Legislature(2001 - 2002)

03/15/2001 07:59 AM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    ALASKA STATE LEGISLATURE                                                                                    
      SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE                                                                    
                         March 15, 2001                                                                                         
                            7:59 a.m.                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Lyda Green, Chair                                                                                                       
Senator Loren Leman, Vice Chair                                                                                                 
Senator Bettye Davis                                                                                                            
Senator Gary Wilken                                                                                                             
Senator Jerry Ward                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
OTHER MEMBERS PRESENT                                                                                                         
                                                                                                                              
Senator Kim Elton                                                                                                               
Senator Johnny Ellis                                                                                                            
Senator Reggie Joule                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
Key Campaign                                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
Mr. Carl Evertsbusch                                                                                                            
Center for Human Development                                                                                                    
University of Alaska                                                                                                            
Anchorage AK                                                                                                                    
                                                                                                                                
Lori and Tim Moore                                                                                                              
Kake AK                                                                                                                         
                                                                                                                                
Ms. Sam Bush and son, Isaac                                                                                                     
Fairbanks AK                                                                                                                    
                                                                                                                                
Mr. Rick Howard                                                                                                                 
North Pole AK                                                                                                                   
                                                                                                                                
Ms. Linda Thompson                                                                                                              
Mr. Eric Behnke                                                                                                                 
Homer AK                                                                                                                        
                                                                                                                                
Mr. Arthur Walters                                                                                                              
Seward AK                                                                                                                       
                                                                                                                                
Lisa and Jerry Wangberg                                                                                                         
Wasilla AK                                                                                                                      
                                                                                                                                
Ms. Lisa Klessens                                                                                                               
Eagle River AK                                                                                                                  
                                                                                                                                
Mr. Steve Lesko                                                                                                                 
Eagle River AK                                                                                                                  
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
TAPE 01-22, SIDE A                                                                                                            
Number 001                                                                                                                      
                                                                                                                                
CHAIRWOMAN  LYDA  GREEN  called the  Senate  Health,  Education  &                                                            
Social  Services  Committee meeting  to  order  at 7:59  a.m.  and                                                              
announced a discussion on the Key Campaign.                                                                                     
                                                                                                                                
MR.  CARL EVERTSBUSCH,  Center for  Human  Development, UAA,  said                                                              
              th                                                                                                                
this is the 14year   they have testified  at the capitol and there                                                              
has  been  much   done  to  improve  the  lives   of  people  with                                                              
developmental disabilities.  One of the most notable  of those was                                                              
the  closure of  Harborview Developmental  Center  in 1997.  "With                                                              
that  closure  came the  total  commitment  to serve  people  with                                                              
disabilities and their families in their homes and communities."                                                                
                                                                                                                                
He said  another milestone was  the adoption of  Medicaid waivers,                                                              
which currently provides  the means to serve over  700 Alaskans in                                                              
the  places they  choose. This  year,  Mr. Evertsbusch  explained,                                                              
they have reached another milestone:                                                                                            
                                                                                                                                
     Nearly 1,100 families are waiting  for the services that                                                                   
     are critical to their well-being.  Never before has this                                                                   
     number  been  so high.  More  tragic  still is  even  if                                                                   
     funding  miraculously appeared  tomorrow to serve  these                                                                   
     1,100  Alaskans,  the service  delivery  system has  the                                                                   
     capacity to  serve only 82.  This is not good  news. But                                                                   
     while  people  wait, children  become  sicker;  families                                                                   
     become  more   fragile;  aging  parents   become  older;                                                                   
     serious  problems  occur.  What   follows  is  far  more                                                                   
     expensive:  hospitalization,  out  of  home  placements,                                                                   
     incarceration;   and   more    tragically,   lives   are                                                                   
     destroyed.  We are  nearing the breaking  point. We  are                                                                   
     asking for $750,000  to begin fixing the  system that we                                                                   
     have  already built  to capacity  to  serve these  1,100                                                                   
     families.  The  promise  of  Medicaid  waivers  for  the                                                                   
     valued services [provided] around  people in their homes                                                                   
     and communities  and to put  those people in  control of                                                                   
     their  services  will  be  lost if  we  don't  make  the                                                                   
     repairs. And believe me, lives will be lost.                                                                               
                                                                                                                                
     More  bad  news is  we  hear  that $700,000  for  infant                                                                   
     learning we  have been asked  to shift from  interagency                                                                   
     receipts to general  funds and this is not  new money to                                                                   
     serve  316 infants  on the  wait  list, is  at risk  for                                                                   
     being  passed over.  Will Alaska deprive  316 babies  of                                                                   
     these critical services? The answer must be no.                                                                            
                                                                                                                                
MR. EVERTSBUSCH  also informed the committee that  another serious                                                              
matter  was  preventative  and  restorative  dental  services  for                                                              
adults with developmental disabilities.                                                                                         
                                                                                                                                
     These  services  are  currently not  covered  under  the                                                                   
     Medicaid  insurance program.  The  Key Campaign  solidly                                                                   
     backs  the Governor's  Council request  for $250,000  to                                                                   
     pilot a partnership with Alaska's  dental community that                                                                   
     will provide  affordable basic dentistry to  adults. The                                                                   
     health benefits of healthy teeth are well documented.                                                                      
                                                                                                                                
     The  Key Campaign  also  supports  SB 133,  which  would                                                                   
     assure students  receiving special education  would have                                                                   
     fair opportunity  to earn a diploma while  continuing to                                                                   
     participate  in state-wide  standards  testing. We  urge                                                                   
     that the final  version include the three  priorities of                                                                   
     the Council's recommendations.                                                                                             
                                                                                                                                
He said the Key  Campaign has total support for  universal newborn                                                              
hearing screening. This  would provide early detection  to 30 - 40                                                              
infants annually.                                                                                                               
                                                                                                                                
MS. LORI MOORE said she lived in  Kake and her special little girl                                                              
is Xandi and  is five years old  and was born with a  tumor on her                                                              
face.  At  three   months  she  developed  seizures   and  she  is                                                              
developmentally delayed.                                                                                                        
                                                                                                                                
Mr. TIM MOORE said  he wanted to speak on Xandi's  behalf and that                                                              
of  infants  who are  on  the  waiting list  for  Infant  Learning                                                              
services. They  now have seven children,  but when Xandi  was born                                                              
they could  tell she  was not  developing the  way she should  and                                                              
with no  hope or knowledge  about what  to do about  their child's                                                              
development, they  were introduced to the Infant  Learning Program                                                              
when she  was about  12 months old.  "The Infant Learning  Program                                                              
was almost like our savior when they came in."                                                                                  
                                                                                                                                
He said that  the infants on the  waiting list should not  have to                                                              
wait another  day, because  one day  to an infant  is like  a year                                                              
with  an adult  in developmental  delays.  He urged  them to  fund                                                              
additional monies to take care of  the ones who are on the waiting                                                              
list.                                                                                                                           
                                                                                                                                
Number 161                                                                                                                      
                                                                                                                                
MS. SAM BUSH said  her claim to fame was that  she is Isaac's mom.                                                              
Isaac said he is  a junior in high school and  a staff sergeant in                                                              
JROTC. He  read a prepared letter  to the committee. He  said that                                                              
math and English  were hard for him,  but he gets good  grades for                                                              
his work. The exit exam could keep  him from getting a diploma and                                                              
he supported changes so that he could.                                                                                          
                                                                                                                                
CHAIRWOMAN  GREEN said  that  they had  spent  nearly four  months                                                              
working on it and she thought he would like the changes.                                                                        
                                                                                                                                
MS. BUSH said  that Isaac has many  friends at school and  that he                                                              
is a graduate of an Infant Learning  Program in Fairbanks. When he                                                              
was born, there  were so many things wrong with his  body that she                                                              
was  told he  wouldn't be  with her  long. She  credits the  first                                                              
three years of his life with getting  him off to a good start when                                                              
Project Teach  came to  their home  once a week  for an  hour. The                                                              
time they spent with the family made  a tremendous difference. She                                                              
said she had other grown children:                                                                                              
                                                                                                                                
     …but, maternity had nothing  to do with how you handle a                                                                   
     child with  all these special  needs. If it  hadn't been                                                                   
     for that Infant  Learning Program, I don't  know what we                                                                   
     would  have done.  It obviously  got him  off to a  good                                                                   
     start. The wait list now is  obscene. It's terrible that                                                                   
     babies and  infants have to  wait until it's  almost too                                                                   
     late.  Eighteen months  of  age is  almost  too long  to                                                                   
     wait.  Three years is  even longer.  There was money  in                                                                   
     the budget last  year and somehow it didn't  get down to                                                                   
     us.   It  got   lost   because  of   the   way  it   was                                                                   
     appropriated….                                                                                                             
                                                                                                                                
Number 264                                                                                                                      
                                                                                                                                
MR. RICK  HOWARD, North  Pole, said his  son, Sydney, was  9 years                                                              
old and  was diagnosed  as autistic  at three  years old.  He said                                                              
that  they  sought  help  and found  programs,  but  they  had  no                                                              
funding. "So we're on a wait list."                                                                                             
                                                                                                                                
He said  they were  told there  is a  learning window between  the                                                              
ages  of 3 -  5 while  they were  waiting. "Well,  this window  is                                                              
being passed  and I just wonder how  much more of my  son we could                                                              
have gotten  back if  we could have  used this early  intervention                                                              
during this window time."                                                                                                       
                                                                                                                                
He concluded: "The  money is needed for these kids  and they can't                                                              
afford to wait."                                                                                                                
                                                                                                                                
CHAIRWOMAN GREEN said last year the  budget was provided and their                                                              
instructions  were  that  this  money  could  be  used  for  these                                                              
services and after  they adjourned, they heard  the money couldn't                                                              
be used for that.                                                                                                               
                                                                                                                                
MS.  LINDA THOMPSON,  Homer resident,  said that  she raised  Eric                                                              
Behnke in the bush and he is a successful  story for them to hear.                                                              
She is a  certified teacher and  always had something going  on at                                                              
home for him until they moved to  Dillingham. In 1997, when he was                                                              
20,  she got  a job  in  Copper River  and  they moved  to a  road                                                              
school, which  is where things started  to unfold for him.  He was                                                              
diagnosed with autism,  Down's syndrome, and he's  also an elected                                                              
mute   (He  will   only  talk   to  certain   people  in   certain                                                              
environments). He's  a very successful  artist and sells  works in                                                              
11 art galleries  including Washington DC and Boston.  She had the                                                              
help  of Kenny  Lake  vocational  rehab  people and  Miller  House                                                              
Developmental Disabilities people.                                                                                              
                                                                                                                                
In 1998 she  lost her job because  she was not a  tenured teacher.                                                              
She was able to  get a job in Kenai Peninsula  School District and                                                              
Homer.  Eric  needed  a  safe environment  while  she  worked  and                                                              
eventually  he was approved  for  a waiver, but  the money  didn't                                                              
come until  summer.  So she went  through an  entire year  without                                                              
help. She said it  is a lengthy process to get  a waiver and urged                                                              
them to find a way to speed it up once the money is there.                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN asked  if the delay  was from  state or  federal                                                              
overlay.                                                                                                                        
                                                                                                                                
MS. THOMPSON replied  that she didn't know, but she  did know that                                                              
the community "chipped in" and got her through this period.                                                                     
                                                                                                                                
MR.  ARTHUR WALTERS  said  he was  diagnosed  with  a moderate  to                                                              
severe  hearing loss  at the  age of  2 and  a half.  He was  also                                                              
diagnosed with a  form of juvenile diabetes. He lost  his sight at                                                              
age 19 due to  the diabetes and relies on providers  to assist him                                                              
in everyday  living. He wanted  to talk about  2 issues. He  had a                                                              
difficult transition when he became  blind and had only 12 hours a                                                              
month of  respite care  at first.  He now  has a Medicaid  waiver,                                                              
which helps  him in all  the ways he  needs to be  independent and                                                              
productive.                                                                                                                     
                                                                                                                                
He said  one day  he waited for  his provider  to take him  to the                                                              
grocery store,  but he  didn't show  up. He had  quit and  went to                                                              
work for a coffee  shop where he was paid more.  He said providers                                                              
are dedicated people who leave their  families to help people like                                                              
him. Mr.  Walters said  he waited  three days to  be taken  to the                                                              
grocery store at that time because no one was available.                                                                        
                                                                                                                                
He also said  there is not enough training. Sarah  Souders who was                                                              
with  him today  and had been  with him  for the  last six  years,                                                              
didn't  have  any  training.  He  said  that  providers  need  the                                                              
training so  that they can feel  confident that they can  handle a                                                              
client  who might  be  blind and  communication  problems too.  He                                                              
concluded: "If nothing is done today,  tomorrow will be too late."                                                              
                                                                                                                                
SENATOR  WILKEN  asked  if  care  providers  were  also  known  as                                                              
personal care attendants.                                                                                                       
                                                                                                                                
MR. WALTERS answered he thought they were.                                                                                      
                                                                                                                                
SENATOR WILKEN asked what agency provided that service.                                                                         
                                                                                                                                
MR.  WALTERS answered  from CD  Community Services  in Seward.  He                                                              
said  they have  a  hard time  recruiting,  retaining and  keeping                                                              
providers,  because  they  are  only  paid  $8  per  hour  without                                                              
benefits.                                                                                                                       
                                                                                                                                
Number 473                                                                                                                      
                                                                                                                                
MR. JERRY WANGBERG said they were from Wasilla.                                                                                 
                                                                                                                                
MS.  LISA WANGBERG  said  they appreciate  the  difficult talk  of                                                              
working on  a budget and  urged them to  take care of  people with                                                              
special needs:                                                                                                                  
                                                                                                                                
     As the late  great Martin Luther King, Jr.  said, I have                                                                   
     a dream. How  awesome it would be to be a  state that is                                                                   
     at the  forefront in its  care of all individuals,  that                                                                   
     all  individuals  can dream  of reaching  their  fullest                                                                   
     potential, not  being told they  can't or we  don't care                                                                   
     enough to try.                                                                                                             
                                                                                                                                
She supported  churches  and families rallying  around each  other                                                              
during  times of need,  but the  special needs  are issues  beyond                                                              
their  expertise. Highly  trained  individuals  with training  and                                                              
equipment need  to be available.  Parents want to learn  what they                                                              
can  do  for  their children.  The  Infant  Learning  Program  was                                                              
invaluable to them, but it needs help, she said.                                                                                
                                                                                                                                
MS. WANGBERG said that you can't  get insurance for these children                                                              
and if you  have some, there is  a big battle to get  unique needs                                                              
met. She urged them  to fund at least the $750,000  from last year                                                              
and  look at  the overwhelming  infrastructure  needs of  provider                                                              
services  to special  individuals and  families. "Communities  are                                                              
growing and  so are special  needs, but service  provider agencies                                                              
have not. They are  suffering and we will too, if  we don't find a                                                              
way to help them…."                                                                                                             
                                                                                                                                
MS. LISA  KLESSENS said  she was speaking  on behalf of  her three                                                              
children. She supported the Infant  Learning Program (ILP) and the                                                              
Medicaid  Waiver System.  Her  son, Spencer  (9)  is autistic  and                                                              
received services  from the ILP.  Because of the  early assistance                                                              
he received,  he is now  in a regular  third grade  classroom with                                                              
little assistance.                                                                                                              
                                                                                                                                
Her second son,  Chandler, is two years and is  probably autistic.                                                              
He currently  receives services from  the ILP for the  same things                                                              
as  Spencer and  they hope  he will  do as  good as  he is.  Their                                                              
daughter, Morgan,  (5 1/2  years) has  a genetic storage  disorder                                                              
and  also received  ILP  services  as early  as  five months.  She                                                              
received a  Medicaid waiver that  provided equipment  necessary to                                                              
take  care  of  her medical  needs,  in-home  support,  and  staff                                                              
support.                                                                                                                        
                                                                                                                                
Number 562                                                                                                                      
                                                                                                                                
MR. STEVE LESKO, Eagle River, said  he had been coming before them                                                              
for 14  years. He  said they had  accomplished a  lot. One  of the                                                              
things Alaska has done is close down all their institutions.                                                                    
                                                                                                                                
     Once upon a time, there was  a state institution and its                                                                   
     cost  exceeded   $125,000  per   day  per  person.   Our                                                                   
     community  programs which  are  left, the  heart of  our                                                                   
     service  delivery  service system  costs,  are far  less                                                                   
     than half  that. And then a  good thing happened  in the                                                                   
     terms of  history. Waivers came  in and waivers  took in                                                                   
     the  visuals  and  service delivery  that  captured  100                                                                   
     percent  general  funding and  got 50  percent  Medicaid                                                                   
     funding.                                                                                                                   
                                                                                                                                
Eventually the funding was a 60/40  federal/state mix. Millions of                                                              
dollars were  saved and not reinvested  in the program;  they went                                                              
other places  in the budget. He  said the stories they  have heard                                                              
today represent legitimate needs.                                                                                               
                                                                                                                                
TAPE 01-22, SIDE B                                                                                                            
                                                                                                                              
MR. LESKO said:                                                                                                                 
                                                                                                                                
     Our  community programs  are truly  in crisis. Over  the                                                                   
     past  decade, our  base  grants and  community  services                                                                   
     have received less than one  percent cost of living. How                                                                   
     do you survive cut to the bones,  trim government? We've                                                                   
     cut to the  bone in community programs and  it hurts and                                                                   
     we're  bleeding and  we're in  crisis and  we've got  to                                                                   
     have your help.                                                                                                            
                                                                                                                                
     The second thing is when we  started out Key Campaign 14                                                                   
     years ago, you worked with us  and we had a wait list of                                                                   
     125 people and we all certainly  said 125 people are too                                                                   
     many. Today,  we have about  1,100 on our  waiting list.                                                                   
     That's  a shame.  That's a  tragedy,  because if  you're                                                                   
     fiscally  conservative  and  in my  maturity,  money  is                                                                   
     important.  It  is  important  how you  spend  it.  Cost                                                                   
     effectiveness  is  in  community-based  program.  If  we                                                                   
     don't address  crisis now, people will  be incarcerated;                                                                   
     people will  be put back  in nursing homes;  people will                                                                   
     be  in our  penal system  and  on the  streets. All  I'm                                                                   
     going to  ask you today is  one part of the  budget from                                                                   
     my perspective  is in the Governor's capital  budget for                                                                   
     $750,000.  It's a C  for what  we call systems  reforms.                                                                   
     It's  under  the  title  of  developmental  disabilities                                                                   
     systems  reform  initiative….Programs  will  serve  more                                                                   
     people effectively,  with quality  and with safety,  not                                                                   
     haphazardly and not by chance.                                                                                             
                                                                                                                                
He said there needed to be systemic  reform in the Medicaid waiver                                                              
system  to streamline  billing, to  process the  preauthorizations                                                              
quicker and to  stop the community crisis in cash  flow. He begged                                                              
them to maintain the $750,000 in the Governor's capital budget.                                                                 
                                                                                                                                
MR. EVERTSBUSCH thanked the committee members for listening to                                                                  
their stories:                                                                                                                  
                                                                                                                                
     The small  amount of money we  are requesting will  go a                                                                   
     long ways towards guaranteeing  the promises of Medicaid                                                                   
     assuring  that all  Alaskans at  risk for  developmental                                                                   
     delays receive the services  they need in the early part                                                                   
     of their lives, creating a dental  care system that will                                                                   
     assure  good  dental  health for  thousands  of  Alaskan                                                                   
     adults.  We   support  the  fair  opportunity   for  all                                                                   
     students  to  receive  diplomas   upon  graduating  from                                                                   
     public  schools   and  the  establishing   of  universal                                                                   
     screening to  provide parents with the  information they                                                                   
     need to help their children  avoid unnecessary delays…We                                                                   
     believe these are modest requests…                                                                                         
                                                                                                                                
CHAIRWOMAN GREEN thanked everyone for participating and adjourned                                                               
the meeting at 8:50 a.m.                                                                                                        

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