Legislature(2019 - 2020)BUTROVICH 205

02/08/2019 01:30 PM HEALTH & SOCIAL SERVICES

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01:31:52 PM Start
01:32:18 PM Presentation: Governor's Council on Disabilities and Special Education
02:20:43 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation: TELECONFERENCED
Governor's Council on Disabilities & Special
Education
-- Teleconference <Invitation Only> --
-- Testimony <Invitation Only> --
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                        February 8, 2019                                                                                        
                           1:31 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator David Wilson, Chair                                                                                                     
Senator John Coghill, Vice Chair                                                                                                
Senator Gary Stevens                                                                                                            
Senator Cathy Giessel                                                                                                           
Senator Tom Begich                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                                
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
PRESENTATION: GOVERNOR'S COUNCIL ON DISABILITIES AND SPECIAL                                                                    
EDUCATION                                                                                                                       
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
No previous action to record                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
PATRICK REINHART, Executive Director                                                                                            
Governor's Council on Disabilities and Special Education                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Presented on the Governor's Council on                                                                    
Disabilities and Special Education.                                                                                             
                                                                                                                                
MILLI RYAN, Board Member                                                                                                        
Key Coalition of Alaska                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented on the Key Coalition of Alaska.                                                                 
                                                                                                                                
MAGGIE WINSTON, Chair                                                                                                           
Governor's Council on Disabilities and Special Education                                                                        
Kenai, Alaska                                                                                                                   
POSITION  STATEMENT:  Presented  on  the  Governor's  Council  on                                                             
Disabilities and Special Education.                                                                                             
                                                                                                                                
HANS WAGGONER, representing self                                                                                                
Nikiski, Alaska                                                                                                                 
POSITION   STATEMENT:    Testified   about    family's   waitlist                                                             
experience.                                                                                                                     
                                                                                                                                
AMANDA WAGGONER, representing self                                                                                              
Nikiski, Alaska                                                                                                                 
POSITION   STATEMENT:    Testified   about    family's   waitlist                                                             
experience.                                                                                                                     
                                                                                                                                
MICHELE GIRAULT, representing self                                                                                              
Anchorage, Alaska                                                                                                               
POSITION   STATEMENT:  Testified   about   her  ward's   waitlist                                                             
experience.                                                                                                                     
                                                                                                                                
SYDNEY KREBSBACH, representing self                                                                                             
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified on the  difficulty of finding a job                                                             
as someone with autism.                                                                                                         
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
                                                                                                                                
1:31:52 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 Stevens, Coghill,  Begich, and Chair                                                               
Wilson.                                                                                                                         
                                                                                                                                
^Presentation:  Governor's Council  on  Disabilities and  Special                                                               
Education                                                                                                                       
  Presentation: Governor's Council on Disabilities and Special                                                              
                           Education                                                                                        
                                                                                                                                
1:32:18 PM                                                                                                                    
CHAIR  WILSON  announced  the   presentation  on  the  Governor's                                                               
Council on Disabilities and Special Education.                                                                                  
                                                                                                                                
1:32:52 PM                                                                                                                    
PATRICK  REINHART,  Executive  Director,  Governor's  Council  on                                                               
Disabilities and Special Education,  Anchorage, Alaska, said they                                                               
were combining  the Governor's Council presentation  with the Key                                                               
Coalition  because  they are  delivering  the  same messages.  He                                                               
reviewed the five roles of the council:                                                                                         
                                                                                                                                
       Developmental Disabilities Council (each state has                                                                       
     one)                                                                                                                       
     Special Education Advisory Panel (each state has one)                                                                      
        Interagency Coordinating Council for Infants and                                                                        
     Toddlers with Disabilities (another federal role)                                                                          
     Beneficiary Advisory Board to the Alaska Mental Health                                                                     
     Trust Authority (a state role)                                                                                             
     Governing Body of the Special Education Service Agency                                                                     
     (a state role)                                                                                                             
                                                                                                                                
1:34:42 PM                                                                                                                    
MILLI  RYAN,  Board  Member, Key  Coalition  of  Alaska,  Juneau,                                                               
Alaska, said that the Key Coalition  been coming to Juneau for 32                                                               
years. It's  a grassroots  organization comprised  of individuals                                                               
with  intellectual and  developmental disabilities,  their family                                                               
members,  service   providers,  and  other  advocates.   The  Key                                                               
Coalition has worked with the  legislature to do wonderful things                                                               
to  make life  better for  people with  disabilities. One  of the                                                               
major things was to close  Harborview Developmental Center, which                                                               
was Alaska's  sole institution for  people with  disabilities, in                                                               
1997  and to  establish the  groundwork for  home and  community-                                                               
based services. They  worked with the Governor's  Council to pass                                                               
Employment First  legislation, autism  insurance reform,  and the                                                               
reuse program of durable medical equipment.                                                                                     
                                                                                                                                
1:35:45 PM                                                                                                                    
MAGGIE  WINSTON, Chair,  Governor's Council  on Disabilities  and                                                               
Special Education, Kenai,  Alaska, said last year  they worked to                                                               
pass legislation  on the Developmental Disability  Shared Vision.                                                               
They  have been  doing amazing  work  to make  sure Alaskans  are                                                               
living  person-directed and  person-centered  lives, moving  away                                                               
from  the  medical  model  of disabilities  to  a  social  model.                                                               
Individuals with  disabilities are  not broken. They  are leading                                                               
normal lives  that have meaning. That  is the whole point  of the                                                               
vision:                                                                                                                         
                                                                                                                                
     Alaskans share a  Vision of a flexible system  in which each                                                               
     person directs their own supports,  based on their strengths                                                               
     and  abilities,  toward a  meaningful  life  in their  home,                                                               
     their  job   and  their   community.  Our   Vision  includes                                                               
     supported   families,   professional  staff   and   services                                                               
    available throughout the state now and into the future.                                                                     
                                                                                                                                
MS. WINSTON said  they have six project teams.  She co-chairs one                                                               
team. This has made the work they do much easier.                                                                               
                                                                                                                                
MR.  REINHART shared  an  infographic  that illustrates  Alaska's                                                               
developmental disabilities  system. They  have been  changing the                                                               
system to a home and  community-based system. He pointed out that                                                               
the  council was  awarded an  Administration on  Community Living                                                               
federal  grant of  $1.96  million  over five  years  to make  the                                                               
Shared Vision  a reality.  The council was  one of  five grantees                                                               
out of many applications.                                                                                                       
                                                                                                                                
1:38:32 PM                                                                                                                    
SENATOR BEGICH asked if the grant goes directly to the council.                                                                 
                                                                                                                                
MR. REINHART answered that they  are part of Department of Health                                                               
and Social Services (DHSS) and it is a grant to the council.                                                                    
                                                                                                                                
SENATOR   BEGICH    asked   whether   federal    money   requires                                                               
authorization.                                                                                                                  
                                                                                                                                
MR. REINHART answered yes, and  there is enough federal authority                                                               
in the budget, so it does not need to be increased.                                                                             
                                                                                                                                
MS.  RYAN said  the  first  priority for  the  Key Coalition  and                                                               
council is to reduce the  waitlist for developmental disabilities                                                               
services. Alaska's  home and  community-based systems  are funded                                                               
by  Medicaid  with  50  percent  state  funding  and  50  percent                                                               
federal.  Medicaid   recognizes  that   the  demand   can  exceed                                                               
resources and allows  states to maintain a waitlist  for home and                                                               
community-based  waiver  services.  For Alaska  it  only  affects                                                               
people  with  intellectual  and  developmental  disabilities.  In                                                               
Fiscal  Year  16,  the  number  of people  drawn  from  the  list                                                               
annually dropped from 200 to 50.                                                                                                
                                                                                                                                
1:41:00 PM                                                                                                                    
SENATOR GIESSEL joined the committee.                                                                                           
                                                                                                                                
MS.  RYAN said  they  know  that the  longer  people  are on  the                                                               
waitlist,  the costlier  it becomes  because typically  they need                                                               
more services. Intellectual  and developmental disabilities (IDD)                                                               
affect  people  before  age  22.  Individuals  with  IDD  require                                                               
individualized, comprehensive and life-long  services in order to                                                               
live successfully in the community.                                                                                             
                                                                                                                                
SENATOR  BEGICH  asked  if  there  are over  800  people  on  the                                                               
waitlist.                                                                                                                       
                                                                                                                                
MS. RYAN answered that it is 982.  It had been down to 500 before                                                               
the number of draws decreased.                                                                                                  
                                                                                                                                
MS. RYAN displayed graphs that showed  the cost of care with home                                                               
and  community-based  services  vs. institutions.  It  cost  $181                                                               
million to serve 2,069 individuals  with home and community-based                                                               
services.  In  institutions,  the   cost  could  be  almost  $387                                                               
million.                                                                                                                        
                                                                                                                                
MS. RYAN  said the waitlist  has gone up  447 people in  the last                                                               
three  years.  For  the  last  four  or  five  years,  they  have                                                               
submitted cost  savings ideas  to offset  the cost  of increasing                                                               
the number  of draws. This  includes technology that  reduces the                                                               
need  for  direct  staff  assistance.  Some  examples  are  stove                                                               
sensors  and  remote   monitors.  They  used  to   have  a  semi-                                                               
independent  living  option.  A  change  in  regulation  requires                                                               
services to  be done on  a one-on-one  basis, which is  much more                                                               
expensive.  The  services   are  primarily  rehabilitation-based,                                                               
which means  people must learn  skills and have  goals associated                                                               
with that.  People can only  have so many  goals. It can  be more                                                               
important just  to go out in  the community and volunteer  and do                                                               
things like go  to church or go  to a movie. They  have also made                                                               
recommendations about supported employment.                                                                                     
                                                                                                                                
1:45:28 PM                                                                                                                    
                                                                                                                                
MS.  RYAN   said  she  is   happy  to  report  that   Senior  and                                                               
Disabilities  Services (SDS)  has  said it  is  working on  these                                                               
recommendations. Key  Coalition believes that  implementing these                                                               
would  allow an  increase in  the annual  draw from  the waitlist                                                               
from 50 to 100.                                                                                                                 
                                                                                                                                
MR. REINHART  said they had  some real-life testimony  about what                                                               
it was like to be waiting for services.                                                                                         
                                                                                                                                
1:46:34 PM                                                                                                                    
HANS WAGGONER,  representing self,  Nikiski, Alaska, said  he and                                                               
wife Amanda have  an 18-year-old daughter, who  is nonverbal, not                                                               
potty-trained,  and severely  autistic.  A  behaviorist has  told                                                               
them she is  in the top one  percent of the hardest  in the state                                                               
to take  care of. They signed  up for services before  they moved                                                               
and four years later, they still have no services                                                                               
                                                                                                                                
1:46:58 PM                                                                                                                    
AMANDA  WAGGONER, representing  self, Nikiski,  Alaska, said  her                                                               
daughter is  regressing because  she hasn't been  able to  go out                                                               
into  the  community.  They  have two  children  in  their  early                                                               
twenties. One  stopped college and  one moved from New  Jersey to                                                               
help with the family because they  can't work. They are doing 24-                                                               
hour care. The older kids are  watching her while they testify in                                                               
Juneau.                                                                                                                         
                                                                                                                                
MS. WAGGONER said they have to  take shifts to care for her. They                                                               
are burned out.                                                                                                                 
                                                                                                                                
MR. WAGGONER said they have  polycarbonate windows so she doesn't                                                               
break them.                                                                                                                     
                                                                                                                                
MS. WAGGONER  said it has  all been family and  community support                                                               
in Nikiski.  It is all on  their shoulders. They don't  know what                                                               
to do.  They don't think  they will ever  get that little  bit of                                                               
extra  help so  they  can work  and  their kids  can  go back  to                                                               
college.                                                                                                                        
                                                                                                                                
MR. WAGGONER  said his  parents have  given everything,  but they                                                               
are getting older. Family and  extended family have been under so                                                               
much stress.                                                                                                                    
                                                                                                                                
MS. WAGGONER  said they would be  more useful to society  if they                                                               
had some help.                                                                                                                  
                                                                                                                                
SENATOR BEGICH asked  to confirm that their daughter  has been on                                                               
the waiting list four years.                                                                                                    
                                                                                                                                
MR. WAGGONER  responded that they  had signed her up  about eight                                                               
different times. It gets lost in the system every time.                                                                         
                                                                                                                                
SENATOR BEGICH asked if she is on the waiting list now.                                                                         
                                                                                                                                
MR. WAGGONER said he believed so.                                                                                               
                                                                                                                                
SENATOR BEGICH  asked whether she  would be included if  the draw                                                               
increased to 100.                                                                                                               
                                                                                                                                
MR. WAGGONER said she should be.                                                                                                
                                                                                                                                
MS. WAGGONER said she is one of the most extreme cases.                                                                         
                                                                                                                                
SENATOR BEGICH asked  what they would do if she  doesn't come off                                                               
the waiting list.                                                                                                               
                                                                                                                                
MR. WAGGONER  answered, "Just keep  trying to survive. Go  to the                                                               
food bank and just  scrape by any way we can."  He said they have                                                               
caretaker burnout. This  is their first two-day  break from their                                                               
daughter in ten years.                                                                                                          
                                                                                                                                
MS. WAGGONER  said that's why  they were  there. They have  a big                                                               
support system,  but they  are not  the people  who can  sign the                                                               
paperwork to get them help.                                                                                                     
                                                                                                                                
1:50:58 PM                                                                                                                    
MICHELE   GIRAULT,   representing    self,   Anchorage,   Alaska,                                                               
introduced  Carrie Carson,  someone she's  been friends  with for                                                               
almost forty  years. After  Carrie's parents  passed on,  she and                                                               
her husband  became Carrie's  legal guardians.  Carrie is  on the                                                               
waitlist. With  Medicaid reform, SB  74, there was an  impetus to                                                               
change the services for those who  had been on grant services. In                                                               
Alaska, people  get qualified to have  developmental disabilities                                                               
services. For  a number  of years,  she received  basic supports.                                                               
Carrie is  a skilled artist  and participated in Hope  Studios in                                                               
Anchorage.  With  the  transition   of  grant  services  to  ISWs                                                               
(Individualized  Support Waiver),  the expectation  was those  on                                                               
grant services would  seamlessly transition to the  ISW. That did                                                               
not  happen. As  of December  31, a  number of  people were  just                                                               
dropped from services.  Carrie is the face of  the waitlist. They                                                               
are there to  advocate for a path for those  who had services for                                                               
many  years.  She gave  an  example  of  another person  who  was                                                               
dropped from all services. Alaska  is better than that. When they                                                               
process the budget that would be  coming out, she wanted to alert                                                               
and educate  them that  there are faces  behind the  waitlist and                                                               
people who  cannot wait any  longer. Carrie  has a life  to lead.                                                               
She and  her husband were told  that if they kicked  her out, she                                                               
would score higher  on the waitlist draw. That is  not an option.                                                               
They will  be there  for her,  but Carrie needs  to live  her own                                                               
life.                                                                                                                           
                                                                                                                                
1:53:59 PM                                                                                                                    
SENATOR COGHILL asked  whether the issues with  the transition to                                                               
ISWs   were  qualification   changes,   a   funding  switch,   or                                                               
bureaucratic paperwork issue.                                                                                                   
                                                                                                                                
MR.  REINHART  responded  a  little of  all  those  things.  They                                                               
supported  the intention  of taking  grant-funded  services to  a                                                               
Medicaid waiver. A lot of them  helped SDS design that waiver. It                                                               
took longer than  they ever thought it would, so  the grant funds                                                               
were  extended.  Getting people  to  switch  from a  grant-funded                                                               
program to  Medicaid was probably more  complicated than families                                                               
were  used to.  It just  has been  slow. The  regulations took  a                                                               
while to get through the process.  It has been a combination of a                                                               
bunch of different  things. A lot of people  wouldn't qualify for                                                               
Medicaid, so  a safety fund  was set up  for them, but  even that                                                               
utilization has been a slow  transition. People have been dropped                                                               
from services and are scrambling  for support. It was supposed to                                                               
be a smooth  transition to ISWs. There were a  lot of reasons why                                                               
that didn't happen.                                                                                                             
                                                                                                                                
MS.  RYAN said  federal law  mandates institutional  services for                                                               
individuals  (if they  meet the  level of  care) and/or  families                                                               
upon request.  The Waggoners  could ask  for that.  They'd rather                                                               
keep their  daughter at home.  But if  they wanted to,  the state                                                               
would  have  to provide  that  service.  Senior and  Disabilities                                                               
Services  (SDS) administers  home  and community-based  services,                                                               
but  the  funding  is  in the  Medicaid  Services  budget,  which                                                               
includes  adult dental,  behavioral health,  and general  health.                                                               
Those are generally  treatment-oriented services. The expectation                                                               
is that services will fix  people's problems. Home and community-                                                               
based  services   are  vastly   different  from   those  Medicaid                                                               
services. Disabilities will be part  of people's lives. They want                                                               
to make sure they have the  support and flexibility to live their                                                               
lives.  They feel  that  people  with developmental  disabilities                                                               
served by SDS require specific and augmented protections.                                                                       
                                                                                                                                
1:58:41 PM                                                                                                                    
MS. RYAN said they are  recommending that SDS Medicaid funding be                                                               
moved  out of  that Medicaid  Services appropriation.  Before SDS                                                               
was   formed,   people   with  intellectual   and   developmental                                                               
disabilities were  served through  the Division of  Mental Health                                                               
and  Developmental Disabilities,  which  merged  and became  SDS.                                                               
They had Medicaid  funding in their budget at that  time, so they                                                               
think it  would be good to  have the funding out  of the Medicaid                                                               
Services appropriation.                                                                                                         
                                                                                                                                
SENATOR COGHILL  asked if  they had talked  to the  Mental Health                                                               
Trust about that.                                                                                                               
                                                                                                                                
MR.  REINHART  responded  that  not  everyone  agrees  with  this                                                               
concept. It is a separate  conversation about a proportion of the                                                               
budget that is completely different.  Not all the advisory boards                                                               
are in line with that yet, but they are working on it.                                                                          
                                                                                                                                
SENATOR COGHILL said  that the legislature in many  ways looks to                                                               
the trust to figure out a pathway forward.                                                                                      
                                                                                                                                
MS. RYAN and MR. REINHART said  they would talk to the trust more                                                               
about this.                                                                                                                     
                                                                                                                                
MR. REINHART  said they  are passionate about  jobs. A  few years                                                               
ago,  the council  and the  Key  Coalition worked  on passing  an                                                               
Employment  First  law.  It was  aspirational  language  that  if                                                               
someone wanted a  job, they would find ways  of employing people.                                                               
In 2016, 73 percent of Alaskans  of working age were employed, 49                                                               
percent  of those  with disabilities,  but only  27.6 percent  of                                                               
those with  developmental disabilities. They  have a long  way to                                                               
meet the Employment First ideal.                                                                                                
                                                                                                                                
MR.  REINHART said  they have  some  ideas for  working with  the                                                               
administration.  One  is  a  leadership  group  from  departments                                                               
involved with  employment to  work across silos  on the  issue of                                                               
jobs for their beneficiaries.                                                                                                   
                                                                                                                                
MR.  REINHART introduced  a  new member  of  the council,  Sydney                                                               
Krebsbach.                                                                                                                      
                                                                                                                                
2:03:58 PM                                                                                                                    
SYDNEY KREBSBACH, representing self,  Juneau, Alaska, said she is                                                               
a  young  adult   with  autism  on  the   Governor's  Council  on                                                               
Disabilities  and Special  Education. She  has struggled  to find                                                               
gainful  employment. She  has worked  seasonal  jobs in  tourism,                                                               
which built skills and increased  her social interaction, but had                                                               
not found permanent  employment, even with the help  of REACH and                                                               
Division of Vocational  Rehabilitation. In the fall  of 2016, she                                                               
applied for 28  jobs and no one gave her  an opportunity to prove                                                               
that she  can do the work.  Her older sister suggested  she apply                                                               
as  a page  for the  legislature.  This is  her third  year as  a                                                               
Senate  page.  This  has  given  her  confidence  to  create  new                                                               
opportunities.  Last  year  she completed  the  LEND  [Leadership                                                               
Education   in  Neurodevelopmental   and  related   Disabilities]                                                               
program through  the University of  Alaska and she  was appointed                                                               
to the council.  She is there to raise her  voice for people with                                                               
autism and other disabilities who  become frustrated with the job                                                               
search. Her message is never give  up and persevere. She said she                                                               
would speak out  until Alaska made the necessary  changes so that                                                               
they  feel  they   belong  in  their  community   and  are  given                                                               
opportunities to contribute and make a positive difference.                                                                     
                                                                                                                                
SENATOR COGHILL  said that it  has been  a pleasure to  work with                                                               
her and to see her in this role.                                                                                                
                                                                                                                                
SENATOR BEGICH told her to keep guiding them.                                                                                   
                                                                                                                                
SENATOR GIESSEL  said that she  a delight every morning  when she                                                               
comes into her office.                                                                                                          
                                                                                                                                
CHAIR WILSON said he wanted to echo his colleagues.                                                                             
                                                                                                                                
SENATOR COGHILL said the  waitlist for developmental disabilities                                                               
has plagued  them for many years.  He asked if people  are placed                                                               
according to need and services available.                                                                                       
                                                                                                                                
2:08:25 PM                                                                                                                    
MR.  REINHART said  it  is  a weighted  waitlist  with a  scoring                                                               
system. People are  supposed to rise higher on the  list as their                                                               
needs rise.  Sometimes the draw  is more  than 50 a  year because                                                               
people pass away or move.  Sixty-three were drawn this last year.                                                               
They  do  ask  what  happens  when  a  family  has  good  natural                                                               
supports.  Those are  some  of  the nuances  they  are trying  to                                                               
figure out. They  have recently talked about the need  to look at                                                               
the scoring  again. Every  few years they  talk about  that. They                                                               
have heard about  families in crisis who should be  at the top of                                                               
the  list.  There  are  delays  for  people  to  become  Medicaid                                                               
eligible. Becoming eligible is difficult  and there is a backlog.                                                               
That is another reason why people are waiting for an ISW.                                                                       
                                                                                                                                
SENATOR COGHILL  said the Waggoners  up the level  of frustration                                                               
on their part. His  guess is that they are not  only ones in such                                                               
desperate need.  How can that  can go unanswered  still surprises                                                               
him. Thank heaven for family  support, but family burnout happens                                                               
as well.  They have  no solution  today, but  the need  is there.                                                               
They are  looking for  solutions also.  Resources are  scarce. In                                                               
Fairbanks he  has noticed that  the community has stepped  up for                                                               
transportation. He asked how that looks across Alaska.                                                                          
                                                                                                                                
MR. REINHART answered that the  Governor's Council and many other                                                               
groups are  involved with  the Alaska  Mobility Coalition.  He is                                                               
president of  that group.  It has  been a big  issue for  so many                                                               
years. Their beneficiaries need  transportation if they are going                                                               
to participate  in the community.  Fairbanks just went  through a                                                               
coordinated transportation  plan. Anchorage is going  through the                                                               
same thing.  Some of  the smaller communities  are not  getting a                                                               
coordinated system.  It is  catch-as-catch-can many  times. There                                                               
is not a  lot of money for  this. They had some  support from the                                                               
legislature for matching  funding in the capital  budget the last                                                               
few  years. He  thinks last  year it  was $500,000  and the  year                                                               
before it  was a $1  million. It  gets distributed from  small to                                                               
larger providers  in the  hope that they  can draw  federal funds                                                               
for that.  There is  also some Mental  Health Trust  funding. The                                                               
budget  proposal put  forth includes  $800,000  of general  funds                                                               
mental health and  $350,000 from the Alaska  Mental Health Trust.                                                               
Public  transit often  doesn't get  a lot  of local  support. The                                                               
Alaska  Mobility   Coalition  is  always  trying   to  work  with                                                               
providers to  get the message out  about the need. It's  not just                                                               
people with  disabilities but  also seniors,  a number  of folks.                                                               
Some systems in  the state are awesome. Juneau is  a good example                                                               
of a really good system.                                                                                                        
                                                                                                                                
2:15:23 PM                                                                                                                    
SENATOR COGHILL said  three things are always of  benefit to help                                                               
people to  grow and flourish: transportation,  communication, and                                                               
a   helping   hand.   Respite   care   and   transportation   and                                                               
communication  capacity  are  such big  deals.  Communication  is                                                               
getting  better because  of  technology,  but transportation  can                                                               
isolate people.                                                                                                                 
                                                                                                                                
MR.  REINHART replied  that technology  can help  with isolation.                                                               
Technology is becoming less and  less expensive. Things that cost                                                               
$10,000 a few  years ago are apps that can  sometimes be download                                                               
for free. As  Ms. Ryan mentioned, technology can open  up so many                                                               
opportunities for  people to live  more independently  and safely                                                               
in their homes. This will also be for the aging population.                                                                     
                                                                                                                                
SENATOR BEGICH asked about the status of respite care.                                                                          
                                                                                                                                
MS. RYAN  said respite  services are  available through  the home                                                               
and community-based  waiver. It can  be written into the  plan of                                                               
care. It used  to be funded through grants, but  now is available                                                               
through the ISW, so it is not as available as it once was.                                                                      
                                                                                                                                
SENATOR  BEGICH said  then  those  on the  waiting  list are  not                                                               
eligible.                                                                                                                       
                                                                                                                                
MS. RYAN answered yes.                                                                                                          
                                                                                                                                
CHAIR WILSON said the Division  of Behavioral Health will address                                                               
some  of  these issues,  as  well  as general  behavioral  health                                                               
issues,  in a  later presentation.  He said  he has  gotten phone                                                               
calls every week  about the difficulty of navigating  to the ISW.                                                               
It is  a complex system  working out  the bumps. They  don't want                                                               
individuals to  suffer during  this process.  They are  trying to                                                               
work with the administration to lessen the burden on Alaskans.                                                                  
                                                                                                                                
2:20:43 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Wilson adjourned  the Senate  Health  and Social  Services                                                               
Standing Committee at 2:20 p.m.                                                                                                 

Document Name Date/Time Subjects
2019 Council Presentation to House and Senate Final.pptx SHSS 2/8/2019 1:30:00 PM
Governor's Council on Disabilities and Special Education