02/11/2014 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HJR20 | |
| Presentation: the Citizen Review Panel | |
| Presentation: Key Coalition | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HJR 20 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 11, 2014
3:05 p.m.
MEMBERS PRESENT
Representative Pete Higgins, Chair
Representative Wes Keller, Vice Chair
Representative Benjamin Nageak
Representative Paul Seaton
Representative Geran Tarr
MEMBERS ABSENT
Representative Lance Pruitt
Representative Lora Reinbold
COMMITTEE CALENDAR
HOUSE JOINT RESOLUTION NO. 20
Urging the President of the United States and the United States
Congress to repeal the excise tax on medical devices.
- MOVED HJR 20 OUT OF COMMITTEE
PRESENTATION: THE CITIZEN REVIEW PANEL
- HEARD
PRESENTATION: KEY COALITION
- HEARD
PREVIOUS COMMITTEE ACTION
BILL: HJR 20
SHORT TITLE: MEDICAL DEVICE TAX
SPONSOR(s): REPRESENTATIVE(s) LYNN
01/21/14 (H) READ THE FIRST TIME - REFERRALS
01/21/14 (H) HSS
02/11/14 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE BOB LYNN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HJR 20, as the prime sponsor of
the resolution.
NICK LEWIS, Staff
Representative Bob Lynn
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HJR
20.
DIWAKAR VADAPALLI, Chair
Citizen Review Panel
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint titled "Alaska's
Citizen Review Panel."
MARGARET MCWILLIAMS
Citizen Review Panel
Douglas, Alaska
POSITION STATEMENT: Testified and answered questions during the
PowerPoint presentation by Alaska's Citizen Review Panel.
CHRISTY LAWTON, Director
Central Office
Office of Children's Services
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during the presentation
by the Citizen Review Panel.
MILLIE RYAN, Executive Director
REACH, Inc.
Juneau, Alaska
POSITION STATEMENT: Testified during a presentation by the Key
Coalition of Alaska.
RHODA WALKER
Juneau, Alaska
POSITION STATEMENT: Testified during a presentation by the Key
Coalition of Alaska.
ERIC YANUSZ, Intern
Project SEARCH
Matanuska-Susitna Regional Medical Center
Palmer, Alaska
POSITION STATEMENT: Testified during a presentation by the Key
Coalition of Alaska.
LUANN YANUSZ
Palmer, Alaska
POSITION STATEMENT: Testified during a presentation by the Key
Coalition of Alaska.
ART DELAUNE
Fairbanks, Alaska
POSITION STATEMENT: Testified during a presentation by the Key
Coalition of Alaska.
MICHELLE GIRAULT
Anchorage, Alaska
POSITION STATEMENT: Testified during a presentation by the Key
Coalition of Alaska.
ACTION NARRATIVE
3:05:25 PM
CHAIR PETE HIGGINS called the House Health and Social Services
Standing Committee meeting to order at 3:05 p.m.
Representatives Higgins, Keller, Seaton, and Nageak were present
at the call to order. Representative Tarr arrived as the
meeting was in progress.
HJR 20-MEDICAL DEVICE TAX
3:06:16 PM
CHAIR HIGGINS announced that the first order of business would
be HOUSE JOINT RESOLUTION NO. 20, Urging the President of the
United States and the United States Congress to repeal the
excise tax on medical devices.
3:07:09 PM
REPRESENTATIVE BOB LYNN, Alaska State Legislature, introduced
HJR 20 as the prime sponsor of the bill and explained that the
medical device tax was part of the Patient Protection and
Affordable Care Act. He questioned whether pacemakers, heart
stents, artificial hips, and, he opined, some forms of birth
control, should be required to pay an extra 2.3 percent tax. He
declared that he was not in agreement with this, offering his
opinion that most other people would not support this tax. He
read:
The medical device tax will substantially increase the
already high cost of medical care by some $3.7 billion
per year. That money, that tax, the cost of that will
be passed down from the medical device developers to
manufacturers to health care providers, and ultimately
to consumers like us, and like every one of our
constituents. The medical device tax takes direct aim
at American innovation, by punishing researchers and
high tech bio-medical manufacturers, which any one of
us or our constituents may need some day. Why tax
life saving devices? This tax is anti-business and
this tax is bad for patients. This resolution sends a
strong message to Congress and to the President to
eliminate this tax.
REPRESENTATIVE LYNN asked that the committee support passage of
the proposed resolution.
3:09:15 PM
CHAIR HIGGINS opened public testimony, and there being none, he
closed public testimony.
3:09:55 PM
REPRESENTATIVE TARR, directing attention to page 1, line 16, of
the proposed resolution, which read: "Whereas thousands of
layoffs in the United States have already occurred because of
the medical device tax," asked for a specific number and if any
Alaska businesses had been impacted by this excise tax.
3:10:34 PM
NICK LEWIS, Staff, Representative Bob Lynn, Alaska State
Legislature, in response to Representative Tarr, said "I don't
have an answer to that right now."
3:10:48 PM
REPRESENTATIVE KELLER moved to report HJR 20 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, it was so ordered.
3:11:14 PM
The committee took an at-ease from 3:11 p.m. to 3:14 p.m.
^Presentation: The Citizen Review Panel
Presentation: The Citizen Review Panel
3:14:16 PM
CHAIR HIGGINS announced that the next order of business would be
a presentation by Alaska's Citizen Review Panel.
3:16:01 PM
DIWAKAR VADAPALLI, Chair, Citizen Review Panel, presented a
PowerPoint titled "Alaska's Citizen Review Panel," and stated
that the panel presented to the House Health and Social Services
Standing Committee every year. Directing attention to slide 1,
"Panel's mandate," explained that the function of the panel was
to provide oversight and monitor the policies and practices of
the Office of Children's Services (OCS). He pointed out that
both federal and state law mandated the panel.
MR. VADAPALLI moved on to slide 2, "Panel members," and shared
that all Citizen Review Panel (CRP) members were volunteers,
were a broad representation of the state, and offered expertise
and experience in the field of child maltreatment prevention.
MR. VADAPALLI spoke about the annual CRP activities, which
included an annual report in June, two teleconferences per
month, one of which was with the senior leadership at the OCS,
and two site visits to different regions and villages across
Alaska, slide 3, "Panel's annual activities." He declared that
the panel worked about 1000 volunteer hours annually.
3:18:15 PM
MR. VADAPALLI pointed to the map, which depicted the sites
visited by CRP, slide 4, "Site visits since 2002."
MR. VADAPALLI referred to slide 5, "2012-2013 Recommendations
and response," which detailed the recommendations by CRP in
2012, and the subsequent responses by OCS. He explained that
the panel would present its current work, its lessons from the
site visits, and its upcoming goals and work plans. Calling
attention to the first recommendation, "Reduce staff turnover,"
he reported that the staff turnover rate for OCS was almost 35
percent, and he acknowledged the difficulty and intensity for
"front line" staff and the "emotionally loaded situations,"
especially acute in rural Alaska.
3:20:30 PM
CHAIR HIGGINS asked about the pay for OCS staff.
MR. VADAPALLI replied that it would be necessary to ask OCS for
this information.
CHAIR HIGGINS asked about the turnover rate.
MR. VADAPALLI replied that it had been 34 percent in the past
year, and usually varied between 30 - 35 percent.
3:21:25 PM
MR. VADAPALLI returned attention to slide 5, and listed the OCS
responses, which included development of a recruiting video,
experimental scheduling for a week on and a week off, and
assessing the cost effectiveness of travel teams to help local
workers. He acknowledged that there were still issues to be
addressed, including standardization for afterhours work. He
assessed the second recommendation, deadlines for non-emergency
petitions.
3:23:14 PM
MARGARET MCWILLIAMS, Citizen Review Panel, offered some
background for this second recommendation, noting that there
were two models for the handling of children's cases. The
formal model was when a court case was filed, attorneys and
guardians ad litem were appointed, and the child could be
removed from the home. The more informal model was solely
between OCS and the family, was voluntary with no court
oversight, and was an intensive outreach to the family to
improve the safety of the children in the home, while referring
the parents to necessary services. She expressed a concern of
the panel that the in home cases were languishing, and nothing
was actually being provided to the families, so its
recommendation was to file non-emergency petitions to start a
court case and court oversight. This would allow monitoring of
progress for services to the family, and to address any ongoing
reports of harm. In response to this concern, OCS scrutinized
its in-home model, in order to improve its services.
3:25:21 PM
CHAIR HIGGINS redirected his earlier question regarding the
salary range for OCS staff.
CHRISTY LAWTON, Director, Central Office, Office of Children's
Services, Department of Health and Social Services, replied that
the average base salary was about $50,000, and there were
significant cost of living adjustments for the rural areas.
MS. LAWTON, in response, said that the annual OCS survey
indicated that salary was not a major issue for turnover. She
listed workload, lack of support, and job stress as the
predominant reasons for turnover.
3:26:55 PM
REPRESENTATIVE SEATON asked if living quarters in rural areas
was on the list of problems.
MS. LAWTON replied that OCS had no mechanism to pay for housing,
although it was factored in to the cost of living adjustments.
REPRESENTATIVE SEATON asked if adequate housing was available to
the workers, as it had also been a concern for other
professions.
MS. LAWTON agreed that this had been a factor, and was an
ongoing challenge, in specific communities.
3:28:18 PM
REPRESENTATIVE KELLER asked if the recommendations had been
compared to those of other states, and if turnover had been
compared.
MR. VADAPALLI explained that the Citizen Review Panel had a
federal mandate, which was limited to the State of Alaska. He
declared that OCS in Alaska was not far off the national
standard for turnover rate. He pointed out that different
regions in Alaska had different turnover rates.
REPRESENTATIVE TARR asked Ms. Lawton whether new staff were
limited to the cases they were assigned, as it took time to
learn. She asked about a report regarding recommendations for
additional front line workers.
3:30:31 PM
MS. LAWTON said that caseloads were staggered based on a reduced
and integrated case load for new staff, dependent upon their
experience and training. She acknowledged that staffing
shortages did not always allow this to happen. She referenced
the study for additional staff, which had suggested hiring 44
new staff, of which 31 were for support positions, including
administrative support staff and social service associates, as
well as 13 additional community care licensing positions.
REPRESENTATIVE SEATON asked about the OCS response to a 2013
recommendation, which he read: "this will be an ongoing effort
and adds to a larger initiative to change the culture of being a
trauma ridden agency, which results in worker burnout and
leaving the agency." He asked what was meant by "trauma ridden
agency."
MS. LAWTON, in response, explained that there was a national and
local push for recognition to the impact of this work on staff.
She pointed out that people brought traumatized and victimized
incidences to the staff, and the staff absorbed this in a
secondary trauma nature. She declared the importance for
recognizing these factors and working to improve the culture
with more staff support.
REPRESENTATIVE SEATON asked for an explanation to the attempts
for change to the structure.
MS. LAWTON, in response, said that there were a number of
different ways for change, both large and small. She reported
that local managers and supervisors were now talking about the
effects of secondary trauma on staff, and acknowledging that it
existed, whereas previously it had not been discussed. She
shared that OCS was providing staff with training, and
"mechanisms to reach out for self-care, and a system that
supports them in doing that." She pointed to efforts with other
local agencies also focusing on this trauma issue.
3:34:53 PM
REPRESENTATIVE SEATON asked if this was related to the efforts
for changing cases to in-home supervision, or strictly to the
effects of cases on OCS staff.
MS. LAWTON expressed her agreement, stating that it was a desire
of OCS to improve workforce stability and retention. She
allowed that this challenge was a prevailing factor for the
inability to retain staff.
MR. VADAPALLI moved on to slide 6, and pointed to the challenge
for staffing the Western Region, which was the newest region.
He reported that almost 56 villages were administered by the
headquarters in Bethel. He explained that for this office to
function as a fully equipped region similar to the other
regions, it needed several key positions to be filled. He
expressed concern that each region should be able to exercise
specific functions, including a travel specialist. He shared
that travel teams contributed heavily toward reduction of the
workload.
3:38:02 PM
MS. MCWILLIAMS referred to recommendation 4 on slide 6, "Improve
data compilation efforts." She assessed that improvement for
collection of the right data would allow better understanding of
the trends in family problems and child welfare issues in
Alaska. She relayed that OCS had sent a deputy for additional
training for data compilation, and that the data from different
agencies regarding child welfare was now shared. She reported
that access to data from Chapin Hall, a child welfare research
institute at the University of Chicago, was still being pursued.
She explained that Chapin Hall had data sets about national
trends for child protection and welfare issues, which would give
OCS a better handle on trends and how to meet them.
3:39:43 PM
MS. MCWILLIAMS assessed slide 7, "2013- 2014, Work Plan Goals."
She listed screening decisions by OCS, explaining that after a
report of harm, an intake worker either screened-in for another
worker to investigate, or it was screened-out and not
investigated. She opined that both types of decisions had been
on the rise, which could explain the rise in reports of harm.
She explained that the Citizen Review Panel wanted to review the
criteria for screening, and whether it was being used
consistently across all the regions. She declared that a second
goal was to more closely examine the in-home practice model,
which was the informal voluntary service arrangement, with no
court oversight, between OCS and the family. She pointed out
that cases were handled differently in urban and rural areas.
She offered examples of the dedicated in-home units in Anchorage
and Fairbanks, which appeared to "be on the right track in terms
of making a difference in preserving the family." She informed
the committee that this was different in the rural areas, as
there was an increased work load per case worker, a lack of
services, and challenges for travel. She questioned whether
there was a model for rural in-home services. She declared a
concern for the lack of oversight and monitoring, which made it
difficult to measure safety. These issues, as well as the
extreme workload in rural areas, were all going to be monitored
more closely in the upcoming year.
MR. VADAPALLI discussed concerns for the third goal, "Initial
Assessment (IA) Backlog," slide 8, "2013 Work Plan Goals." He
recommended that it was necessary to reduce or eliminate the IA
backlogs, as these had been a problem in the past. He reported
that OCS was diligently monitoring the IAs to ensure no backlog.
He remarked that the panel wanted to establish that the backlog
was not manifesting in any other caseload. As the panel was
established to review systemic issues, the panel wanted to
review a sample of case files. He allowed they were in
discussion with OCS for a process to facilitate this.
MR. VADAPALLI moved on to discuss the final goal, "Service needs
assessment in Unalaska." He reported that, as the Unalaska
field office had closed, the CRP wanted to ensure there were not
any unmet needs in the community. He stated that although OCS
had already done this needs assessment, the panel was reviewing
it. He reminded the committee that these work plan goals were
for the current year, and the CRP was still working through
them. He repeated the desire of the CRP to have people contact
them with any concerns, which was useful for the setting of
goals in the future.
3:46:34 PM
MR. VADAPALLI reviewed the three latest site visits, Barrow in
September, and Kodiak and Bethel in January, slide 9, "2013-
2014 Site Visits." He identified the major concerns, slide 10,
"Current Concerns," and specified that there was a tribal-state
work group discussing local tribal relationships with OCS staff.
He declared that, although there was not a pattern, there were
extremes from great relationships to tension. A second concern
was for the shift by OCS from a local to a regional intake. He
declared that there was still a great deal "of work to make it
really functional," which would require time. He shared a
perception that the calls to the regional offices were often not
forwarded to the local offices. He declared that a lack of
housing options in rural areas had continued to be a problem for
recruiting and retaining staff.
3:50:32 PM
REPRESENTATIVE SEATON asked for pictures and more detailed
evaluations of the problem areas. He clarified that his request
was to DHSS and OCS, in order to address some of the
difficulties for retention. He suggested that a plan to tackle
these problems could then be addressed.
CHAIR HIGGINS expressed his agreement that the concerns had been
targeted, and he acknowledged a need for an action plan to meet
these concerns.
3:52:57 PM
REPRESENTATIVE KELLER asked for more information about the
relationship and agreement with Barrow.
MR. VADAPALLI, in response, clarified that there was no
indication of a pattern. He explained that "the native village
of Barrow was one of two tribes, if I'm not mistaken, that has
exclusive jurisdiction over children, in child of need aid
cases." He pointed out that there was an existing memorandum of
understanding (MOU) between Barrow and OCS. He shared that
although Barrow was not aware of this MOU, whereas OCS was aware
of it, both partners needed to be active for the MOU to be
effective. He expressed the CRP concern for the needs of the
children. He declared that the staff in Barrow had good,
strong, long standing, individual relationships in the
community; however, there was not a trusting relationship from
the local law enforcement with the regional office. He shared
the desire to create a more formal framework to foster these
relationships in case the current Barrow staff left their
positions.
3:56:56 PM
MS. MCWILLIAMS furnished slide 11, "Current Concerns," and
expressed concern for the in-home model, the increase in the
number of screened out decisions, and the backlog for Initial
Assessments.
MR. VADAPALLI indicated slide 12, "Current Concerns," and
declared that, although budget cuts were looming, OCS could not
afford any cuts as its key functions were similar to those of
public safety, especially in rural areas. He declared that OCS
was "already stretched to their limits, and they have very
difficult case loads and they have very little budget for
essential supplies." He emphasized that OCS could not afford
any cuts to its budget.
REPRESENTATIVE SEATON asked about the cap on caseloads for OCS
staff, and whether it included the less formal, voluntary cases.
MS. MCWILLIAMS, in response, said that OCS counted cases by
family, which included the voluntary, non-court cases. She said
that she did not know about caps on worker caseloads, as the
loads varied from region to region. She noted that there was a
recommended case load; however, due to staff turnover, workers
often had to absorb extra cases.
REPRESENTATIVE SEATON asked for an update from OCS about case
load caps, although it did not yet appear to have been
instituted.
REPRESENTATIVE KELLER asked if the CRP responsibility was to
look at specific cases and make comprehensive evaluation. He
asked how many specific cases would CRP review, and he asked for
clarification regarding the confidentiality.
4:03:09 PM
MR. VADAPALLI, in response, reported that CRP had performed case
reviews only once, since 2002. He explained that, as the case
files were extensive, CRP had not done any case reviews. He
acknowledged that case reviews were a tool used by many CRPs
nationwide to help OCS, without replicating reviews already
performed. He reported that a sample of caseloads was typically
reviewed for those systemic issues which were under the mandate
of CRP. He suggested that even 20 cases would be a lot for
seven members of the CRP to review. Regarding the
confidentiality issue, he reported that each request of data
from OCS did not contain any information that would compromise
any individual or family. He relayed that CRP also had a
confidentiality rule.
CHAIR HIGGINS asked for clarification that no cases had as yet
been reviewed.
MR. VADAPALLI stated that the review was only a suggested tool
and was not part of the mandate.
REPRESENTATIVE TARR asked if the reference to extreme caseloads
in rural areas was comparative, and whether there were actual
numbers.
MS. MCWILLIAMS offered her understanding that the target for OCS
family service caseloads was 30 - 40, counted by family,
although there had been reports from rural areas of 75 cases for
a staffer. She declared that this was "way too many" and that
the person would not be able to do their job. Stating that CRP
was not aware whether this was a daily occurrence, she suggested
asking the department.
REPRESENTATIVE TARR requested an OCS response, and she then
asked if CRP engaged with other safety net organizations for any
anecdotal information to areas of concern.
MR. VADAPALLI replied that CRP had attempted to reach out to
other organizations, although there had not been any outreach
for information. He confirmed that CRP met with the local
partners during site visits. He pointed out that CRP was trying
to recruit and increase its own membership and capacity.
4:09:37 PM
REPRESENTATIVE SEATON expressed his concern with previous OCS
problems and suggested that the public safety and protection for
children in need of aid should be aligned with the Division of
Juvenile Justice.
CHAIR HIGGINS expressed appreciation and acknowledged that OCS
and CRP had a tough job in working "to do the best we can for
our children." He declared that there would be answers to the
questions that arose.
4:12:21 PM
REPRESENTATIVE KELLER asked for clarification to an earlier
statement that the federal mandate for CRP was only for Alaska.
MR. VADAPALLI explained that there was a federal mandate for
each state to have at least one Citizen Review Panel, but that
Alaska's Citizen Review Panel was limited to the State of
Alaska.
4:13:18 PM
The committee took an at-ease from 4:13 p.m. to 4:16 p.m.
^Presentation: Key Coalition
Presentation: Key Coalition
4:16:54 PM
CHAIR HIGGINS announced that the final order of business would
be a presentation by the Key Coalition of Alaska.
MILLIE RYAN, Executive Director, REACH, Inc., reported that
REACH provided service in northern Southeast Alaska to more than
400 individuals with disabilities. She shared that she was also
the secretary for the Key Coalition. She described the Key
Campaign as an annual event which brought together individuals
with developmental disabilities, family members, service
providers, and other advocates to talk with legislators and the
administration about issues impacting them. She gave a brief
overview of developmental disabilities, as well as the home and
community based services available. She defined developmental
disability as a severe lifelong disability occurring before the
age of 22. She explained that developmental disabilities
included intellectual disability, cerebral palsy, epilepsy,
autism, and others which resulted in substantial limitations to
three of the seven major life areas: mobility, self-care,
receptive and expressive language, capacity for independent
living, economic self-sufficiency, and self-direction. This all
required that individuals receive a combination of services
which would change according to their needs. She reported that
home and community based services helped individuals with
developmental disabilities to live successfully at home and stay
in their local communities, either with families or on their
own. She explained that the services were individualized to
each person's needs, and, as they changed over time, it allowed
people to live to their full potential, and become contributing,
productive members of the community. She directed attention to
the Complex Behavior Collaborative (CBC) and its success for
keeping people with intensive behavioral needs living in Alaska.
4:19:57 PM
RHODA WALKER reported that she and her husband were the
grandparents of a severely autistic, non-communicative 15 year
old young man. She shared that she had been the subject of his
rage attacks until one year prior. She declared that the CBC
had directed them to a behaviorist, who had worked with her
grandson, as well as her and her husband, the school, and the
care givers. She established that there was now a behavior plan
that was extremely successful. She affirmed that her grandson
had now graduated from the behavior list, and the rage attacks
were less often. She observed that a year prior, the only
future she envisioned for him was in an institution, but that
the CBC program had given her grandson a life and a future.
4:21:53 PM
REPRESENTATIVE TARR asked for more detail about the behaviorist
services and its frequencies.
MS. WALKER replied that initially the rage attacks had been
daily and very violent. She explained that the behaviorist met
with her grandson daily, and offered specific suggestions for
him. She shared that the initial response by her grandson had
been for worse behavior, as the program was drastically changing
his life. As her grandson became settled with the program, the
behaviorist came less frequently, although she was always
available for telephone contact.
CHAIR HIGGINS asked how many behavior specialists were
available.
MS. RYAN explained that the CBC had "a stable of experts, that
are located some in-state, and some out-of-state." The CBC
would determine which expert was available, and who would best
fit with a specific individual. The expert would then come to
the community and work with the family and the service provider
to develop the best program.
MS. RYAN stated that the next item for discussion was with
regard to employment for people with disabilities, and she
referred to proposed HB 211, which was "an employment first
bill, that the outcome of publicly funded services for youth and
adults with disabilities is employment."
4:25:36 PM
ERIC YANUSZ, Intern, Project SEARCH, Matanuska-Susitna Regional
Medical Center, described his projects and his responsibilities.
He shared that he had worked in day surgery and food service as
an intern, and that he now wanted to find a paid job, instead of
volunteering. He explained that he had been on the wait list
[for services] since 2002.
4:27:03 PM
LUANN YANUSZ confirmed that she was Eric's mother. She affirmed
that, as a parent, you wanted your child to be independent and
able to support themselves, while having a healthy and happy
life. She shared that children with a disability needed other
kinds of support to attain this happy and healthy life. She
noted that a parent was not sure of what to expect, or how far
their child could go. She reported that the skills learned in
Project SEARCH included following directions, work ethic,
employer expectations for daily attendance and good appearance,
communication, the chain of command, and initiative. She
conveyed that her son had brought those skills back to their
home, as well. She expressed her hope that Eric, as he would
soon be 21 years-of-age, would now be able to transition
directly to a job, to become more independent, to decrease his
reliance on public benefits, and to increase his self-esteem and
self-worth. She mentioned that Eric was reliant on routine, and
that structure was important. She expressed her desire that he
transition directly into a job, in order to keep the motivation,
and she stated her hope for his long, successful work experience
in Alaska. She asked for support to decrease the wait list for
services, as the recipients would continue to need supported
living. She noted that Eric would need job coaches and
supported employment until he learned the routine. She
expressed her desire that he be included with his peers in the
work force, with compensation at the level of his peers. She
added that Project SEARCH had a very good success rate.
4:31:34 PM
REPRESENTATIVE TARR noted that there were 652 individuals and
families still on the wait list [for services]. She opined that
the goal would be an end to the list in a few more years, and
she asked for clarification that the family had been on the wait
list since 2002.
MR. YANUSZ declared that he still wanted to get off the list.
MS. YANUSZ, in response to Representative Tarr, said that Eric's
respite was supported with grants from Mat-Su Services for
Children and Adults. She established that her family was not
yet in a critical need situation, as Eric was not homeless and
had not become a parent, things that put you higher on the wait
list. She reported that, as Eric graduated into the work world,
the waiver was necessary to continue the services that they had
sought out for him.
CHAIR HIGGINS declared that everyone was excited for Eric and
his first paycheck.
4:33:29 PM
MS. RYAN, in response to Representative Tarr, expressed her
agreement with the numbers on the wait list, which she declared
was now lower since the Governor's Council on Disabilities and
Special Education first convened in 2006. She pointed out some
problems with the old system, and noted that the legislature had
allocated $2 million of state and federal funds to "jump start
the recommendations." She reported that the Division of Senior
and Disabilities Services had, since 2007, routinely drawn 200
people each year, based on need. She allowed that this current
system was again being reviewed for its effectiveness. She
reported that, although progress had been made for lowering the
wait list numbers, there were always new people being added to
that list.
4:35:13 PM
ART DELAUNE shared that he had two sons with Fetal Alcohol
Spectrum Disorder (FASD) and developmental disabilities.
Referring to his youngest son, he reported that this son had
completed all his high school requirements in five years, with
the exception of the exit examinations. The desire to work and
pass these exams had spurred his son to an additional year and a
half of school, which resulted in passage of the exams. He
detailed his son's search for permanent employment, and the
resulting contact with an employment specialist, who had
suggested a sheltered work experience. His son had, instead,
returned to the Division of Vocational Rehabilitation,
Department of Labor & Workforce Development, which recommended a
new process called "Discovery," as well as "Access Alaska," for
a closer review of his skills and desires. He then entered a
work experience program at Fred Mayer, as he wanted to be a meat
cutter.
MR. DELAUNE declared that this experience had increased his
son's self-esteem. Over the last few years, his son had stated
that he was tired of people giving him things. Although his son
was now eligible for social security supplemental income
benefits, Medicaid, and other state benefits, he preferred to be
off benefits, providing for himself. He opined that, with
support, his son would be able to continue working toward self-
care. Directing attention to the Medicaid intellectual and
developmental wait lists, he declared the importance of these
services for support to those transitioning from childhood into
adulthood. He reported that there were still more than 650
families waiting for services, all of them experiencing "the
anguish, the frustration, and the overwhelming unknown, the fear
of not knowing what's gonna happen with their children." He
reported that his two sons had been on the wait list for 16
months and 13 months respectively, although they were declared
to be too high functioning to be eligible for the [Medicaid]
waiver. He stated that families had expectations for "something
to happen at the end of the tunnel," a hope that services would
become available. He emphasized that families were "in anguish
and really its problematic for them waiting that long for
services." He asked for committee support to work toward
elimination of the wait list.
4:40:03 PM
REPRESENTATIVE TARR asked about the relationship between
Medicaid waivers and private insurance for a family. She
reminded that private insurance had been expanded to include
coverage of services for autism spectrum disorder. She asked if
there were any other opportunities for similar services.
MS. RYAN replied that most long term services were not covered
by private insurance.
MR. DELAUNE expressed his agreement that many of the services
were limited to a few sessions.
CHAIR HIGGINS asked what was lacking for the fulfillment of
services to those on the wait list.
MR. DELAUNE, in response, stated that he did not understand why
eligibility was not determined before being put on the wait
list.
MS. RYAN referred to the aforementioned grants for services, for
those who did not meet the more strict requirements for waivers.
She reported that grant funding had "remained stagnant over the
years."
MR. DELAUNE expressed his agreement that his youngest son had
received grant funding, although earlier determination of
eligibility for waivers would have allowed for an earlier
pursuit of grant funds.
4:42:41 PM
MICHELLE GIRAULT, offered a retrospective for the work done in
Juneau by the Key Campaign during the last 27 years. She
recalled the earlier years when children had to leave their
homes and the State of Alaska for out of state institutions.
She reflected on the closure of the in-state institutions in the
1990s, with a focus on individuals being included in the
community. She shared that individuals were now able to live
with their families, get the services, and be included in the
schools. She declared that "kids with disabilities are part of
our Alaskan community and all of us want to have a state where
we feel like every citizen belongs and has value." She lauded
the current initiatives of the Key Campaign. Referring to the
employment first initiative, she opined that, as many people
define ourselves by our jobs, this is "how we give value to each
other and to our communities." She declared her desire that
individuals who were differently abled have the same opportunity
to feel they were contributing members. She acknowledged a need
to reduce the Medicaid budgets, and emphasized that people
working in the community were less dependent on those subsidies.
She asked for consideration that the aforementioned CBC become a
$450,000 increment of the governor's budget, in order to keep
people out of institutions, keep families intact, and create
support plans for individuals. She declared that keeping
individuals out of institutions increased the quality of life
for everyone. She expressed her desire to eliminate the wait
list for services, noting that service was much cheaper than
crisis intervention. She urged that the future of Alaska
continue to embrace those who were differently abled to live and
work in their own communities.
4:47:11 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:47 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HJR020 Ver A.pdf |
HHSS 2/11/2014 3:00:00 PM |
|
| HJR 020 SPONSOR STATEMENT.pdf |
HHSS 2/11/2014 3:00:00 PM |
|
| HJR 020 SUPPORTING DOCUMENT Legislative Research Report HJR20 2013 14-133 with footer.pdf |
HHSS 2/11/2014 3:00:00 PM |
|
| 1 Key 2014 PRIORITIES Book 2014 FINAL.pdf |
HHSS 2/11/2014 3:00:00 PM |
|
| CRP 2014 HSS Committee Presentation 02072014.pdf |
HHSS 2/11/2014 3:00:00 PM |