02/15/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB181 | |
| SB115 | |
| SSCR2 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 181 | TELECONFERENCED | |
| *+ | SSCR 2 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 115 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 15, 2024
3:30 p.m.
DRAFT
MEMBERS PRESENT
Senator David Wilson, Chair
Senator James Kaufman, Vice Chair
Senator Löki Tobin
Senator Forrest Dunbar
Senator Cathy Giessel
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 181
"An Act relating to placement of a child in need of aid;
relating to adoption; and providing for an effective date."
- HEARD & HELD
SENATE BILL NO. 115
"An Act relating to physician assistants; relating to
physicians; and relating to health care insurance policies."
- MOVED CSSB 115(HSS) OUT OF COMMITTEE
SENATE SPECIAL CONCURRENT RESOLUTION NO. 2
Disapproving Executive Order No. 125.
- MOVED SSCR 2 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 181
SHORT TITLE: CHILD PLACEMENT; DILIGENT SEARCH
SPONSOR(s): SENATOR(s) BJORKMAN
01/16/24 (S) READ THE FIRST TIME - REFERRALS
01/16/24 (S) HSS
02/15/24 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 115
SHORT TITLE: PHYSICIAN ASSISTANT SCOPE OF PRACTICE
SPONSOR(s): SENATOR(s) TOBIN BY REQUEST
03/27/23 (S) READ THE FIRST TIME - REFERRALS
03/27/23 (S) HSS, L&C
01/23/24 (S) HSS AT 3:30 PM BUTROVICH 205
01/23/24 (S) Heard & Held
01/23/24 (S) MINUTE(HSS)
02/06/24 (S) HSS AT 3:30 PM BUTROVICH 205
02/06/24 (S) Heard & Held
02/06/24 (S) MINUTE(HSS)
02/15/24 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SSCR 2
SHORT TITLE: DISAPPROVE EO 125
SPONSOR(s): RULES
02/12/24 (S) READ THE FIRST TIME - REFERRALS
02/12/24 (S) HSS
02/15/24 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
SENATOR BJORKMAN, District D
Alaska State Legislature,
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 181.
LAURA ACHEE, Staff
Senator Jesse Bjorkman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided a sectional analysis for SB 181.
JENNIFER RODRIGUEZ, Executive Director
Youth Law Center
San Francisco, California
POSITION STATEMENT: Invited testimony for SB 181.
BOBBI OUTTEN, Director
Southcentral Foundation
Anchorage, Alaska
POSITION STATEMENT: Invited testimony for SB 181.
KENDALL SEAL, Vice President
The Center for the Rights of Abused Children
Phoenix, Arizona
POSITION STATEMENT: Invited testimony for SB 181.
NANCY MEADE, General Counsel
Administrative Offices
Alaska Court System
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 181.
MEGHAN MASON, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 181.
DESTINEE MCCLUNG, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 181.
EMILY BOLANDER, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of SB 181.
ANDREA DOESHART, representing self
Kenai, Alaska
POSITION STATEMENT: Testified in support of SB 181.
DANIELLE WAKEFIELD, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 181.
KRISTEN HADDOX, representing self
North Pole, Alaska
POSITION STATEMENT: Testified in support of SB 181.
HEIDI HEDBERG, Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Provided an overview of EO 125.
GENE WISEMAN, Section Chief
Rural and Community Health Systems
Department of Health (DOH)
Juneau, Alaska
POSITION STATEMENT: Available to answer questions on EO 125.
ACTION NARRATIVE
3:30:41 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:30 p.m. Present at the
call to order were Senators Dunbar, Giessel, Kaufman, Tobin, and
Chair Wilson.
SB 181-CHILD PLACEMENT; DILIGENT SEARCH
3:31:35 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 181
"An Act relating to placement of a child in need of aid;
relating to adoption; and providing for an effective date."
CHAIR WILSON stated this is the committee's first hearing on SB
181. The committee will hear invited and public testimony.
3:31:54 PM
SENATOR BJORKMAN, District D, Alaska State Legislature, Juneau,
Alaska, speaking as sponsor, introduced SB 181:
[Original punctuation provided.]
It is an unfortunate and heartbreaking truth that
sometimes a child must be removed from the care of
their parents. It is then incumbent on the State of
Alaska to ensure that these kids receive the best
possible care while they are in the State's custody.
This includes amending Alaska Law as necessary to
ensure the Department of Family and Youth Services and
the Alaska Court System have guidelines that will
allow for the best possible outcomes.
Studies show that every time a child is moved from one
placement to another, there is an impact on the child.
Kids in the foster care system on average show greater
issues with behavior, mental health, and cognitive
abilities than their peers. However, there can be a
direct correlation drawn between the number of
placements a child experiences and the impact it has
on them. I have invited subject matter experts that
are online to speak more about these concerns.
Senate Bill 181 seeks to minimize the number of
placements a child may experience in two ways.
First, the bill would place a 30-day timeline and more
specific requirements on the Office of Children's
Services for finding family members and family friends
who are able to take on the care of a child earlier in
the process to help minimize the number of placements
a child experiences and help maintain connections with
family and community. I have heard stories of
relatives that were unaware for months or even years
that a child was in foster care. Ensuring that more
thorough and timely searches are conducted will help
create better outcomes for kids.
Second, this bill provides more latitude to apply the
placement preferences placed on OCS and the Court
System. SB 181 would allow the State to consider
placing a child with a foster family instead of a
family member if the child is under 6, has been with
the family for more than 12 months, and it is
determined to be in the best interest of the child. 20
years ago, the Alaska Legislature enacted policies
giving family members preference when placing a child,
policies I support through the provisions that
strengthen family searches. However, children under
six are going through their most significant phases of
brain development, and placement changes can have a
much larger impact than for older children.
It is difficult to craft laws that will perfectly
apply to situations that are guaranteed to vary widely
from one child to the next. This change in statute
wouldn't mandate where a child is placed. SB 181
provides more latitude for making the decision that is
in the best interest of the child. Also, by
encouraging timely and diligent family searches the
number of these difficult situations that occur can be
minimized or avoided entirely.
It's important to note that the statutory change about
placement will not apply to kids that fall under the
Federal Indian Child Welfare Act. Placement decisions
will still be made under the federal guidelines.
In addition, the bill clarifies that foster families
have the right to request a hearing over placement of
a child they have been caring for in order to ensure
they, as the people most knowledgeable about the
children in their care, have a seat at the table when
decisions are made. The bill also amends the statutes
regarding family placement to give OCS and the Courts
more latitude to place children with family members by
allowing for decisions that are in the best interest
of the child.
It's also important to acknowledge that hard work of
the Office of Children's Services and the heavy
headwinds they face every day. I am looking forward to
the outcome of the salary survey promised by the
Administration, and I hope that we will be able to
find ways to help the Division recruit and retain
enough people to keep up with their heavy and
challenging workload.
3:36:22 PM
LAURA ACHEE, Staff, Senator Jesse Bjorkman, Alaska State
Legislature, Juneau, Alaska, provided the following sectional
analysis for SB 181:
[Original punctuation provided.]
Senate Bill 181 Child Placement; Diligent Search
Version H Sectional Analysis
Section 1: Adds language to AS 47.10.080(s) to clarify
that foster parents may request a hearing regarding
the Department of Family and Community Services'
(DFCS) decision to transfer a child out of the foster
home.
Section 2: Amends AS 47.10.088(i) to allow for
determination of the best interest of the child when
making decisions regarding permanent placement of a
child. For exceptions to family notification
requirements, the section changes the criteria from a
person being ineligible for a foster care license to a
placement not being in the best interest of the child.
This section also adds language regarding
determination of best interest, including whether a
child is under six years old and has been in the care
of the foster family for at least 12 consecutive
months.
Section 3: Adds language to AS 47.10.142(i) that
conforms to the changes in Section 4.
Section 4: Adds a new section, AS 47.10.145, that
requires the Department search for adult family
members and family friends suitable for placement of a
child within 30 days of the State removing the child
from the home, describes what constitutes a diligent
statutorily required search, and requires ongoing
searches until excused to do so by the court or the
child is in a permanent placement.
Section 5: Adds language to AS 47.14.100(e) allowing
for consideration of placement with a foster family of
children who are under six years old and have been in
the care of that foster family for at least 12
consecutive months when an adult family member has
also expressed interest. Also amends language to
conform to the change in Section 4.
Section 6: Amends AS 47.14.100(m) to remove language
prohibiting placement with a family member if the
family member does not meet the requirements for a
foster care license. Adds language that denying
placement due to the best interest of a child with a
family member may not include consideration of poverty
of the family member or inadequate or crowded housing.
Section 7: Provides for a January 1, 2025 effective
date.
3:39:03 PM
CHAIR WILSON announced invited testimony for SB 181.
3:39:26 PM
JENNIFER RODRIGUEZ, Executive Director, Youth Law Center, San
Francisco, California, stated that the Youth Law Center focused
on advocating for the rights of children in foster care and
juvenile justice systems. The Youth Law Center collaborated with
developmental experts nationwide to translate research into
policy and practice. Drs. Charles Zeanah and Mary Dozier
requested she testify on their behalf. She highlighted the
importance of science in informing policy decisions. The Youth
Law Center was actively engaged in aligning foster care systems
with research findings, particularly emphasizing the
significance of attachment and relationships for children's
development. The Youth Law Center worked with leadership in 12
states and about 80 jurisdictions. She stressed the critical
necessity of immediately searching for relatives, ideally before
removal, to assist in the success of children. The organization
advocated for policy changes to meet the developmental needs of
infants and young children in foster care, recognizing the
importance of stability and attachment for their well-being.
MS. RODRIGUEZ stated that research had demonstrated that
delaying the search for relatives could inflict significant
trauma on children, particularly when they were separated from
long-term caregivers. Introducing relatives later in a child's
life, especially when children are under the age of six when
they enter foster care, stands to exacerbate emotional,
behavioral, and biological issues later. Delays in the search
and approval process, often due to inefficiencies within the
child welfare system, prolonged the trauma for children. Even
short delays of a day or a week could have profound effects on
young children. She mentioned that some children experience
delays of a year or more, resulting in unnecessary loss and
trauma with lifelong consequences for the children, their
families, and communities. The system needs to prioritize
immediate identification of relatives.
MS. RODRIGUEZ emphasized two additional perspectives beyond
scientific evidence. First, drawing from her personal experience
as both a lawyer and a former foster child, she highlighted the
profound impact of lacking familial connections. Growing up in
foster care without familial support or cultural ties, she
experienced a loss of identity and language. This sense of
disconnection led to the predictable struggles that research
indicates children experience. These struggles resulted in
restrictive placements in foster care, juvenile justice, and
mental health facilities. She mentioned that the failure to
conduct an adequate search for relatives during her time in
foster care resulted in years of instability and disruption.
Despite system failures, she overcame these challenges and built
a successful life. However, many youths are not as fortunate.
She emphasized how the system's failure to prioritize early and
robust efforts to connect children with relatives significantly
alters their life trajectories, affecting not only them but also
future generations.
3:45:44 PM
BOBBI OUTTEN, Director, Southcentral Foundation, Anchorage,
Alaska, provided a brief history of her work with children and
defined trauma as any form of impairment to a child's psyche
that is a direct result of a difficult event. Long-lasting
effects of childhood trauma include brain impairment, changes to
genetics, and complications forming attachments. Advancements in
biological embedding technologies have enabled differences in
genomes to be compared. She provided some Adverse Childhood
Experiences (ACEs) findings and emphasized there are more:
- 1 ACE doubles the chance of perpetrating domestic violence
- 4 ACEs correlates with a 5 times greater risk of domestic
violence
- 7-8 ACEs increases the risk of adolescent suicide 51 times.
- 4 is the average number of ACEs a child experiences. People
with 4 ACEs have:
• 2 times the rate of cancer.
• 3.6 times the rate of heart disease.
• 2.2 times increased risk of diabetes.
• 6.5 times the likelihood of using drugs.
She stated that ACEs are applicable to SB 181 and the Office of
Children's Services because investigations, removals, and
replacements adversely affect children and leads to life-long
consequences if not handled appropriately. She opined that
without laws specific to the removal, placement changes,
kinship, and reunification the interventions can shift from
positive to adverse. The resiliency in children does not negate
the permanent effect of adverse childhood experiences.
3:51:39 PM
MS. OUTTEN said the problems with services for children are
systemic in that decisions are not trauma-sensitive, trauma-
informed, or trauma-responsive. The current system will resist
change. However, change is necessary if Child Protective
Service's decisions are to be about children and not about
liabilities, money, staffing, and adults. Change should begin
with developmentally targeted decisions. She opined that the
only place that maintains the same guidelines for a child,
regardless of age, is the Office of Children's Services.
3:53:13 PM
MS. OUTTEN stated that the department needs to establish
developmentally appropriate guidelines to minimize attachment
disruptions. Disturbed placements lead to increased rejection in
a child's life, creating a cycle of damaged attachments, future
mental instability, and health issues. She spoke to the need for
diligent and detailed searches for safe family members. Current
language is ambiguous, lacking accountability, definition, or
reporting. Language must define and require family searches to
be conducted within three months of a child coming into state
custody. Finding family members is critical to the well-being of
a child because it allows the child to form attachments with
family instead of foster family. She mentioned instances where
family members were not contacted for over a year. When family
members are unable to care for the child, guidelines should
follow attachment research and allow interaction with family
members through in-person or virtual meetings.
3:55:28 PM
MS. OUTTEN spoke about transitions and the benefits of having a
plan when removing a child from a safe home versus sudden
unexpected removal. There are safe, healthy, developmentally
appropriate best practices for removing children from safe
homes. Permanency decisions should always be trauma-responsive,
based on attachment research, and developmentally appropriate.
The best interest of the child should always include what is
safest, least disruptive, and most nurturing. The state does
more harm than good if every step in the child protective
services process is not developmentally appropriate and trauma
responsive. Every child matters.
3:57:36 PM
KENDALL SEAL, Vice President, The Center for the Rights of
Abused Children, Phoenix, Arizona, said the center works with
welfare agencies, stakeholders, and policymakers nationwide. Its
mission is to ensure that every abused or neglected child has a
safe and loving home. The center supports finding families to
ensure children are protected and have stability. It is in the
best interest of the children to place them with a safe family
or a foster family as quickly as possible. He stated the
organization's belief that placement and permanency should occur
with the child's best interests in mind. Currently, Alaska law
requires the state to search for relatives or close family
friends, prioritizing placement with family. Unfortunately, the
parameters regarding due diligence are inadequate. He provided
statistics regarding the placement of Alaska's youth:
- 20 percent of youth in foster care have 3 or more placements
- On average youth spend 22 months in foster care
- 13 percent of youth reenter care one year following a prior
incident.
He said instability fuels negative outcomes such as
exploitation, missing children, and human trafficking. As a pro
bono legal clinic, the center knows firsthand the suffering
children face when obedience to preferential lists is valued
over doing what is in a child's best interest. SB 181 promotes
safety and stability and would increase the speed at which
children are placed with relatives.
4:01:26 PM
MR. SEAL spoke about the fiscal note for SB 181 and opined that
it would not delay the finding of permanent placements.
Furthermore, finding children's families reduces litigation and
accelerates the removal of children from the foster care system.
The state of Missouri reported needing only one full-time
position to handle the changes proposed in SB 181, despite
having between 12,000 - 13,000 children in foster care. Alaska,
with between 2,500 - 3,000 youth in foster care, would require
only 0.2 percent of a full-time position if the numbers remained
consistent. He expressed his opinion that the numbers in the
fiscal note are inaccurate. He suggested changing the time
requirement in SB 181, Section 2, from 12 months to 9 months.
Additionally, he proposed changing Section 4 to include
databases that the state must utilize when conducting a search
for relatives. He emphasized that the department should consider
the databases as a minimum requirement for conducting a search,
not a maximum. He added that Section 4 could also incorporate a
notice period for relatives to respond to a search. He stated
his belief that SB 181 is a strong piece of legislation.
4:04:21 PM
CHAIR TOBIN asked what stipulations the court would consider
when determining a child's best interest.
4:04:44 PM
NANCY MEADE, General Counsel, Administrative Offices, Alaska
Court System, Juneau, Alaska, replied that there is a well-
prescribed definition for "best interest of a child." She said
she would provide it to the committee. The definition is well-
known and utilized by judges.
4:05:30 PM
CHAIR TOBIN asked how the department would obtain access to
databases outside of the state to locate family members living
outside of Alaska or outside of the United States.
4:06:14 PM
SENATOR BJORKMAN stated he is open to stipulations for database
searches that make it possible to identify and contact a child's
relatives.
CHAIR TOBIN asked how the department would establish
partnerships to ensure an extensive family search is conducted.
4:07:05 PM
MS. ACHEE replied that a diligent search is multifaceted and
involves more than searching databases.
4:07:37 PM
CHAIR TOBIN asked what would happen if the only relative of a
child lived outside of the U.S.
MS. ACHEE reiterated that statute would require a continued
search until stipulations were met.
4:08:44 PM
CHAIR TOBIN asked whether the creation of stipulations is
necessary to foster communication between state and federal
databases.
MS. ACHEE replied that the department would need to investigate
how agencies would work together; it might only require a phone
call from one agency to another.
4:09:26 PM
SENATOR DUNBAR asked what the legal difference is between the
"good cause standard" and the "best interest of the child
standard."
4:10:16 PM
SENATOR BJORKMAN stated his belief that the language exists in
Sections 2 and 5 of SB 181. The court system is familiar with
the definition of "good cause" within the context of the "best
interest." The best interest finding is utilized in making
numerous determinations. SB 181 contains a significant amount of
permissive language, which empowers the court system to consider
all available information. Page 5, line 21, of SB 181 permits
preference of placement to a foster family if both the court and
OCS agree, the child is under 6 years old, and has resided with
the foster family for 12 months. It is not a mandate but rather
allows all parties involved to have a voice in the decision-
making process.
4:12:31 PM
SENATOR DUNBAR asked if the reference to the reordering of
preferences in a document from Facing Foster Care was a
misreading of SB 181.
4:12:55 PM
SENATOR BJORKMAN replied yes. He stated he has explained to the
organization multiple times that SB 181 does not put one group
above another. SB 181, page 5, lines 20-21, allows the court to
consider a foster family as a placement option when the child is
under six years old and in the family's care for at least six
months.
SENATOR DUNBAR asked if it is a legitimate concern that a
relative who wants custody of a child would not have access to
the same resources as the state for litigation or be
disadvantaged in some way.
4:14:25 PM
SENATOR BJORKMAN stated that wealth and resources are omitted
from best interest findings. He opined that there is a
significant amount of case law stating that wealth cannot be
considered. An additional provision in SB 181, on pages 4-5,
states that the court can excuse family members from
consideration for placement. A time limit is necessary to
account for when a child finds permanency.
4:16:45 PM
CHAIR WILSON opened public testimony on SB 181.
4:16:53 PM
MEGHAN MASON, representing self, Anchorage, Alaska, testified in
support of SB 181. She stated her family was a licensed foster
family since 2017, loving and caring for eight children. The
foster care system lacks the resources to provide for the needs
of children, which leads to long term trauma and trust issues.
She opined that it is the responsibility of a foster family to
ensure that the child is safe, loved, and protected so the child
can heal. However, the state then uproots the child. She said
children are not made a priority and the system needs to change.
She shared a personal experience of raising a foster child from
birth to 4 years old. Adoption by the state was approved until a
biological family member, whom the child had never met, decided
to take placement. She spoke of the hardships such decisions
cause children and foster families. SB 181 would allow children
to stay with foster families, and it would also do a better job
of locating all potential relatives and friends within a
reasonable amount of time.
4:20:12 PM
DESTINEE MCCLUNG, representing self, Anchorage, Alaska,
testified in support of SB 181. She said she has been a foster
parent for 8 years. Foster parents are frontline workers that
witness the devastation caused by the Office of Children's
Services (OCS). Alaska has experienced a 31 percent decrease in
foster care families. OCS would point out that there are 16
percent fewer children in the system than five years ago.
However, OCS screens 16 percent fewer reports than five years
ago. Foster parents are closing their licenses because they feel
they are being forced to contribute to the child's trauma.
Current laws do not take into consideration the detriment and
trauma that removal from long-term placements creates for
children and foster families. Attachment is the first building
block to healthy, happy, well-adjusted adults. SB 181 would
increase OCS's accountability and speed permanent placement. The
state needs to change its laws to prioritize the needs of
children over the needs of adults.
4:22:33 PM
EMILY BOLANDER, representing self, Fairbanks, Alaska, testified
in support of SB 181. She stated seven children have resided in
her home over the past 1.5 years, all of whom were under the age
of six. The needs of the children were widely varied and serving
them was a privilege. Children are born deserving of safety and
stability. SB 181 supports timely connections with family
whenever possible. Connections to biological family are proven
to increase unification outcomes, which is the goal of foster
care. OCS should prioritize timely and appropriate searches for
safe family placements for children in crisis. SB 181 also
addresses placement of children in a licensed foster home when
family members are unavailable. Children form attachments to
foster families. Foster families also form safe, healthy
relationships with members of the child's biological family.
Children experience trauma when they form attachments to their
homes and are then removed for other permanency options.
Compounded trauma is difficult to treat and stays with children
into adulthood. The court should at least consider permanent
placement an option in situations where children have formed
attachments to their safe, stable, foster care families.
4:25:23 PM
ANDREA DOESHART, representing self, Kenai, Alaska, testified in
support of SB 181. She stated her family was a licensed foster
care family from 2018 to September of 2023. She voluntarily
closed her license. The time periods that children stayed with
her ranged from a long weekend to 3.5 years. She stated that in
the summer of 2022 she sat on a therapist's floor with a puppet
on her hand trying to explain to her three-year-old foster
daughter that she must leave the only home she knew since birth.
Words like "legal" or "biological" do not mean anything to a
three-year-old, but "mama" does. She stated that after the
puppet show, she was required to pull a crying child from her
body, force her into the arms of someone else, and walk out of
the building. She stated she betrayed the parent-child
relationship that she had built for three years and had to
participate in shattering the only reality the child knew. She
has not been allowed to see her since. She stated that the
experience was gut wrenching and she, her spouse, and her
biological children still grieve. She stated the "good cause"
clause is narrowly written and does not include psychological
and developmental well-being.
4:28:46 PM
DANIELLE WAKEFIELD, representing self, Anchorage, Alaska,
testified in support of SB 181. She said she has been a licensed
foster parent for five years. Children in the foster care system
face profound instability and uncertainty. In her home is a
four-year-old girl she has cared for since birth. Although the
federal guideline for custody is 15 months, the court has
extended custody three times and is comfortable extending it for
a fourth time because permanent placements do not occur within
that timeframe. She stated her home is not considered an option
for permanent placement and she has no voice or legal standing
to advocate for the girl she has raised. She opined that to OCS
she is nothing more than a babysitter. She is forced to
participate in unnecessary adverse childhood experiences. The
limbo that foster care children experience due to delays in
court hearings leads to emotional and psychological distress. It
is unacceptable for children to remain in foster care for years.
She urged support for SB 181 so foster children can receive the
care, stability, and permanency they deserve.
4:30:51 PM
SENATOR DUNBAR asked if the 15-month federal guideline was part
of the Indian Child Welfare Act (ICWA).
MS. WAKEFIELD replied that the federal guidelines require the
department to file a termination petition at 15 months if the
child's parent has not made substantial progress.
SENATOR DUNBAR said his understanding is SB 181 does not impact
ICWA. He asked for confirmation that the 15-month guideline is
separate from ICWA.
4:31:38 PM
MS. WAKEFIELD replied she is uncertain whether it is a state or
federal guideline, but children are not to remain in custody
more than 24 months. The guideline is not part of ICWA.
4:32:03 PM
KRISTEN HADDOX, representing self, North Pole, Alaska, testified
in support of SB 181. She stated she lives with her husband,
four biological children, and three foster children. She has
been a licensed ICWA foster home for seven years and a relative
placement. She has cared for 14 children and adopted a six-year-
old child after five years and three months of caring for him.
She stated that as a relative placement, she did not see OCS as
an intrusion. Frequently, family members spend years trying to
advocate for a child, but the child is hidden from them by the
parent. OCS needs to find a healthy family as a child enters
care because birth parents do not provide the contact
information of family members and close friends. The state needs
to raise the bar on relative expectations. When a child goes
through a traumatic experience, the state should expect the
presence of a family member, even if solely for emotional
support. SB 181 asks for expressed interest, not immediate
placement. A relative failing to act because they do not want to
deal with OCS is silly. Ignoring a child's best interest makes
everyone involved feel like the bad guy. Foster parents and
employees become part of the system because they want to help
children but leave because of the secondary trauma the system
causes. Children's brains remember trauma. She had children who
stopped feeling gravity due to anxiety. Their lives are
unstable, not knowing where they will live from week to week.
Small children do not understand why they cannot stay with a
family and the stress causes regression. She stated that when
she adopted a foster child, she adopted the child's extended
family into her home. Biological family against foster family is
a false narrative.
4:35:16 PM
CHAIR WILSON held SB 181 in committee.
4:35:33 PM
CHAIR WILSON closed public testimony on SB 181.
SB 115-PHYSICIAN ASSISTANT SCOPE OF PRACTICE
4:35:48 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 115
"An Act relating to physician assistants; relating to
physicians; and relating to health care insurance policies."
SB 115 was first heard on January 23, 2024. Invited and public
testimony was heard. On February 6, 2024, a committee substitute
was considered and withdrawn. Before the committee is SB 115,
version B.
4:36:12 PM
CHAIR WILSON solicited a motion.
4:36:18 PM
SENATOR DUNBAR moved to adopt Amendment 1, work order 33-
LS0542\B.4, to SB 115, version B.
33-LS0542\B.4
Gunther
2/15/24
AMENDMENT 1
OFFERED IN THE SENATE BY SENATOR DUNBAR
TO: SB 115
Page 2, line 28:
Delete "2,000"
Insert "6,000"
4:36:25 PM
At ease
4:36:53 PM
CHAIR WILSON reconvened the meeting and objected for purposes of
discussion.
4:36:56 PM
SENATOR DUNBAR stated that overall, he agrees with SB 115. He
wants physician assistants (PAs) to have independence within the
field's scope of practice. However, other states require a
higher number of hours working under a physician. In SB 115,
page 2, line 28, "2,000 hours" would change to "6,000 hours." He
opined that the change would provide needed training for
increased safety.
4:38:10 PM
CHAIR TOBIN responded that the committee discussed the clinical
and patient training PAs receive before they can care for
patients. The addition of 2000 hours is to untether PAs from
physicians. PAs are not trying to replace physicians. The goal
is to provide more services at different tiers. The average PA
has over 3000 hours of direct patient contact during their
training. She described the continuing education and exams that
PAs complete to maintain certification. She opined that the
amendment is onerous and unnecessary. However, in the spirit of
collaboration she proposed a conceptual amendment.
4:41:35 PM
CHAIR WILSON asked for a motion.
4:41:35 PM
SENATOR TOBIN moved Conceptual Amendment 1 to Amendment 1:
CONCEPTUAL AMENDMENT 1 TO AMENDMENT 1
OFFERED IN THE SENATE BY SENATOR TOBIN
TO: SB 115
Page 1, line 3:
Delete "2,000"
Insert "4,000"
4:41:48 PM
CHAIR WILSON asked is there was objection.
4:41:50 PM
SENATOR DUNBAR objected for purposes of discussion.
4:41:53 PM
SENATOR DUNBAR stated his belief that most PAs do not want to
practice without a collaborative physician, especially early in
their practice. He opined that most PAs who would take advantage
of SB 115 already meet the required hours. He stated that he
might put forth a future amendment regarding specificity of
hours in another committee of referral.
4:43:27 PM
SENATOR DUNBAR removed his objection to Conceptual Amendment 1
to Amendment 1.
4:43:32 PM
CHAIR WILSON found no further objection and Conceptual Amendment
1 to Amendment 1 was adopted.
4:43:47 PM
CHAIR WILSON said Amendment 1 [as amended] was before the
committee. He asked if there was further discussion.
4:43:50 PM
CHAIR TOBIN removed her objection to Amendment 1 [as amended].
4:43:54 PM
SENATOR GIESSEL objected to Amendment 1 [as amended] and stated
that the discussion is arbitrary. PAs are highly educated
healthcare professionals. She opined that it is a bureaucratic
assertion to arbitrarily choose a number to establish
competency. She stated that the national exam is difficult, and
PAs must pass it every 10 years. The letters of concern that the
committee received were not constituents injured by PAs. They
were from a special interest group. She challenged the committee
of non-health care professionals to explain how the extra hours
were determined.
4:46:34 PM
SENATOR DUNBAR rhetorically replied that the committee does not
drill for oil and gas but sets oil and gas policy. Other states
have set hours of up to 10,000 to ensure the public's safety. He
opined that 4,000 seemed like a reasonable compromise.
4:47:48 PM
SENATOR GIESSEL stated that continuing education is required of
PAs every two years. PAs primarily work in family practice. She
wondered if hours would need to be obtained working in varying
clinical settings. She noted that physicians are remunerated for
the clinical care that PAs provide, and PAs must also pay a
supervising physician fee. She suggested SB 115 should place
limits on the fees physicians can charge PAs.
4:49:38 PM
CHAIR TOBIN thanked Senator Giessel for her expertise on PAs in
Alaska. She said she agrees that the conversation denigrates the
education and experience of PAs. Rural areas in Alaska rely on
PAs for healthcare. PAs in Alaska agreed to the 2000 hours
because they understand there is opposition from doctors who
hold the power position. She wondered whether doctors want to
continue agreements with PAs for financial and professional
reasons. She acquiesced to the increase in hours because she is
committed to moving SB 115.
4:51:59 PM
CHAIR WILSON asked for further discussion and if objection was
maintained.
4:52:01 PM
SENATOR GIESSEL maintained her objection.
4:52:03 PM
CHAIR WILSON asked for a roll call vote on Amendment 1 as
amended.
A roll call vote was taken. Senators Kaufman, Dunbar, and Wilson
voted in favor of Amendment 1, as amended, and Senators Giessel
and Tobin voted against it. The vote was 3:2.
4:53:43 PM
CHAIR WILSON announced that Amendment 1, as amended, was adopted
on a vote of 3:2.
4:53:46
SENATOR KAUFMAN moved to report Amendment 1, workorder 33-
LS0542|B, as amended, from committee.
4:53:57 PM
CHAIR WILSON found no further objection and CSSB 115 (HSS) was
reported from the Senate Health and Social Services Standing
Committee.
4:54:07 PM
At ease
SSCR 2-DISAPPROVE EO 125
4:56:14 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE SPECIAL CONCURRENT RESOLUTION NO. 2
Disapproving Executive Order No. 125.
CHAIR WILSON stated that the committee heard EO 125 on February
1, 2024. SSCR 2 is the instrument documenting the committee's
action on EO 125. The associated report is similar to a
committee report for bills, where members make individual
recommendations.
4:57:10 PM
HEIDI HEDBERG, Commissioner, Department of Health (DOH), Juneau,
Alaska, provided and overview of EO 125 and stated it removes
the Alaska Council on Emergency Medical Services (ACEMS) from
statute and transfers its responsibilities to the Department of
Health (DOH). She said her intent is to create the EMS Advisory
Council within DOH. She values the advisory council, but it was
established 47 years ago and the 11 seats that represent ACEMS
do not reflect the current EMS system. Transitioning the council
through EO 125 will allow DOH to create an advisory committee
that is reflective of today's EMS system.
4:58:35 PM
SENATOR DUNBAR said he is pleased that EO 125 does not raise
unconstitutional concerns by including new unspecified seats. He
asked why DOH didn't pursue statute to accomplish the changes.
4:59:22 PM
MS. HEDBERG replied there are a lot of policy priorities that
come up each session. The department has known for a long time
that the original intent of ACEMS was accomplished, which was to
recommend an EMS system for the state. Utilizing a bill as the
tool to create the seat changes would require future amendments
as EMS evolves. She stated it is efficient to maintain the
intent of the council by taking the identified seats out of
statute and transferring authority to DOH. She noted examples of
ACEMS not having seats for dispatch and air medical transport.
DOH would have the ability to evolve the council as new services
emerge.
5:01:09 PM
CHAIR WILSON stated his belief that no one has testified in
favor of keeping the board in statute. People who have served on
the board for 47 years have testified in favor of EO 125.
5:01:38 PM
GENE WISEMAN, Section Chief, Rural and Community Health Systems,
Department of Health (DOH), Juneau, Alaska, thanked the
committee for their consideration EO 125.
5:01:47 PM
CHAIR WILSON solicited a motion.
5:01:48 PM
SENATOR KAUFMAN moved that EO 125 with individual
recommendations be reported from committee, and SSCR 2, with
individual recommendations and attached fiscal note(s) be
reported from the Senate Health and Social Services Standing
Committee.
5:02:11 PM
CHAIR WILSON found no objection and EO 125 and SSCR 2 were
reported from the Senate Health and Social Services Standing
Committee.
5:02:28 PM
SENATOR GIESSEL stated that signing the reports does not reflect
an intent by any of the members to vote for or against a special
concurrent resolution disapproving the Executive Order in joint
session.
5:02:51 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 5:02 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 181 Ver H.PDF |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 Sectional Analysis Version H.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 Sponsor Statement Ver H.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 FN DFCS.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 Months to Permanent Placement With Kinship.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 Placement Narratives.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 The Effect of Placement Instability.pdf |
SFIN 4/3/2024 9:00:00 AM SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 Letters of Support Rcvd by 020924_Redacted.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 LOS Hazen_Redacted.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB 181 Martin LOS_Redacted.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SB181 FFCA Concerns.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 181 |
| SSCR 2 v A (EO 125).pdf |
SHSS 2/15/2024 3:30:00 PM |
SSCR 2 |
| SSCR 2 Webb in Favor of EO125_Redacted.pdf |
SHSS 2/15/2024 3:30:00 PM |
SSCR 2 |
| SSCR 2 DoH FN (EO 125).pdf |
SHSS 2/15/2024 3:30:00 PM |
SSCR 2 |
| SSCR 2 re EO 125 Vinton Support.pdf |
SHSS 2/15/2024 3:30:00 PM |
SSCR 2 |
| SB 115 Ak Academy of Physican Assistants Support.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 115 |
| SB 115 Johnson Opposition.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 115 |
| SB 115 Am No. 1 as amended 2.15.24.pdf |
SHSS 2/15/2024 3:30:00 PM |
SB 115 |