Legislature(2017 - 2018)BUTROVICH 205

03/19/2018 01:30 PM HEALTH & SOCIAL SERVICES

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Audio Topic
01:31:25 PM Start
01:31:45 PM HB151
02:44:37 PM Confirmation Hearing(s): State Medical Board
02:54:31 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: TELECONFERENCED
Sai-Ling Liu, State Medical Board
Catherine Hyndman, State Medical Board
-- Public Testimony --
+ HB 151 DHSS;CINA; FOSTER CARE; CHILD PROTECTION TELECONFERENCED
Heard & Held
-- Testimony <Invited and Public> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         March 19, 2018                                                                                         
                           1:31 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator David Wilson, Chair                                                                                                     
Senator Natasha von Imhof, Vice Chair                                                                                           
Senator Cathy Giessel                                                                                                           
Senator Tom Begich                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Peter Micciche                                                                                                          
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 151(FIN)                                                                                
"An Act  relating to the duties  of the Department of  Health and                                                               
Social Services; relating to training  and workload standards for                                                               
employees of  the Department  of Health  and Social  Services and                                                               
providing  immunity  from  damages related  to  those  standards;                                                               
relating to  foster care  home licensing;  relating to  civil and                                                               
criminal history background checks  for foster care licensing and                                                               
payments;  relating to  placement  of  a child  in  need of  aid;                                                               
relating to  the rights and  responsibilities of  foster parents;                                                               
requiring  the  Department  of  Health  and  Social  Services  to                                                               
provide  information  to a  child  or  person released  from  the                                                               
department's custody; and providing for an effective date."                                                                     
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
CONFIRMATION HEARING(S):                                                                                                        
                                                                                                                                
State Medical Board                                                                                                           
     Catherine Hyndman - Dillingham                                                                                             
     Sai-Ling Liu - Nome                                                                                                        
                                                                                                                                
     - CONFIRMATIONS ADVANCED                                                                                                   
                                                                                                                              
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 151                                                                                                                  
SHORT TITLE: DHSS;CINA; FOSTER CARE; CHILD PROTECTION                                                                           
SPONSOR(s): REPRESENTATIVE(s) GARA                                                                                              
                                                                                                                                
03/01/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/01/17       (H)       HSS, FIN                                                                                               
03/16/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/16/17       (H)       Heard & Held                                                                                           
03/16/17       (H)       MINUTE(HSS)                                                                                            
03/21/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/21/17       (H)       Heard & Held                                                                                           
03/21/17       (H)       MINUTE(HSS)                                                                                            
03/23/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/23/17       (H)       Moved  CSHB 151(HSS) Out of Committee                                                                  
03/23/17       (H)       MINUTE(HSS)                                                                                            
03/24/17       (H)       HSS RPT CS(HSS) NT 3DP 1DNP 1NR 2AM                                                                    
03/24/17       (H)       DP: TARR, EDGMON, SPOHNHOLZ                                                                            
03/24/17       (H)       DNP: EASTMAN                                                                                           
03/24/17       (H)       NR: KITO                                                                                               
03/24/17       (H)       AM: JOHNSTON, SULLIVAN-LEONARD                                                                         
03/28/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/28/17       (H)       <Bill Hearing Canceled>                                                                                
04/12/17       (H)       FIN AT 1:30 PM HOUSE FINANCE 519                                                                       
04/12/17       (H)       Heard & Held                                                                                           
04/12/17       (H)       MINUTE(FIN)                                                                                            
04/13/17       (H)       FIN AT 1:30 PM HOUSE FINANCE 519                                                                       
04/13/17       (H)       Heard & Held                                                                                           
04/13/17       (H)       MINUTE(FIN)                                                                                            
05/15/17       (H)       FIN AT 1:30 PM HOUSE FINANCE 519                                                                       
05/15/17       (H)       Moved CSHB 151(FIN) Out of Committee                                                                   
05/15/17       (H)       MINUTE(FIN)                                                                                            
05/16/17       (H)       FIN RPT CS(FIN) NT 4DP 1NR 4AM                                                                         
05/16/17       (H)       DP: ORTIZ, GARA, SEATON, FOSTER                                                                        
05/16/17       (H)       NR: GUTTENBERG                                                                                         
05/16/17       (H)       AM: TILTON, THOMPSON, KAWASAKI, WILSON                                                                 
05/17/17       (H)       TRANSMITTED TO (S)                                                                                     
05/17/17       (H)       VERSION: CSHB 151(FIN)                                                                                 
01/18/18       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/18/18       (S)       HSS, FIN                                                                                               
03/19/18       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
REPRESENTATIVE LES GARA                                                                                                         
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of HB 151.                                                                                        
                                                                                                                                
AMANDA METIVIER, Statewide Coordinator                                                                                          
Facing Foster Care in Alaska (FFCA)                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Supported HB 151.                                                                                         
                                                                                                                                
CHRISTY LAWTON, Director                                                                                                        
Office of Children's Services                                                                                                   
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Supported HB 151.                                                                                         
                                                                                                                                
TAMMY SANDOVAL, Director                                                                                                        
Alaska Child Welfare Academy                                                                                                    
University of Alaska Anchorage                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Supported HB 151.                                                                                         
                                                                                                                                
ELIZABETH RIPLEY, Chief Executive Officer                                                                                       
Mat-Su Health Foundation                                                                                                        
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT: Supported HB 151.                                                                                         
                                                                                                                                
BARBARA MALCHUK, Representing Self                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Supported HB 151.                                                                                         
                                                                                                                                
SAI-LING LIU, M.D., Appointee                                                                                                   
State Medical Board                                                                                                             
Nome, Alaska                                                                                                                    
POSITION STATEMENT: Testified as appointee to the State Medical                                                               
Board.                                                                                                                          
                                                                                                                                
CATHERINE HYNDMAN, M.D., Appointee                                                                                              
State Medical Board                                                                                                             
Dillingham, Alaska                                                                                                              
POSITION STATEMENT: Testified as appointee to the State Medical                                                               
Board.                                                                                                                          
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:31:25 PM                                                                                                                    
CHAIR DAVID WILSON  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:31 p.m.  Present at the                                                               
call  to order  were  Senators Giessel,  von  Imhof, Begich,  and                                                               
Chair Wilson.                                                                                                                   
                                                                                                                                
        HB 151-DHSS;CINA; FOSTER CARE; CHILD PROTECTION                                                                     
                                                                                                                                
                                                                                                                                
1:31:45 PM                                                                                                                    
CHAIR  WILSON  announced  the  consideration  of  HB  151.  [CSHB                                                               
151(FIN) was before the committee.]                                                                                             
                                                                                                                                
1:32:00 PM                                                                                                                    
REPRESENTATIVE LES GARA, Alaska  State Legislature, sponsor of HB                                                               
151 said  the bill is  a major reform in  the way the  state does                                                               
child protection.  This bill will  result in  healthier children,                                                               
healthier   families,   more   stability,   more   retention   of                                                               
caseworkers, and  fewer wasted resources from  losing caseworkers                                                               
that  could otherwise  be  going to  children  and families.  The                                                               
founder of UPS was the founder  of the Casey Family Programs, the                                                               
largest nonprofit foster care in  the nation. Their motto is that                                                               
child  protection should  be about  customer service,  not crisis                                                               
management. In most states it  is about crisis management. When a                                                               
system is operated on the  premise of crisis management, children                                                               
and families are harmed and families are torn apart.                                                                            
                                                                                                                                
He said this is where we are today:                                                                                             
                                                                                                                                
By age 21                                                                                                                       
 • 29 percent of Alaskan foster youth have been incarcerated                                                                    
   • 53 percent have been homeless (after leaving care)                                                                         
   • 37 percent have children of their own                                                                                      
   • 40 percent are utilizing public assistance                                                                                 
   • 34 percent are employed                                                                                                    
                                                                                                                                
He said these statistics are  similar to other states. The system                                                               
in Alaska  is like the  system in  many states where  the reforms                                                               
have  not  been adopted.  Alaska's  bigger  problem is  that  the                                                               
maltreatment  rate  is  70  percent   higher  than  the  national                                                               
average.  According  to  the Child  Welfare  League  of  America,                                                               
Alaska consistently has one of the  top five rates of child abuse                                                               
in  the U.S.  This  results  in more  youth  being physically  or                                                               
emotionally  damaged  in  their  own  homes.  With  the  kind  of                                                               
caseloads  in  the  system,  Alaska  loses  almost  half  of  its                                                               
caseworkers  within the  first  year.  He said  this  can all  be                                                               
fixed.                                                                                                                          
                                                                                                                                
REPRESENTATIVE GARA  said the  nation has  the highest  number of                                                               
foster  youth  ever.  It  is  time  to  adopt  comprehensive  and                                                               
recommended reforms  like New Jersey  did. That state had  one of                                                               
the most  in-crisis foster care  systems in the country.  After a                                                               
2005  lawsuit, the  court  ordered the  state  to adopt  caseload                                                               
limits and training standards. Today  over 80 percent of children                                                               
in foster care  in New Jersey experience two  or fewer placements                                                               
within the  first year, not 20  or 30 like people  heard from the                                                               
youth [from  Facing Foster Care  in Alaska] who came  through the                                                               
Capitol  recently. The  number of  youth  in foster  care in  New                                                               
Jersey is  down almost  50 percent from  when these  reforms were                                                               
adopted. He said  almost nothing is more important  in the foster                                                               
care  system  than  placement  with   relatives.  In  New  Jersey                                                               
relative  placements have  gone up  ever since  the reforms  were                                                               
adopted.                                                                                                                        
                                                                                                                                
1:36:43 PM                                                                                                                    
REPRESENTATIVE GARA  said when  a child  is in  care, a  child is                                                               
being damaged, a child is living  in a temporary home or a number                                                               
of  temporary  homes. Being  in  care  is  a series  of  damaging                                                               
placements, especially for  the youth who end up in  5, 10, 15 or                                                               
20 different  homes. The average time  a child is in  care in New                                                               
Jersey is ten  months. The average time in care  nationally is 12                                                               
to  24  months. Reunification  with  the  original family  is  up                                                               
substantially in  New Jersey. There  are fewer  placement changes                                                               
in New  Jersey and for those  youth who cannot be  reunified with                                                               
their original families, adoptions  are occurring faster and more                                                               
frequently.  The  biggest  indicators   that  lead  to  childhood                                                               
success and opportunity are working in New Jersey.                                                                              
                                                                                                                                
In  Alaska,  50 percent  of  cases  called  into OCS  (Office  of                                                               
Children's Services)  are not screened  in. They  are essentially                                                               
rejected. Of the remaining half,  about half are placed in foster                                                               
care.  Over  70   percent  of  OCS  calls   come  from  mandatory                                                               
reporters, not meddling neighbors.                                                                                              
                                                                                                                                
In Alaska,  there has been  a 43  percent increase in  reports of                                                               
harm since  2014, a  51 percent increase  in children  in out-of-                                                               
home care since 2012, and only a 14 percent increase in front-                                                                  
line caseworkers  from FY 11-FY  19, including the 31  added last                                                               
year.                                                                                                                           
                                                                                                                                
REPRESENTATIVE GARA quoted Casey Family Programs:                                                                               
                                                                                                                                
     A  well-trained,  highly  skilled,  well-resourced  and                                                                    
     appropriately deployed  workforce is foundational  to a                                                                    
     child   welfare  agency's   ability  to   achieve  best                                                                    
     outcomes  for   the  vulnerable  children,   youth  and                                                                    
     families it serves.                                                                                                        
                                                                                                                                
He said Alaska has unmanageable caseloads.                                                                                      
                                                                                                                                
REPRESENTATIVE GARA  listed the ways an  excessive caseload harms                                                               
children.                                                                                                                       
                                                                                                                                
   • Can't work with families to arrange frequent visitation,                                                                   
     which increases reunification                                                                                              
   • High caseloads lead to more turnover 49 percent for new                                                                    
     workers at OCS                                                                                                             
   • More turnover leads to damaging placement changes                                                                          
   • Inadequate time to investigate cases and work with families                                                                
     and youth                                                                                                                  
                                                                                                                                
He highlighted  that a  youth recently  reported having  lived in                                                               
over 50 homes.  He said it is  his belief that when  there is not                                                               
enough time  to investigate a case,  you will err on  the side of                                                               
child safety.  That means you err  on the side of  taking a child                                                               
away from a family. That is  not the kind of system Alaska should                                                               
have and it costs money.                                                                                                        
                                                                                                                                
According  to surveys,  excessive  workloads are  the number  one                                                               
factor affecting someone's decision to  leave OCS. The higher the                                                               
caseload, the higher  the turnover, and the  higher the turnover,                                                               
the worse the  results. A study from Wisconsin  shows that timely                                                               
placement into  a permanent home  happens 75 percent of  the time                                                               
when there  is one caseworker.  With two  caseworkers, permanency                                                               
drops to  17 percent. Children  who have many caseworkers  do not                                                               
go into a permanent, loving home.  They will languish and as they                                                               
languish  they  will  be  harmed. With  more  turnover  and  more                                                               
placements, ACEs (Adverse Childhood Experiences) scores go up.                                                                  
                                                                                                                                
1:42:35 PM                                                                                                                    
REPRESENTATIVE  GARA said  the federal  Children's Bureau  uses a                                                               
study  from Texas  to estimate  the cost  per lost  caseworker is                                                               
about  $54,000  after  recruiting,  hiring, and  training  a  new                                                               
caseworker. This is money that  should instead be spent on making                                                               
healthier families and healthier children.                                                                                      
                                                                                                                                
In 2013  a New York  report found  counties in which  workers had                                                               
higher caseloads also had higher  rates of repeated maltreatment.                                                               
Maltreatment is abuse  and neglect. A 2006 study  by the National                                                               
Council on  Crime and Delinquency found  "the correlation between                                                               
turnover  rate and  maltreatment recurrence  at every  time point                                                               
was strong and statistically significant."                                                                                      
                                                                                                                                
REPRESENTATIVE  GARA  said HB  151  is  a cost-effective  way  to                                                               
create healthier outcomes for children  and families, more stable                                                               
families,  and more  family reunification.  It is  cost effective                                                               
because the  less time a  child spends  in foster care,  the less                                                               
staff is needed at an agency,  the less paid for the daily foster                                                               
care rate, which is  $30 a day in Anchorage and up  to $100 a day                                                               
for  high-needs children.  It also  produces healthier  children.                                                               
Financially, you  are not  paying for  jail or  homelessness. You                                                               
are getting people who work instead of costing the state money.                                                                 
                                                                                                                                
1:45:18 PM                                                                                                                    
REPRESENTATIVE GARA said HB 151 would set manageable caseloads.                                                                 
     .                                                                                                                          
        • For new caseworkers, 6 families in the first                                                                          
         three months and 12 families in the first six                                                                          
          months                                                                                                                
He noted an Ombudsman report about a caseworker in the MatSu                                                                    
Valley who had about 50 cases.                                                                                                  
        • A statewide average caseload limit of not more                                                                        
          than 13 families per worker                                                                                           
        • These levels are consistent with national                                                                             
          recommendations, taking Alaska travel times into                                                                      
          account                                                                                                               
                                                                                                                                
He noted  that OCS believes  12 families should be  the statewide                                                               
standard for caseloads  on average, but at 13 the  cost went down                                                               
$1 million.  Even with the  31 staff  that were added  last year,                                                               
the caseloads  are not close to  these limits. In 12  offices the                                                               
caseload is much higher than what caseworkers can handle.                                                                       
                                                                                                                                
He said the evidence shows that  children do better when they are                                                               
placed with healthy  family members. Part of the  bill focuses on                                                               
that.  Foster  youth will  say  this  is  often missed,  but  the                                                               
caseworker  with a  high  caseload does  not have  time  to do  a                                                               
family search.  He knows of  one caseworker  who did not  know it                                                               
was part of the  job to do a family search. The  bill says that a                                                               
supervisor must sign off that a thorough family search was done.                                                                
                                                                                                                                
HB  151 says  that caseworkers  need to  be trained,  which makes                                                               
sense. Before last  year's budget amendment, OCS  did three weeks                                                               
of training. That was inadequate.  This bill says there should be                                                               
six weeks of training, which is not  six weeks in a row. The bill                                                               
also adopts  a best practice  of assigning mentors.  The training                                                               
is  being provided  at  the University  of  Alaska Child  Welfare                                                               
Academy.                                                                                                                        
                                                                                                                                
1:50:25 PM                                                                                                                    
REPRESENTATIVE GARA  said the goal  is to keep  families together                                                               
and  cut red  tape.  Roughly  11 other  states  have adopted  the                                                               
prudent  parent  standard.  It  lets  foster  care  parents  make                                                               
decisions that a prudent parent  would, such as allowing children                                                               
to play sports  and go on vacation. Foster care  parents won't be                                                               
as likely to  quit out of frustration when they  have to call for                                                               
permission.  The bill  reduces removals  from homes.  As long  as                                                               
there is a  safe family member in the house--it  does not need to                                                               
be parent--the child can remain  in the house. The bill maintains                                                               
connections and  support, including with former  foster families.                                                               
The  old  model said  no  contact  with former  foster  families.                                                               
Another provision  in the bill  is that decisions on  foster care                                                               
home license applications must be  made within 45 days and allows                                                               
youth 14 and older to participate in their case plan.                                                                           
                                                                                                                                
He  said it  is not  all bad  news. He  pointed out  the National                                                               
Conference of  State Legislatures  magazine article  that focused                                                               
on what states do  when foster kids are on own  to make sure they                                                               
have   an  opportunity   in  life.   These  measures   are  being                                                               
implemented in  Alaska. Foster care  is extended  to age 21  if a                                                               
child needs  it. More is  being done  to get youths  into college                                                               
and more  are graduating  than ever before  at the  University of                                                               
Alaska Anchorage.                                                                                                               
                                                                                                                                
The other  good news, he  said, is that for  the first time  in a                                                               
long time  more Alaskan kids  went out  of foster care  than went                                                               
in.  He cannot  guarantee  that that  trend  will continue  every                                                               
month,  but the  predictors  from New  Jersey  and other  studies                                                               
suggest  that that  is  going  to happen.  Youth  will exit  from                                                               
foster care faster into permanent  homes and not left to languish                                                               
in a system that is often harming them.                                                                                         
                                                                                                                                
1:55:21 PM                                                                                                                    
SENATOR GIESSEL  asked Representative  Gara his thoughts  on OCS'                                                               
tribal compacts.                                                                                                                
                                                                                                                                
REPRESENTATIVE GARA  said he is  not the expert, but  he believes                                                               
that  the benefit  for every  tribal organization  is that  those                                                               
communities know  better than social  workers from  Anchorage who                                                               
the best  family placement is. The  kind of casework they  can do                                                               
will depend on how well trained  and how well financed the tribal                                                               
entity is.  The obvious benefit  is they will find  more kindship                                                               
homes and possibly more adoptive homes.                                                                                         
                                                                                                                                
SENATOR BEGICH  asked Representative Gara  what it meant  that in                                                               
2017 removals were down and discharges were up.                                                                                 
                                                                                                                                
REPRESENTATIVE GARA said that means  Alaska is doing a better job                                                               
getting children into permanent homes.                                                                                          
                                                                                                                                
SENATOR VON IMHOF  said she learned that a case  doesn't mean one                                                               
child. It can mean a wide variety of numbers.                                                                                   
                                                                                                                                
REPRESENTATIVE GARA  said in the  child welfare world,  cases are                                                               
families. That could be three children.                                                                                         
                                                                                                                                
1:58:52 PM                                                                                                                    
REPRESENTATIVE GARA paraphrased the  sectional for CSHB 151(FIN),                                                               
version L, as follows:                                                                                                          
                                                                                                                                
Section 1 is the bill title.                                                                                                  
                                                                                                                                
Section 2 talks  about more contact with  prior caregivers, prior                                                             
foster homes.                                                                                                                   
                                                                                                                                
Sections 3-5 are conforming amendments.                                                                                       
                                                                                                                                
Section  6 is  an  amendment  that says  even  if  someone has  a                                                             
barrier crime more than ten  years old, someone can be considered                                                               
as a placement if it is in the child's best interest.                                                                           
                                                                                                                                
Sections 7 and 10 require  that supervisors certify that a family                                                             
or family friend search has occurred.                                                                                           
                                                                                                                                
Section 8 adopts the prudent parent standard.                                                                                 
                                                                                                                                
Section  9  allows  someone  14  or  older  to  be  part  of  the                                                             
development of the case plan and permanency goals.                                                                              
                                                                                                                                
Section 10 is a way to keep siblings in contact with each other.                                                              
                                                                                                                                
Sections  11 and  12  are  repeats of  the  supervisor's duty  to                                                             
certify that a thorough family search has been done.                                                                            
                                                                                                                                
Section  13 states  no removal  from a  home if  there is  a safe                                                             
adult family member in the home.                                                                                                
                                                                                                                                
Section 14 is about sibling contact.                                                                                          
                                                                                                                                
Section  15  is the  guts  of  the  bill.  This is  the  training                                                             
standards and workload standards.  With those standards, turnover                                                               
will  be reduced,  childhood health  will  increase, ACEs  scores                                                               
will be reduced,  and the state will have  more positive outcomes                                                               
with less cost over the long term.                                                                                              
                                                                                                                                
Section 16.  All foster care is  considered out-of-home placement                                                             
but  some out-of-home  placements, with  relatives, for  example,                                                               
are not considered  foster care. Those relatives  not entitled to                                                               
the  daily reimbursement  rate. Sometimes  they cannot  afford to                                                               
take  care of  a child  for  a longer  period of  time. OCS  will                                                               
assist  in   those  relatives   becoming  licensed   foster  care                                                               
families.                                                                                                                       
                                                                                                                                
Section 17.  Many times foster  care leave youth without  a birth                                                             
certificate, social security  card, health insurance information,                                                               
etc. OCS shall help a child leaving care have those things.                                                                     
                                                                                                                                
Section 18 requires a variance for foster homes within 45 days.                                                               
                                                                                                                                
Sections 19-22  are the timelines  for the sections to  come into                                                             
effect over a three-year period.                                                                                                
                                                                                                                                
2:02:49 PM                                                                                                                    
AMANDA  METIVIER, Statewide  Coordinator, Facing  Foster Care  in                                                               
Alaska (FFCA), supported  HB 151. She said she  spent three years                                                               
in foster care  in Anchorage and aged out of  the system. She has                                                               
been a  licensed foster parent for  ten years. She has  two young                                                               
people in her home, along with  her baby. She helped start Facing                                                               
Foster Care when she was 19 to  give young people in the system a                                                               
voice.                                                                                                                          
                                                                                                                                
She  said last  week FFCA  brought 28  current and  former foster                                                               
youth  to  the Capitol  to  advocate  and  lobby. She  wanted  to                                                               
highlight a few  things in the bill that are  really important to                                                               
foster youth. Current  law says OCS is supposed to  try to find a                                                               
relative or family friend up front  to prevent a child from going                                                               
into stranger  foster care. HB  151 adds that a  supervisor would                                                               
certify that a relative search  did happen. One of the priorities                                                               
of tribal compacting is relative search.                                                                                        
                                                                                                                                
She  addressed  the  45-day  response  for  licensing.  She  said                                                               
someone interested  in becoming  a foster  parent may  never hear                                                               
back on  an application  because people  are overwhelmed.  HB 151                                                               
forces a response within 45 days,  which will prevent the loss of                                                               
quality foster  families or  relatives. A  child coming  into the                                                               
protection system  can stay at home  if someone safe is  added to                                                               
the home,  such as  an aunt.  If a child  can safely  maintain in                                                               
their home,  they can stay in  their schools and be  in their own                                                               
neighborhoods with their friends.                                                                                               
                                                                                                                                
2:06:14 PM                                                                                                                    
MS. METIVIER said  contact with siblings is  very important. Last                                                               
week  during the  Lunch and  Learn  program at  the Capitol,  the                                                               
topic of  siblings was very  emotional. The state is  supposed to                                                               
make  an effort  to keep  siblings  together. If  they aren't,  a                                                               
supervisor has to  sign off that efforts were made.  HB 151 would                                                               
require  that  if  siblings  are  separated,  they  have  contact                                                               
information.  They have  a lot  of youth  who complain  that they                                                               
never get  to talk  to their brothers  and sisters.  When someone                                                               
experiences abuse  and neglect  with siblings,  the bond  is even                                                               
stronger.  Many  older  siblings  become  parentified  and  being                                                               
separated  from their  younger siblings  is like  having a  child                                                               
removed.                                                                                                                        
                                                                                                                                
She  said the  reasonable and  prudent parent  standard has  been                                                               
adopted federally but  would be helpful in  state statute because                                                               
then Alaska  courts would  follow it. It  would be  in regulation                                                               
and  licensing.  Their youth  call  it  normalcy. As  a  licensed                                                               
foster  parent, she  knows  the rules  are  strict sometimes  and                                                               
foster parents are  held liable. When she was in  foster care she                                                               
was not allowed  to jump on a trampoline.  Letting foster parents                                                               
allow children  to engage in  normal activities takes  the burden                                                               
off caseworkers  to respond  to all  the requests  because foster                                                               
parents are empowered  to make those decisions. That  may lead to                                                               
them becoming a  permanent loving family because  they can better                                                               
bond with that  child. It's not just about fun  things, it's also                                                               
about disciplinary actions.                                                                                                     
                                                                                                                                
2:09:21 PM                                                                                                                    
MS. METIVIER  said many  studies show that  young people  who are                                                               
engaged in  their case plan are  more likely and more  quickly to                                                               
move toward permanency. Efforts are  being made to get more youth                                                               
into court  hearings, so  judges hear their  voices and  not just                                                               
the  caseworker and  guardian ad  litem. She  said the  bill also                                                               
states  that foster  youth should  not leave  care without  their                                                               
documents.  That should  be  happening now  but  does not  always                                                               
happen.  She noted  that she  left  foster care  without a  birth                                                               
certificate.                                                                                                                    
                                                                                                                                
She said the training and workload  standards in the bill are the                                                               
most comprehensive thing  Alaska has considered. For  the past 15                                                               
years,  young people  have made  many recommendations  for foster                                                               
care.  Many  of  the  problems  and  challenges  are  related  to                                                               
workload  and  staff  time  and  caseworkers  being  able  to  do                                                               
meaningful social  work and do  home visits. If a  caseworker has                                                               
30  cases  and is  responsible  for  50-70  children, it  is  not                                                               
possible  to visit  those  children  every 30  days  and know  if                                                               
children are safe and their needs are being met.                                                                                
                                                                                                                                
MS.  METIVIER said  many  of us  believe that  the  state is  the                                                               
parent to children in the  system. The expectation should be that                                                               
it does do a better job. HB 151 will achieve that.                                                                              
                                                                                                                                
2:13:10 PM                                                                                                                    
CHRISTY   LAWTON,  Director,   Office  of   Children's  Services,                                                               
Department  of Health  and Social  Services (DHSS),  supported HB                                                               
151. She  said she started her  career in child welfare  in 1996.                                                               
She  completed  her  undergraduate internship  in  the  Fairbanks                                                               
office of the then-called Division  of Family and Youth Services.                                                               
That was when she developed a  passion for child welfare. She had                                                               
led a  relatively privileged  and sheltered  life without  a real                                                               
concept of  the hardships many  Alaskan face and the  impact that                                                               
can  have on  their  children. It  was a  rude  awakening to  see                                                               
children who suffered and parents  who hated themselves for being                                                               
the cause. But  she saw the resiliency of children  and the great                                                               
love  parents  have  for  their   children,  despite  their  many                                                               
challenges.                                                                                                                     
                                                                                                                                
She said some of her biggest  worries were the aggressive dogs in                                                               
the  vast  dog  lots  of Interior  Alaska  and  occasionally  the                                                               
emotionally explosive  parent. Even  after obtaining a  Master of                                                               
Social Work in  Anchorage, she only had a handful  of cases where                                                               
she  remembers  real   anxiety  and  fear  working   with  a  few                                                               
particularly ill and dangerous parents.  Back then, she handwrote                                                               
her case notes in her car and did  her best to meet the myriad of                                                               
requirements. She worked  10-12 hours a day and  most weekends to                                                               
put a small  dent in the effort required for  her cases. She kept                                                               
many children  safe and  saw many happy  endings, but  there were                                                               
too many  situations where she  felt she could have,  should have                                                               
done better.                                                                                                                    
                                                                                                                                
MS. LAWTON said she was  soon promoted to supervisor. She thought                                                               
she  could  help   new  workers  avoid  the   pitfalls  of  child                                                               
protection.  She mentored  and  supervised them.  But with  every                                                               
bright light that came into her  unit, it wouldn't be long before                                                               
the light began  to diminish as they become  overwhelmed with the                                                               
burden of  responsibility and the  frustration of not  being able                                                               
to do  the job they  were hired to  do. Caseloads were  high back                                                               
then also and requirements began  to increase with the electronic                                                               
case  management system.  Caseworkers not  only had  to handwrite                                                               
their notes  in the field, but  they had to return  to the office                                                               
and enter  the data in the  computer. That's still the  way it is                                                               
today.                                                                                                                          
                                                                                                                                
MS. LAWTON related her thoughts after she became a manager:                                                                     
                                                                                                                                
     Now, now  I'll be  able to really  make the  changes to                                                                    
     help the  caseworkers and families. I  worked with some                                                                    
     of  the most  dedicated  and brightest  leaders and  we                                                                    
     worked  tirelessly  to  improve  worker  retention  and                                                                    
     improve outcomes for the families  we served and to try                                                                    
     to  build the  credibility of  the profession  of child                                                                    
     welfare in  the eyes  of the community.  By then  I had                                                                    
     the  benefit of  some greater  insight and  was acutely                                                                    
     aware  of the  systemic challenges  we faced  and every                                                                    
     other child welfare  agency in the country  faced. As I                                                                    
     continued  my career,  I had  increased opportunity  at                                                                    
     every  step to  make improvements.  And along  the way.                                                                    
     I'm proud of  the accomplishments I and  so many people                                                                    
     have  made, but  with  those  accomplishments came  the                                                                    
     continued  reality of  the  workforce problem.  Despite                                                                    
     countless   new   ideas,  technical   assistance   from                                                                    
     countless  national experts  and  dedicated energy,  we                                                                    
     simply  couldn't fix  the turnover  of caseworkers  and                                                                    
     the impact it had on those we served.                                                                                      
                                                                                                                                
She  said  the challenges  workers  face  today  are on  a  whole                                                               
different level  than 20  years when she  was a  caseworker. They                                                               
face increasing credible threats to  their personal safety in the                                                               
office  and  in  the  field.  Crime  and  the  never-ending  drug                                                               
epidemic  on top  of the  previous high  rates of  alcohol abuse,                                                               
domestic violence, and  sexual assault make the  work harder than                                                               
ever, and more dangerous. She  has been director for almost eight                                                               
years  and the  child welfare  system has  had as  many highs  as                                                               
lows. It  is a  roller coaster  every single  day. The  one thing                                                               
that never changes  is the inability to give  their employees the                                                               
one thing they  really want most, which is the  time and caseload                                                               
size  to enable  them to  see  countless more  kids and  families                                                               
reunified or never separated to  begin with. Alaska has a choice.                                                               
She said you can decide to  invest in the workforce by supporting                                                               
HB  151  and fix  the  primary  problem  or  you can  let  things                                                               
continue as they are.                                                                                                           
                                                                                                                                
2:18:46 PM                                                                                                                    
MS.  LAWTON said  investing will  help ensure  safe children  and                                                               
strong families with many opportunities  for budget reductions in                                                               
the future  when the system  is able  to give families  what they                                                               
need. Choosing not to support  this legislation may put Alaska at                                                               
risk to be the next state  subject to a class action lawsuit. The                                                               
number of  states with  consent decrees in  place is  growing and                                                               
those consent  decrees go on and  on. New Jersey is  one of those                                                               
states.   That  kind   of  investment   and  focus   didn't  come                                                               
voluntarily.  Alaska  could  do  something  different.  Workforce                                                               
retention in  child welfare has  been a chronic problem  for over                                                               
five decades.  Alaska could  and should be  proactive, so  it can                                                               
develop its  own solutions  for the  challenges the  system faces                                                               
and not have it be a byproduct of a lawsuit settlement.                                                                         
                                                                                                                                
SENATOR  VON  IMHOF  said it  was  extraordinarily  powerful  and                                                               
effective to  have the kids  [from Facing Foster Care  in Alaska]                                                               
in the  Capitol last week.  She thanked  Ms. Lawton for  her work                                                               
and said she can only imagine  what she has seen and experienced.                                                               
The previous speaker  said some the provisions in  this bill came                                                               
directly from foster youth. Two ideas  came from the youth in her                                                               
office when  asked what  could have helped  them stay  with their                                                               
parents. One  said requiring  a urinalysis  for her  parents. The                                                               
second said  when counseling  was required, he  was able  to stop                                                               
the  conflict with  his father  but after  counseling ended,  the                                                               
conflict increased  and he left  the house. She asked  Ms. Lawton                                                               
for her thoughts on those ideas.                                                                                                
                                                                                                                                
2:21:33 PM                                                                                                                    
MS. LAWTON said urinalysis testing  is an area where the pendulum                                                               
goes  back  and forth.  It  is  expensive  and research  says  if                                                               
someone  is  verified to  be  working  a  program, that  sort  of                                                               
excessive  testing   isn't  needed.  OCS  has   tried  to  tailor                                                               
urinalysis testing  to match what  is happening with  the parent.                                                               
If  a  parent  is  in  a  residential  or  intensive  out-patient                                                               
program, urinalysis testing  is provided by those  programs. If a                                                               
parent is doing their own  program, then there usually is regular                                                               
urinalysis testing. If every parent  with a substance abuse issue                                                               
was tested  (which is 80 percent  of the families they  have) the                                                               
cost would be prohibitive.                                                                                                      
                                                                                                                                
She  said for  counseling, every  case is  different. They  worry                                                               
that  workers can  be  automatic when  setting  up referrals  for                                                               
counseling and  sometimes providers will continue  counseling for                                                               
a long time  without reevaluating whether it is  needed. This too                                                               
is expensive  so it  is a  case-by-case determination.  OCS takes                                                               
its  lead from  the  therapeutic person  providing the  services.                                                               
Many of their staff do not  have the expertise to dictate when it                                                               
is appropriate to end therapeutic services.                                                                                     
                                                                                                                                
SENATOR  BEGICH called  the testimony  outstanding.  He asked  if                                                               
most of the caseworkers still don't have laptops.                                                                               
                                                                                                                                
MS.  LAWTON confirmed  that the  majority of  caseworkers do  not                                                               
have laptops.  It has not  been feasible with their  budget. Some                                                               
workers in  some officers  can check out  laptops. Over  the next                                                               
three or four years as  computers are replaced, workers will have                                                               
docking tablets.                                                                                                                
                                                                                                                                
2:25:07 PM                                                                                                                    
CHAIR WILSON said in his  professional career, he has worked with                                                               
OCS  almost  11  years  advocating   for  youth  and  working  on                                                               
reunifications. One  part of  the bill  is to  strengthen systems                                                               
within OCS and another part  addresses the foster care situation.                                                               
He asked what  the average application time for  placement is and                                                               
how private organizations are able to certify foster homes.                                                                     
                                                                                                                                
MS. LAWTON  responded that the  average time to process  a foster                                                               
care  application varies  significantly around  the state.  Their                                                               
goal  is 45  days, but  they are  struggling to  meet that  goal.                                                               
Getting  fingerprints  in  smaller communities  is  a  challenge.                                                               
Applications often  need a lot of  information clarified. Getting                                                               
past  court records  can lead  to delays.  She noted  that a  few                                                               
years ago  OCS received  more funding to  increase the  number of                                                               
licensing staff. In  a place like Anchorage, where  there are not                                                               
have enough foster homes in  a time of increasing demand, someone                                                               
would get  a call for a  placement right away, unless  they had a                                                               
specialty license or were asking for a specific type of child.                                                                  
                                                                                                                                
CHAIR WILSON asked  Ms. Lawton to provide  information on whether                                                               
OCS recruits  for foster homes  and how private  organizations do                                                               
their certification of foster homes.                                                                                            
                                                                                                                                
He also asked for information  about whether training has changed                                                               
for  the new  workers  added last  year and  how  many are  still                                                               
employed.  He  likes to  look  at  problems  as either  a  single                                                               
occurrence or  a systemic issue.  Before he makes  an investment,                                                               
he  wants  to make  sure  that  there is  a  plan  in place  that                                                               
addresses the  research, the data, and  the historical situation.                                                               
When he  goes to administration  with an issue, he  is constantly                                                               
reminded  that he  is  there to  legislate  and appropriate,  not                                                               
administrate. He  sees this bill  as an  administrative function.                                                               
He is  supportive of  the whole concept,  but feels  these things                                                               
are  more  of  an  administrative  function  than  a  legislative                                                               
function. He has talked to the  department about having a plan in                                                               
place  like the  Department  of  Public Safety  has  in terms  of                                                               
recruitment and  retention efforts  before dollars and  folks are                                                               
invested. He wants  DHSS to have an investment plan  of how these                                                               
positions, once  hired, will be  different in terms  of training.                                                               
He  asked if  PCNs [Position  Control Numbers]  would need  to be                                                               
modified before some  of these items can be  implemented. He said                                                               
he wants to  make sure the department is ready  before it adds 30                                                               
additional positions.  He also asked  what has happened  with the                                                               
previous 30 workers.                                                                                                            
                                                                                                                                
MS. LAWTON  said she would  be happy to provide  the information.                                                               
She clarified that the fiscal note is 21 additional positions.                                                                  
                                                                                                                                
2:31:50 PM                                                                                                                    
At ease.                                                                                                                        
                                                                                                                                
2:31:54 PM                                                                                                                    
CHAIR  WILSON   reconvened  the  meeting  and   continued  public                                                               
testimony.                                                                                                                      
                                                                                                                                
TAMMY   SANDOVAL,  Director,   Alaska   Child  Welfare   Academy,                                                               
University of  Alaska Anchorage, supported  HB 151. She  said the                                                               
academy does  the training  for OCS staff.  She is  also Director                                                               
Lawton's predecessor at  OCS. In her 34 years  of experience with                                                               
child  welfare,  she has  never  witnessed  any magic  or  silver                                                               
bullets.  It takes  the  kind of  reform  Representative Gara  is                                                               
proposing  in HB  151. It  takes enough  qualified staff  working                                                               
with  community  partners  to  work  with  children,  youth,  and                                                               
families that are more complex  than she's ever seen. The changes                                                               
that were  made last year are  a good start. They  added two more                                                               
weeks  of training  for  new  workers and  OCS  added mentors  to                                                               
transfer learning  from the classroom  to practice.  Workers have                                                               
expressed  gratitude  for  these  improvements,  but  it  is  not                                                               
enough.  They  can pay  now  or  pay  later  when youth  move  to                                                               
homelessness, juvenile justice, and/or  corrections. "Let's do it                                                               
right from  the beginning,"  she said.  To decrease  the negative                                                               
rates of family dysfunction will take this kind of legislation.                                                                 
                                                                                                                                
2:35:04 PM                                                                                                                    
ELIZABETH   RIPLEY,  Chief   Executive  Officer,   Mat-Su  Health                                                               
Foundation,  supported  HB  151.  She   said  that  in  2013  the                                                               
foundation conducted a Mat-Su  community health needs assessment.                                                               
Mat-Su residents identified their  number one health objective as                                                               
insuring  all  children   are  safe  and  well   cared  for.  The                                                               
foundation  created a  focus area  dedicated  to building  family                                                               
resilience  and  preventing  child  maltreatment,  which  led  to                                                               
staffing  and funding  a place-based,  collective impact  project                                                               
called  Raising  Our  Children with  Kindness,  R.O.C.K.  Mat-Su.                                                               
Since that  time maltreatment  reports in  the Mat-Su  OCS office                                                               
has increased  from 2,840 in  2014 to  3,528 in 2015.  The Palmer                                                               
court Child in Need of Aid  cases have increased from 216 in 2014                                                               
to 271  in 2016, largely due  to the opioid epidemic.  The Mat-Su                                                               
OCS had  653 children in out-of-home  care over 30 days  in 2016.                                                               
The  Mat-Su  Health Foundation  and  R.O.C.K.  Mat-Su staff  have                                                               
become familiar with the caseload  ratios, training deficits, and                                                               
challenging conditions of  the Mat-Su OCS office.  They hear lots                                                               
of complaining from parties across  sectors across the state, but                                                               
very little  constructive assistance to  set OCS and  their staff                                                               
up for  success. HB 151 takes  a crucial step in  that direction.                                                               
It seeks  to improve  both caseload  levels and  worker retention                                                               
through  new  training and  workforce  standards.  The bill  also                                                               
provides for  mentors to help  caseworkers become  more effective                                                               
and make the  transition from training to a  full caseload. These                                                               
evidence-based   standards  will   improve  outcomes   and  allow                                                               
caseworkers  to  perform their  duties  as  intended. The  Mat-Su                                                               
Health  Foundation  recognizes  that  the  Alaska  child  welfare                                                               
system needs reform. HB 151 takes  the step to make real positive                                                               
changes to  support youth  and families  and the  caseworkers who                                                               
serve them.                                                                                                                     
                                                                                                                                
2:38:13 PM                                                                                                                    
BARBARA MALCHUK,  Representing Self, supported HB  151. She spent                                                               
over 25  years as a  guardian ad litem representing  foster youth                                                               
and children around the state.  She retired in 2010 and continued                                                               
as a  CASA [court appointed  special advocate] volunteer.  She is                                                               
now working with  a group of eight siblings. She  is on the Board                                                               
of Directors  for Facing  Foster Care in  Alaska and  traveled to                                                               
Juneau with them  last week. She developed  a training curriculum                                                               
for  the  court  system  for lawyers,  judges,  child  advocates,                                                               
tribal representatives,  and social  workers who handle  Child in                                                               
Need  of Aid  cases. Her  experience has  given her  a good  feel                                                               
about how  the child  protection system works  or does  not work.                                                               
She  supports  the  entire  bill,  but she  wanted  to  focus  on                                                               
children  and  youth  keeping  family  connections.  The  sibling                                                               
relationship  is  even  more  important  for  children  who  have                                                               
experienced  abuse and  neglect. Often  times the  older children                                                               
are caregivers for the younger children.                                                                                        
                                                                                                                                
She said  during the  Lunch and  Learn program  last week  at the                                                               
Capitol, nearly  all the  foster youth  there had  been separated                                                               
from  their  siblings   and  most  of  them   have  lost  contact                                                               
altogether. She's  seen numerous  youth tell their  stories about                                                               
foster care. They always seem to  hold it together until they get                                                               
to  the part  about losing  contact  with siblings  and then  the                                                               
tears start to flow. Under  the current law siblings are supposed                                                               
to  be  together if  possible  and  OCS policy  requires  ongoing                                                               
contact  between siblings.  But the  reality  is that  it is  not                                                               
happening. HB 151  has mechanisms to enforce  ongoing contact. It                                                               
gives  OCS  the  authority  and responsibility  to  give  contact                                                               
information   and   encourages   caregivers  to   give   siblings                                                               
opportunities to remain in touch.                                                                                               
                                                                                                                                
2:41:56 PM                                                                                                                    
MS.  MALCHUCK  said  relative placement  is  important  for  many                                                               
reasons. When  children are with  relatives they are  more likely                                                               
to be  in contact with  other family  members. It allows  them to                                                               
maintain  their   cultural  identity.  It  leaves   foster  homes                                                               
available to children  without relatives to stay  with. She hears                                                               
from  many youth  about the  years  in foster  care and  numerous                                                               
placements and many find out  relatives were never contacted. All                                                               
too often  the family search  doesn't happen. HB 151  offers some                                                               
improvements  to make  relative placement  a reality.  Also, many                                                               
relatives  cannot  afford  to  take care  of  children  and  need                                                               
assistance through a foster care  license. HB 151 requires OCS to                                                               
assist with that. HB 151 gives  advocates in court a mechanism to                                                               
enforce good policy.                                                                                                            
                                                                                                                                
2:44:25 PM                                                                                                                    
CHAIR WILSON held HB 151 in committee.                                                                                          
                                                                                                                                
^CONFIRMATION HEARING(S): State Medical Board                                                                                   
                    CONFIRMATION HEARING(S)                                                                                 
                      State Medical Board                                                                                   
                                                                                                                              
2:44:37 PM                                                                                                                    
CHAIR   WILSON  reconvened   the   meeting   and  announced   the                                                               
consideration of  the Governor's appointees to  the State Medical                                                               
Board.                                                                                                                          
                                                                                                                                
SAI-LING LIU, M.D.,  Appointee, State Medical Board,  said she is                                                               
a  family practice  certified physician  for Norton  Sound Health                                                               
Corporation in  Nome, Alaska. She  has been a board  member since                                                               
2013. This will be her second term.                                                                                             
                                                                                                                                
SENATOR GIESSEL asked why she is interested in continuing.                                                                      
                                                                                                                                
DR.  LIU  said there  is  a  lot of  turnover  in  the board  and                                                               
continuity is important. At the  request of several board members                                                               
she  will  continue  for  another  term if  confirmed.  It  is  a                                                               
dedicated  group of  physicians  safeguarding  public safety  for                                                               
medical  care.  There  is  an   increasing  number  of  licensing                                                               
applications  for  Alaska  because  of  telemedicine.  It  is  an                                                               
important board. She is honored to be on it.                                                                                    
                                                                                                                                
SENATOR  GIESSEL  said   it  is  a  huge   time  commitment,  but                                                               
continuity on the  board important. She thanked  her for stepping                                                               
up again.                                                                                                                       
                                                                                                                                
2:48:02 PM                                                                                                                    
CATHERINE HYNDMAN, M.D., Appointee,  State Medical Board, said in                                                               
2000  she  became  employed  by   the  Bristol  Bay  Area  Health                                                               
Corporation. She is the clinical  director. She brings viewpoints                                                               
of those in the bush region,  particularly with regard to the odd                                                               
combinations one  must have  in the bush  without the  ability to                                                               
immediately  access tertiary  care.  She can  speak  to the  care                                                               
patients have gotten in the bush.                                                                                               
                                                                                                                                
CHAIR  WILSON asked  what  the most  challenging  aspects are  to                                                               
providing medical care to rural communities.                                                                                    
                                                                                                                                
DR.  HYNDMAN  said  care  is  often quite  a  distance  away  and                                                               
oftentimes the coordination of care  becomes a challenge in terms                                                               
of determining  what means  of transportation  is needed  and how                                                               
that can  be arranged. Her hospital  is a level 4  trauma center.                                                               
They  cannot do  much more  than stabilize,  but they  need well-                                                               
trained physicians in the bush  who can deal with emergency care.                                                               
They face a  lot of problems that also exist  in the cities, such                                                               
as the difficulties  with alcohol and drug abuse.  Alcohol is the                                                               
cause of  most of the trauma  that they see. Getting  and keeping                                                               
physicians is  difficult because of  the privations of  living in                                                               
the bush,  such as getting a  gallon of milk when  the weather is                                                               
bad  and the  public transportation  issue. They  are blessed  to                                                               
have strong  health aides. She  suspects all the bush  regions of                                                               
the state are  blessed with strong health aides,  but she started                                                               
at ground  zero in learning  how to  deal with health  aides when                                                               
she started.  That can be a  challenge for physicians new  to the                                                               
bush.                                                                                                                           
                                                                                                                                
2:52:22 PM                                                                                                                    
SENATOR GIESSEL  noted that  Dr. Hyndman  was first  appointed in                                                               
December. She asked if she had attended a board meeting.                                                                        
                                                                                                                                
DR. HYNDMAN said her first meeting will be in May.                                                                              
                                                                                                                                
SENATOR GIESSEL  said she  may be able  to write  regulations for                                                               
new  clinicians  to assist  physicians.  There  is a  bill  going                                                               
through  the  legislature  that  will  allow  the  delegation  to                                                               
unlicensed  assistant  personnel  as well  as  certified  medical                                                               
assistants.  She will  be  learning a  lot  about the  regulatory                                                               
process.                                                                                                                        
                                                                                                                                
2:53:24 PM                                                                                                                    
CHAIR WILSON opened and closed public testimony.                                                                                
                                                                                                                                
2:53:56 PM                                                                                                                    
SENATOR  VON  IMHOF  moved that  the  appointments  of  Catherine                                                               
Hyndman and Sai-Ling Liu to  the State Medical Board be forwarded                                                               
to a joint  session for consideration. She  reminded members that                                                               
this does  not reflect an  intent by any  of the members  to vote                                                               
for  or against  the confirmation  of the  individual during  any                                                               
further sessions.                                                                                                               
                                                                                                                                
There being no objection, the names were forwarded.                                                                             
                                                                                                                                
2:54:23 PM                                                                                                                    
At ease.                                                                                                                        
                                                                                                                                
2:54:31 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Wilson adjourned  the Senate  Health  and Social  Services                                                               
Standing Committee at 2:54 p.m.                                                                                                 

Document Name Date/Time Subjects
State Medical Board Liu.pdf SHSS 3/19/2018 1:30:00 PM
SHSS March 19, 2018
State Medical Board Hyndman.pdf SHSS 3/19/2018 1:30:00 PM
SHSS March 19
HB 151 version L.PDF SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Sponsor Statement Senate HSS.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Sectional analysis version L.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Alaska Caseloads FY 17 and 18.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
Conference Committee Action 6-21 on OCS funding increase.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Additional letters of support (Trust, AMHB, ARC, Access Alaska, FFCA).pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Applying the Science of Child Development in Child Welfare Systems excerpt.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Article - High caseloads hinder face-to-face visits with foster kids.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Article - Iowa's social workers see growing foster care loads.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 article High Caseloads Hinder Face-to-Face Visists with Foster Kids.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Article High Turnover, Caseloads in Louisiana Foster Care System.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Article Indiana Foster Care System is in Crisis.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 article Opioid Crisis Strains Indiana Foster Care System.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Caseload and Workload Management.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Facts about Child Abuse in Alaska.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Family Reunification, What the Evidence Shows.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Foster Care PowerPoint for SEN HSS.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 How Heroin is Hitting the Foster Care System.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 National Child Welfare Workforce Institute Brief on the Importance of Manageable Caseloads.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 New Jersey DCF Work Force Report excerpt.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 New Jersey's Child Welfare Outcomes Report 2017.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Reunification, Bringing Your Child Home from Foster Care.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Supporting Document 1. OCS Office by Office Caseloads.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Supporting Document 3. Children Waiting to be Adopted 2014.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Supporting Document 10. Relevant Statistics.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Supporting Document 14. Letters of Support.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Supporting Document 2. High Caseloads How Do They Impact Health and Human Services 3.1.17.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Supporting Document 15. Casey Family Programs Testimony.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 Summary of New Jersey Settlement Agreement.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
LetterOfSupport-R.O.C.K.MatSu-HB151.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
MSHF Letter of Support HB151.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 FN Dept Admin Ofc Public Advocacy.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 FN DHSS Children's Services Training.pdf SHSS 3/19/2018 1:30:00 PM
HB 151
HB 151 FN DHSS Front Line Social Workers.pdf SHSS 3/19/2018 1:30:00 PM
HB 151