Legislature(2005 - 2006)SENATE FINANCE 532
02/08/2006 09:00 AM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| Alaska Mental Health Trust Authority Presentation | |
| SB233 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 233 | TELECONFERENCED | |
| + | TELECONFERENCED |
MINUTES
SENATE FINANCE COMMITTEE
February 8, 2006
9:03 a.m.
CALL TO ORDER
Co-Chair Gary Wilken convened the meeting at approximately 9:03:23
AM.
PRESENT
Senator Lyda Green, Co-Chair
Senator Gary Wilken, Co-Chair
Senator Con Bunde, Vice Chair
Senator Fred Dyson
Senator Bert Stedman
Senator Lyman Hoffman
Senator Donny Olson
Also Attending: JEFF JESSEE, Chief Executive Officer, Alaska Mental
Health Trust Authority, Department of Revenue; JOHN PUGH, Chair,
Board of Trustees, Alaska Mental Health Trust Authority; NELSON
PAGE, Trustee, Alaska Mental Health Trust Authority; DR. WILLIAM
DOOLITTLE, Trustee, Alaska Mental Health Trust Authority; JOHN
MALONE, Trustee, Alaska Mental Health Trust Authority; MARGARET
LOWE, Trustee, Alaska Mental Health Trust Authority; TOM HAWKINS,
Trustee, Alaska Mental Health Trust Authority; CHERYL FRASCA,
Director, Office of Management and Budget, Office of the Governor;
ERIC SWANSON, Director, Division of Administrative Services,
Department of Administration; SHARLEEN GRIFFIN, Director, Division
of Administrative Services, Department of Corrections; EDDY JEANS,
Director, Division of Finance, Department of Education and Early
Development; TOM LAWSON, Director, Division of Administrative
Services, Department of Fish and Game; JANET CLARKE, Assistant
Commissioner, Finance and Management Services, Department of Health
and Social Services
Attending via Teleconference: There were no teleconference
participants.
SUMMARY INFORMATION
ALASKA MENTAL HEALTH TRUST AUTHORITY PRESENTATION
The Committee heard a presentation from the Alaska Mental Health
Trust Authority in regards to its FY 07 Budget Priorities.
SB 233-APPROPRIATIONS FOR CAPITAL PROJECTS
The Committee heard overviews from the Department of
Administration, the Department of Education and Early Development,
the Department of Corrections, the Department of Fish and Game, and
the Department of Health and Social Services. The bill was held in
Committee.
9:03:46 AM
^Alaska Mental Health Trust Authority Presentation
ALASKA MENTAL HEALTH TRUST AUTHORITY
FY 07 BUDGET PRIORITIES
PRESENTATION
9:04:54 AM
JOHN PUGH, Chair, Board of Trustees, Alaska Mental Health Trust
Authority, noted that he and another Board Member, Nelson Page, had
been members of the Alaska Mental Health Trust Authority (The
Trust) Board of Trustees for eleven years. This would be their last
year on the Board.
9:05:34 AM
JEFF JESSEE, Chief Executive Officer, Alaska Mental Health Trust
Authority, Department of Revenue noted that it has been a pleasure
to work with Mr. Pugh and Mr. Page, who were two of The Trust's
original Board members. Mr. Pugh has led the effort to develop The
Trust's comprehensive plan for numerous years, and Mr. Page has
served as both the Chair of the Board and the Chair of the Board's
Finance Committee. The state of The Trust today could be credited
to their participation, and their input would be missed.
Mr. Pugh's and Mr. Nelson's contribution to the Board was
acknowledged by applause from the Committee and other attendees.
9:06:25 AM
Mr. Pugh introduced the other members of the Board of Trustees in
attendance: Nelson Page, Dr. William Doolittle, Tom Hawkins, John
Malone who was another original member of the Board, and recent
Board appointee Margaret Lowe. Due to a commitment made prior to
her recent appointment to the Board, Laraine Derr was unable to
attend today's meeting.
9:07:05 AM
Mr. Pugh noted that a handout titled "Alaska Mental Health Trust
Authority Senate Finance FY 07 Budget Priorities" [copy on file]
would accompany today's presentation.
Page 2
TRUST FY 07
Trust Distributable Income
Land Office Income $2,600,000
Trust Fund Payout 4.00%
(up from 3.75%) $16,028,605
Prior Year Lapse $ 1,500,000
Interest $ 923,750
Total Trust Projected $21,052,355
Expenditure Recommendations $12,854,400 Operating
$ 2,250,000 Capital
$ 5,581,000 Direct Grants
Total Recommendations $20,685,400
Mr. Pugh informed the Committee that The Trust is performing its
judiciary responsibilities "very well", as attested by the
information depicted on page two of the handout. The Land Office,
managed by Wendy Wolf, has continued to perform well and is
projected to generate $2,600,000 in FY 07. The Trust recently
increased its payout from 3.75 percent to four percent based on a
determination that this level would be sustainable. The four
percent payout would provide $16 million. Lapsed funds from
programs The Trust had granted but which had not transpired would
provide $1,500,000. $923,750 in interest income from a Trust fund
within the Department of Revenue would also contribute to the total
FY 07 expenditure of $21,052,355.
Mr. Pugh reviewed the recommendation to expend $20,685,400. The
amount provided in Direct Grants would continue its recent years
growth trend. Increased capital partnerships with entities such as
the Denali Commission and the Rasmuson Foundation as well as
operating partnerships with entities such as Native Corporations
would continue. Such funds are provided directly from The Trust to
the organization.
9:08:32 AM
Co-Chair Green assumed Chair of the Committee.
9:08:48 AM
Mr. Pugh reiterated that The Trust is healthy and would continue to
grow. The FY 07 Expenditure Recommendations would be the largest in
the approximate ten-year history of The Trust.
9:09:44 AM
Page 3
FOUR FOCUS AREAS
· Bring the Kids Home
· Affordable, Appropriate Housing
· Justice for Persons with Disabilities
· Trust Beneficiary Group Initiatives
Mr. Pugh stated that The Trust would continue to focus on the Four
Focus Areas identified on page two of the handout.
Mr. Pugh communicated that, in cooperation with the Department of
Health and Social Services, an effort was undertaken to identify
the "major areas" that Trust funds could support. The objective was
to develop initiatives that would make a difference in providing
and delivering services to the beneficiaries of The Trust. The four
areas depicted on page three were identified as focus areas. One of
the resulting efforts has been labeled "Bring or Keep The Kids
Home." The goals of the Bring the Kids Home (BTKH) effort would
include allowing children and youth who might need psychiatric
treatment to remain in the State and receive treatment. The
Department of Health and Social Services has developed a handout
titled "Bringing and Keeping the Kids Home" [copy on file].
Mr. Pugh stated that another issue of importance to both The Trust
and the State in general is affordable and appropriate housing. The
objective of the Justice for Persons with Disabilities issue would
be to provide "more appropriate" and "front-end" services such as
the Anchorage and Palmer Therapeutic Courts. Instead of being
incarcerated by the Department of Corrections, people who are
developmentally disabled or have mental disorders or are chronic
alcoholics could be served through these Courts.
Mr. Pugh stated that the Trust Beneficiary Group Initiative effort
is being achieved through The Trust's grant process. As a result,
"peer to peer services" are being offered to consumers and their
families in communities throughout the State.
Mr. Pugh shared that, while the BTKH program would be the primary
focus of today's presentation, the discussion would include the
other focus areas.
9:12:11 AM
Page 4
Guiding Direction for Trust Program Investment
· Focused on results.
· Investing in policies, programs, services that make a
difference.
· Example in Justice Focus Area:
- Therapeutic Courts
o Apply sound scientific principles of behavior
change - effective use of incentives and sanctions,
with treatment and other new technologies.
o Effectively coordinates the persuasive and coercive
power of the court with essential treatment and
supports and oversight of treatment and behavioral
compliance.
o Results measured in reduction in recidivism rates.
Mr. Jessee stressed that The Trust and its programs would endeavor
to deliver benefits to Trust beneficiaries. The Trust would invest
in practices that would achieve results by acquiring data and
holding itself accountable. Policies "that catalyze some kind of
change in how we deliver" or develop services would be furthered in
order to improve efficiencies and the effectiveness of The Trust's
programs. "Every dollar that is not used as effectively as it could
be is a dollar not doing what it needs to be doing for the
beneficiaries." The Therapeutic Court is an example of a program
that has been developed in the Justice Focus Area. The objectives
of The Trust are depicted in the language pertaining to the
Therapeutic Courts.
9:13:55 AM
Mr. Jessee reminded the Committee that two years prior, Governor
Frank Murkowski had appointed a council to address the homeless
issue in the State. That council developed a handout titled
"Keeping Alaskans Out of the Cold" which is depicted on page five.
Two steering committees have been formed to address the
homelessness issue. The first is a committee spearheaded by Dan
Fauske, the Executive Director of the Alaska Housing Finance
Corporation (AHFC). That committee would review the inventory of
"affordable housing" in the State and endeavor to determine how
"existing tools" might be utilized to increase the State's
inventory of affordable housing. The second committee would be
responsible for developing "a framework for a housing trust" for
the State.
Mr. Jessee stated the basic problem with the State's affordable
housing efforts is that "at the same time that we are creating
affordable housing units, we are losing affordable housing units".
Many existing housing assistance programs assist low-income
individuals "to afford unaffordable housing, but when they are able
to increase their economic independence and no longer need that
subsidy, the housing remains unaffordable". Other housing
development programs such as tax credit programs "only require that
the housing stock be maintained in an affordable status" for a
certain length of time. At the end of that time period, the
developer could increase the property to fair market value. Thus,
while funding is being invested to provide more affordable housing,
previous housing provided in that manner is being lost. "Many
states have used housing trusts and community land trusts as an
effective way of creating a permanent affordable housing
inventory." Thus the working group would attempt "to conceptualize"
how a housing trust might be developed in this State. "This would
be a major advance in terms of addressing some of the housing needs
in the State."
9:16:22 AM
Mr. Jessee stated that page six of the presentation focuses on the
need to address dental coverage. The Senate Finance Committee is in
possession of SB 79-MEDICAID FOR ADULT DENTAL SERVICES and the
Governor has requested that the Committee schedule a hearing on the
bill. The Trust "is very supportive" of the bill. He acknowledged
the concern about the costs of the Medicaid program; however, noted
that The Trust views this legislation as "an important strategic
investment" on the part of the State. Currently the federal
Medicaid program is limited to "palative care and antibiotic care"
treatment in an emergency room, and because it does not address
"the underlying problem, it's the most expensive way to deal with
the crisis that people have".
Mr. Jessee shared that the Trustees became aware of this issue
several years earlier when mini-grants of up to $3,000 were awarded
to individual beneficiaries. It was found that in some cases, up to
80-percent of that money was used for dental care.
9:17:31 AM
Mr. Jessee stated that the fact that people spent that money in
that manner could be indicative of how dental health is affecting
people's lives. It is also "an employment issue". The Division of
Vocational Rehabilitation, Department of Labor and Workforce
Development, has spent "a substantial" amount of general fund money
"on dental care in order to get people to a point where they are
able to work and are employable". This would be a good investment.
The fact that a high percentage of Alaska Natives would be
recipients of this care would allow a significant portion of the
expense to qualify for federal reimbursement. Therefore, only $3.8
million of the $11.5 million specified in the bill's fiscal note
would be general fund money.
Page 7
Bring the Kids Home (BTKH)
FY 06 - FY 12
Trust, DHSS, & Tribal Collaboration
· BTKH model provided by DHSS expertise
· Trust Work Group formed (meets quarterly):
- Established 7 indicators of progress
- 20 stakeholders: tribal reps (40% AK Native), family,
providers
- Reviews progress of 4 subcommittees:
Care Coordination
Home & Community-based services
Work force development
Data
Mr. Jessee reminded the Committee that approximately 400 kids are
being housed out of State in residential psychiatric treatment
programs due to the lack of continuum care services within the
State. Not all of these kids require that level of care; however,
when they reached a point at which they could no longer remain at
home, no other in-State care facility was available.
Mr. Jessee stated that a work group consisting of 20 stakeholders
has been created. A significant number of the stakeholders are
Tribal organizations, as 40 percent of the kids that are sent
outside of the State are Alaska Natives. "It is critical that the
Tribal entities be totally engaged in developing the continuum of
care for these kids across the State." More than $40 million is
spent annually on out of State facilities. The Trust believes that
money could be brought back to Alaska, to provide services for
these kids, and create jobs to assist them in communities
throughout the State.
Page 8
Seven Indicators of Progress
· Indicator 1: Client Shift - A reduction in the total
number of SED children/ youth placed out of state by 90
percent by SFY 12 (15 percent per year)
· Indicator 2: Funding Shift - Ninety percent reduction in
Medicaid/General Fund match dollars from out-of-state
services to SED children/youth with a corresponding
increase in Medicaid/General Fund match dollars for in-
state services by SFY 12. (15 percent per year)
· Indicator 3: Length of Stay - Reduction in the average
length of stay for in-state and out-of-state residential
institutions by 50 percent by SFY12. (8.3% per year)
· Indicator 4: Service Capacity - Increase in the number of
children/youth receiving home and community-based
services in communities or regions of meaningful ties by
60 percent by SFY 12. (10 percent per year)
· Indicator 5: Recidivism - Decrease in the number of
children/youth returning to residential care by 75% by
SFY 12. Defined as children/youth returning within one
year to the same or higher level of residential care.
(12.5% per year)
· Indicator 6: Client Satisfaction - Via annual reporting,
85 percent of children and families report satisfaction
with services rendered.
· Indicator 7: Client Improvement - 85% of children and
youth show functional improvement in one or more life
domain areas at discharge and one year after discharge.
Mr. Jessee noted that efforts in regards to keeping kids in the
State have involved either "throwing" resources at the effort or
conducting it in an uncoordinated manner. In addition, insufficient
feedback mechanisms had been implemented through which to determine
whether the intended progress was being made. These factors
necessitated identifying "the seven indicators of process" depicted
on page eight. "This is the dashboard; the dials and gauges that
will be watched" during both the development of the program and to
monitor the program after it is established. Problematic areas
could be identified and addressed through this approach. The
measurements of performance would be at "the core" of the project.
Mr. Jessee stated that even though the BTKH project has not yet
begun, there has been "a turn" in the trend of sending clients to
out-of-state facilities, as reflected in the Indicator 1: Client
Shift chart on page 9. The reduction in the placement of kids and
youth in out of state facilities is the result of the State's work
group focus on how to address these issues. "There has been an
increase in the in-State non-custody service numbers." This is the
desired trend. As additional capacity is provided, the expectation
would be that most of the State's kids would remain in the State.
9:21:52 AM
Mr. Jessee noted that the Indicator 2: Funding Shift chart on page
ten would indicate that Medicaid expenditures for out-of-state
Residential Psychiatric Treatment Care (RPTC) service are leveling
out. Again, the information would indicate a reduction in out-of-
state placement costs and an increase in in-State placement costs.
Rather than saving the money that had been spent on out-of-State
services, the money must be "reinvested in an in-State continuum of
care". Absent an investment in in-State services, the State would
be unable "to sustain a reduction in out of state placements".
9:22:31 AM
Mr. Jessee noted that the chart on page eleven continues to address
the Indicator 2: Funding Shift. In terms of controlling costs, the
State has experienced the most problems in the non-custody area.
This is due to the fact that "in the past, a family working with
their doctor could send a child" who was not in State custody out
of state without the State having had any involvement. However,
"within 30 days, the parent's income's no longer deemed to that
child", and the child would become Medicaid eligible. Therefore,
the State would become responsible without having had "any
opportunity to manage that situation" or investigate what other
option, including in-State services, might have been available.
While changes in this area are occurring, a fully operational
program through which to address people going out of Alaska for
services has not been developed.
9:23:34 AM
Mr. Jessee explained that due to the [unspecified] Division's
development of a utilization review function that identifies when a
child could be moved to a lower level of care, the "Indicator 3:
Length of Stay" chart depicted on page twelve, indicates that the
length of stay for in-State RPTC treatment is decreasing. No such
system has of yet been developed through which to assess youth
undergoing out-of-State RPTC treatment. Nonetheless, the same
results would be expected once the State develops a system to
review out-of-state youth's progress. Once that assessment system
is developed, youth who benefited from the RPTC treatment could be
brought back to the State for further service.
Page 13
Strategies
· Strategy 1: Theory of change Articulate and communicate a
formal theory of change and continue ongoing
communication.
· Strategy 2: Strong family voice Develop a strong family
and youth voice in policy development, advocacy, family
education and support, and quality control/assurance and
evaluation.
· Strategy 3: Examine financing & policy issues
· Strategy 4: Performance & QA measures Ensure that strong
performance measurement /continuous quality improvement
procedures are in place.
· Strategy 5: Home & community -based services Develop a
wide range of accessible home and community-based
services that reduce the need for kids to enter
residential care and ease transition back into the
community for those in out of home care.
· Strategy 6: Work force development Build the capacity and
core competencies of in-state providers to provide
services that meet the needs of kids with severe
behavioral health disorders.
· Strategy 7: Assessment & Care Coordination Develop "gate
keeping" policies and practices and implement regional
resource committees to divert kids from psychiatric
residential care.
Mr. Jessee noted that seven strategies have been identified in the
effort to "bring the kids back home". To that point, he shared that
the development of the BTKH initiative was "the most complex and
complicated effort" he has ever participated in; surpassing his
involvement in the ten-year effort relating to the Mental Health
Lands Trust Settlement and the eight-year effort associated with
obtaining a new Alaska Psychiatric Institute (API) hospital. Each
of the seven strategies could be likened to "a major effort in and
of itself, and yet they all have to work seamlessly together in a
coordinated fashion for this initiative to succeed."
Page 14
Strategy 2: Strong family voice
FY 06 $25.0 Trust
· Managed by Alaska Mental Health Board
o Ensures youth & family member involvement in
planning
o Statewide teleconference with each Work Group
quarterly meeting
o Assists Resource Committees with
- Provider representative
- Consumer representative
Mr. Jessee read through the list of strategies and pointed out that
The Trust "realized that amazingly, at times, you can forget the
very people you're trying to help". While management might develop
"great ideas" about how to help people, oftentimes, the effort to
ask them what they would need is overlooked. Thus, Strategy 2 would
assist the effort by providing families a voice in the process.
Page 15
Strategy 3: Examine financing & policy issues
FY 06 $1,150.0 Trust in Individualized Services
o Individualized Services Assists with non-Medicaid
services to keep youth near home
o Medicaid Rate Review (BRS) will ensure reimbursement fits
each level of care appropriately (BRS - Behavioral
Rehabilitation Services)
o BRS regs change adds 54 OCS/BRS residential beds
o School-based Medicaid provides funding incentives for
early intervention services in schools
o Out of State regulations will enhance negotiations with
out of state providers on funding issues
Mr. Jessee stated that Strategy 3 would address financing and
policy issues. The review of the rates and regulations of the
Behavioral Rehabilitation Services (BRS) is "a very important part
of this initiative". Previously, "a bifurcated children's' and
adolescent mental health system was conducted by three different
entities including the Office of Children's Services (OCS),
Department of Health and Social Services and the Division of
Behavioral Health, Department of Health and Social Services. "It's
not surprising that these systems didn't work well together". Now
the OCS and the Division of Behavioral Health operations "would be
managed as one coordinated integrated service system." He credited
the OCS for their willingness to work toward that goal. OCS "is on
the hook when they have a custody kid, they've got to find a
placement, and that's why in the past they've have held on so
tightly to control over these beds." This cooperative effort would
provide "a unified management system" that would provide "better
and more appropriate services to kids" regardless of whether they
are in custody or not.
9:27:13 AM
Mr. Pugh noted that the Native corporations are also involved in
this effort. For example, Juneau Youth Services and Southeast
Regional Health Corporation have formed a joint partnership that is
"in the process of completing a 15-bed residential psychiatric
facility that will serve the Southeast region." The facility, which
should be completed in May 2006, would assist in allowing youth
from Southeast Alaska to be treated in Juneau rather than having to
be treated outside the State.
Page 16
Strategy 5: Home & Community-based Services
FY06 $1,050.0 Trust (Operating)
FY06 $350.0 Trust (Capital)
FY05 $4,150.0 Denali Commission (Capital)
· FY 06 increased in-state service capacity
- Start up operating provided for expanded capacity for
ten grantees
- Types of care: group, therapeutic foster & transitional
care homes; respite bed, etc.
- 186 additional youth to be served annually
- Available by spring 2006
- Another RFP is planned for FY 07 reaching more
providers
· Some capital dollars are available to increase service
capacity
- $674.0 Trust and Denali Commission
- $1.25 million Denali Commission
· BRS changes will assist in keeping kids in state
- Recommendations for Rate increases are currently under
review and will enhance system capacity
- Expansion of facility use to non-custody kids will
allow 54 new beds
9:27:59 AM
Mr. Jessee characterized the information on page 16 as being "the
heart and soul of the initiative" as it would address building the
home and community based capacity. The Trust would contribute both
capital and operating funds. Information about the involvement of
the Denali Commission's funding support would be forthcoming. He
also voiced being encouraged by the Department's efforts in
developing both the framework of this initiation as well as the
ten-year timeline for implementing the services of this initiative.
Page 17
Strategy 6: Workforce development
FY06 $500,0 Trust (with U of A)
FY06 $140,0 Trust (CoDI)
FY 06 $200.0 DHSS (CoDI)
· Part of a larger Trust initiative
- U of A SE offering Behavioral Health Certificate for
BTKH workers
- UAF Training Academy for continuing training
· Co-occurring Disorders Institute (CoDI)
- includes BTKH work force training
- training to BRS residential care providers
Mr. Jessee stressed that even were all the facilities available in
which to house youth currently housed out of State, there would not
be an adequate workforce to provide the necessary services,
particularly in Rural Alaska. To that point, a partnership has been
formed with the University of Alaska and other educational entities
in order to develop the required workforce.
Page 18
Strategy 7: Assessment & Care Coordination
FY 06 $132.0 Trust
FY 06 $431.5 DHSS
· Regional & Out-of-State Resource Committees
- New law asserts state "gate-keeping" function for ALL
children
- Committees will partner with local agencies to review
each youth placement to encourage in-state and
lowest level of care
· Utilization Review Staff
- To review RPTC and acute care placements, and refer to
lower levels of care
· "InterQual" Level of Care Assessment
- Ensure consistent review of each youth's situation
- Currently being piloted at two sites
Mr. Jessee characterized Strategy 7 as being the brains of the
initiative. Proper assessment must be conducted in order to manage
the care provided to youth. Absent that, control over the continuum
of care functions would be lost. Consistency of care would be
critical in the evaluation and placement of youth.
9:29:41 AM
Page 19
DHSS Certificate of Need
· CON ensures against overbuilding of highest levels of
care
· For BTKH facilities over $1 million
· Establishes formula, based on underserved population,
referral trends
· If >29 beds are proposed, CON requires campus-like
setting with secure & non0secure beds
· So far, only North Star Anchorage approved for 60 beds
with 20 secure
Mr. Jessee stated that the State's Certificate of Need (CON) "for
these adolescent facilities" is critical to this initiative.
Otherwise, if "we let the free market reign, we would have way too
many high-end most expensive in-patient psychiatric facilities.
They would drive our system for our lifetimes and beyond, and we
would never achieve a continuum of care in this State for these
kids that focused on helping them stay in their families and in
their communities ….The CON process is essential and the Department
has done an excellent job in managing that process; sometimes to
the consternation of those that would like to build large in-State
facilities."
Mr. Jessee stated that "the funding matrix" is depicted on the
"BTKH Funding FY 06 & Proposed FY 07" chart on page 20. The chart
specifies The Trust's FY 06 and FY 07 "venture capital" investment
that would be used to advance the infrastructure. State general
funds would also be invested beginning in FY 07. Some of the money
that is currently going out-of-State would be reinvested to support
in-State operations. AHFC funds would also be provided in FY 07
Mr. Jessee noted that the chart also depicts funding from the
Denali Commission. The Murkowski Administration and The Trust
approached Alaska Congressional Senator Ted Stevens and requested a
$10 million earmark for the capital component of the BTKH
initiative. Unfortunately other issues before Congress negated the
earmark. However, the Denali Commission would cooperate by
providing $5,500,000 from its health facilities base budget, which
is used to support the construction of clinics and similar
projects. That money would be used to support the capital expenses
of the BTKH program; however, it would require a 50 percent State
match. Efforts are being furthered to include a $5,500,000 capital
request in the Governor's FY 07 capital budget for this match.
Otherwise, the Trust would be required to approach service
providers, who should be concentrating on developing service
capacity rather than providing a match to the Denali Commission
funding. It should also be noted that the likelihood of other
entities being able to provide that amount of money is minimal. In
summary, he urged the Committee to seriously consider including the
matching funds in the FY 07 capital budget.
Page 21
Unduplicated Medicaid RPTC Recipients by Ethnicity
FY 03 FY04 FY05
Alaska Native 280 338 381
American Indian 14 16 18
Asian 5 12 11
Black 39 45 52
Hispanic 24 28 21
Pacific Islander 4 4 6
Unknown 54 46 44
White 432 476 469
Totals 854 965 1,002
Page 22
Percentage Medicaid RPTC Recipients by Ethnicity
FY 03 FY04 FY05
Alaska Native 33% 35% 38%
American Indian 2% 2% 2%
Asian 1% 1% 1%
Black 5% 5% 5%
Hispanic 3% 3% 2%
Pacific Islander 0% 0% 1%
Unknown 6% 5% 4%
White 51% 49% 47%
Totals 100% 100% 100%
Mr. Jessee pointed out that nearly 40 percent of the youth in out-
of-state treatment facilities are Alaska Native. This is one of the
reasons that an emphasis has been made to include tribal entities
in the workgroup process.
Mr. Jessee reviewed the recipients by gender.
9:33:49 AM
Page 24
Additional Resources
Bring the Kids Home Documents can be found on-line at the DBH
webpage at http://www.hss.state.ak.us/dbh/ under System Re-
design. Select the Bring the Kids Home Work Group and you will
find more materials to inform you about this exciting project.
- BTKH Data 2005 Update (Preliminary)
- Annual Report FY 05
Mr. Jessee noted the places that could provide further information
on the BTKH effort.
9:34:11 AM
Senator Hoffman asked whether the intent of the program would be to
bring youth back to the State or specifically back to their region.
Mr. Jessee responded "both". The optimal scenario would be to allow
youth to remain in their home. Each step away from that scenario is
one that should be made "after exhausting" the previous options. It
might not be feasible for some young individuals to remain in their
villages, but it might be possible for them to stay at a regional
hub. Other kid's needs might be "so severe" that that would not be
plausible. The emphasis would first be to keep them in their
community, then in their region, and certainly within the State.
9:35:22 AM
Senator Hoffman asked the projected timeframe in which the entirety
of the out-of-State youth could be served within the State.
Mr. Jessee emphasized that the effort would entail "keeping the
kids home" not just "bringing the kids home". Many of the youth
currently being treated out of state would be unable to benefit
from this endeavor, as they would "age out of the adolescent health
system" before the infrastructure could be developed. "One of the
weaknesses of the project" is that no comprehensive transitional
services for kids coming out of the system have been developed. The
hope is to first stem the flow of youth going outside the State for
services.
9:36:49 AM
Senator Dyson asked whether the CON process was "a material
impediment to getting more facilities" constructed in the State.
Mr. Jessee viewed that CON process as an essential piece of making
sure that "we don't cripple our system before we get started."
Simply building facilities to house the 400 kids that are being
treated outside the State would not be the answer, as other
services would be required. Many of those kids were sent out of
State because lower levels of care such as group homes, foster
homes, and in-home support were unavailable. The Department must
assess each of the out-of-state kids to determine what in-patient
services must be available by region to support them when they
return to the State. This would allow a plan to be developed that
would consider how many beds would be required and where they
should be located. This would prevent the overbuilding of in-
patient beds. Otherwise, once in-patient beds are built, that
facility would remain full. The CON process has essentially slowed
down "the over building of in-patient beds to allow the State time
to develop the lower levels of care that would make those beds
unnecessary in the long run".
Senator Dyson regarded Mr. Jessee's response as being contrary to
the needs of the State. The need is "so huge" that overbuilding
would be unlikely. To that point, he asked whether the State is
able to manage the volume of CON "requests in a timely and
professional manner".
Mr. Jessee acknowledged the process was "a little dicey at the
beginning". "The project had not progressed to the point" at which
the Department could "determine the overall inpatient need," or
ascertain "what the regional distribution need would be". That was
the reason the Commissioner at the time delayed action on the
awarding of CONs. While he is not actively involved in the process,
he understood that requests are currently being managed
appropriately.
9:40:52 AM
Co-Chair Green opined that "in the time since" legislation and its
associated resolutions were enacted, Mr. Jessee might have
developed "a bias … away from institutional care". This bias might
affect the determination as to how many beds should be built in
State. Were there justification for having 400 kids being housed
out-of-state, then there would certainly be a need to have more
than 80 beds available in-State "to even start the transition." She
believed that the process has been occurring "too slow" and that
the eventual numbers would be increasing. While the BTKH initiative
should be applauded, "the bar for number of beds is way too low."
Mr. Jessee appreciated "that sentiment" as there are a lot of kids
being treated out-of-state. Another factor that should be
considered in regards to in-patient beds is that 40 percent of the
kids housed outside are Alaska Native. In consideration of that
fact, the first step would be to allow the Native health
corporations to build the capacity to handle those Native kids.
This would provide more culturally appropriate care closer to their
home communities. This effort would be 100 percent funded by
federal Medicaid funds. Were a non-Native for-profit or non-profit
organization to build the in-patient capacity, the State would be
responsible for providing the required match for the Native kids
residing there. Then were a CON application received from a health
corporation for additional in-patient beds to serve that 40 percent
of the population that is Alaska Native, the number of beds would
exceed the need. While he understood the desire to move the process
along faster, such things should be considered.
9:43:50 AM
Senator Olson agreed that the CON issue is controversial. To that
point, he opined that the CON process might be working against the
need. Efforts are being made to not over-build beds, however, the
State has not, of yet, reached a point at which it could provide an
adequate number of beds.
Senator Olson asked how non-Medicaid eligible mental health
recipients' needs would be addressed.
9:44:42 AM
Mr. Jessee agreed that the State would require more in State in-
patient beds. The question "is how many, run by whom, and where"
would they be located. Those are the issues involved in the
management of the CON process.
9:45:05 AM
Mr. Jessee stated that as beds are built, the needs of the non-
Medicaid recipients would be met. The initial concern is to address
the needs of youth who are receiving treatment outside of Alaska.
Constructing facilities and perhaps overbuilding those facilities
without considering psychiatric needs and levels of care that would
be required would escalate costs and provide an inadequate system
of lower levels of care. When beds are provided, "kids will bubble
up into them".
9:46:06 AM
Co-Chair Green stated that the review committee should address such
concerns.
9:46:14 AM
Senator Stedman asked for clarification as to whether the 38
percent Native youth sent to out-of-State treatment centers in FY
05, as depicted in the "Percentage Medicaid RPTC Recipients by
Ethnicity" information on page 22, was the information being
referenced by Mr. Jessee's comments that 40 percent of kids who are
housed out of State are Native.
Mr. Jessee acknowledged that it was; he had rounded the 38 percent
to 40 percent.
Senator Stedman asked whether Native youth were sent outside while
White kids stayed in the State.
Mr. Jessee stated that the youth who are sent out of State are RPTC
Recipients. The information would include both in-State and out-of-
State recipients.
Senator Stedman commented therefore that the largest ethnic group
receiving RPTC is White, followed by Alaskan Native, and then
Black. To that point, he asked whether the allocation of kids sent
to outside facilities would correlate to the ethnicity percentages.
9:47:21 AM
Mr. Jessee believed that to be the case.
9:47:33 AM
Senator Dyson highlighted Mr. Jessee's comments that the first
entities that should provide facilities and treatment ought to be
regional or Native health corporations. To that point, he asked the
reason that is not currently happening, and whether the Legislature
should consider providing incentives to encourage that.
9:48:01 AM
Mr. Jessee responded that regional and Native health organizations
are slowly providing services. They have had to address several
issues such as the cost of doing business in Rural Alaska as well
as workforce issues. Regional health corporations are fairly new.
Some "have experienced significant periods of growth" and others
have experienced "financial and programmatic difficulties" in
recent years. Some operations such as South Central Foundation are
now established and are moving forward. There remain some
organizations that are still faltering. The key is to keep them
engaged in partnership with the State, specifically in regards to
providing capital dollars in areas where the development of a group
home is being considered.
Mr. Jessee stressed that doing business in Rural Alaska is quite
different than doing business in urban areas. Places such as
Anchorage have an abundance of rental properties suitable for group
homes. That is not the case in Rural areas where housing, in
general, is in short supply, and in all likelihood a group home
would have to be built. While money from the Denali Commission
would be available, the State would be required to provide a match.
In summary, continuing efforts to maintain dialogue with and
support these groups would be required. He also cautioned against
the "overbuilding of non-Native in-patient beds", as it would
undermine the "market share" of these organizations.
9:50:10 AM
Senator Dyson echoed Co-Chair Green and Senator Olson's concerns
about being "overcautious when there is a need that is just huge";
particularly in regards to kids who might be "institutionalized for
all of their childhood, far from home..." He characterized the
Trust's perspective on building in-patient beds as being " overly
cautious" and "imaginary or largely an illusionary problem." In
light of the number of youth who suffer from prenatal alcohol
poisoning and other "behavioral dysfunctions", he would welcome the
day when the number of available beds exceeded the need.
Mr. Jessee stated The Trust "would be happy to provide you with an
accelerated budget schedule to build in-State lower level capacity
at a rate much faster than currently contemplated in the plan."
More could be done were the resources more readily available.
9:51:39 AM
Page 25
Maintenance of Medicaid
Medicaid funding is critical to beneficiaries of The Trust.
- Refinanced Grants
- Waivers avoid more costly care
- Fairshare replacement
- Inflation
- Uninsured population growing
Mr. Jessee affirmed that "Medicaid is absolutely the core" of The
Trust's health system for its beneficiaries and the Bring the Kids
Home initiative. The Trust decided a few years prior to refinance
programs under the Medicaid program and now "the consequences … of
being totally dependent on the Medicaid program" are being
experienced. Medicaid is "at the heart" of The Trust's health care
system, mental health system, elder care system and numerous other
programs. The Legislature's desire to change eligibility
requirements and reduce services to offset the increase in Medicaid
programs is understandable; however, it should be understood that
"Medicaid is an economic force in this State, and it does create
quality jobs in health care and it does provide critical services
to our beneficiaries."
Page 26
FY 07 GF/MH Budget Recommendations
Not in Governors Budget
· $500.0 Capital funds for Fairbanks Detox
· $5000.0 50% match for Denali Commission
· $500.0 Flexible Long Term Care for Seniors
· $400.0 Integrated Behavioral Health Services for Older
Alaskans
· $6360.0 Developmental Disabilities Waitlist Reduction and
Base Grant Restoration
Mr. Jessee overviewed Trust projects not included in the Governor's
FY 07 budget proposal. He warned that, while proactive response to
foreseen catastrophes is often delayed, the State should not delay
in preparing to address its rapidly expanding senior citizen
population. The goal of "getting ahead of this curve" is the reason
The Trust has proposed the Flexible Long Term Care for Seniors and
the Integrated Behavioral Health Services for Older Alaskans
programs.
Mr. Jessee concluded his remarks.
9:54:46 AM
Senator Stedman commented in regards to the testimony that
oftentimes the people for whom a program is developed are sometimes
omitted from the discussion. To that point, he voiced concern about
The Trust's efforts on the sale of its timber in Southeast Alaska.
There is a "high correlation between unemployment or under
employment and lack of economic opportunity and the issues" that
the Trust addresses such as alcoholism, mental disorders, "and
other related issues such as family violence..." When timber "is
exported in the round for the benefit of" the Trust, "we lose sight
of the jobs created by added value of processing those logs". While
it might be detrimental to the harvesters of the logs, the State
might benefit were the added value to transpire. Communities would
benefit from that employment opportunity. While the Legislature
currently has "limited ability" in influencing the actions of the
Trust, he would "not hesitate …to force the issue" were any extra
flexibility provided, as the impact of the Trust's actions in
Southeast Alaska for the past "decade is intolerable. Two of three
Southeast Alaska sawmills have ceased to operate. "Family issues
and society issues" resulting from that industry's unemployment
status has created a ripple effect in affected Southeast Alaska
communities. Any "directional change" in this regard would be
appreciated. The Trust might experience "some gains on the
expenditure side" that might offset any "basis points" lost.
9:57:46 AM
Mr. Pugh responded that The Trust "is not opposed" to working with
other entities in consideration of such issues. While a "value
added" timber package had not transpired, an effort had been made
in this regard on a recent Thorne Bay timber harvest. This issue
would continue to be included in future timber sales.
Senator Stedman acknowledged that a successful value added timber
sale had recently occurred in Wrangell. It would be "good public
policy" were this issue a consideration in the future.
The presentation was CONCLUDED.
AT EASE 9:59 AM / 10:05:13 AM
SENATE BILL NO. 233
"An Act making appropriations for capital projects; and
providing for an effective date."
This was the first hearing for this bill in the Senate Finance
Committee.
CHERYL FRASCA, Director, Office of Management and Budget, Office of
the Governor, stated this bill is the vehicle through which
Governor Frank Murkowski has proposed to spend a portion of the
$1.2 billion in unanticipated FY 2006 (FY 06) State revenue.
Approximately $565,000,000, or half of that revenue, would be
separately allocated to support FY 2007 (FY 07) K-12 education. She
reminded the Committee that, in FY 2005, the Legislature had
approved funding FY 06 Education expenses with unanticipated FY 05
revenue.
Ms. Frasca continued that the Governor has also proposed to
allocate approximately $400 million, or one-third, of the FY 06
unanticipated revenue to fund the Gas Pipeline Project.
Ms. Frasca specified that this supplemental capital budget bill
would allocate ten percent, or $130 million, of the FY 06
unanticipated revenue to support transportation and deferred
maintenance expenses.
Ms. Frasca stated that, of the entirety of the aforementioned
proposals, the Administration would "view" this proposal as being
the "more traditional way" of spending FY 06 additional revenues.
She noted that "some others who cover the Legislature's
deliberations" had "characterized" this legislation in that
fashion.
Ms. Frasca pointed out that department projects are being presented
in this supplemental bill rather than being requested in the FY 07
capital budget because the funds are available in FY 06. This could
be likened to the Legislature's decision last Session to expend
unanticipated FY 05 revenue on transportation projects.
Ms. Frasca stated that of the total $130 million expenditure being
proposed in this bill, $86 million would be allocated for
Department of Transportation and Public Facilities' transportation
projects including $12 million for Seward Highway safety
improvements. Funds for enforcement activities on that Highway
would be requested separately. $44 million would be spent on
deferred maintenance to address State facilities needs.
Ms. Frasca pointed out that in years past, the Legislature exerted
substantial efforts to catalog the backlog of deferred maintenance
needs for school districts, local governments, and State
facilities. This request would be limited to addressing State
facilities needs, as the total need would exceed available funds.
Ms. Frasca noted that representatives from the departments are in
attendance and would be able to address Committee questions.
Co-Chair Green surmised that Members might continue to question the
need to address these projects with FY 06 funding. Except for the
aforementioned Legislative action the previous Session,
Supplemental Budgets have traditionally been utilized to fund
"unanticipated" expenses rather than being a mechanism through
which to spend "unanticipated revenue".
10:09:14 AM
Senator Bunde concurred with Co-Chair Green's remarks and noted
never before having experienced a supplemental capital budget bill
during his 14-years as a Legislator. To that point, he asked
whether such a budget had ever been presented.
10:09:33 AM
Ms. Frasca responded that "perhaps its a question of structure".
The supplemental bill that passed the Legislature the previous
Session included appropriations that utilized FY 05 revenues. She
noted that a project's effective date would dictate the fiscal year
in which the project would be funded. The Administration opted to
present the projects in a Supplemental bill since the effective
dates would dictate the use of "current year revenues". There was
no intent to imply that these were unanticipated needs.
Senator Bunde opined that that would "expand the definition of
supplemental a bit". From his point of view, the request must also
be accompanied by a "pretty solid justification of need" rather
than simply being requested because there was money available. "I
think we can always find an excuse to spend money; we don't always
find the needs."
10:10:53 AM
Ms. Frasca stated that, as the projects are reviewed, the needs
would become obvious; the requests are not "frivolous". The total
departments deferred maintenance needs exceeded $700,000,000; 60
percent of which were University of Alaska needs. Through the use
of a "threshold test of merit", the projects were "carved down
significantly"."
10:11:31 AM
Department of Administration
Maintenance Projects for Facilities Outside the Public
Building Fund
$3,620,000 General Funds
Reference No.: 41581
Category: General Government
Location: Statewide
Election District: Statewide
Estimated Project Dates: 03/15/2006 - 06/30/2011
Funding is necessary for continued maintenance of facilities
outside the Public Building Fund. The group of facilities
includes the Governor's House, 3rd floor of the Capitol
Building, the Dimond Courthouse, the Archives/Records Center,
the State Museum and Building Annex, and the Subport Building.
All of these facilities are located in Juneau.
On-Going Project
10:12:36 AM
ERIC SWANSON, Director, Division of Administrative Services,
Department of Administration, stated that this request would
include major projects such as the structural and foundation work
needs for the Archives and Museum Buildings and the water line
replacement project for the Dimond Courthouse. Also included were
smaller projects, such as the window replacements and generator
replacements.
Co-Chair Green communicated to Mr. Swanson that when the projects
included in this request were compared to the "outside of the
Public Building Fund" projects included in the $3.1 million FY 06
capital bill, it was found that six of the projects were
duplicates. "That's a little troublesome."
Mr. Swanson explained that the list could be characterized as a
"snapshot in time", as the priorities of the list change from year
to year. A project included last year could "drop off" the list
this year were another project's needs to escalate. Nonetheless,
the Department would review the list in order to avoid duplication.
10:14:35 AM
Co-Chair Green asked whether this could be interpreted to mean that
the funds allocated to the Department could be used "for anything";
the Department "would not be required to adhere to the list".
Mr. Swanson clarified that while the Department does endeavor to
adhere to "the overall list", the priority list would be affected
by changes in facilities circumstances. He understood that
communiqué in this regard had been provided.
Co-Chair Green acknowledged that language to that effect had been
provided. Nonetheless, she viewed the changing of priorities as
being "problematic". Therefore, she asked that notification be
provided when priorities change in order to prevent confusion about
the request.
Mr. Swanson stated that a review of the projects would be
conducted.
Public Building Fund Facilities Projects
$5,500,000 General Funds
Reference No.: 41583
Category: General Government
Location: Statewide
Election District: Statewide
Estimated Project Dates: 03/15/2006 - 06/30/2011
Funding is necessary for continued maintenance of state owned
facilities that make up the group known as Public Building
Fund Facilities. These facilities include the State Office
Building, the Alaska Office Building, the Community Building,
the Public Safety Building, and the Court Plaza Building (all
located in Juneau), the Douglas Island Building (Douglas), the
Atwood Building (Anchorage), and the Fairbanks Regional Office
Building.
On-Going Project
Mr. Swanson reviewed the facilities that would be addressed by this
request.
10:16:35 AM
Co-Chair Green requested that notification about changes in this
prioritization list also be communicated. She asked regarding the
zero funding need anticipated for FY 07, as indicated on the
project summary sheet.
Mr. Swanson stated that that information was erroneous, as the
Department has not of yet developed its FY 07 capital budget
request.
Co-Chair Green asked that the information be corrected. She assumed
that the Department's FY 07 request would amount to approximately
$3,000,000, which was the amount requested in FY 06.
Mr. Swanson communicated that the information would be updated.
10:17:38 AM
Co-Chair Wilken, observing that the Department of Administration's
deferred maintenance requests amount to $9,120,000 and the
Department of Transportation and Public Facilities' deferred
maintenance request equates to $2,000,000, commented in regards to
"the imbalance in the requests, as it was his understanding that
they each operate approximately the same number of buildings. To
that point, he requested that the departments' requests include
facility's square footage and/or number of buildings. This would
assist in clarifying the imbalance, and, in addition, might provide
evidence to support increasing funding to the Department of
Transportation and Public Facilities.
10:19:00 AM
Co-Chair Green understood therefore that Co-Chair Wilken was
suggesting that funding should be increased for the Department of
Transportation and Public Facilities.
Co-Chair Wilken responded that such decisions could be made
following the receipt of the aforementioned information.
10:19:14 AM
Senator Bunde requested that the Departments provide requests in
order of priority. He assumed that the project backup material, as
presented, is in "random order" as otherwise, it would imply that
the replacement of the rock wall around the Alaska State Museum is
a higher priority than replacing sewer lines.
Co-Chair Green asked the Department whether the list accompanying
the request was in order of priority.
10:19:59 AM
Mr. Swanson clarified that non-public building fund and public
building fund requests were presented in priority order.
Co-Chair Green understood therefore that the number one Department
of Administration priority would be the request regarding the
Alaska State Museum.
Mr. Swanson expressed that the number one priority for the Public
Building Fund was the State Office Building and the number one
priority for the non-public building fund was the State Museum
annex.
Senator Bunde puzzled over the fact that the State Museum rock wall
replacement, listed as number ten on the non-public building fund
priority list, outranked a roof replacement project.
10:21:31 AM
Department of Corrections
Deferred Maintenance, Renovation and Repair
$2,500,000 General Funds
Reference No.: 41925
Category: Public Protection
Location: Statewide
Election District: Statewide
Estimated Project Dates: 03/15/2006 - 06/30/2012
This project will provide funding for essential repair and
renovation of electrical, mechanical, roofing, walls,
fire/life safety, security, structural, food service,
pavements and site drainage systems for all correctional
facilities. This work is required to enable continued safe,
secure and efficient operation of the 24-hour incarceration
facilities.
On-Going Project
SHARLEEN GRIFFIN, Director, Division of Administrative Services,
Department of Corrections, informed the Committee that, like the
Department of Administration, the Department of Corrections' list
of deferred maintenance needs is in priority order. In addition,
the Department develops a six-year plan.
Ms. Griffin affirmed that when a project on the list experiences an
urgent need, it would be elevated on the list. An unanticipated
failure might "bump" a project on the list.
Ms. Griffin noted that the entirety of the projects included in
this request are correctional facilities ranging between 20 and 40
years of age. The pump involved in the Palmer Medium Security
facility sprinkler system repair is undersized for the sprinkler
heads and is unable to pump water for 15 minutes. The water system
repair needs at the Wildwood Correctional Center are similar to
those of Palmer. The fire alarm system at the Juneau Lemon Creek
Correctional Center is failing. The Spring Creek Correctional
Center security fence must be enhanced and the fence alarm system
must be replaced. The Highland Mountain Correctional Center is in
need of roof and wall replacement as well as asbestos abatement.
Numerous other projects are included in the Department's priority
list.
Senator Bunde noted that a list of the projects has not been
provided.
In response to a question from Co-Chair Green, Ms. Griffin
responded that the Department would provide Members a copy of both
the six-year plan and the deferred maintenance list in priority
order.
Co-Chair Green inquired to the reason for the elevated request
levels depicted on the project summary for the out years 2008 and
2009.
Ms. Griffin stated that the projections would include items on the
Department's six-year plan such as deferred maintenance needs,
repair and renovation projects, security operating systems, as well
as fire and life safety issue projects.
10:26:06 AM
Department of Education and Early Development
10:26:23 AM
Mt. Edgecumbe High School Facility and Infrastructure Repairs
and Upgrades
$500,000 General Funds
Reference No.: 41992
Category: Education
Location: Sitka
House Election District: Sitka/Wrangell/Petersburg
Estimated Project Dates: 03/16/2006 - 06/30/2007
Upgrades and repairs to facility and infrastructure.
EDDY JEANS, Director, Division of Finance, Department of Education
and Early Development, explained that this request would address a
leaking roof and asbestos abatement needs in the aging fire hall
building currently being used as a storage facility for the Mt.
Edgecumbe High School. The second project that would be addressed
would be the floor replacement in the girl's dormitory. The receipt
of the funds as requested would allow the dormitory work to be
conducted this summer when the school is not in session.
Co-Chair Green recalled that the school had been appropriated
$2,500,000 last year for school repairs and maintenance needs.
Mr. Jeans responded that the master plan developed for the school
would include "tens of millions of dollars in repairs." An
additional $2,500,000 would be requested in the FY 07 capital
budget to provide for boiler replacement and other structural
repairs.
Co-Chair Green asked for information as to how this funding would
be distributed to other areas of the State.
Mr. Jeans clarified that this funding would be dedicated to the Mt.
Edgecumbe School. The school is a State operated facility.
Senator Stedman informed the Committee that, as Mt. Edgecumbe High
School is included in his district, he had recently toured the
facility. The storage building is a metal frame building that was
constructed during World War II, and the asbestos coating the pipes
has "literally collapsed" and is laying "inches thick on the
ground." Everything in the building is ruined. Other buildings,
while not in as bad a shape, also have asbestos issues. The issues
at the storage building must be addressed.
Department of Fish and Game
10:29:15 AM
Deferred Maintenance, Renovation, Repair and Equipment
$300,000 General Funds
Reference No.: 30128
Category: Health/Human Services
Location: Statewide
Election District: Statewide
Estimated Project Dates: 03/15/2006 - 06/30/2010
This project will provide for repair, maintenance and
renovation of department facilities statewide.
On-Going Project
TOM LAWSON, Director, Division of Administrative Services,
Department of Fish and Game explained that this request would
address several of the Department's deferred maintenance issues.
The Department has facilities in more than 40 areas of the State
including offices, bunkhouses, warehouses, workshops, laboratories,
and other similar types of structures.
Mr. Lawson noted that the Department manages a "running list" of
its annual deferred maintenance needs. The FY 06 list included $3.4
million in project needs. The list is updated as projects are
completed.
10:30:24 AM
Senator Bunde requested that, rather than listing projects by
region, the Department's list be depicted in priority order.
Mr. Lawson concurred.
10:30:49 AM
Fairbanks Infrastructure Renewal and Replacement
$150,000 General Funds
Reference No. 39885
Category: Health/Human Services
Location: Fairbanks Areawide
Election District: Fairbanks Areawide
Estimated Project Dates: 03/15/2006 - 06/30/2010
Funds are requested to design and relocate the small wildlife
research laboratory in the Fairbanks office away from the
existing office space, and to remodel the existing lab space
into additional workspaces that could be used to lessen the
overcrowding in the facility.
One-Time Project
Mr. Lawson stated that this request would allow for the
construction of a separate building to house a small wildlife
research laboratory in the Fairbanks areas. The existing laboratory
is attached to a regional office building. The smells generated by
the laboratory activities permeate the office. In addition, the
current office facility is at capacity. The construction of a
separate laboratory would serve two purposes: it would negate the
concern about the smells and would allow the office space to be
expanded.
Department of Health and Social Services
10:32:29 AM
Deferred Maintenance, Renovation, Repair and Equipment
$1,100,000
$ 100,000 Federal Receipts
$1,000,000 G/F Match
Reference No.: 31862
Category: Health/Human Services
Location: Statewide
Election District: Statewide
Estimated Project Dates: 03/15/2006 - 06/30/2009
This request is for deferred maintenance projects for 29
Department maintained facilities including health centers,
youth facilities and behavioral health facilities statewide
with a combined replacement value of $158.0 million. Funds
would be used for immediate and critical renewal, repair,
replacement and equipment needs in state-owned facilities
along with selected leased facilities. This request does not
include the deferred maintenance needs for the Pioneer Homes,
or for recently constructed facilities, including the new
Alaska Psychiatric Institute (API), the Anchorage Public
Health Lab and Office of the State Medical Examiner, or the
Ketchikan, Kenai, or Nome Youth Facility.
JANET CLARKE, Assistant Commissioner, Finance and Management
Services, Department of Health and Social Services, informed the
Committee that this request would address the deferred maintenance
needs for the entirety of the Department's facilities other than
the Pioneer Homes. She alerted the Committee to the fact that the
Department would not be presenting any deferred maintenance project
requests in the FY 2007 capital budget.
Ms. Clarke noted that a list of prioritized projects is included
with the backup material for this request. In addition, a separate
handout titled "FY07 Deferred Maintenance Capital Request
Representative Photos" [copy on file] would provide photographs of
some of the specific projects included in this request. The
Department's number one and number two priority concerns, as
depicted in the handout, would be to replace obsolete building
controls in both the Fairbanks Health Center and the Ketchikan
Health Center with modern digital controls.
Ms. Clarke noted that the fourth item on the priority project would
be to cover an outdoor walkway at the McLaughlin Youth Center.
Other projects would include replacing building water system pipes,
exterior painting, outside siding replacement, and interior wall
repairs. The pictures are presented in order to reflect the
severity of the needs.
Pioneer Homes Deferred Maintenance, Renovation, Repair and
Equipment
$2,000,000 General Funds
Reference No.: 37934
Category: Housing/Social Services
Location: Statewide
Election District: Statewide
Estimated Project Dates: 03/15/2006 - 06/30/2009
This request is for deferred maintenance projects for Pioneer
Homes statewide, including immediate and critical renewal,
repair, replacement and equipment needs. The Department is
responsible for operating and maintaining the six Pioneer
Homes throughout the state. Locations include Ketchikan,
Sitka, Juneau, Anchorage, Palmer, and Fairbanks.
On-Going Project
Ms. Clarke reiterated that this request would allow for deferred
maintenance needs at the six Pioneer Homes in the State. Again,
there would be no request in the FY 07 capital budget for deferred
maintenance needs for these facilities. The back-up material
includes a prioritized listing of needs. A handout titled "FY2007
Deferred Maintenance Capital Request Pioneers' Homes -
Representative Photos" [copy on file] presents pictures of the
various Pioneer Home needs. The number one priority would be the
fire alarm and system replacement at the Fairbanks Pioneer Home.
The system is failing and replacement parts are difficult to
locate. The number four priority on the list is the Sitka Pioneer
Home, which is the oldest of the six Pioneer Homes. Heating valves
are failing and must be replaced. The number six item on the
priority list would be the lighting upgrades for the Anchorage
Pioneer Home. This is a large request. The ballasts are failing and
the associated smells and drips are creating health hazards. Other
projects would include duct cleaning at the Ketchikan Pioneer Home;
ceiling replacements at the Ketchikan Pioneer Home; and 26 bathroom
upgrades at the Fairbanks Pioneer Home. These projects are
important in order to address safety concerns, equipment failures,
senior citizen accessibility needs, or to meet building codes.
10:39:30 AM
Priority 14: Anchorage Pioneer Home Glass Replacement
(411,250)
Most of the exterior glazing panels of the original building
have lost their seal. There is now moisture in between the
panes and causes the windows to fogged up. Moisture in the
panes often incurs mold growth, which can affect indoor air
quality. This project will replace panels and weather
stripping on all exterior windows.
Ms. Clarke pointed out that the seals are failing in all of the
windows in the facility. Moisture and mold are being experienced as
a result. This is dangerous in a 24-hour senior citizen facility.
The panels must be replaced and weather stripping would be required
on all the exterior windows.
Senator Stedman stated that were this issue the result of defective
windows, a manufacturer's commercial guarantee might apply to this
project.
Ms. Clarke voiced that this would be further investigated.
10:40:19 AM
Senator Bunde appreciated having the projects listed by priority.
Continuing, he questioned the reason that the Anchorage Pioneer
Home Exterior Planter Repairs for $329,000 was ranked higher than
the Anchorage Pioneer Home Reseal Highlights request for $32,900.
Ms. Clarke replied that further information in this regard would be
provided. It could be that the planters are located on the roof,
and, as a consequence, might be creating further problems.
10:41:22 AM
Safety and Surveillance for Pioneer Homes, Juvenile Detention
Facilities, and Public Health Facilities
$898,300
$ 33,000 Fed Recpts
$150,000 G/F Match
$715,300 Gen Fund
Reference No.: AMD41456
Category: Health/Human Services
Location: Statewide
Election District: Statewide
Estimated Project Dates: 03/15/2006 - 06/30/2009
Project provides for critical security and surveillance
upgrades to Health and Social Services facilities statewide.
State Match Required
One-Time Project
Amendment
Ms. Clarke informed the Committee that there is growing concern
about the safety of residents and visitors at the Pioneer Homes.
For example, cars have been broken into. Therefore, the Department
has, for the first time, determined that such things as
surveillance cameras should be installed at the Anchorage, Palmer
and Ketchikan Pioneer Homes in order to ensure a safe environment.
Ms. Clarke continued that this request has been amended to correct
the inadvertent omission of some of the juvenile justice center
projects. The projects that would be advanced by this request would
include such things as installing a security fence at the Kenai
Peninsula Youth Facility. No fence currently exists at that
facility and issues involving facility residents are occurring.
Other projects would include the installation of a detention camera
near the entrance of the McLaughlin Youth Center as well as
electronic locks, finger print scanners, and other security
cameras. Security cameras would also be installed at the Fairbanks
and Mat-Su Juvenile Centers. A security fence would also be
installed at Mat-Su. Security enhancements would also be
implemented at the Johnson Youth Center.
Ms. Clarke stated that security projects would also be required at
the Division of Vital Statistics to insure that such things as
birth records are secure. These upgrades would be required in order
to comply with federal Homeland Security regulations. Security and
confidentially concerns would also be addressed at the Fairbanks
Health Center.
Ketchikan Pioneer Home Roof Replacement
$532,000 Gen Fund
Reference No.: 41369
Category: Health/Human Services
Location: Ketchikan
Election District: Ketchikan
Estimated Project Dates: 03/15/2006 - 06/30/2009
The Ketchikan Pioneer Home was built in 1981. The original
roof is failing in numerous areas and needs to be replaced. A
roofing consultant was hired to investigate and analyze
options for repairing the existing leaks. Based on age,
condition, and the labor that would be required to repair the
areas that are leaking, the consultant's recommendation is to
replace the roof with a new single-ply membrane system.
Replacement of the roof would involve replacing the existing
membrane with a more durable membrane and a smooth paver
surface. The greenhouse, which is on the roof, would also need
to be replaced with a new polycarbonate panel design. Funds
would be used for construction and management of the project.
Phased-Underway
Ms. Clarke referred the Committee to a Department handout titled
"SB 233 Ketchikan Pioneer Home Roof Replacement" [copy on file]
that provides pictures of the needs. A visitor to the facility
would observe there being catch-buckets scattered around the
facility due to the roof leaks. This issue must be addressed. The
fact that there is a greenhouse on the roof of the facility has
increased the cost of the project. The pictures reflect eroded
siding, fasteners that are failing, and the leaks from the
greenhouse. The project is extensive.
10:45:35 AM
Senator Stedman stated that the State would benefit by a decision
"not to hire Arizona architects" to design buildings in
rainforests. Designing buildings with atriums and placing
greenhouses on flat roofs is impractical in this climate.
Fairbanks Youth Facility Building Improvements
$500,000 Gen Fund
Reference No.: 41339
Category: Health/Human Services
Location: Fairbanks Areawide
Election District: Fairbanks Areawide
Estimated Project Dates: 03/15/2006 - 06/30/2009
This request would provide for the reconfiguration of the
Fairbanks Youth Facility to allow for maximum use of the
existing area. The reconfiguration would allow for more
useable space without increasing the square footage of the
facility.
Phased-New Project
Ms. Clarke stated that this request would change the configuration
of some portions of the interior of the Fairbanks Youth Facility,
thereby making it a more efficient facility. Approximately one-half
of a multi-purpose room would be reconfigured to allow for
additional storage space with a stairway and additional office
space.
AT EASE 10:46:44 AM / 10:46:54 AM
Co-Chair Green noted that the remainder of Department requests
would be addressed at the subsequent Committee meeting [NOTE: The
overviews of the additional projects included in this bill were
provided3 at the February 9, 2006 Committee meeting.]
ADJOURNMENT
Co-Chair Green adjourned the meeting at 10:47:24 AM.
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