02/14/2007 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SCR2 | |
| Presentation: Bring the Kids Back Home Initiative | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| * | SCR 2 | ||
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
February 14, 2007
1:37 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Thomas, Vice Chair
Senator John Cowdery
Senator Kim Elton
Senator Fred Dyson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE CONCURRENT RESOLUTION NO. 2
Relating to establishing March 2007 as brain injury awareness
month.
MOVED SCR 2 OUT OF COMMITTEE
Presentation: Bring the Kids Back Home Initiative
PREVIOUS COMMITTEE ACTION
BILL: SCR 2
SHORT TITLE: BRAIN INJURY AWARENESS MONTH: MARCH 2007
SPONSOR(s): SENATOR(s) MCGUIRE
01/24/07 (S) READ THE FIRST TIME - REFERRALS
01/24/07 (S) HES
02/14/07 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
Marit Carlson-Van Dort, staff
to Senator McGuire
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Presented SCR 2
Margaret Lowe
Alaska Mental Health Trust Authority
3745 Community Park Loop, Suite 200
Anchorage AK 99508
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Debbie Keith
No address provided
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Shell Purdy
No address provided
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Cindy Anderson, Director
Secondary Special Education
Anchorage School District
Anchorage AK
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Fred Kopacz, Director
Planning and Grants
Southcentral Foundation
No address provided
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Carol Greenough, Planner
Department of Health & Social Services
Juneau AK
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Renee Cook
Kiana, AK
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Jackie Johnson
Kiana, AK
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Alex Noon
Anchorage, AK
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Jeff Jesse, Chief Executive Officer
Alaska Mental Health Trust Authority (AMHTA)
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
Bill Hogan, Deputy Commissioner
Department of Health & Social Services
Anchorage AK
POSITION STATEMENT: Participated in overview of the Bring the
Kids Back Home Initiative
ACTION NARRATIVE
CHAIR BETTYE DAVIS called the Senate Health, Education and
Social Services Standing Committee meeting to order at 1:37:00
PM. Present at the call to order were Senators Thomas, Dyson,
Elton, Cowdery, and Chair Davis.
SCR 2-BRAIN INJURY AWARENESS MONTH: MARCH 2007
CHAIR DAVIS announced SCR 2 to be up for consideration.
MARIT CARLSON-VAN DORT, staff to Senator Lesil McGuire, Sponsor
of SCR 2, explained that SCR 2 would make March 2007 Brain
Injury Awareness Month. Alaska has the highest incidence of
Traumatic Brain Injuries (TBI) in the nation; over 800 are
reported annually and 12,000 Alaskans are living with such
injuries. Permanent disabilities can often result. The Brain
Injury Association of America (BRIA) annually recognizes March
as Brain Injury Awareness month.
1:39:33 PM
SENATOR DYSON asked about the difference between traumatic and
non-traumatic brain injuries, and where prenatal alcohol
poisoning fits.
MS. CARLSON-VAN DORT said that she did not know how the BRIA
differentiates between the two.
SENATOR DYSON said that non-traumatic brain injuries such as FAS
can still have a profound effect on people.
1:40:58 PM
SENATOR THOMAS asked for statistics on the age groups in which
TBIs occur, and the types of brain injuries included in the
definition.
MS. CARLSON-VAN DORT said that many brain injuries happen
rurally, more frequently among Alaska Natives and males aged 18-
24. TBIs are often the result of motor vehicle accidents.
1:42:18 PM
SENATOR ELTON moved to pass SCR 2 from committee and asked for
unanimous consent. There being no objection, the motion carried.
^PRESENTATION: BRING THE KIDS BACK HOME INITIATIVE
1:42:52 PM
MARGARET LOWE, Trustee for the Alaska Mental Health Trust
Authority (AMHTA), said that in recent years hundreds of Alaskan
children have been sent to the contiguous United States for
residential psychiatric treatment. Years ago Alaska was selected
as having the best comprehensive youth mental health services in
the US, but increasing population and heightened case evaluation
have led to a lack of facilities in Alaska. The cost of sending
children outside Alaska is great, fiscally and emotionally.
Ideally children would be serviced as close to home as possible,
where families could visit.
1:46:56 PM
MS. LOWE introduced Debbie Keith, Shell Purdy, Cindy Anderson,
and Fred Kopacz, Director of Planning and Grants for the
Southcentral Foundation.
DEBBIE KEITH, representing herself, related a personal story
about her son, who was sent outside Alaska for residential
treatment. He would have been more successful in school and his
personal life if he would have had treatment closer to home.
1:50:03 PM
SHELL PURDY, representing herself, related a personal story
about her experience in Alaskan and out-of-state youth treatment
facilities. She said that consistency of provider and care and
family support are important for effective treatment, as well as
community education.
1:54:18 PM
CINDY ANDERSON, Director of Secondary Special Education for the
Anchorage School District (ASD), said that the ASD provides a
spectrum of services for special education youth. Out-of-state
treatment centers are often not informing the schools that the
child will be returning when their treatment has been completed,
and in some cases the children are not ready for assimilation
into the schools. Communication and consistency need to be
improved between schools and agencies, and transitional planning
must be improved.
She said that children can be treated and supported in Alaska
with the appropriate facilities. The ASD currently aids in
transitioning children into schools while still in residential
treatment, and offers vocational programs through the King
Career Center.
1:58:26 PM
MS. ANDERSON said that increased staffing is needed to improve
the student-to-staff ratio. Improved counseling services in
school, better training for staff, and set behavior plans are
all important goals. Anchorage is not necessarily close enough
to home for many children, so services must be improved across
the state.
2:00:25 PM
FRED KOPACZ, Director of Planning and Grants for the
Southcentral Foundation, said that the tribal system is finding
ways to partner with the state to aid Native children with
treatment beginning at the village level. There are 158
residential beds in Anchorage. The state has been working on a
pilot program utilizing Medicaid benefits for residential
treatment and case management, but the greatest challenge facing
effective treatment in Alaska is staff training, which is needed
for a fully functional system of care.
2:05:00 PM
CAROL GREENOUGH introduced Renee Cook, Jackie Johnson, and Alex
Noon.
2:07:41 PM
JEFF JESSE, Chief Executive Officer for the Alaska Mental Health
Trust Authority (AMHTA), said that the Bring the Kids Back Home
(BTKBH) initiative is extremely complex. In the last five years
400 youth yearly were in treatment programs outside of Alaska,
and expenditures grew 60 percent. The growth has since
stabilized and the number of youth in treatment centers is now
362. At this point more residential beds are not needed;
building family and community support and prevention is the most
important issue.
2:11:21 PM
MR. JESSE said that 40 percent of youth in out-of-state centers
are Alaska Native, and many have co-occurring disorders. All
are Medicaid eligible after 30 days from home, but the state is
often not informed that the children are leaving Alaska.
He said that the new in-state residential capacity for years
2007 to 2009 will improve. There are specialty populations, like
that of those affected with Fetal Alcohol Syndrome (FAS), which
will require specially designed programs.
2:15:55 PM
BILL HOGAN, Deputy Commissioner with the Department of Health
and Social Services (DHSS), explained that there has been a
yearly 4 percent reduction in the length of residential
placement stay and client satisfaction is between 75 and 85
percent.
2:17:07 PM
MR. JESSE explained the collaborations and general efforts made
by the BTKBH initiative, and how participation on every level is
critical to improvement.
He said that 2008 goals for the initiative are improving levels
of outpatient care, early intervention opportunities, and peer
support. Peer resources are particularly important, and the
initiative wants to partner with the legislature on funding peer
support.
2:20:32 PM
MR. HOGAN said that performance measures in all levels of
service are important to validate the initiative's efforts.
MR. JESSE referenced a slide to show progress in home and
community-based resources, and how capacity has been measured in
the state. The Denali Commission has been helpful in meeting
financial needs, but a Residential Psychiatric Treatment Center
(RPTC) certificate of need is necessary for such treatment.
He said that an area that should be addressed is transitional
housing, which helps youth leaving the care system for more
independent living.
2:25:03 PM
MR. HOGAN talked about workforce development and its current
inadequacy. He has worked with the University of Alaska to
develop a rural training academy for crisis intervention,
suicide prevention, and basic counseling, and the UA has
expanded their bachelor and master in social work programs, as
well as starting a PhD program in psychology with the
expectation that graduates will work in the community.
MR. JESSE said that the goals of the initiative will create
Alaskan jobs in the long term, and gave examples of how jobs are
currently being out-sourced.
2:27:50 PM
MR. JESSE explained that care coordination between agencies and
providers is one of the most important aspects of the health
care system. He showed a slide explaining the partnership the
initiative wishes to have with the legislature.
2:29:32 PM
CHAIR DAVIS asked how comprehensive services can be improved,
considering the current lack in communication between different
health services.
MR. HOGAN said that out-of-state providers are obligated to
inform the state, school district, and local providers when
children return to the state, but not enough notice is being
given. Providers need to work more on developing discharge
plans.
2:31:38 PM
CHAIR DAVIS asked if there is a committee or board that
discusses these problem areas on a regular basis.
MR. JESSE said there is a Care Coordination subcommittee of the
AMHTA that meets regularly to work on different issues. He
talked about out-of-state providers and how children are sent
off to different residencies.
2:33:15 PM
CHAIR DAVIS said that facilities need to be as non-restrictive
as possible considering the youth's level of need.
MR. HOGAN said that a national assessment tool is now being used
to determine the level of care needed for each patient.
MR. JESSE said that ideally the AMHTA would have begun by
improving preventative care, but more immediate action needed to
be taken.
2:35:49 PM
SENATOR ELTON asked what help is needed by school districts.
MR. HOGAN said that the youths' needs should be assessed
properly, aides are needed in classrooms, and access to therapy
and psychological services is important.
SENATOR ELTON asked if funding is readily available for these
needs.
MR. HOGAN said that the BTKBH initiative will receive some money
from HSS.
2:40:20 PM
SENATOR THOMAS asked if behavioral problems and treatment are
different regarding youth sent out-of-state.
MR. HOGAN said that many kids sent to out-of-state treatment
centers have serious psychological problems. They haven't been
able to be served in Alaska, but programs are in development to
aid them in-state.
MR. JESSE said that home and community-based services are
helpful in early intervention and problem reduction.
2:43:50 PM
SENATOR THOMAS asked if problem prevention is an educational
matter.
MR. JESSE said that community behavioral health centers address
preventative education.
2:45:13 PM
SENATOR DYSON asked what the cost of high-level out-of-state
treatment per day currently is, and what it will be in Alaska.
MR. HUGGIN replied that out-of-state residential treatment costs
approximately $280 per day, and that the same high level of care
would cost $357 per day in Alaska. As more preventative care is
implemented, fewer children will need high-level care.
MR. JESSE said that moving children in-state would be an
investment, but would pay off.
2:48:14 PM
SENATOR DYSON said that allowing private facilities to open in
Alaska would mean losing control of the treatment process, and
asked for Mr. Jesse's opinion.
MR. JESSE gave an example of poor supply-and-demand response,
and explained the negative aspects of private residential care.
2:52:24 PM
MR. HUGGIN said that a national care benchmark is needed and
will be implemented.
MR. DYSON said that Alaskan boarding schools may have been
negative in some respects, but many children profited from the
experience, and he did not want negative statements made earlier
in the meeting to stand uncorrected.
2:54:15 PM
SENATOR COWDERY mentioned an upcoming television show about
addiction that he recommended to the committee and audience.
There being no further business to come before the committee,
Chair Davis adjourned the meeting at 2:54:54 PM.
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