Legislature(2003 - 2004)

03/10/2003 01:32 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE HEALTH, EDUCATION AND SOCIAL SERVICES                                                                        
                       STANDING COMMITTEE                                                                                     
                         March 10, 2003                                                                                         
                           1:32 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Senator Fred Dyson, Chair                                                                                                       
Senator Lyda Green, Vice Chair                                                                                                  
Senator Bettye Davis                                                                                                            
Senator Gretchen Guess                                                                                                          
MEMBERS ABSENT                                                                                                                
Senator Gary Wilken                                                                                                             
COMMITTEE CALENDAR                                                                                                            
HOUSE CONCURRENT RESOLUTION NO. 8                                                                                               
Requesting the Governor to declare March 16 - 22, 2003, to be                                                                   
Inhalants and Poisons Awareness Week.                                                                                           
     MOVED HCR 8 OUT OF COMMITTEE                                                                                               
SENATE BILL NO. 124                                                                                                             
"An Act relating to grants for alcoholism and drug abuse                                                                        
programs; and providing for an effective date."                                                                                 
     MOVED SB 124 OUT OF COMMITTEE                                                                                              
SENATE BILL NO. 123                                                                                                             
"An Act relating  to adoptions that include a  subsidy payment by                                                               
the state; eliminating  annual review of the subsidy  paid by the                                                               
state after adoption  of a hard-to-place child  has occurred; and                                                               
providing for an effective date."                                                                                               
     MOVED SB 123 OUT OF COMMITTEE                                                                                              
SENATE BILL NO. 55                                                                                                              
"An Act relating to tampering with public records."                                                                             
     SCHEDULED BUT NOT HEARD                                                                                                    
SENATE BILL NO. 8                                                                                                               
"An Act relating to tampering with public records."                                                                             
     SCHEDULED BUT NOT HEARD                                                                                                    
PREVIOUS ACTION                                                                                                               
HCR 8 - No previous action to record.                                                                                           
SB 123 - No previous action to record.                                                                                          
SB 124 - No previous action to record.                                                                                          
WITNESS REGISTER                                                                                                              
Representative Kapsner                                                                                                          
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT: Sponsor of HCR 8.                                                                                         
Ms. Martha Moore                                                                                                                
Department of Health &                                                                                                          
  Social Services                                                                                                               
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT: Supported HCR 8.                                                                                          
MR. Elmer Lindstrom, Special Assistant                                                                                          
Department of Health &                                                                                                          
  Social Services                                                                                                               
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT: Supported SB 124 and SB 123.                                                                              
Ms. Karen Pearson, Acting Director                                                                                              
Division of Alcoholism and Drug Abuse                                                                                           
Department of Health &                                                                                                          
  Social Services                                                                                                               
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT: Commented on SB 124.                                                                                      
Ms. Joanne Gibbens, Program Administrator                                                                                       
Division of Family and Youth Services                                                                                           
Department of Health &                                                                                                          
  Social Services                                                                                                               
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT: Commented on SB 123.                                                                                      
ACTION NARRATIVE                                                                                                              
TAPE 03-9, SIDE A                                                                                                             
          HCR  8-INHALANTS AND POISONS AWARENESS WEEK                                                                       
CHAIR FRED DYSON  called the Senate Health,  Education and Social                                                             
Services Standing  Committee meeting  to order  at 1:32  p.m. and                                                               
announced  HCR  8  to  be  up  for  consideration.  Present  were                                                               
Senators Dyson, Guess and Davis.                                                                                                
REPRESENTATIVE  KAPSNER, sponsor  of HCR  8, explained  that this                                                               
bill  asks the  governor to  recognize the  nationally recognized                                                               
inhalant,  abuse and  poisons awareness  week,  March 16-22.  She                                                               
said  that  inhalant abuse  is  not  a  new  problem, but  it  is                                                               
reaching rampant  proportions throughout  Alaska and  among youth                                                               
across the nation.  One of the frustrating  things about inhalant                                                               
abuse is  that the chemical  substances used for huffing  are not                                                               
contraband or illegal.  In fact, those substances  are useful and                                                               
needed for  the use  they are intended  for. Over  1,400 chemical                                                               
substances are commonly used as a means of getting high.                                                                        
REPRESENTATIVE  KAPSNER said  in an  informal discussion  she had                                                               
with  the Senate  president,  he  asked if  this  addiction is  a                                                               
chemical  or psychological  one. It  is both.  The high  one gets                                                               
from inhalant  abuse is very  sudden and potent and,  because the                                                               
absorption  is through  the lungs,  it goes  to the  vital organs                                                               
quicker  and penetrates  deeper than  most highs.  Inhalant abuse                                                               
affects all  of the  major organs.  A major  concern is  that the                                                               
abusers  are   very  young  and  inhalant   abuse  affects  their                                                               
reproductive organs. She concluded,  "So, this is affecting young                                                               
generations and generations to come."                                                                                           
CHAIR DYSON asked how it affects reproductive health.                                                                           
REPRESENTATIVE KAPSNER replied that  it affects the brain, liver,                                                               
lungs, and bone  marrow and there is evidence  that chronic abuse                                                               
of  some  inhalants  causes  chromosome  and  fetal  damage.  She                                                               
thought it could cause birth defects and explained:                                                                             
     A  lot of  people  who abuse  inhalants  have the  same                                                                    
     symptoms as  someone with  fetal alcohol  syndrome. The                                                                    
     way  experts can  tell the  difference between  someone                                                                    
     who is a  chronic inhalant abuser and an  FAS victim is                                                                    
     that a fetal alcohol  syndrome person doesn't have many                                                                    
     childhood  memories,  if  any,  and someone  who  is  a                                                                    
      chronic inhalant abuser has childhood memories from                                                                       
      before they started using inhalants, but afterwards                                                                       
     they have a very short-term memory.                                                                                        
1:37 p.m.                                                                                                                     
SENATOR GREEN arrived.                                                                                                          
MS.  MARTHA   MOORE,  Intervening  Surveillance   and  Prevention                                                               
Program Manager,  DHSS, supported HCR  8. She explained  that her                                                               
office tracks all hospitalized poisonings  and has found over the                                                               
years that  it is a  substantial problem with about  525 Alaskans                                                               
per  year. She  said that  compares  to about  570 motor  vehicle                                                               
crash  victims   hospitalized  every   year.  Only  14%   of  the                                                               
poisonings are accidental, the other 86% are suicidal.                                                                          
MS. MOORE  said this resolution  addresses the problem  of access                                                               
to  the poison  substances from  the time  children are  young up                                                               
through  the  teenage years.  She  said  that  a quarter  of  the                                                               
accidental poisonings happen to children under 5 years old.                                                                     
Since  2001, Alaska  has an  arrangement with  the Oregon  Poison                                                               
Center, which  fields poison calls  for Alaska. As a  result, she                                                               
has information  on calls  for Alaskan  poisonings and  has found                                                               
that children under 5 years  of age are getting into medications.                                                               
Thirty years  ago the childproof  caps made a big  difference and                                                               
accidental poisonings  went way down,  but now they  are creeping                                                               
up again. She thinks it's  because people are disabling the caps.                                                               
The center  received over  400 calls  for cosmetic  poisoning for                                                               
kids under 15 years old.                                                                                                        
She said  the neat  thing about  this system is  that 75%  of the                                                               
poison  calls that  came into  the center  were handled  over the                                                               
phone, a huge cost savings.                                                                                                     
MS.  MOORE  also  related  that   the  first  victim  of  huffing                                                               
poisoning in the hospital registry  was a seven-year old girl who                                                               
was  taught how  to do  it by  older kids.  The suicide  attempts                                                               
start  at around  10 years  old and  as children  go through  the                                                               
teenage  years,  huffing  becomes   the  predominant  reason  for                                                               
CHAIR  DYSON said  the governor  agrees with  what Representative                                                               
Kapsner is trying to do.                                                                                                        
REPRESENTATIVE KAPSNER added  that according to a  1999 survey of                                                               
eighth graders, 19.5% had used  inhalants compared to 22% who had                                                               
used marijuana or  hashish. Inhalants are often a  gateway to the                                                               
abuse of other illicit substances;  70% of one group of substance                                                               
abusers in  treatment indicated that  inhalants were  their first                                                               
drug  and 50%  of them  said  they would  go back  to huffing  or                                                               
inhaling  if  they  did  not  have  access  to  alcohol.  Because                                                               
inhalants enter the lungs in  such high concentrations, they have                                                               
a much more  formidable toxic profile than other  types of drugs.                                                               
It takes  4 to  6 weeks  to detoxify someone  before they  can go                                                               
into the treatment process.                                                                                                     
SENATOR DAVIS moved  to pass HCR 8 from committee.  There were no                                                               
objections and it was so ordered.                                                                                               
            SB 124-ALCOHOLISM AND DRUG ABUSE GRANTS                                                                         
CHAIR DYSON announced SB 124 to be up for consideration.                                                                        
MR.   ELMER   LINDSTROM,   Special  Assistant   to   Commissioner                                                               
Gilbertson,  Department of  Health  and  Social Services  (DHSS),                                                               
said SB 124 is very  straightforward. He thought these grants are                                                               
the only  ones that require  a state  match that is  specified in                                                               
statute.  Typically,  the local  match  is  25%. [SB  124]  would                                                               
actually save state  general funds with the  expectation that the                                                               
state grant  funds would be  replaced by larger  matches provided                                                               
by local communities. He said the  bill has four fiscal notes and                                                               
a spreadsheet is available that  lists all of the grants provided                                                               
by the division based on FY 03 activity.                                                                                        
CHAIR DYSON  asked which  programs are  protected from  the match                                                               
increase from 75% to 90%.                                                                                                       
MR. LINDSTROM referred the committee  to the second column of the                                                               
spreadsheet  entitled   "Notes,"  [which   lists]  a   number  of                                                               
exemptions from  the match.  They are grants  of $30,000  or less                                                               
with the  assumption that they  would have a very  difficult time                                                               
making any  local match requirement.  For the most part  they are                                                               
associated with  the community  based suicide  prevention program                                                               
($10-$17,000  grants) and  grants to  the very  small communities                                                               
throughout Alaska.  A number of items  are in the 10%  column and                                                               
those  have been  held harmless  for  the increase  in the  local                                                               
match  requirement. Those  are  programs  that provide  treatment                                                               
services for families, particularly  for women with children. The                                                               
fiscal note was predicated on those assumptions.                                                                                
MR. LINDSTROM noted  that under existing law,  the department has                                                               
the  ability to  waive the  local match  requirement and  that is                                                               
their intent - as indicated  on the spreadsheet. He thought there                                                               
would  be requests  from other  grantees  to waive  the match  in                                                               
whole or  in part. Any relief  given to another grantee  would by                                                               
definition be at the expense of  someone else and he assumed what                                                               
would happen  would be  very close  to what  is described  on the                                                               
SENATOR DAVIS  asked if he  would consider  in-kind contributions                                                               
or volunteer labor as a match to make up the 25%.                                                                               
MR. LINDSTROM  said he  didn't know for  certain, but  he thought                                                               
some types of in-kind support might be accepted.                                                                                
2:05 p.m.                                                                                                                     
MS. KAREN  PEARSON, Acting Director,  Division of  Alcoholism and                                                               
Drug  Abuse,  added that  the  in-kind  match could  probably  be                                                               
managed, but  because of the change  in the fiscal note,  it will                                                               
mean a decrease in actual dollars going to that grantee.                                                                        
SENATOR GUESS asked her how DHSS determined who would be exempt.                                                                
MR. LINDSTROM  replied that  he thought the  rule was  $30,000 or                                                               
less or  providing treatment  services to  families, particularly                                                               
women  with children.  He asked  her if  she was  referring to  a                                                               
unique situation.                                                                                                               
SENATOR  GUESS  said  the  Alaska   Military  Youth  Academy  and                                                               
Community  Prevention [grants]  were less  than $30,000  but they                                                               
still have a match. She was trying to understand that.                                                                          
MR. LINDSTROM admitted  she was correct and said he  would try to                                                               
find out why.                                                                                                                   
SENATOR GUESS added  there are a handful of such  cases and asked                                                               
why the Fairbanks Memorial Hospital was held harmless.                                                                          
MR. LINDSTROM said he didn't know, but would find out.                                                                          
SENATOR GUESS said  she wouldn't waste the  committee's time, but                                                               
would give  him a list  of her  concerns afterwards and  he could                                                               
get back  to her with information.  She asked how 25%  was chosen                                                               
and not something based on wealth in a community.                                                                               
MR. LINDSTROM replied the reason is  because that tends to be the                                                               
norm in the department.                                                                                                         
SENATOR GUESS asked how many waivers DHSS provides now with 10%.                                                                
MR.  LINDSTROM  replied  that   he  thought  the  community-based                                                               
suicide  projects have  historically been  waived from  the local                                                               
community  match.  The  ASAP  programs   have  not  had  a  match                                                               
historically, but  he thought  the grantees  had a  provision for                                                               
sliding fee  scales. He knew  that some  of them had  been fairly                                                               
aggressive in that  respect, but it hadn't been shown  as a match                                                               
requirement. Those  are the  two that  leapt out  at him  when he                                                               
reviewed the document.                                                                                                          
SENATOR GUESS asked  how many on the list  that normally received                                                               
waivers in the  past would not receive waivers  under the $30,000                                                               
MR. LINDSTROM said he would have to tabulate that for her.                                                                      
SENATOR GUESS asked how he determined the $30,000.                                                                              
MR. LINDSTROM  replied that it  was as  simple as looking  at the                                                               
total project cost  that determined whether or  not something was                                                               
greater or lesser than $30,000.                                                                                                 
SENATOR GUESS asked why DHSS picked $30,000 as a number.                                                                        
MR. LINDSTROM replied that he didn't know.                                                                                      
SENATOR GUESS  asked if it  was a  policy call by  the department                                                               
and whether  anything in regulation  or statute says there  is no                                                               
match for grants that are $30,000 or less.                                                                                      
MR. LINDSTROM  replied that is  correct, but  the community-based                                                               
suicide  prevention projects  have historically  been exempt  for                                                               
the  local match  requirement  and they  are  all under  $20,000.                                                               
There will be  an administrative process where  the division will                                                               
petition the commissioner  for approval to waive  the local match                                                               
requirement and the commissioner would make the decision.                                                                       
SENATOR GUESS  asked if that  is the current process  and whether                                                               
DHSS is changing it.                                                                                                            
MR. LINDSTROM replied DHSS is not changing the process.                                                                         
SENATOR GUESS  referred to the department's  statement that there                                                               
would be no  impact on services at the community  level and asked                                                               
whether DHSS had  done an analysis of any  decreases. She thought                                                               
local communities would have to  either raise taxes or, in places                                                               
like Anchorage with a tax cap,  choose to fund those services and                                                               
not fund something  else. She asked if DHSS had  done an estimate                                                               
of the services he thought would be impacted.                                                                                   
MR. LINDSTROM replied  that DHSS had not done so  and that she is                                                               
correct, but  it was  DHSS's belief that  by exempting  the small                                                               
grantees, the others  would have the ability to come  up with the                                                               
local match. He  based that assumption on  DHSS's experience with                                                               
other grant programs.                                                                                                           
CHAIR DYSON  noted that very  few of  the programs fall  close to                                                               
the $30,000 rule.                                                                                                               
SENATOR GUESS asked  whether the community match  funds come from                                                               
a  city or  a borough.  Basically, she  wanted to  know what  the                                                               
restrictions  are  for  the match  relating  to  Senator  Davis's                                                               
question about in-kind matches.                                                                                                 
MS. PEARSON responded that the  grantee has the responsibility to                                                               
find the  match. Grantees  sometimes get  the funds  from another                                                               
entity, but  the administrative entity  handling the cash  has to                                                               
be the grantee.                                                                                                                 
CHAIR DYSON announced an at-ease from 2:05 to 2:06 p.m.                                                                         
SENATOR GREEN moved  to pass SB 124 with  its accompanying fiscal                                                               
notes from committee with  individual recommendations. There were                                                               
no objections and it was so ordered.                                                                                            
         SB 123-ELIMINATE REVIEW OF ADOPTION SUBSIDIES                                                                      
CHAIR DYSON announced SB 123 to be up for consideration.                                                                        
MR. LINDSTROM  said SB 123 is  an act relating to  adoptions that                                                               
include a subsidy paid by the  state after adoption of a hard-to-                                                               
place child has occurred.                                                                                                       
He explained  that under current  law the department  is required                                                               
to annually  review the subsidy  payment amounts for  each person                                                               
who  has an  adoption  or  a guardianship.  SB  123 repeals  that                                                               
requirement and instead, individuals  would retain the ability to                                                               
petition the department at any time  for a subsidy review and the                                                               
department would do  so. This is an efficiency  measure and would                                                               
save a fair  amount of staff time. The  adoption assistance cost-                                                               
saving proposal  language is also  in HB 166. Annual  reviews are                                                               
not an effective  strategy to reduce or contain the  costs of the                                                               
CHAIR  DYSON asked  what  percentage  of them  got  changed as  a                                                               
result of the annual review.                                                                                                    
MR.  LINDSTROM replied  that a  significant  number of  subsidies                                                               
were changed as a result of the reviews.                                                                                        
MS.  JOANNE GIBBENS,  Program Administrator,  Division of  Family                                                               
and  Youth Services,  responded  that she  didn't  have an  exact                                                               
number, but could  get it for him. She said  there are times when                                                               
subsidies are decreased,  but the majority of  them are increased                                                               
by virtue of the annual review.                                                                                                 
CHAIR  DYSON declared  a  conflict of  interest  as his  youngest                                                               
daughter is a legal guardian  of two children who are subsidized.                                                               
One of those children was a  danger to her infant children and he                                                               
is taking care of that child and receiving the subsidy.                                                                         
SENATOR  GREEN  noted  that  any parent  can  still  request  the                                                               
SENATOR DAVIS  said there are  more increases than  decreases and                                                               
asked if there was anything  in the suggested language that would                                                               
prevent a requested review from taking place in a timely manner.                                                                
MS. GIBBENS replied no.                                                                                                         
CHAIR DYSON  commented that the  department could do a  review if                                                               
they thought they were being taken advantage of.                                                                                
MS. GIBBENS replied  that they could do a review  at anytime, but                                                               
a subsidy  may not  be decreased without  the concurrence  of the                                                               
adoptive parents or the legal guardian according to federal law.                                                                
SENATOR GUESS  asked if the  administration was working  with the                                                               
federal government to change that federal policy.                                                                               
MR. LINDSTROM replied that this was not an item.                                                                                
SENATOR GUESS asked if the process  of requesting a review at any                                                               
time is in statute or regulation.                                                                                               
MS. GIBBENS replied that she thought  it was in DHSS's policy and                                                               
SENATOR  GUESS suggested  if it's  in policy  and procedures  and                                                               
they  are  deleting  a  particular  clause,  they  should  insert                                                               
language  stating that  the parents  have  a right  to request  a                                                               
review. She pointed  out, "It seems that's an  important right to                                                               
have, especially  if you are  adopting a young child  whose needs                                                               
may change over time."                                                                                                          
SENATOR GUESS then asked what she  thought the impact would be on                                                               
finding enough people  to go through the  adoption process versus                                                               
being a  foster parent,  because the  adoption process  is really                                                               
better for the child and better for the community.                                                                              
MS.  GIBBENS said  she  didn't think  it would  have  much of  an                                                               
impact.  DHSS will  make  it clear  to  all perspective  adoptive                                                               
parents that the  parents have a right to request  an increase in                                                               
their subsidy if the needs of the child change over time.                                                                       
SENATOR GUESS asked what the timeline is for a review.                                                                          
MS. GIBBENS replied  that the formal review process  is done once                                                               
a year in the fourth quarter.                                                                                                   
SENATOR GUESS asked how long the process takes.                                                                                 
MS. GIBBENS replied  that it would be about  a one-month process,                                                               
depending on the circumstances.                                                                                                 
CHAIR  DYSON  announced an  at-ease  so  that Ms.  Gibbens  could                                                               
locate the  language that states  that the parents can  request a                                                               
SENATOR  GREEN  pointed out  that  the  original reason  for  the                                                               
review was cost  containment and that is not occurring.  It was a                                                               
cost saving measure  for the state, not a vehicle  for parents to                                                               
raise their subsidy.                                                                                                            
SENATOR DAVIS said she thought the  state had to abide by federal                                                               
laws and asked if that language should be in state law also.                                                                    
MR. LINDSTROM  responded that  the department  would be  bound by                                                               
the  federal  provision to  the  extent  that the  assistance  is                                                               
provided  by   federal  4(e)  dollars.  Of   the  1,530  adoption                                                               
subsidies, 1,277 are federal and 253 are state.                                                                                 
TAPE 03-9, SIDE B                                                                                                             
CHAIR DYSON announced an at-ease from 2:27-2:30 p.m.                                                                            
MS. GIBBENS confirmed that the right to review language is in                                                                   
the department's policy and procedures.                                                                                         
CHAIR DYSON requested a copy of the federal and department                                                                      
language for the committee. He wondered if any parent groups had                                                                
been contacted on this issue or have provided any feedback.                                                                     
SENATOR GREEN moved to pass SB 123 and the fiscal notes out of                                                                  
committee with individual recommendations. There were no                                                                        
objections and it was so ordered.                                                                                               
CHAIR DYSON adjourned the meeting at 2:34 p.m.                                                                                  

Document Name Date/Time Subjects