Legislature(2003 - 2004)

02/26/2003 08:04 AM Senate FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                              MINUTES                                                                                         
                     SENATE FINANCE COMMITTEE                                                                                 
                         February 26, 2003                                                                                    
                              8:04 AM                                                                                         
                                                                                                                                
                                                                                                                                
TAPES                                                                                                                       
                                                                                                                                
SFC-03 # 10, Side A                                                                                                             
SFC 03 # 10, Side B                                                                                                             
                                                                                                                              
CALL TO ORDER                                                                                                               
                                                                                                                                
Co-Chair Lyda  Green convened the meeting at approximately  8:04 AM.                                                            
                                                                                                                                
PRESENT                                                                                                                     
                                                                                                                                
Senator Lyda Green, Co-Chair                                                                                                    
Senator Gary Wilken, Co-Chair                                                                                                   
Senator Lyman Hoffman                                                                                                           
Senator Robin Taylor                                                                                                            
Senator Ben Stevens                                                                                                             
                                                                                                                                
Also Attending: SENATOR  BETTYE DAVIS; SENATOR JOHNNY ELLIS; SENATOR                                                          
CON  BUNDE;   SENATOR  GEORGIANNA   LINCOLN;   SENATOR  KIM   ELTON;                                                            
REPRESENTATIVE   BILL  STOLTZE;  REPRESENTATIVE   NANCY   DAHLSTROM;                                                            
REPRESENTATIVE  CARL GATTO; Key Coalition  Members: MAUREEN  MCCLONE                                                            
from Anchorage;  WYNN LEVITT from Homer; CARY WEBB,  from Anchorage;                                                            
VIRON  WEBB,  from Anchorage;  JAMIE  POLTY  from  Anchorage;  KATHY                                                            
MARLEY from Fairbanks;  MILLIE RYAN, Executive Director,  Governor's                                                            
Council  on  Disabilities  and  Special  Education  from  Anchorage;                                                            
SHIRLEY EVANS  from Seward; CARLA  NORMAN from Seward; CAT  THOMPSON                                                            
from Seward;  DEBRA BABCOCK from Fairbanks;  JASON SCOTT  from Eagle                                                            
River                                                                                                                           
                                                                                                                                
Attending   via  Teleconference:   There   were  no  teleconference                                                           
participants.                                                                                                                   
                                                                                                                                
SUMMARY INFORMATION                                                                                                         
                                                                                                                                
The Senate Finance Committee,  joined by other members of the Senate                                                            
and the House of Representatives,  heard a presentation from the Key                                                            
Coalition Campaign.                                                                                                             
                                                                                                                                
                                                                                                                                
     Key XVI Campaign 2003 Presentation                                                                                         
                                                                                                                                
                                                                                                                                
MAUREEN MCCLONE,  Coordinator, Key  Coalition Campaign, thanked  the                                                            
Committee  for the  opportunity to  make today's  presentation.  She                                                            
noted  that  approximately  300  individuals,  who  include  family,                                                            
friends, caregivers,  and medical  professionals, were at  the State                                                            
Capitol today to present  a unified voice in support of services for                                                            
Alaskans  with   disabilities.  She   stated  that  some   of  these                                                            
participants  are  attending even  though  "they are  risking  their                                                            
personal privacy."                                                                                                              
                                                                                                                                
Ms  McClone  announced  that  the  Key  Campaign  is  presenting  to                                                            
Legislators  three recommendations.  The first  recommendation,  she                                                            
identified,  is that the  Key Coalition be  allowed to partner  with                                                            
the  State  for "a  one  hold harmless  year"  to  address  improved                                                            
services and cost  effectiveness measures for the  Medicaid program.                                                            
The  second  request,  she continued,   is for  the  Legislature  to                                                            
support the  Mental Health Trust Authority's  $625,000 general  fund                                                            
request  for the  Medicaid  Waiver  Budget  Review Unit  (BRU).  She                                                            
reminded that,  since 1994, these  Home and Community Based  Waivers                                                            
have provided  the matching  funds necessary  to attract  additional                                                            
federal monies  and have offset, by  more than 50-percent,  the cost                                                            
of  services  for  more  than  1,000  Alaskans  with  developmental                                                             
disabilities  (DD). She applauded  the 1997  closure of the  State's                                                            
Harborview  Institution,  and,  she  noted, that  since  that  time,                                                            
statistics  support  the  Coalition's  claim  that  community-based                                                             
services and  home care are more cost  effective than institutional                                                             
care, and  in addition,  allow people  to have  a better quality  of                                                            
life. She specified  that, on an annual basis, the  waiver costs the                                                            
State $68,724, as compared  to an annual cost of $117,00 for nursing                                                            
home care and  $183,000 for institutional care. She  stated that, in                                                            
addition to these  savings, funding the waiver program  would assist                                                            
the State  in reducing the  waiver program  wait list which  numbers                                                            
approximately 1,500.                                                                                                            
                                                                                                                                
Ms. McClone  stated that the third  request is that the Legislature                                                             
support  the Mental Health  Trust Authority's  request for  $625,000                                                            
for  the  Infant  Learning  Program  (IFP),  as  she  noted,  it  is                                                            
"recognized" that  early intervention improves a child's  health and                                                            
wellbeing  and assists  in  reducing long-term  costs  of care.  She                                                            
attested  that these  funds would  assist in reducing  the ILP  wait                                                            
list  that  currently   numbers  approximately  176,   and  thereby,                                                            
positively impact individual's  eligibility for pre-school programs.                                                            
She stated  that this funding would  also assist in the recruitment                                                             
and retention of qualified program staff.                                                                                       
                                                                                                                                
WYNN LEVITT, resident  of Homer, informed the Committee  that due to                                                            
being  granted a  Medicaid waiver  two  years ago,  her 25  year-old                                                            
disabled  daughter  who  has multiple  developmental  delays  and  a                                                            
complex seizure  disorder, is able  to live at home and be  involved                                                            
in the community. She shared  that the waiver allows her daughter to                                                            
benefit from 60 hours a  week of attendant personal care, which, she                                                            
shared,  also  provides  the  family reprieve  from  the  stress  of                                                            
constant  care giving.  She  noted that  her daughter's  health  has                                                            
improved,  her seizures  are less  frequent, and  that the  family's                                                            
situation  has improved. She  asked the Legislators  to support  the                                                            
continued  funding  of  these   waivers  and  to  support  other  DD                                                            
programs,  such as the Base  Grant program.  In addition, she  urged                                                            
that this funding  be provided in order to allow people  on the wait                                                            
list  to receive  assistance,  as she recalled  how  lonely and  un-                                                            
supported  life  was  prior  to  receiving  this  waiver.  She  also                                                            
attested  that training  and  recruiting of  qualified  staff is  an                                                            
important part of the process.                                                                                                  
                                                                                                                                
CARY WEBB,  Resident of  Anchorage, introduced  his wife VIRON  WEBB                                                            
and their foster  child JAMIE POLTY.  He communicated how  Jamie has                                                            
positively affected  his family's life. He also noted  that in years                                                            
prior, he had  been a student in one  of Senator Bundy's  classes at                                                            
the University, and because  of Senator Bunde's teaching, he learned                                                            
that people should use  their voice to speak to people in authority,                                                            
such as the Legislators, as their voice could make a difference.                                                                
                                                                                                                                
VIRON  WEBB shared  that nine-year  old  Jamie Polty,  their  foster                                                            
child, joined  the family four years ago, and she  noted that, while                                                            
caring for  a child with  disabilities is  a challenge, the  family,                                                            
which consists  of three  of their  own children,  loves Jamie.  She                                                            
stated that Jamie  has blossomed from the therapy  and care that the                                                            
family is able  to receive through the Medicaid waiver  program, and                                                            
that her  progress has improved  to a level  that "amazes"  even her                                                            
doctors.  She  stated  that  Jamie  and  other  DD  individuals  and                                                            
families  all benefit  from being  on the  waiver  program, and  she                                                            
declared that,  "the sky is the limit"  as far as the advances  that                                                            
might  be possible  from the  care  these individuals  receive.  She                                                            
stated  that the waiver  program  must continue  and that  providing                                                            
care to the 1,300  people on the waiting list should  be viewed with                                                            
Jamie's accomplishments in mind.                                                                                                
                                                                                                                                
KATHY MARLEY, resident  of Fairbanks, stated that she is a mother of                                                            
a 23-year old  special needs daughter,  Lisa. She shared  details of                                                            
her  daughter's  medical condition,  and  how  Lisa reaches  out  to                                                            
unbuckle or "free"  other people who are in wheelchairs.  She stated                                                            
that  she loves  Lisa for  many reasons,  one  of which  is for  her                                                            
"unique  perspective  of  the world  around  her."  Continuing,  Ms.                                                            
Marley revealed  that her daughter  is still on the Medicaid  waiver                                                            
wait-list  and, as  such,  she, the  mother, must  provide  constant                                                            
care,  and,  as a  result,  has  had  to resign  from  her  teaching                                                            
position.  She  stated  that  the  situation  has  taken  its  toll,                                                            
financially and  health-wise. She urged the Legislators  to fund the                                                            
Medicaid  waiver  and other  DD  grant  funding  in order  to  allow                                                            
individuals and families  to receive assistance and to help avoid "a                                                            
more serious fate."                                                                                                             
                                                                                                                                
Co-Chair  Wilken  noted  that  the  DD wait  list  is  comprised  of                                                            
approximately  fourteen  different  categories  of service,  and  he                                                            
asked the testifier which wait list category her daughter is in.                                                                
                                                                                                                                
Ms. Marley responded with  uncertainty as to her daughter's specific                                                            
DD category.                                                                                                                    
                                                                                                                                
Co-Chair Wilken  voiced that this  information would be appreciated                                                             
as he noted that  further understanding of how people  are placed on                                                            
the wait list would be helpful.                                                                                                 
                                                                                                                                
MILLIE RYAN, Executive  Director, Governor's Council on Disabilities                                                            
and Special  Education, from Anchorage,  explained that the  Council                                                            
"tracks  trends and  issues that  impact people  with developmental                                                             
disabilities and  their families." She stated that  "the recruitment                                                            
and retention  of direct service staff  is a major problem  not only                                                            
for the DD program," but  also for mental health and substance abuse                                                            
programs. She  stated that the caliber of staff affects  the quality                                                            
of the services,  results in health  and safety issues, and  affects                                                            
the continuity  of the program. She stated that a  survey of current                                                            
and prior workers  revealed that staffers  leave the profession  due                                                            
to low  wages, low  social status,  and the lack  of value that  the                                                            
general  population places  on the  jobs these  workers provide.  In                                                            
addition, she  stated that the situation  is acerbated by  a lack of                                                            
coaches  and mentors.  She  stated  that to  address  some of  these                                                            
issues, a media campaign  is being conducted and that a "whole life"                                                            
and leader  seminars would  be conducted  to boost these  providers'                                                            
knowledge and  self-esteem. She voiced support for  HB 10 and SB 28,                                                            
as these  pieces of  legislation  would assist  in providing  better                                                            
health coverage for these health care providers.                                                                                
                                                                                                                                
SHIRLEY  EVANS, resident  of  Seward, shared  that  her 16-year  old                                                            
daughter has multiple disabilities  and requires "help with each and                                                            
every activity."  She shared that  her daughter, Lela, has  required                                                            
numerous  brain, spinal and  other surgeries  that the family  could                                                            
not have  afforded without  the help of Medicaid.  She stated  that,                                                            
while her daughter would  require lifelong care, the Medicaid waiver                                                            
has enabled Lela  to develop self-care skills such  as communication                                                            
skills  and "hand over  hand assistance"  in setting  the table  and                                                            
preparing lunch and snacks,  and it has allowed her to remain living                                                            
with her family. She urged  the Committee to continue support of the                                                            
Medicaid   waiver   as   she   stated   that   were   her   daughter                                                            
institutionalized,  the cost of care  would be $300,000 per  year as                                                            
opposed  to the  cost of  the  $65,000 waiver  which  allows her  to                                                            
remain in  her home. She  stated that the  waiver has provided  Lela                                                            
with "opportunities to  reach her potential and contribute," and she                                                            
asserted  that, "it  is also  the most  humane,  cost effective  and                                                            
sensible  approach."  She distributed  a  copy of  her presentation                                                             
[copy on file] to the Members.                                                                                                  
                                                                                                                                
CAT THOMPSON,  Caregiver and Resident of Seward, accompanied  by her                                                            
35-year old  employer CARLA NORMAN,  spoke on behalf of Ms.  Norman,                                                            
who is  disabled as  the result  of an automobile  accident  she was                                                            
involved  in at  the age  of 21. Ms.  Thompson  communicated to  the                                                            
Legislators that  Ms. Norman had to live for ten years  in a nursing                                                            
home before  she was granted a waiver  that has allowed her  to live                                                            
in her home with the assistance  of a caregiver. She stated that Ms.                                                            
Norman has learned sign  language, participates in physical therapy,                                                            
and is  now able to  walk a few  steps and to  use her left  hand to                                                            
eat. In addition, she stated  that Ms. Norman has started a business                                                            
in which she makes dog  biscuits that are sold via local businesses.                                                            
She explained  that the profits from  the business would  be used to                                                            
purchase  a service dog.  She declared that  Ms. Norman is  truly an                                                            
amazing woman. She stated  that the saddest part of the situation is                                                            
that, were  Ms. Norman to loose her  Medicaid funding, the  services                                                            
she requires to  live in her own home would be lost,  and "she would                                                            
slide backwards" and "would  be forced to become invalid." She urged                                                            
the Legislators  to remember  Ms. Norman  when making their  funding                                                            
decisions.                                                                                                                      
                                                                                                                                
DEBRA  BABCOCK, Resident  of  Fairbanks, spoke,  as a  parent and  a                                                            
professional,  regarding  the  Infant Learning  Program  (ILP).  She                                                            
shared that  in March of 1993, she  became a foster parent  to three                                                            
brothers  whom she subsequently  adopted. She  stated that  the boys                                                            
were waitlisted for the  ILP, and, when finally accepted, the oldest                                                            
brother was  only able to  receive a few  months of assistance,  and                                                            
therefore, missed  the "window of opportunity" that  the two younger                                                            
brothers were able to receive.  Furthermore, she stated that, as the                                                            
boys,  who suffer  from Fetal Alcohol  Syndrome  (FAS), have  grown,                                                            
their qualifying for other  programs has varied. She stated that she                                                            
became an Early  Interventionist for the ILP, and  she stressed that                                                            
early intervention is extremely  important to both the child and the                                                            
family,   and  that   the  collaborative   care   provided  by   the                                                            
interventionists team is  important. She attested that qualified IFP                                                            
staff recruitment  and retention is  difficult, and she noted  that,                                                            
as a  single  parent, she  has had  to take  a job  with the  school                                                            
district because  it provides better  pay and benefits. She  pleaded                                                            
with the Legislators to  support the $625,000 request for the Infant                                                            
Learning Program.                                                                                                               
                                                                                                                                
JASON SCOTT, Resident  of Eagle River, Member of Focus  Incorporated                                                            
Service  Agency,  showed  the  Legislators  a picture  of  his  son,                                                            
Andrew, who, he shared,  began to demonstrate symptoms of disability                                                            
at the age  of seven months. He noted  that Andrew began  to receive                                                            
ILP assistance at that  time; however, he noted that the full extent                                                            
of Andrew's  disabilities became apparent  later on. He stated  that                                                            
Andrew was waitlisted for  Medicaid waiver services for seven years,                                                            
and has just  begun receiving the  waiver from the State.  He shared                                                            
the  difficulty that  the  family experienced  during  the  waitlist                                                            
time,  and  he detailed   the services  that  Andrew  is  now  being                                                            
provided.  He  stated that  at  the age  of  eleven, Andrew  is  now                                                            
experiencing  a different range of  emotional issues that  has "spun                                                            
our family  into a  fair crisis  situation," and  he noted that  the                                                            
family is realizing  "that Andrew's needs are certainly  going to be                                                            
lifelong,  they  won't  go  away,  and  that  they  would  be  ever-                                                            
changing."  He concluded that  without the  support of Medicaid  and                                                            
other services,  Andrew would not be able to live  at home. He urged                                                            
the Committee to support  the three recommendations presented by the                                                            
Key Campaign,  as he  stated, these  support systems  "must stay  in                                                            
place," as other options are unavailable.                                                                                       
                                                                                                                                
Ms. McClone  stated that  the testimony that  has been presented  is                                                            
indicative  of the  situations  faced by  people with  DD and  their                                                            
families. She stated that  approximately 1,300 people are waitlisted                                                            
for the  Medicaid Waiver  program and that  200 children are  on the                                                            
ILP waitlist.  She stated that this intervention makes  a tremendous                                                            
difference to the individuals and families being served.                                                                        
                                                                                                                                
                                                                                                                                
SFC 03 # 10, Side B 08:51 AM                                                                                                    
                                                                                                                                
                                                                                                                                
Ms. McClone  urged  the Legislators  to support  the Key  Coalitions                                                            
three requests  for the Medicaid  waiver program;  the ILP;  and for                                                            
one year of cooperative  efforts by the Key Coalition  and the State                                                            
to  address  the  issues.  She  thanked   the  Legislators  for  the                                                            
opportunity to present these recommendations.                                                                                   
                                                                                                                                
Co-Chair  Green  reiterated  Co-Chair   Wilken's  request  that  any                                                            
specific  information  the  Coalition could  supply  to Legislators                                                             
would  be   appreciated,  as  it   would  further  assist   them  in                                                            
understanding the needs of the program.                                                                                         
                                                                                                                                
Co-Chair Wilken asked whether  the Key Campaign could provide a copy                                                            
of the programs' wait list, sorted both by city and by need.                                                                    
                                                                                                                                
Ms. McClone  responded that the State  is endeavoring to  revise the                                                            
wait list format  so that the needs are more easily  identified. She                                                            
stated  that currently,  the lists  could  be sorted  by age and  by                                                            
region;  however, she  voiced  uncertainty  as to  whether the  sort                                                            
could be by city.                                                                                                               
                                                                                                                                
Co-Chair Wilken  asked whether a wait  list sort, by city,  could be                                                            
managed.                                                                                                                        
                                                                                                                                
Ms.  McClone responded  that,  in  addition to  this  being a  human                                                            
resource  issue, it might  be a  database issue  as people move  and                                                            
have changes in health status.                                                                                                  
                                                                                                                                
Co-Chair  Wilken commented  that  a wait  list, sorted  by city  and                                                            
need,  would be beneficial,  as  it would provide  Legislators  with                                                            
meaningful  information. He asserted  that the current 26-page  wait                                                            
list consists  "of numbers that don't tell you anything."   He asked                                                            
the Coalition  to assist  the State  with "breaking"  the wait  list                                                            
into meaningful information.                                                                                                    
                                                                                                                                
Ms. McClone agreed.                                                                                                             
                                                                                                                                
SENATOR GEORGIANNA  LINCOLN  stated that the  Key Campaign  has been                                                            
presenting  to  the  Legislature   for sixteen   years.  She  voiced                                                            
appreciation for their  sharing of the positive accomplishments that                                                            
have occurred,  however, she stated  that it saddens her  to realize                                                            
that the Key Coalition  must continue to come before the Legislature                                                            
and "beg  for the  services  for your  loved ones  and for  Alaska's                                                            
future." She voiced  appreciation for their efforts,  and asked that                                                            
they do not  to halt their efforts  to raise the awareness  of these                                                            
issues, across the State.                                                                                                       
                                                                                                                                
Senator Bunde  noted that  the Coalition's  desire to work  with the                                                            
Legislature to  solve these issues is heartening.  However, he noted                                                            
that the State's  budget deficit is  substantial, and that  money is                                                            
scarce. Therefore,  he asked that  Coalition members communicate  to                                                            
their  communities that,  such things  as resource  development  and                                                            
other revenues  sources would  be required  in order to provide  for                                                            
the needs of the State.                                                                                                         
                                                                                                                                
ADJOURNMENT                                                                                                                 
                                                                                                                                
Co-Chair Lyda Green adjourned the meeting at 08:58 AM                                                                           

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