLBERT, Commander
Local Disabled American Veterans (DAV) Post Chapter 4
Juneau, Alaska
POSITION STATEMENT: Testified about HJR 10.
MIKE WALSH, Adjutant
Local Disabled American Veterans (DAV) Post Chapter 4
Juneau, Alaska
POSITION STATEMENT: Testified about HJR 10.
REPRESENTATIVE DAVID GUTTENBERG
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HJR 10 as the sponsor, and
responded to questions.
SHELLY HUGHES, Government Affairs Director
Alaska Primary Care Association (APCA)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HJR 10.
EVANGELYN DOTOMAIN, President & CEO
Alaska Native Health Board (ANHB)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HJR 10.
MCHUGH PIERRE, Director of Communications;
Legislative Liaison
Office of the Commissioner/Adjutant General
Department of Military & Veterans' Affairs (DMVA)
Fort Richardson, Alaska
POSITION STATEMENT: Testified about HJR 10.
JILL HODGES, Executive Director
Alaska Brain Injury Network, Inc. (ABIN)
Anchorage, Alaska
POSITION STATEMENT: Testified about traumatic brain injury.
CHRISTIE ARTUSO, Director of Neurosciences
Providence Alaska Medical Center
Anchorage, Alaska
POSITION STATEMENT: Presented a Power Point and answered
questions about traumatic brain injury.
CHRISTINE DECOURTNEY
Anchorage, Alaska
POSITION STATEMENT: Testified about her experiences with
traumatic brain injury.
PATRICIA CHAPMAN
Ketchikan, Alaska
POSITION STATEMENT: Testified about her experiences as a member
of a brain injury support group.
ACTION NARRATIVE
3:07:41 PM
CO-CHAIR BOB HERRON called the House Health and Social Services
Standing Committee meeting to order at 3:07 p.m.
Representatives Herron, Keller, Coghill, Cissna, and Lynn were
present at the call to order. Representatives Seaton and Holmes
arrived as the meeting was in progress.
HJR 10-VETERANS' HEALTH CARE
3:08:02 PM
CO-CHAIR HERRON announced that the first order of business would
be HOUSE JOINT RESOLUTION NO. 10, Urging the United States
Congress to improve health care for veterans. [Before the
committee was CSHJR 10(MLV).]
3:09:43 PM
HOWARD COLBERT, Commander, Local Disabled American Veterans
(DAV) Post Chapter 4, observed that HJR 10 addressed rural and
native areas, and he offered his belief that this was
discriminatory against all veterans. He emphasized that the DAV
did not "discriminate against color, religion, creed,
anything...we are all brothers." He explained that the
logistics in Alaska were a "nightmare." He reported that there
was not a [Veterans Administration (VA)] hospital, only a clinic
in Alaska. He affirmed that he had worked for several years
with Representative Kerttula regarding care for veterans in SE
Alaska, though he mentioned that progress had been very slow.
3:12:57 PM
MIKE WALSH, Adjutant, Local Disabled American Veterans (DAV)
Post Chapter 4, declared support for the recommendation that the
United States Congress provide adequate funds for the veterans'
needs. He noted the increase of injuries to military personnel
in Iraq, and he affirmed support for increased funding for
traumatic brain injuries (TBI) and mental health centers.
3:16:42 PM
MR. COLBERT offered his belief that there were not any
psychiatrists or analysts to help veterans in Juneau that "know
what they are doing," as they do not have any combat experience.
He called attention to the lack of housing for veterans when
they arrive from out of town for any medical service. He
reported that 540,000 medals had been awarded since the
beginning of combat in Iraq and Afghanistan, and that for each
of these medals "there's a consequence, there's a part of a
man's life that has totally changed." He pointed out that
veterans had made the sacrifice, and that they deserved the
benefits.
3:18:17 PM
MR. WALSH affirmed his support for federal and state funding to
ensure that veterans had access to quality health care at
community health centers. He explained the DAV outreach program
in Southeast Alaska. He offered support of local care for
veterans in the small communities.
3:19:56 PM
MR. COLBERT noted that a new facility for women veterans
suffering from Post Traumatic Stress Disorder (PTSD) had opened
in Menlo Park, California, yet there was not any facility for
women combat veterans in Alaska. He asked if any of the $22
million VA allocation for rural health care would be apportioned
to Alaska.
3:21:33 PM
MR. WALSH expressed support for electronic claims if adequate
privacy was maintained.
3:22:29 PM
REPRESENTATIVE DAVID GUTTENBERG, Alaska State Legislature, noted
that Senator Lisa Murkowski had suggested for Alaskans to remind
the U.S. Congress about Alaskan issues. He reported that
veterans in Alaska were not getting the necessary health care.
He cited inadequate facilities, inadequate delivery systems, and
distance as problems. He expressed his desire to ensure that
the VA had state wide service in all the communities. He
recognized that travel was a hardship. He acknowledged that a
new generation of veterans endured new challenges. He
emphasized that veterans had earned the right for health care
benefits without undue hardships, and he urged the U.S. Congress
to "do a better job than they have been doing right now."
3:24:51 PM
CO-CHAIR HERRON asked for Representative Guttenberg to comment
on the not yet offered amendment to CSHJR 10 (MLV). [Included
in the members' packets. Text provided below.]
3:25:05 PM
REPRESENTATIVE GUTTENBERG agreed that the amendment was
succinct, and he offered his support for the not yet offered
amendment.
3:25:33 PM
Co-Chair Herron opened public testimony.
3:25:55 PM
SHELLY HUGHES, Government Affairs Director, Alaska Primary Care
Association (APCA), noted that she was the wife and the mother
of veterans. She testified that this was an important
resolution as there had not been very much response from the
Veterans Administration (VA). She expressed concern for rural
veterans without access to VA health care facilities. She
explained that required care was only received if the medical
condition was military service related and met certain criteria.
She reported that veterans either did not receive the needed
care or they went to the Community Health Centers (CHC) or the
tribal health clinics, neither of which received reimbursement
from the VA. She offered support for a partnership between the
VA and the Department of Health and Human Services to streamline
the process. She directed attention to the increasing health
needs of aging veterans and returning veterans. She pointed out
that CHCs were in the local communities, so that family members
were available for support.
3:28:55 PM
EVANGELYN DOTOMAIN, President & CEO, Alaska Native Health Board
(ANHB), said that ANHB supported HJR 10. She stressed that the
services and funding should "follow the veteran." She explained
that tribal health provided health service to veterans, but did
not receive any reimbursement from the VA.
3:30:12 PM
MCHUGH PIERRE, Director of Communications; Legislative Liaison,
Office of the Commissioner/Adjutant General, Department of
Military & Veterans' Affairs (DMVA), stated that DMVA had
concerns for the sharing of federal funding with Alaskan
agencies.
3:31:13 PM
REPRESENTATIVE GUTTENBERG reiterated that the veterans deserved
the benefits, and he noted that other states also had this same
problem.
3:32:24 PM
[Co-Chair Herron closed public testimony.]
3:32:33 PM
CO-CHAIR KELLER moved to adopt Amendment 1, labeled 26-
LS0313\S.1, Bailey, 3/10/09, which read:
Page 4, following line 10:
Insert new material to read:
"FURTHER RESOLVED that the Alaska State
Legislature urges the United States Congress to ensure
that health care services follow veterans to where
they live and work so that veterans are not obligated
to search for the veterans' services to which they are
entitled; and be it"
There being no objection, Amendment 1 was adopted.
3:33:11 PM
CO-CHAIR KELLER moved to report CSHJR 10 (MLV), as amended, out
of committee with individual recommendations and the
accompanying fiscal notes. There being no objection, CSHJR 10
(HSS) was reported from the House Health and Social Services
Standing Committee.
^Presentation: Alaska Brain Injury Network: Traumatic Brain
Injury
3:34:53 PM
CO-CHAIR HERRON announced that the next order of business would
be a presentation on traumatic brain injury (TBI) and a Power
Point, "Combating T.B.I. in Alaska" by the Alaska Brain Injury
Network. [Included in the members' packets.]
3:35:20 PM
JILL HODGES, Executive Director, Alaska Brain Injury Network
(ABIN), reflected that there had been good discussion at the
last House Health and Social Services Standing Committee meeting
about prevention of brain injuries. She commented that both the
military and the tribal system both had recognized the
challenges of traumatic brain injuries.
3:36:32 PM
[Ms. Hodges showed a short video about, Will and Jennie, two
Alaskans with traumatic brain injuries.]
3:48:14 PM
MS. HODGES pointed out that Will and Jennie were able to
function in school and be the best that they could be. She
identified the three programs that she wanted to highlight: a
solution to fund access for needed care, a means to develop
these programs in Alaska, and a system to arrange case
management for more access to care.
3:49:17 PM
CHRISTIE ARTUSO, Director of Neurosciences, Providence Alaska
Medical Center, stated that Alaska was the leading state for
traumatic brain injury (TBI) to children, adolescents, and older
adults, and second for overall TBIs. She directed attention to
her Power Point, "Combating T.B.I. in Alaska" and referred to
slide 3, "Recent case ...." She described the patient to have
had a T.B.I. associated with alcohol consumption. She detailed
his multiple hospitalizations, the unreimbursed healthcare
costs, and his assaults on 27 staff members, and opined that
this was the result of a lack of a location that met his needs
in Alaska, and his lack of resources to go out of state.
3:51:21 PM
MS. ARTUSO spoke about slide 4, "A growing public health
crisis," and she read "The human brain itself controls physical,
cognitive and behavioral functions." She pointed out that the
medical industry focused on the physical functions, but that she
would discuss the cognitive and behavioral functions. She
explained that a traumatic brain injury (TBI) could be a blow, a
jolt, or a penetrating injury to the head which could
temporarily or permanently disrupt normal function. She showed
slide 5, which depicted Alaskans engaged in adventuresome
activities.
3:52:17 PM
MS. ARTUSO said that even helmets did not guarantee protection
from TBI. She commented on slide 6, "Causes of T.B.I," and
listed some of the causes. She explained that improvised
explosive devices (IEDs) were a leading cause for military
personnel and that shock blast could have an effect for 100
feet. She observed that, similar to a broken leg, brain
injuries needed time to heal.
3:53:19 PM
MS. ARTUSO explained the diagram on slide 7, "Simplified Brain
Behavior Relationships," which described the functions for the
different lobes of the brain. She said that a brain injury
could have no obvious signs or symptoms. She showed slide 8, a
picture of a game of hockey.
3:53:58 PM
MS. ARTUSO introduced slide 9, "Meet Jonathan...." She
described Jonathan to be a 14 year old, 'A' student, who was
hurt playing hockey. She shared that the CT scan of the brain
did not show anything out of the ordinary, so Jonathan played
soccer the next night. She disclosed that it was the soccer
coach who realized that something was not right with Jonathan.
She discussed the tests that were then given to Jonathan. She
spoke about the IMPACT (Immediate Post-Concussion Assessment and
Cognitive Testing) program, which used a computer based
cognitive test of memory, as memory was a major brain function.
She emphasized that proper gear was only part of the concern,
and that awareness of the significance of impact related
injuries was even more important. She spoke about the danger of
second impact injuries.
3:57:27 PM
MS. ARTUSO reported on slide 10, "Significance in Alaska," and
reported that TBIs occurred statewide to almost 1 out of 1,000
people, and to more than 2 out of 1,000 in Southcentral Alaska.
She revealed that Alaska was second in the nation for the
overall incidence of TBI, and that 32 percent of completed
suicides in Alaska had a history of TBI.
3:57:57 PM
MS. ARTUSO directed attention to slide 11, "Military
significance..." and she noted that TBI was historically present
in 14 - 20 percent of surviving casualty reports, but that this
percentage had increased with the conflicts in Iraq and
Afghanistan. She reported that the only cognitive therapies in
Alaska were "for-pay" services. She emphasized that specific
therapy in a controlled environment with trained support staff
was necessary to re-teach use of the non-injured parts of the
brain.
3:59:45 PM
MS. ARTUSO turned to slide 12, "Ongoing impact...." and reported
that military sources identified the "lack of community-based
services as a looming barrier to treatment." She further noted
that the Department of Defense had estimated that 10 - 20
percent of soldiers would incur a TBI.
4:00:25 PM
MS. ARTUSO detailed slide 13, "Cost of Care in Alaska," and
related that Providence Alaska Medical Center diagnosed almost
1300 patients with brain injury in 2006 and 2007. She shared
that the cost to patients with mild to moderate TBIs during the
third quarter of 2008 was more than $500,000.
4:00:57 PM
MS. ARTUSO spoke about patients with stroke, as described on
slide 14, "Acquired Brain Injury." She listed strokes in Alaska
to be the fourth leading cause of death, the leading cause of
disability, and the highest rate for mortality in the US. She
detailed the advances to stroke support currently being
implemented in Alaska, which included telemedicine carts, a
stroke neurologist, and new therapies.
4:02:51 PM
MS. ARTUSO continued on to slide 15, "Acquired Brain Injury" and
revealed that, in 2005, there were almost 3000 strokes in
Alaska, and that an additional 8000 Alaskans lived with the
effects from stroke. She emphasized the need for ongoing
cognitive rehabilitation services in Alaska.
4:03:57 PM
MS. ARTUSO, referring to slide 16, "Alaska's
scorecard...Documented success...." said that public awareness
had lead to an overall decrease in the incidences of TBI. She
noted that TBIs from ATV and falls were the exception.
4:04:31 PM
MS. ARTUSO mentioned slide 17, "National Standard of Care" and
stated that this "early, intensive acute treatment and
rehabilitation" was available in Alaska. She called attention
to the lack of a full continuum of care in Alaska.
4:05:19 PM
MS. ARTUSO discussed slide 18, "The time to act is now...," and
shared that there was a need "to facilitate more public and
private cooperation in all of the aspects: awareness, education,
treatment, and research." She stated emphatically that Alaskans
"deserve no less."
4:05:39 PM
MS. ARTUSO cited slide 19, "What is needed...." and shared that
a continuum of care for TBI patients was being developed that
included both day and residential programs. She announced the
necessity of a funding source for Medicaid patients.
MS. HODGES reported that SB 118, "An Act relating to medical
assistance coverage for traumatic brain injury services," was
recently introduced to target the needs for this group.
4:07:21 PM
MS. ARTUSO explained slide 20, "Why a Waiver?" She shared that
23 other states had Medicaid waivers, and that this was a
foundation to start the programs. She supported the need for
waivers to allow Medicaid-eligible individuals to live
independently in the community, rather than in a hospital or
nursing facility.
4:08:01 PM
MS. ARTUSO summarized slide 21, "Waivers on the national scene"
and noted that, since 1991, 23 states had recognized the need
for additional funding for the TBI population. She shared that
many states had multiple Medicaid waivers for home and
rehabilitative services for TBI patients. She asked the
eligibility be redefined, and explained that waivers "were
established because the states lacked the capacity to provide
these special services to individuals with brain injury."
4:09:35 PM
MS. ARTUSO read from slide 22, "National significance...," that
"six states reported that prior to their waiver, Medicaid
eligible individuals [with brain injuries] were frequently
placed in specialized, high cost facilities outside the state."
She confirmed that the decision to establish waivers was an
effort by the state to keep its citizens in the communities with
their families.
4:09:57 PM
MS. ARTUSO commented that slide 23, "Why Now?" was a proactive
response to meet the service needs of TBI individuals. She
reported that the Alaska Brain Injury Network had a structured
10-year plan that would decrease the out of state placement.
4:11:12 PM
CO-CHAIR HERRON asked how many brain injuries the average person
received.
4:11:51 PM
MS. ARTUSO revealed that, until recently, concussions were not
recognized as a brain injury. She noted that the different
levels of severity had allowed for a different philosophy of
response. She explained that the recent development of tests
now revealed the changes of brain function. She said that most
people had probably suffered a brain injury, but that there were
not any published statistics.
4:12:57 PM
CO-CHAIR HERRON asked if there was a danger from minor
repetitive injuries to the brain.
4:13:33 PM
MS. ARTUSO agreed.
4:13:39 PM
MS. HODGES mentioned that articles had been written, based on
concussions to NFL players, which detailed the deep damage to
the brain from repetitive concussions.
4:14:26 PM
CO-CHAIR HERRON asked why Alaska was leading the nation in TBI
injuries to teens.
4:15:12 PM
MS. ARTUSO pointed out that Alaska had a young, physically
active population who participated in TBI potential activities.
4:15:41 PM
Co-Chair Herron opened public testimony.
4:16:04 PM
CHRISTINE DECOURTNEY said that she had worked for Alaska tribal
health. She shared that she had suffered two TBIs about 11
months apart. She stated that the symptoms had occurred without
any physical signs. She opined that it was her own initiative
to seek a provider with a definitive answer that allowed her
recovery. She said that it was very difficult to find any
answers in Alaska, and she stressed that Alaskans deserved the
opportunity to find TBI resources in Alaska.
4:20:16 PM
PATRICIA CHAPMAN described her work with a brain injury support
group in Ketchikan, and she shared that her daughter had TBI.
She said that there were hundreds of people with TBI in
Ketchikan, yet there were not any local TBI experts. She
explained that her daughter qualified for a developmentally
disabled waiver, even though she was brain injured, not
developmentally disabled. She described the limitations of the
waiver, which instructed that service givers were not provided
during her daughter's napping times. She emphasized the need
for specialized care for TBIs. She offered her belief that
there was better recovery for TBI when patients were in their
own community and had community support. She declared that
there was a lack of neuro counselors in Alaska. She announced
that many people in Ketchikan who suffered from TBI were not
able to find services, so they resorted to self medication.
4:25:51 PM
Co-Chair Herron closed public testimony.
4:26:04 PM
REPRESENTATIVE COGHILL explained that a waiver was an exemption
to the Medicaid general rules. He asked about the problems with
getting the waiver.
4:27:20 PM
MS. HODGES recounted that the ABIN had recommended a waiver for
TBI since the completion of a needs assessment for Alaska many
years before. She opined that there had not been any action
toward improvement for the existing Medicaid program or to allow
an additional waiver. She cited three reasons for non support
by Medicaid for TBI: Medicaid eligibility criteria were based on
physical, not cognitive, issues; cognitive therapy was not a
component in Medicaid; and the level of care would need to be
changed. She shared that other states had amended Medicaid and
included a level of care that included TBIs. She mentioned that
although SB 61 had suggested recommendations, these did not
offer much direction to Home and Community Based Services
(HCBS).
4:29:01 PM
REPRESENTATIVE COGHILL said that the Department of Health and
Social Services (DHSS) had to apply for the waiver, and the
individual had to qualify.
4:29:57 PM
MS. ARTUSO, in response to Representative Coghill, opined that
the level of care was not well defined for the existing waivers.
She explained that the current definition for disability was
defined by functional disability, not cognitive disability. She
noted that many TBIs had cognitive disabilities, and not
functional disabilities; therefore, they did not qualify for
medical waivers. She said that there were now evidence based
tests to document cognitive disability.
4:31:17 PM
REPRESENTATIVE COGHILL asked about Alzheimer's.
4:31:49 PM
MS. ARTUSO explained that Alzheimer's was a chronic,
debilitative condition that did not reverse, and could not be
treated. She said that these patients did well in assisted
living, with medication that would slow the condition. She
explained that TBI was an injury that could heal, depending on
the level of severity, when given time and cognitive therapy.
She compared that TBI necessitated a healing environment,
whereas Alzheimer's required a protective environment.
4:33:46 PM
REPRESENTATIVE COGHILL reflected that the dilemma was that both
required payment for services and that the federal government
would not acknowledge some of the Alzheimer's issues, either.
4:34:18 PM
MS. HODGES said that the ABIN had recommended that the Medicaid
waiver language be written to better define the cognitive
component for Alzheimer's, as well.
4:34:49 PM
REPRESENTATIVE CISSNA asked about the term, 'universal worker.'
4:36:54 PM
MS. ARTUSO, in response to Representative Cissna, said that this
was not the type of care that the population needed. She
reported the best to be a day care, therapeutic, group
environment, structured for their needs. She relayed that the
national best practice standard for cognitive therapy were
exercises to allow recovery for parts of the brain. She added
that day care group settings were much more economical than
individual care in the home.
4:38:04 PM
REPRESENTATIVE CISSNA asked if telemedicine and telepsychiatry
would be successful for these patients.
4:38:39 PM
MS. ARTUSO agreed. She explained that this was already being
implemented with the existing telemedicine programs and being
developed with the tribal health facilities. She said that the
first prototype residential and day care program was being
developed in Southcentral Alaska, and that this would be the
model for smaller rural programs. She shared that one model
allowed for educated and trained, though not licensed,
providers. She offered her belief that this would allow create
more job opportunities.
4:39:56 PM
REPRESENTATIVE LYNN asked about the difference between TBI and
stroke, and each of the different therapies.
4:40:36 PM
MS. ARTUSO explained that stroke was a decrease in the oxygen
and nutrient supply to an area of the brain. She said that
those brain cells ceased to function, and were either injured or
dead. She said that the cells don't conduct an impulse, similar
to an electric current. She explained that with a TBI, the
impulse carrying tissue was sheared and was no longer
conductive. She allowed that although these were two different
types of injuries, they sometimes resulted in similar cognitive
disabilities. She explained that each therapy program was
unique to the individual; but that some therapies would work for
both types of injury to either recover or retrain another area
of the brain for compensation.
4:42:42 PM
REPRESENTATIVE COGHILL asked about a systems approach for
funding.
4:43:08 PM
MS. ARTUSO explained that, after the emergency response, the
hospital evaluation, the cognitive screening, and the discharge,
there were limited resources for referral. She said that there
were no day care programs for cognitive therapy, and that
neuropsychologists were "for-pay" service. She allowed that if
the patient did not have insurance which paid for this, the
result was very large expenses. In response to a question from
Representative Coghill, she explained that many severe brain
injuries were transferred to Anchorage and Providence Hospital,
but that once the patient returned to a rural area, there was
not a continuum of care.
4:44:39 PM
REPRESENTATIVE SEATON asked for a definition for cognitive
therapy.
4:45:11 PM
MS. ARTUSO responded that there were several types and that a
group of cognitive therapies were designed to meet the specific
needs of the patient.
4:45:45 PM
REPRESENTATIVE SEATON asked about ways to identify a cognitive
disability.
4:47:27 PM
MS. ARTUSO reported that the nationally recognized IMPACT test
for cognitive disability showed results that were different than
with a developmental disability. She explained the necessity
for appropriate wording to a waiver because the current
qualifying tests for benefits did not allow for documented,
evidence based cognitive disability. She said that waivers only
allowed for developmental disability.
4:48:54 PM
REPRESENTATIVE HOLMES asked where the majority of TBIs were
occurring.
4:49:29 PM
MS. ARTUSO said that the majority of incidences were in the most
populated area, Southcentral Alaska. She related that 34
percent were Alaskan Native.
4:50:00 PM
REPRESENTATIVE HOLMES clarified that a higher number were in the
Anchorage region, but that the higher rate were outside
Anchorage. She asked about the type of services available with
a waiver.
4:50:42 PM
MS. ARTUSO said that a day care cognitive therapy program was
being developed for the Matanuska-Susitna area, with a
residential program planned as the next stage. She assessed
that after this stage, there would be a needs evaluation to
determine whether to grow the Mat-Su capacity, or to build
smaller programs in rural regions. She mentioned that the
stroke services program would be developed simultaneously,
though separately. She reported that both programs would link
at some future time.
4:51:55 PM
CO-CHAIR KELLER asked if the community health centers also
required waivers.
4:52:38 PM
MS. ARTUSO said yes.
4:52:52 PM
CO-CHAIR KELLER asked if the Mat-Su Regional Medical Center was
the only center working on the TBI care program.
MS. ARTUSO replied that no other centers were currently
interested in pursuit of the entire program development.
4:53:47 PM
MS. HODGES, in response to Co-Chair Keller, said that the TBI
statistics were based on five year averages.
MS. ARTUSO said that Texas and New Jersey both had TBI
fatalities which prompted the state legislatures' to increase
awareness.
4:54:33 PM
MS. HODGES, in response to Co-Chair Keller, said that, since
1999, behavioral health centers were required to screen for
brain injuries. She explained that behavioral health focused on
cognitive, behavioral, and emotional aspects, but not the
occupational and physical therapy components. She said that
Alaskans needed a collaborative effort for all these therapies.
4:56:17 PM
MS. HODGES, in response to Representative Cissna, said that the
Alaska Mental Health Trust Authority (AMHTA) had been supportive
with money toward brain injury training. She expressed the need
for general fund financial allocations to continue the training.
She said that an introduction to brain injury curriculum had
been developed, and that this program would teach 15 rural
leaders to become mentors and the point of contact in their
community. She acknowledged that a lot of training was still
necessary to support the workforce.
4:57:47 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:57 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| CS for HJR 10.PDF |
HHSS 3/10/2009 3:00:00 PM |
|
| HJR 10 letters of support.PDF |
HHSS 3/10/2009 3:00:00 PM |
|
| HJR 10, updated sponsor statement.PDF |
HHSS 3/10/2009 3:00:00 PM |