Legislature(2019 - 2020)BUTROVICH 205

03/22/2019 01:30 PM HEALTH & SOCIAL SERVICES

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Audio Topic
01:32:29 PM Start
01:32:51 PM Presentation: Office of Children's Services Response to the Citizen's Review Panel
02:34:44 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation: TELECONFERENCED
Department of Health & Social Services - Office
of Children's Services Response to the Citizen's
Review Panel by Natalie Norberg, Director
-- Testimony <Invitation Only> --
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         March 22, 2019                                                                                         
                           1:32 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator David Wilson, Chair                                                                                                     
Senator John Coghill, Vice Chair                                                                                                
Senator Gary Stevens                                                                                                            
Senator Cathy Giessel                                                                                                           
Senator Tom Begich (via teleconference)                                                                                         
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
PRESENTATION: OFFICE OF CHILDREN'S SERVICES RESPONSE TO THE                                                                     
CITIZEN'S REVIEW PANEL                                                                                                          
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
No previous action to record                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
NATALIE NORBERG, Director                                                                                                       
Office of Children's Services (OCS)                                                                                             
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Gave the OCS response to the Citizen's                                                                    
Review Panel.                                                                                                                   
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:32:29 PM                                                                                                                    
CHAIR DAVID WILSON  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:32 p.m.  Present at the                                                               
call to order were Senators  Coghill, Stevens, Giessel, and Chair                                                               
Wilson.                                                                                                                         
                                                                                                                                
^Presentation:  Office of  Children's  Services  Response to  the                                                               
Citizen's Review Panel                                                                                                          
  Presentation: Office of Children's Services Response to the                                                               
                     Citizen's Review Panel                                                                                 
                                                                                                                                
                                                                                                                                
1:32:51 PM                                                                                                                    
CHAIR  WILSON announced  the  presentation  Office of  Children's                                                               
Services  Response  to  the Citizen's  Review  Panel  by  Natalie                                                               
Norberg, Director of the Office  of Children's Services. He noted                                                               
it was the third year in a  row that OCS has presented a response                                                               
to the Citizen Review Panel (CRP) presentation.                                                                                 
                                                                                                                                
1:33:15 PM                                                                                                                    
NATALIE NORBERG,  Director, Office of Children's  Services (OCS),                                                               
Department of Health and Social  Services (DHSS), Juneau, Alaska,                                                               
thanked the  CRP and especially  its new chair, JP  Ouellete, for                                                               
its extensive  commitment and  volunteer time  on the  board. She                                                               
said  she  appreciates  their  work   and  the  new  emphasis  on                                                               
collaboration. It is  very appreciated that the CRP  is trying to                                                               
intentionally align  its priorities with the  OCS priorities. OCS                                                               
doesn't have  much latitude in  their priorities because  so much                                                               
of what OCS does is  compliance-driven by the federal government.                                                               
They have  over 36 different  compliance measures that  they must                                                               
adhere to for a state-run child protection system.                                                                              
                                                                                                                                
CHAIR WILSON noted that Senator Begich was online.                                                                              
                                                                                                                                
MS. NORBERG said  that one of the first things  that Mr. Ouellete                                                               
spoke  about  was  the administrative  review  process,  and  she                                                               
presented the following information on the process:                                                                             
                                                                                                                                
     Background: Federal Requirements tied to funding require a                                                                 
     formal case review of all child protection cases every six                                                                 
     months until case closure.                                                                                                 
                                                                                                                                
        • To comply, OCS employs six full time staff and two                                                                    
          administrative assistants, to facilitate the federally                                                                
          required reviews.                                                                                                     
        • These staff complete 2855 reviews per year.                                                                           
        • Alaska is one of only 2 states who have not                                                                           
          incorporated these functions into the court system.                                                                   
                                                                                                                                
MS. NORBERG  said the review  process was  put in place  in 1997.                                                               
The federal government  instituted it to create a  third level of                                                               
oversight for cases. The purpose is  to make sure that cases have                                                               
an  outside perspective  to  make sure  certain  elements are  in                                                               
place.  They don    disagree that  it's very  important. However,                                                               
many  states have  implemented this  process into  their judicial                                                               
system. Alaska  is only one  of two  states that didn't.  Many of                                                               
the elements  of the review  are already incorporated  into court                                                               
hearings. So  for OCS,  it feels like  a redundant  process. They                                                               
are steadfast  that they want  to continue to work  toward having                                                               
the  administrative   reviews  incorporated  into   the  judicial                                                               
system. As  part of  the program improvement  plan that  they are                                                               
negotiating  with  the  federal   government,  they  are  working                                                               
closely with the  court improvement program to  implement a pilot                                                               
in the Fairbanks judicial court  system, which has agreed to take                                                               
on  elements of  the reviews  into their  hearings. It  will only                                                               
require  an additional  hearing after  the case  has been  in the                                                               
system  for  about   a  year.  They  will   examine  the  pilot's                                                               
effectiveness and  efficiencies, but  they are hopeful  that this                                                               
process will  work out  and be  a better  use of  resources. They                                                               
employ  six full-time  employees  to  do reviews.  It  is a  high                                                               
utilization of their resources.                                                                                                 
                                                                                                                                
MS.  NORBERG  presented  the following  information  on  the  CRP                                                               
second goal and the OCS response:                                                                                               
                                                                                                                                
     #2 Improve Outcomes for Family Reunification                                                                               
                                                                                                                                
        Background: Reunification  is the  priority goal  for all                                                               
        children in foster for at  least the first 9  - 12 months                                                               
        in care.                                                                                                                
          • In 2018, of the children who exited foster care                                                                     
             54.5% were reunified                                                                                               
          • National rate for reunification is: 49%                                                                             
                                                                                                                                
        Summary of CRP  Recommendations: Recruit and  retain more                                                               
        local  caseworkers;   provide  training   to  caseworkers                                                               
        regarding the importance of reunification  and the trauma                                                               
        of separation, be more trauma informed; train and support                                                               
        workers to  provide more  early intervention  and in-home                                                               
        efforts  to  prevent  removal;  ensure  caseworkers  have                                                               
        access to seasoned workers in their  regions who are good                                                               
        family support and reunification.                                                                                       
                                                                                                                                
     OCS Response                                                                                                               
                                                                                                                                
        OCS remains aligned with the priority to improve rates of                                                               
        reunification. Reunification is largely  dependent on two                                                               
        systemic issues:                                                                                                        
          1. Stable workforce                                                                                                   
          2. The accessibility of appropriate community services.                                                               
                                                                                                                                
        New Opportunities created by the 1115 Behavioral Health                                                                 
        Waiver and Family First Prevention Services Act                                                                         
                                                                                                                                
MS.  NORBERG  pointed out  that  OCS  is  doing better  than  the                                                               
national average  for reunification. CRP did  identify many great                                                               
strategies that  they are  aligned with. OCS  is working  to have                                                               
workers   embrace   the   notion  of   reunification.   Sometimes                                                               
caseworkers hit barriers  with that. It is important  not to rush                                                               
reunification  if the  family  is  not ready.  They  do not  want                                                               
repeat entries.  OCS does not  provide direct  intervention other                                                               
than  creating the  linkages to  help  families access  community                                                               
resources. If  there are no  community resources, it  makes their                                                               
work very difficult.                                                                                                            
                                                                                                                                
MS. NORBERG  said OCS is  very excited about the  1115 Behavioral                                                               
Health Waiver:                                                                                                                  
                                                                                                                                
     1115 Behavioral Health Waiver                                                                                              
        • Services designed to target families at risk of                                                                       
          entering the child welfare system                                                                                     
        • Continuum of community based, in-home family support                                                                  
          services                                                                                                              
        • Current Gap Analysis includes OCS to ensure the unique                                                                
          needs of families involved with child welfare are                                                                     
         being discussed and addressed with providers.                                                                          
                                                                                                                                
MS. NORBERG said she was fortunate  to be involved in some of the                                                               
initial design work. She was part  of a work group that looked at                                                               
target  populations   and  the   services  that  would   be  made                                                               
available. She is  very happy that one of  the target populations                                                               
for  the 1115  Behavioral Health  Waiver is  families at  risk of                                                               
entering  the foster  care system.  One  of the  targets for  the                                                               
initiative  is  what  services  are  needed  to  help  struggling                                                               
families and  what are the  community-based supports  that should                                                               
be  and  must  be  made  available for  those  families.  OCS  is                                                               
participating  in  the  current  gap analysis.  The  Division  of                                                               
Behavioral Health  is working on  this statewide  initiative with                                                               
the assistance of the Mental  Health Trust. Communities are being                                                               
visited by a team from the  Division of Behavioral Health and OCS                                                               
who meet with  providers to ask about their capacity  and to help                                                               
them  understand what  the new  services  will be  under the  new                                                               
waiver.  OCS  is part  of  the  process  so  they can  have  that                                                               
intimate conversation with providers  about the specific needs of                                                               
families in  the child welfare system  and how are they  going to                                                               
be able to take advantage  of these new funding opportunities and                                                               
be  able to  provide  those in-home  family  supports that  their                                                               
families so desperately need.                                                                                                   
                                                                                                                                
1:40:33 PM                                                                                                                    
SENATOR  STEVENS said  he was  responding to  questions from  his                                                               
constituents about racial  differences with family reunification.                                                               
He asked if she had figures on that.                                                                                            
                                                                                                                                
MS.  NORBERG   said  that  the  reunification   rate  for  Alaska                                                               
Native/American Indian  children in Alaska  is higher than  it is                                                               
for their  nonwhite counterparts. It  is around 55  percent while                                                               
the reunification  rate for non-Native  children is closer  to 50                                                               
percent.                                                                                                                        
                                                                                                                                
SENATOR STEVENS said that was very interesting.                                                                                 
                                                                                                                                
MS.  NORBERG  said OCS  is  optimistic  about  a large  piece  of                                                               
legislation  passed  by  Congress  last year  and  presented  the                                                               
following  information  about  the Family  First  Prevention  and                                                               
Services Act:                                                                                                                   
                                                                                                                                
        • Allows states to claim reimbursement for 50% of costs                                                                 
         for the services after they have been provided                                                                         
        • Children  and   parents    must   meet    eligibility                                                                 
          requirements:                                                                                                         
             o the child must be a "candidate" for foster care,                                                                 
               or                                                                                                               
             o be a pregnant or parenting youth in foster care                                                                  
                                                                                                                                
        • Allows the following evidence-based services to be                                                                    
          reimbursed:                                                                                                           
             o Mental health prevention and treatment services                                                                  
               provided by a qualified clinician for not more                                                                   
               than a 12-month period.                                                                                          
             o Substance abuse prevention and treatment services                                                                
               provided by a qualified clinician for not more                                                                   
               than a 12-month period.                                                                                          
             o In-home parent skill-based programs that include                                                                 
               parenting skills training, parent education and                                                                  
               individual and family counseling for not more                                                                    
               than a 12-month period.                                                                                          
                                                                                                                                
MS.  NORBERG said  that  the  Act opens  up  the opportunity  for                                                               
states to claim up to  50 percent reimbursement through the Title                                                               
IV-E  program, which  is the  open-ended  entitlement that  funds                                                               
child welfare  services through the  federal government. It  is a                                                               
very new opportunity which for the  first time will allow for the                                                               
purchase of  services. Never  before have they  been able  to use                                                               
this   funding  stream   for  services.   It   is  an   excellent                                                               
opportunity;  however, there  are  certain  criteria. The  family                                                               
must have come  to the attention of the child  welfare system and                                                               
it must have  been determined that they  needed intervention. The                                                               
services  are very  prescribed. The  federal government  has been                                                               
slow in providing the list of services.                                                                                         
                                                                                                                                
MS. NORBERG shared the preliminary list of services:                                                                            
                                                                                                                                
     Prevention Services/Mental Health:                                                                                         
        • Parent-Child Interaction Therapy                                                                                      
        • Trauma Focused-Cognitive Behavioral Therapy                                                                           
        • Multisystemic Therapy                                                                                                 
        • Functional Family Therapy                                                                                             
                                                                                                                                
     Substance Abuse:                                                                                                           
        • Motivational Interviewing                                                                                             
        • Multisystemic Therapy                                                                                                 
        • Methadone Maintenance Therapy                                                                                         
                                                                                                                                
     In-Home Parent Skill-Based:                                                                                                
        • Nurse-Family Partnership                                                                                              
        • Healthy Families America                                                                                              
        • Parents as Teachers                                                                                                   
                                                                                                                                
MS. NORBERG said OCS is  exploring provider capacity with the gap                                                               
analysis  and  through  other outreach  efforts.  Some  of  these                                                               
programs exist in Alaska, but  many don't. The exhaustive list is                                                               
coming out in  May. The services can  only be paid for  as a last                                                               
resort after  Medicaid. There is  a lot  to figure out,  but they                                                               
see it  as an  opportunity to create  more targeted  services for                                                               
families in the child welfare system.                                                                                           
                                                                                                                                
1:43:56 PM                                                                                                                    
SENATOR COGHILL  commented on  the compliance  requirements under                                                               
Title  IV-E. He  asked if  this is  a new  set of  criteria or  a                                                               
rearranging of the criteria.                                                                                                    
                                                                                                                                
MS. NORBERG replied  that it is separate  criteria. She suggested                                                               
he was thinking  of the criteria for things like  foster homes to                                                               
be licensed in  a certain way and the family  to have met certain                                                               
income requirements.  Those types of  things do not apply  to the                                                               
new dollars because  [families] are not entering  the foster care                                                               
system, so it is a little looser.                                                                                               
                                                                                                                                
CHAIR WILSON said  the Family Prevention and  Services Act offers                                                               
many different opportunities  for the state and this  was the tip                                                               
of the iceberg.  He asked if there is also  funding for extending                                                               
the  age range  of foster  youth eligible  for grant  funding for                                                               
continuing education.                                                                                                           
                                                                                                                                
MS. NORBERG  said there is  the opportunity for states  to expand                                                               
the reimbursement rate  for the age of children  they consider to                                                               
be in the  independent living category. Alaska did  not choose to                                                               
expand because  of its  smaller population,  but there  are other                                                               
dollars  for independent  living  services. They  are not  taking                                                               
advantage  of some  of  the  act because  with  the economies  of                                                               
scale, it did  not make sense for Alaska. There  are many aspects                                                               
of this act that OCS has already taken advantage of.                                                                            
                                                                                                                                
CHAIR WILSON said  he was hoping that it would  be an opportunity                                                               
for the university to be  involved with working with foster youth                                                               
and their certification  programs to have a  partnership with the                                                               
department to expand on those funds, but apparently not.                                                                        
                                                                                                                                
MS. NORBERG  replied that  OCS does have  a partnership  with the                                                               
university. They provide extensive  supports through a program to                                                               
assist  foster  youth  in  their journey  to  getting  a  college                                                               
education. Last year  they had the highest number  of high school                                                               
graduates and youth enrolled and  graduating from the university.                                                               
They partner  with the university  to offer  educational training                                                               
vouchers. That is  a program OCS takes advantage of  in the state                                                               
and more youth than ever are taking advantage of that program.                                                                  
                                                                                                                                
CHAIR  WILSON  asked  if  that  is  funded  through  unrestricted                                                               
general funds or federal dollars.                                                                                               
                                                                                                                                
MS. NORBERG answered that those are federal dollars.                                                                            
                                                                                                                                
1:48:21 PM                                                                                                                    
SENATOR  STEVENS  asked  whether   Parents  as  Teachers  on  the                                                               
preliminary  list  of allowable  services  was  the same  program                                                               
eliminated in the governor's budget.                                                                                            
                                                                                                                                
MS. NORBERG  answered that  she not aware  of that  program being                                                               
eliminated.                                                                                                                     
                                                                                                                                
SENATOR STEVENS said there is  a Parents as Teachers program, but                                                               
he  is  not  sure if  it  is  same  thing.  He thought  that  was                                                               
eliminated in the proposed budget.                                                                                              
                                                                                                                                
CHAIR WILSON  said the  committee would get  a response  from the                                                               
department for that question.                                                                                                   
                                                                                                                                
SENATOR STEVENS  said his question was  what do they do  with the                                                               
program if that was eliminated.                                                                                                 
                                                                                                                                
MS. NORBERG said  Parents as Teachers is  an evidence-based model                                                               
and the  Division of  Public Health  supports one  program. There                                                               
are  other programs  provided by  nonprofits  agencies that  also                                                               
support the  same model. They  are very interested  in partnering                                                               
with those  entities to see  if there is a  way to draw  down the                                                               
new funding  opportunity to offset  the expenses of  the existing                                                               
programs. It is an opportunity to  see if they can supplement the                                                               
funding.                                                                                                                        
                                                                                                                                
SENATOR STEVENS  said that the governor's  budget eliminated Best                                                               
Beginnings  and  other early  learning  programs.  One is  called                                                               
Parents as Teachers. He said it  may be two different things with                                                               
the same name, but he would like an answer.                                                                                     
                                                                                                                                
CHAIR  WILSON said  that  is  more the  modality  of the  service                                                               
provided. If the  agency provided this modality  of service, that                                                               
funding may have been cut, but  it is reimbursable under this new                                                               
act. They will try to get a response to committee members.                                                                      
                                                                                                                                
MS.  NORBERG  presented  the  OCS response  to  the  CRP's  third                                                               
priority, cultural competency:                                                                                                  
                                                                                                                                
     OCS  is   concerned  about   and  committed   to  addressing                                                               
     potential  racism and  cultural  bias  among its  workforce.                                                               
     This  has  been  addressed  in an  ongoing  fashion  through                                                               
     multiple strategies, including:                                                                                            
        • Tribal State Collaboration Group Meetings                                                                             
        • Extensive required training on the Indian Child                                                                       
          Welfare Act for new workers                                                                                           
        • Cultural Humility curriculum is required for all new                                                                  
          staff                                                                                                                 
        • Two-day Knowing Who You are Training, provided and                                                                    
          required for the last decade        designed to help                                                                  
          caseworkers address and acknowledge the unique                                                                        
          experiences of racial minorities.                                                                                     
        • Cultural Resources for Alaska Families: Traditional                                                                   
          Health and Wellness Guide                                                                                             
        • Tribal partners are involved on hiring teams for                                                                      
                                                                                                                                
MS.  NORBERG  said  cultural   competency  remains  an  important                                                               
priority  for OCS  because  of  the continued  disproportionality                                                               
rate  of Alaska  Native  children in  the  child welfare  system.                                                               
Today 64  percent of  their cases are  comprised of  children who                                                               
are Alaska  Native or American  Indian; they are only  23 percent                                                               
of the  child population in  Alaska, so  it is quite  a disparate                                                               
number. They appreciate the CRP's  support of this as a continued                                                               
priority. They  do offer staff  trainings and they have  tried to                                                               
do creative  things. They  invite tribal partners  to be  part of                                                               
their  interviewing  team  for their  critical,  frontline  staff                                                               
positions and supervisory positions  because it is important that                                                               
the tribal partners  feel comfortable with the  people OCS hires.                                                               
They   have   received   permission  from   the   Department   of                                                               
Administration to do that.                                                                                                      
                                                                                                                                
1:52:46 PM                                                                                                                    
SENATOR COGHILL said OCS was  dealing with three things regarding                                                               
cultural competency.  One is how  to deal with  blended families,                                                               
specifically as  it relates to  ICWA [Indian Child  Welfare Act].                                                               
Tribal groups  don't always  follow ICWA rules,  and he  saw that                                                               
tribal compacting is  on the next slide. They  have children with                                                               
both federal and  state requirements, but the  tribal groups have                                                               
a different view of it. He  asked if there is a good relationship                                                               
with tribal groups who have different authorities.                                                                              
                                                                                                                                
MS. NORBERG  asked whether Senator  Coghill was asking  about OCS                                                               
relationships with tribal government.                                                                                           
                                                                                                                                
SENATOR COGHILL clarified that they  have clear, directive rules,                                                               
federal and state. ICWA has directive  rules. He asked if that is                                                               
also  true  of some  of  the  tribal  groups because  they  don't                                                               
operate under the same directives.                                                                                              
                                                                                                                                
MS. NORBERG  replied that  the requirements  of the  Indian Child                                                               
Welfare Act  do not  apply to tribal  governments who  are taking                                                               
over their own  child welfare cases. Because they  are the tribe,                                                               
they don't  have to adhere  to the  same oversight, and  they can                                                               
provide services  and conduct their  child welfare system  in any                                                               
way they  decide. The  Indian Child Welfare  Act is  about making                                                               
sure the state allows for  tribes to have that legal intervention                                                               
and ability  to be a legal  party to the case.  Because there are                                                               
so many tribal jurisdictions in  Alaska, it is a very complicated                                                               
process for  OCS staff  to navigate.  They do  it better  in some                                                               
regions than others.  The relationship is working  well in Sitka.                                                               
Sitka is  one tribe  out of 229.  It is a  lot of  navigating for                                                               
their staff.  They can do  a better job helping  staff understand                                                               
the  nuances  between  tribal   courts,  tribal  social  services                                                               
entities,  and  tribal  health.   There  are  so  many  different                                                               
aspects. It  is confusing  for brand new  workers, but  they work                                                               
hard and have  implemented different strategies for  staff to get                                                               
to know and  understand these various systems and to  be aware of                                                               
the  very  rich and  important  and  exciting opportunities  that                                                               
having so many  diverse tribal communities brings  to families in                                                               
Alaska.                                                                                                                         
                                                                                                                                
CHAIR WILSON  said that  there is a  federal case  regarding ICWA                                                               
that might be  heard by the Supreme Court. He  asked if there had                                                               
been any  injunctions or any  changes about how ICWA  operates in                                                               
the state.                                                                                                                      
                                                                                                                                
MS.  NORBERG responded  that there  have been  no injunctions  at                                                               
this time.                                                                                                                      
                                                                                                                                
SENATOR COGHILL said  that the Texas Supreme Court  made a ruling                                                               
regarding  ICWA that  might make  its way  to the  Supreme Court.                                                               
There  is  a difference  between  cultural  competency and  legal                                                               
directives. Both  the review  panel and OCS  are traveling  in an                                                               
interesting  world.  They  want  to  take the  best  out  of  the                                                               
culture, but the legal entanglement  isn't always well described.                                                               
They have tried to figure out how  to do that. On the other hand,                                                               
the Alaska  Native children should  never lose their rights  as a                                                               
citizen  of the  United  States. They  haven't  figured that  out                                                               
totally. Meanwhile,  the best care  is still at the  local level.                                                               
He  wanted to  highlight that  competency is  one thing,  but the                                                               
legal rules are a very different thing.                                                                                         
                                                                                                                                
SENATOR STEVENS asked what is meant by cultural humility.                                                                       
                                                                                                                                
MS.  NORBERG  answered  that  it  refers to  the  ability  to  be                                                               
respectful of  other cultures. It  is being humble and  having an                                                               
openness  to  learning  about  and   being  respectful  of  other                                                               
cultures.   Because  the   staff  works   with  such   a  diverse                                                               
population,  it important  that they  understand and  respect and                                                               
want to learn and understand the strength of other cultures.                                                                    
                                                                                                                                
SENATOR STEVENS  said that it  seems an  odd choice of  words. To                                                               
him, it  suggests that humility of  one's own culture so  that it                                                               
doesn't interfere with other cultures.  He asked if that was part                                                               
of it.                                                                                                                          
                                                                                                                                
MS.  NORBERG replied  that it  could be  potentially part  of the                                                               
message.                                                                                                                        
                                                                                                                                
1:59:50 PM                                                                                                                    
SENATOR  BEGICH referenced  the university  graduation rates.  He                                                               
asked how many kids they were talking about.                                                                                    
                                                                                                                                
MS.  NORBERG said  she could  get that  to him.  It was  probably                                                               
under 25.                                                                                                                       
                                                                                                                                
MS. NORBERG said the CRP  goal of finding relatives for placement                                                               
of children in foster care remains  a high priority for OCS. They                                                               
have done  a lot of  things over the  last five years  to improve                                                               
their effectiveness  in this  area. They  are slowly  starting to                                                               
see the  numbers of children  placed with relatives  increase. In                                                               
the last five  years it increased ten percent. When  they look at                                                               
the span of  a child's life in foster care,  they oftentimes were                                                               
placed  at  least  once  with a  relative,  but  sometimes  those                                                               
placements don't  last. They  do try to  prioritize that,  but it                                                               
can  be challenging  for  family members  to  take on  additional                                                               
relatives. They try  to support them. The  percentage placed with                                                               
relatives is  a constantly  varying number.  They have  done some                                                               
interesting  things. With  their  ORCA [Online  Resource for  the                                                               
Children  of  Alaska]  system, they  can  generate  an  automated                                                               
letter to  inform relatives  that they have  a relative  child in                                                               
the child  welfare system.  They must  make that  notification to                                                               
all known relatives  within 30 days of a child  being removed and                                                               
throughout the  life of the  case at various intervals.  If there                                                               
is going  to be an  adoption, they  must renotify relatives  if a                                                               
child is not going to be adopted into a relative home.                                                                          
                                                                                                                                
MS.  NORBERG said  that the  first  scope of  work undertaken  by                                                               
tribal compacting  cosigners was relative searches  for OCS. They                                                               
have worked out  an amazing system with tribal  partners. They do                                                               
the  search  for  OCS.  They  have  access  to  their  electronic                                                               
database and enter  names of relatives on the  state's behalf and                                                               
the  letters  get automatically  generated.  Because  of HB  151,                                                               
there  were   new  training  and  policy   requirements  for  the                                                               
supervisory  oversight for  making  sure  relative searches  were                                                               
happening on an ongoing basis.                                                                                                  
                                                                                                                                
CHAIR WILSON asked if parents  whose children are removed put the                                                               
names of relatives in the automated system also.                                                                                
                                                                                                                                
MS.  NORBERG replied  that part  of the  relative search  process                                                               
requires someone to  interview the parents and ask  for all known                                                               
relatives  and  then those  individuals  are  asked and  then  it                                                               
branches  out  like a  tree.  It  is  common  for parents  to  be                                                               
reluctant to identify  relatives. Then they use what  they can of                                                               
electronic databases and  the tribes have access  to their tribal                                                               
enrollment databases.  They use  a variety of  sources, including                                                               
the PFD database to figure out who the relatives are.                                                                           
                                                                                                                                
CHAIR  WILSON  said   that  for  kinship  care,  HB   151  has  a                                                               
requirement of  45 days. A few  weeks ago a constituent  shared a                                                               
story about a  worker who said, "I got 45  days to complete you."                                                               
He asked if it has become a new norm to wait 45 days.                                                                           
                                                                                                                                
MS.  NORBERG said  the policy  is that  the Office  of Children's                                                               
Services has  45 days  to assess a  request for  placement. There                                                               
can  be  a  lengthy  background  check  and  home  inspection  to                                                               
determine if  a family is  appropriate to take a  relative child.                                                               
Sometimes they get numerous requests  for a specific child, which                                                               
is wonderful.  The timeline has  not changed. They are  trying to                                                               
adhere to that  because they had heard it was  taking a long time                                                               
to  asses  relatives. The  committee  is  aware of  the  multiple                                                               
demands  on  case  workers. Identifying  and  exploring  numerous                                                               
relative placements  when a  child perhaps  is in  an appropriate                                                               
placement may  or may  not be  the top priority  that day.  It is                                                               
certainly their expectation that  every relative identified has a                                                               
thorough examination  done to determine if  they are appropriate.                                                               
When there are multiple appropriate  homes, it can be a difficult                                                               
decision about  who is going to  get that child. It  can be quite                                                               
complex and multilayered.                                                                                                       
                                                                                                                                
2:07:27 PM                                                                                                                    
SENATOR STEVENS said  that last year when they  were dealing with                                                               
HB  151, they  were visited  by foster  children. He  was shocked                                                               
that two young ladies who visited  him had been with eight to ten                                                               
foster families. He asked if that  is common, if the 45 days kick                                                               
in with each  placement, and if they keep track  of the number of                                                               
times a child is in a foster home.                                                                                              
                                                                                                                                
MS.  NORBERG replied  they  are  required to  keep  track of  the                                                               
number and where the children  are placed. Every time a placement                                                               
disrupts,  it can  take  a long  time to  find  a new  placement.                                                               
Unfortunately, grief  and trauma  can manifest in  behaviors that                                                               
are quite challenging  for foster families and  for all involved.                                                               
Sometimes children  must be moved.  There are lots  of variables.                                                               
Oftentimes  placements  aren't  found  right  away  or  they  are                                                               
temporary placements.  So yes, children  have to move  around. It                                                               
is a very, very sad part of the work.                                                                                           
                                                                                                                                
MS.  NORBERG  gave  an  update  on efforts  related  to  HB  151,                                                               
Children  Deserve  a Loving  Home  Act.  The  bill had  many  new                                                               
requirements  for  OCS,  and  they  have  been  working  hard  to                                                               
implement them. The  addition of 21 new positions was  one of the                                                               
most important  parts of the  bill. The  bill was signed  in June                                                               
2018,  and they  were  given authority  to  begin recruiting  for                                                               
those  positions in  July 2018.  Many positions  were not  filled                                                               
until  October. They  have  worked  hard over  the  last year  to                                                               
incorporate  the   new  training   requirements.  They   have  an                                                               
excellent relationship  with the  child welfare  training academy                                                               
at  the university.  They are  constantly revamping  and changing                                                               
the training  to meet their needs  and the needs of  their staff.                                                               
It  takes about  two months  from posting  a recruitment  to hire                                                               
someone. The training is spread over  four months. It is mixed up                                                               
with a lot  of time in the field. They  hear often that classroom                                                               
is training  is great, but workers  don't know what to  do in the                                                               
field. They  are trying new strategies,  including five traveling                                                               
mentors, which was part of HB  151, who are assigned to staff and                                                               
work with  them in the  field. They offer real-time  support when                                                               
trying to  make decisions.  The transfer  of learning  process is                                                               
improving with  the new training  system, but it does  take time.                                                               
The question  has been asked of  where all the new  positions are                                                               
and  what is  their case  carrying capacity.  She would  like the                                                               
committee to know, that with  their new positions, their analysis                                                               
is they can be afforded a  35 percent vacancy rate. They have 231                                                               
frontline positions. Today, they  have 134 positions filled. They                                                               
have a  vacancy rate  of 51.7  percent. They can  only have  a 35                                                               
percent vacancy rate  to implement case load  standards. Today 53                                                               
percent  of the  staff have  been on  the job  one year  or less.                                                               
Retention remains one  of their highest priorities  and crises at                                                               
this point.  They continue to not  have the staff to  do the job.                                                               
It is better in some parts of the state.                                                                                        
                                                                                                                                
MS. NORBERG  said that in  2017, they received 31  new positions;                                                               
the  majority went  to the  Wasilla office  because of  its large                                                               
population growth. They doubled the  staff there. In the year and                                                               
a half  that they have  had the  extra staff, their  vacancy rate                                                               
has  gone down  to about  40 percent.  They are  starting to  see                                                               
wonderful results  with their  ability to do  the case  work they                                                               
want  them  to be  doing--meeting  with  families, creating  case                                                               
plans, visiting  children, making  sure kids  are safe.  They are                                                               
starting  to  see  positive  results because  of  the  influx  of                                                               
positions from a year  and a half ago, but it  does take time for                                                               
these positions to get trained  and to start taking on caseloads.                                                               
The bill  requires the caseload  caps to implement by  June 2020.                                                               
They won't  be implementing those  caseload caps until  they have                                                               
enough staff because it would not be safe for them to do that.                                                                  
                                                                                                                                
CHAIR  WILSON said  he  is very  appreciative  of the  additional                                                               
staff in Mat-Su.  He asked about the physical  space capacity for                                                               
OCS to  work efficiently because  he remembers people  working in                                                               
the hallway. He knows Bethel is  looking for more space. He asked                                                               
about  space utilization  statewide  if they  are increasing  the                                                               
number of staff.                                                                                                                
                                                                                                                                
MS. NORBERG replied that currently  the Wasilla office has enough                                                               
space.  Some of  the  staff  moved into  the  new child  advocacy                                                               
center.  Some are  offsite. New  staff does  create the  need for                                                               
more space, which leads to  more expensive lease agreements. They                                                               
are struggling  to figure that  out. They have enough  space now,                                                               
but they continue to look  at office configurations in Anchorage.                                                               
OCS is  about to  lease new  space in  Bethel after  the building                                                               
they  were in  basically  collapsed. For  now,  OCS has  adequate                                                               
space.                                                                                                                          
                                                                                                                                
2:16:43 PM                                                                                                                    
SENATOR STEVENS commented  that HB 151 was sold  on the principle                                                               
that  staff were  quitting faster  than they  could be  hired and                                                               
that they could get ahead of  that curve by adding new positions.                                                               
He asked her to repeat the information about the turnover rate.                                                                 
                                                                                                                                
MS.  NORBERG answered  that  the current  turnover  rate is  51.7                                                               
percent. They can afford to be  at 35 percent but their target is                                                               
less  than that.  Nationally,  the turnover  rate  for the  child                                                               
welfare workforce  is between 30  to 40 percent. They  can expect                                                               
that, but theirs is  quite high. They need to get  it to at least                                                               
35 percent to change the trend.                                                                                                 
                                                                                                                                
SENATOR STEVENS clarified what the 51.7 number was for.                                                                         
                                                                                                                                
MS.  NORBERG said  51.7 is  the  current vacancy  rate. They  are                                                               
basically at 50 percent.                                                                                                        
                                                                                                                                
SENATOR  BEGICH  asked  if  any   of  the  vacant  positions  are                                                               
eliminated in the governor's budget.                                                                                            
                                                                                                                                
MS.  NORBERG answered  that no  positions are  eliminated in  the                                                               
governor's amended budget.                                                                                                      
                                                                                                                                
MS. NORBERG presented the OCS  response to the CRP priority about                                                               
worker burnout and vacancies:                                                                                                   
                                                                                                                                
        • Dedicated staff to Recruitment and Retention                                                                          
        • Letters of Agreement to address unique challenges                                                                     
        • Commitment to Recruiting the Right People for the Job                                                                 
        • Develop Managers and Supervisors                                                                                      
        • Support for Wellness Activities                                                                                       
        • First Year Onboarding                                                                                                 
        • Mentorship Program                                                                                                    
        • Recognition and Welcome Packages                                                                                      
        • Exit Surveys                                                                                                          
        • Social media and local recruitment efforts                                                                            
                                                                                                                                
MS.  NORBERG said  that  CRP  is committed  to  identify ways  to                                                               
support OCS staff to acknowledge  the challenging work they do on                                                               
a daily basis  that involves not only the trauma  of dealing with                                                               
child abuse but also navigating  the complicated governing system                                                               
that is  the child  welfare system with  so many  expectations on                                                               
the staff. They inform their  staff about the Employee Assistance                                                               
Program, but  many areas are  not able  to take advantage  of the                                                               
program. Since she became director,  they are committed to taking                                                               
a good look  at what is happening to staff  during the first year                                                               
and  making  the  onboarding  process   a  very  intentional  and                                                               
deliberate  process  such that  they  try  to eliminate  as  many                                                               
external distractions as possible and  focus on what is available                                                               
to them to support them, to  focus on wellness and having a plan.                                                               
Many small  offices cannot  have a  wellness committee.  They are                                                               
looking to support them from a regional office.                                                                                 
                                                                                                                                
MS. NORBERG said  OCS is trying to centralize  as many activities                                                               
as  possible  around  the   recruitment  and  retention  process.                                                               
Frankly, the regional offices are  often in crisis and cannot pay                                                               
attention  to all  the  details.  In the  state  office they  are                                                               
committed to doing  as much as they can. They  are trying to work                                                               
with unions on  different letters of agreement  to address unique                                                               
challenges and create special opportunities  for staff in certain                                                               
areas  where  they  need  the   flexibility  to  offer  different                                                               
incentives  and supports.  They would  like to  pay for  time off                                                               
after a staff  has experienced a very traumatic event.  It is not                                                               
something they  can currently do.  There are so many  things they                                                               
are  trying  to   address  on  a  systemic  level.   It  is  very                                                               
challenging.  They are  doing  what  they can  without  a lot  of                                                               
money. Nonprofits  in some communities  have been  very generous.                                                               
Beacon  Hill in  Anchorage  is providing  furniture  to make  the                                                               
office nicer. Chaplains come in  for emotional support. OCS deals                                                               
with real-life crises and they  need support. Canines come in for                                                               
emotional  support.   There  are   pockets  of   creative  things                                                               
happening,  but  they  have  no  ability  to  implement  anything                                                               
statewide. They  have tried to dedicate  a few staff to  focus on                                                               
the  recruitment process  because the  state has  taken cuts  and                                                               
human  resources  is backed  up.  They  can't always  get  timely                                                               
processing of the  applicant pool, so they have had  to take that                                                               
on  within  the division.  They  are  doing everything  they  can                                                               
within  the  confines  of  the  state  system  to  impact  timely                                                               
recruitment  and retention.  It will  take  a lot  of effort  and                                                               
different strategies. They are not giving  up on it. It is a huge                                                               
problem. They are very committed to it.                                                                                         
                                                                                                                                
2:23:53 PM                                                                                                                    
SENATOR  BEGICH   said  that  Mr.   Ouellete  talked   about  the                                                               
importance  of CRP  traveling to  different sites  and asked  for                                                               
more travel resources. He wondered  how they had been impacted by                                                               
the governor's  travel restrictions  and how their  future travel                                                               
plans would be affected.                                                                                                        
                                                                                                                                
MS. NORBERG replied  that CRP's budget, like the  budget for OCS,                                                               
has not been changed from last  year. They have looked into their                                                               
request for  more money,  but they haven't'  spent all  the money                                                               
allocated for this  year. They still have $48,000  for travel. If                                                               
they request  more money for  this fiscal year, they  will assess                                                               
that. All state boards and commissions have taken travel hits.                                                                  
                                                                                                                                
SENATOR  BEGICH  asked  if  left-over money  is  rolled  over  or                                                               
returned.                                                                                                                       
                                                                                                                                
MS. NORBERG answered that she is  not sure. They get a new budget                                                               
at the beginning of the fiscal year.                                                                                            
                                                                                                                                
SENATOR COGHILL thanked her for  her work and willingness to take                                                               
on the  director role.  It is  one of the  more sobering  jobs in                                                               
Alaska. Besides recruitment, they  struggled with technology. The                                                               
ORCA system  is now up and  running. Then there is  bandwidth. He                                                               
asked  if they  have the  tools for  the new  people to  do their                                                               
work. They fought to get bandwidth in the Bethel area.                                                                          
                                                                                                                                
MS. NORBERG  responded that  she was not  aware of  any bandwidth                                                               
issues lately.  The bandwidth  there is slower,  but they  can do                                                               
their work. They struggle with  making their devices more mobile.                                                               
They are behind  the nation with available  technology. The staff                                                               
cannot send  or receive anything  of a confidential  nature while                                                               
in the field.  The new commissioner is committed  to figuring out                                                               
the issues with  mobile device management. There  are many things                                                               
they  could do  more quickly  if they  could manage  confidential                                                               
information in the field.                                                                                                       
                                                                                                                                
SENATOR COGHILL  said there must be  off-the-shelf encryption. He                                                               
asked if it were a cost issue.                                                                                                  
                                                                                                                                
MS.  NORBERG  answered  that  she  doesn't  understand  what  the                                                               
barriers  are.  Some  of  it is  that  with  the  standardization                                                               
through  the Office  of  Technology, whatever  they  use must  be                                                               
compatible with  the rest of the  state. They would love  to just                                                               
go out  and get  what they  need, but they  must work  within the                                                               
confines of  the rest of  state. That  makes sense, but  it slows                                                               
down the process.                                                                                                               
                                                                                                                                
SENATOR  COGHILL  said  this  is  a quality  of  life  issue  for                                                               
frontline workers,  which includes everything from  travel issues                                                               
to computer  issues. Having the  tools they need might  make them                                                               
feel more  respected. That has  been a struggle. They  are living                                                               
in very  frugal times, but it  is not just the  actual equipment.                                                               
It is how to make that  equipment work in the system. They should                                                               
keep a fire under it.                                                                                                           
                                                                                                                                
2:29:42 PM                                                                                                                    
SENATOR STEVENS  commented that the  turnover rate of  50 percent                                                               
is a shocking figure. It is one  of the toughest jobs he has ever                                                               
heard of in the state of Alaska.  He asked her to thank her staff                                                               
for sticking with it. Half the  people leave every year, but half                                                               
stay. That is remarkable  in a job that has a  lot of burnout. He                                                               
asked if there are people who  stay for years and are happy doing                                                               
this. They have  heard the bad stories about  people leaving, but                                                               
he asked if she can give them an idea of how long some stay.                                                                    
                                                                                                                                
MS.  NORBERG replied  that the  frontline staff  vary. Perhaps  a                                                               
quarter of  the staff  have been  on the job  longer than  two to                                                               
five  years.  Most staff  who  stay  quickly promote  and  become                                                               
supervisors  or managers  or take  related jobs  to help  support                                                               
caseworkers.  Many people  are extremely  passionate about  child                                                               
welfare  and  want to  stay  around  the  work, but  they  cannot                                                               
sustain the frontline  for long periods of time.  They don't know                                                               
if it  is healthy for  people to stay  in the frontline  for very                                                               
long because it is such  traumatic and emotionally draining work.                                                               
She tends to worry about people  who are exposed to that level of                                                               
trauma for that long.                                                                                                           
                                                                                                                                
CHAIR WILSON said that in  the Mat-Su they have amazing frontline                                                               
workers. He  gets upset  when they leave  and become  promoted to                                                               
supervisors because  they are effective. He  understands that and                                                               
loves  the  team at  the  children's  advocacy center.  They  are                                                               
amazing staff. They don't always  get to appreciate the hard work                                                               
they do.  He is appreciative of  that staff that have  stayed and                                                               
have the passion and drive to do this hard work.                                                                                
                                                                                                                                
MS.  NORBERG  said that  she  wanted  to  share an  exciting  new                                                               
initiative called  Plans of Self-Care.  It is a model  that looks                                                               
at assisting women who may  have been identified during pregnancy                                                               
screens  who   are  using  or   abusing  substances.  It   is  an                                                               
interdisciplinary approach  to assisting  women before  birth and                                                               
after birth. They will be doing  a pilot with a birthing hospital                                                               
and  other entities  in Mat-Su  to create  a systemic  process to                                                               
support moms and  their babies and the whole  family if substance                                                               
abuse  during pregnancy  has been  an issue.  They are  trying to                                                               
avoid  those kids  coming  into  the foster  care  system in  the                                                               
future.  It  is  a  promising initiative.  Anything  to  do  with                                                               
prevention is  exciting to her.  They don't have  the opportunity                                                               
with their current needs to  pursue prevention opportunities, but                                                               
there may be  others in the near future. She  can't wait to share                                                               
those with them next.                                                                                                           
                                                                                                                                
CHAIR WILSON  said the  committee would  look forward  to hearing                                                               
from her next year.                                                                                                             
                                                                                                                                
2:34:44 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Wilson adjourned  the Senate  Health  and Social  Services                                                               
Standing Committee meeting at 2:34 p.m.                                                                                         
                                                                                                                                
                                                                                                                                

Document Name Date/Time Subjects
OCS CRP Response 3-22-19.pdf SHSS 3/22/2019 1:30:00 PM
DHSS OCS response to CRP