02/08/2010 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SCR12 | |
| SB215 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SCR 12 | TELECONFERENCED | |
| *+ | SB 215 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 8, 2010
1:33 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Paskvan, Vice Chair
Senator Johnny Ellis
Senator Joe Thomas
Senator Fred Dyson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE CONCURRENT RESOLUTION NO. 12
Proclaiming September 9, 2010, as Fetal Alcohol Spectrum
Disorders Awareness Day.
- MOVED SCR 12 OUT OF COMMITTEE
SENATE BILL NO. 215
"An Act requiring the Department of Health and Social Services
to accept federal prescription drug benefits or to provide
comparable benefits for residents of the Alaska Pioneers' Home."
- MOVED SB 215 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SCR 12
SHORT TITLE: FETAL ALCOHOL SPECTRUM DISORDERS DAY
SPONSOR(s): SENATOR(s) MEYER
01/19/10 (S) READ THE FIRST TIME - REFERRALS
01/19/10 (S) HSS
02/08/10 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 215
SHORT TITLE: PIONEERS HOME RX DRUG BENEFIT
SPONSOR(s): SENATOR(s) WIELECHOWSKI, OLSON, KOOKESH, ELLIS,
DAVIS
01/19/10 (S) PREFILE RELEASED 1/15/10
01/19/10 (S) READ THE FIRST TIME - REFERRALS
01/19/10 (S) HSS, FIN
02/08/10 (S) HSS AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
JEANNE GERHARDT-CYRUS
Parent Training & Information Navigator, Stone Soup Group
Case Manager, Maniilaq Association
Kiana, AK
POSITION STATEMENT: Supported SCR 12.
BARBARA KNAPP, Manager
Division of Behavioral Health
Department of Health and Social Services (DHSS)
Anchorage, AK
POSITION STATEMENT: Supported SCR 12.
SHANNON CROSS, Mental Health Clinician
Division of Behavioral Health
Department of Health and Social Services (DHSS)
Anchorage, AK
POSITION STATEMENT: Supported SCR 12.
TRAVIS HEDWIG, Project Coordinator
Family to Family Health Information Center
Stone Soup Group
Anchorage, AK
POSITION STATEMENT: Supported SCR 12.
KATE BURKHART, Executive
Director, Advisory Board on Alcoholism and Drug Abuse
Director, Alaska Mental Health Board
Juneau, AK
POSITION STATEMENT: Supported SCR 12.
MICHAEL BALDWIN, representing himself
Anchorage, AK
POSITION STATEMENT: Supported SCR 12.
SENATOR WIELECHOWSKI
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Sponsor of SB 215.
DAVE COTE, Director
Alaska Division of Pioneer Homes
Department of Health and Social Services (DHSS)
Juneau, AK
POSITION STATEMENT: Supported SB 215.
RIC DAVIDGE
President, Vietnam Veterans of America (VVA)
Chair, Municipal Commission on Military and Veterans Affairs
Anchorage, AK
POSITION STATEMENT: Supported SB 215.
ACTION NARRATIVE
1:33:00 PM
CHAIR BETTYE DAVIS called the Senate Health and Social Services
Standing Committee meeting to order at 1:33 p.m. Present at the
call to order were Senators Dyson, Paskvan and Davis.
SCR 12-FETAL ALCOHOL SPECTRUM DISORDERS DAY
1:33:46 PM
CHAIR DAVIS announced consideration of SCR 12.
SENATOR ELLIS joined the meeting.
1:34:16 PM
SENATOR MEYER, sponsor of SCR 12, said that this resolution
proclaims September 9, 2010 as Fetal Alcohol Spectrum Disorders
(FASD) Awareness Day; FASD Awareness Day is observed
internationally on that date. This is a reminder on the ninth
day of the ninth month that during a woman's nine months of
pregnancy she should not drink alcohol.
He said Alaska has the highest known rate of FASD in the United
States. It is caused by prenatal exposure to alcohol and can
cause permanent brain damage, birth defects, learning
disabilities, behavioral problems, and most tragically, the loss
of individual potential. That, he said, has been the most
difficult thing for him in working with these children; they try
as hard as anyone else, but are frustrated by the limitations of
their condition. It is even more frustrating because this
disease is totally preventable.
SENATOR MEYER continued to say that the lifetime cost of medical
and residential services for 15 children born in Alaska with FAS
can be up to $47 million according to the 2005 update prepared
by McDowell Group on the economic costs of alcohol and other
drugs.
1:36:32 PM
In conclusion, he reiterated that this is totally preventable.
He referred to the strides that have been made through education
about the dangers of drinking and driving and of tobacco use;
the more people are educated about FASD, the greater the chances
of turning the tide on this problem as well.
1:37:23 PM
SENATOR DYSON said he suspects it was during Chair Davis's
professional career when a medical professional in the Seattle
area recognized a remarkable number of persons coming out of
Alaska who had certain distinctive facial features in common,
and started the research that finally identified what is now
known as Fetal Alcohol Spectrum Disorder. Alaska has not only
been hugely impacted, but has played a significant role in that
research, leading the nation in identifying children with FASD.
He stated that he has friends who are social workers and child
advocates working in western Alaska, who think there are some
communities in which as much as two-thirds of the adult
population has prenatal alcohol poisoning issues. For those
affected people who do not have the identifying physiological
features, there are still neurological patterns that are not
there and never will be there. These people have great
difficulty in reasoning between cause and effect; they often
have problems with empathy; they can't take a long view when
making decisions; they are easily victimized and will require a
great deal of structure all of their lives.
1:40:28 PM
SENATOR DYSON referred to successes in the fight against FASD
such as the bill that requires posting warning signs in bars,
and noted that Alaska now has one of the better programs in the
nation and is making some progress. He ended by saying that
Senator Davis, Senator Ellis and others who are here deserve
credit for that. This resolution is another step in the
educational progress, and he said he would be privileged to move
this bill.
1:42:43 PM
JEANNE GERHARDT-CYRUS, Kiana, Alaska, said she is a parent to
children with prenatal alcohol exposure, a professional who
conducts training in FASD, a Parent Training and Information
(PTI) Navigator with Stone Soup Group, and a case manager with
Maniilaq Association. FASD is an issue that crosses entities; it
belongs to all of us in every community. It impacts schools,
corrections, and behavioral health. It is preventable, but there
is no prevention without intervention. Those who are affected by
FASD now, need to get services so they do not develop the
characteristics that come from a poor fit with the environment.
Not everyone who is affected has the physical indicators, and
those who don't look as if they have a disability often don't
get the help they need to be successful. A lot of people with
prenatal alcohol exposure end up in the correctional system and,
sadly, get the 24 hour per day supervision and structure they
need in a correctional facility. That support needs to be
provided in the community where people can become viable members
and make a contribution to community life.
1:45:57 PM
MS. GERHARDT-CYRUS concluded that most of these people do not
qualify for developmental disability services, although the FASD
waiver program will help a great deal. As a youth she once
worked with told her, she said, they shouldn't have to get in
trouble to get services.
1:46:49 PM
BARBARA KNAPP, Manager, Treatment & Recovery Section, Division
of Behavioral Health, Juneau, Alaska, spoke on behalf of Melissa
Stone, Director, and the Division of Behavioral Health, in
support of all of the families who struggle on a day-to-day
basis with Fetal Alcohol Spectrum Disorder. They support SCR 12
proclaiming this day FASD Awareness Day.
1:47:59 PM
SHANNON CROSS, Mental Health Clinician, Division of Behavioral
Health, Anchorage, Alaska, said she also supports SCR 12.
1:48:26 PM
SENATOR DYSON asked how Alaska is doing on the availability of
diagnostic capacity for parents and in the Department of
Corrections population.
MS. KNAPP answered that she cannot speak to the Department of
Corrections, but the Department of Health and Social Services
(DHSS) has diagnostic teams located all around the state, where
families can go through a battery of testing with professionals
who can make that diagnosis. They are working on getting more
services out to those families.
She said she and Shannon Cross represent what is called the
Residential Psychiatric Treatment Center/FASD Waiver, which
provides home and community-based services to children who live
in their home communities instead of receiving treatment in an
institution.
1:50:11 PM
TRAVIS HEDWIG, Project Coordinator, Family to Family Health
Information Center, Stone Soup Group; PHD Candidate in Medical
Anthropology, Anchorage, Alaska, said he has been involved in
disability organizations in Alaska for the last decade and has
most recently become interested in Fetal Alcohol Spectrum
Disorder. He supports any and all intervention and prevention
services for this population in Alaska. He knows first-hand that
diagnostic accessibility is a problem here, but that is
changing; there is a new diagnostic team that has opened up at
Assets Inc. Prior to that, there was only one diagnostic team in
Anchorage, affiliated with Southcentral Foundation and only
available to beneficiaries, so it is a very positive
development. He reiterated his support for SCR 12.
1:52:01 PM
KATE BURKHART, Executive Director, Advisory Board on Alcoholism
and Drug Abuse and the Alaska Mental Health Board, Juneau,
Alaska, said she had not intended to testify, but has the answer
to Senator Dyson's question. She said they have been working
with the Department of Health and Social Services and the
Prevention and Early Intervention unit within the Division of
Behavioral Health, because they have recommended some funding
for services. The most recent data they have received is that
there are active diagnostic clinics in the following
communities:
Bethel - YKHC
Sitka - SEARCH
Kenai - Frontier Community Services
Juneau - Central Council of Tlingit and Haida Indians
Fairbanks - Southcentral Foundation
Palmer - Mat-Su Family Services
Anchorage - Assets Inc.
Over the past three years, these clinics have been actively
diagnosing two to three people per month in each clinic that
meets about once per month. So for example, in Bethel they
diagnosed 16 individuals in 2009, which may not sound like many,
but it is a very intensive all-day process. In Sitka they
diagnosed 10 in 2009; in Kenai they diagnosed 34 last year; in
Juneau they 23 diagnoses in 2009 and 11 by February of 2010.
Fairbanks diagnosed 22 last year and 16 so far in 2010.
Southcentral is by far the most active, with 35 in 2009 and 52
so far in 2010. She added that, after receiving a diagnosis, if
people don't have access to the services they need, the
diagnosis is not going to be of any help. That is one of the
benefits of having an awareness day like this one, which
addresses the opportunity to educate the public about the unique
needs of individuals with FASD and the services they need to
thrive.
MS. BURKHART thanked Senator Meyer and the committee for
bringing attention to this issue.
1:55:12 PM
SENATOR DYSON commented that he appreciates Ms. Burkhart's
testimony, but she is wrong to say that knowing the diagnosis is
not helpful. For people who are affected, just knowing it is not
their fault is very helpful, and there is a lot of literature
available now that friends and families can access to find the
resources they need to help children.
1:56:15 PM
KATE BURKHEART thanked him for pointing that out; she did not
mean to minimize in any way that it is important for people to
understand it is a medical issue and an issue of disability, not
one of blame or fault. She admitted that she did mis-speak and
said she meant to convey that they have heard public comment
from around the state expressing frustration from educators and
family members about the supportive services that are needed.
1:56:43 PM
MICHAEL BALDWIN, representing himself, Anchorage, Alaska, said
he has worked as a behavioral health clinician over the past two
decades in a number of different settings and with those
affected by prenatal alcohol exposure. He is thankful that
Senator Meyer has proposed this resolution. As others have
testified, it is important to keep this in people's awareness.
Echoing Ms. Gearhardt-Cyrus's comments, he said, the impact goes
far beyond the affected individuals, affecting many of our
systems and communities across the state at significant
emotional and financial cost.
1:58:57 PM
CHAIR DAVIS closed public testimony.
SENATOR THOMAS joined the committee.
1:59:40 PM
SENATOR DYSON moved to report SCR 12 from committee with
individual recommendations and attached zero fiscal note(s).
There being no objection, the motion carried and SCR 12 moved
from the committee.
SB 215-PIONEERS HOME RX DRUG BENEFIT
CHAIR DAVIS announced consideration of SB 215.
2:00:15 PM
SENATOR WIELECHOWSKI, sponsor of SB 215, said this bill came
about after months of discussions between state and federal
agencies, veterans' advocates, and members of the legislature,
who sought to reinstate federal prescription benefits for about
a dozen of the Alaska Pioneer Home residents. Although only
about a dozen veterans were impacted last year, the veteran
population grows each year, and this bill will ensure that the
residents of the Alaska Pioneer Homes will continue to receive
their federal prescription drug benefits for years to come.
He explained that in April 2009, veterans who were residing in
Alaska Pioneer Homes and were unable to administer their own
medications stopped receiving the free or low-cost medications
to which they were entitled through the Veterans Administration
(VA). These veterans were then forced to purchase the same
medications from the Pioneer Home's pharmacy. The Pioneer Home's
pharmacy prepares medications in blister-packs so nurse aides
can administer them to the patients safely and accurately; the
VA prepares medications in bottles and cannot provide
medications in blister-packs. VA doctors cannot write
prescriptions to Pioneer Homes' pharmacies, because the Pioneer
Homes are outside the VA system, and the Pioneer Homes cannot
repackage VA medications because the lot numbers and expiration
would change upon repackaging, which is currently not allowed
under state law. The Pioneer Homes were previously placing
veteran medications in Monday through Sunday Medisets, but that
was determined to be unsafe; the concern was that pills from the
VA often look different from those sold by the Pioneer Home
pharmacies, and it would be difficult to determine if the pills
had been taken or removed from the set due to a dosage change.
SENATOR WIELECHOWSKI continued that these veterans were caught
up in the middle of a bureaucratic mix-up between state and
federal policies. This resulted in a combined effort between the
Department of Health and Social Services (DHSS), the Pioneer
Homes, the Veterans Administration. Veteran Advocates, and
several members of the legislature who were previously
mentioned. A solution was found. The Pioneer Homes involved all
interested parties to determine the appropriate protocol for
ordering, receiving, storing, administering, and disposing of
medications. The Alaska VA health care system and the regional
office chief pharmacist and chief of staff conducted in-service
visits to the Pioneer Homes to ensure nurses are properly
administering medications directly from original VA bottles.
What this bill does, he said, is ensure that the struggles many
people went through last summer to resolve the problems, don't
have to be repeated in the future. It says that the Pioneer
Homes should continue to do things the way they are doing them
now; if the Pioneer Homes identify a safety precaution that
prevents them from disbursing medications as they are doing
currently, the state-run Pioneer Homes will cover the cost of
the medications. It is his understanding however, that the
Pioneer Homes do not anticipate any changes to what they are
currently doing, and thus this bill has a zero fiscal note. SB
215 prevents the need to recreate the wheel and ensures that
individuals who have earned federal prescription benefits will
continue to receive their benefits even in the face of future
administrative staffing changes.
2:04:26 PM
SENATOR WIELECHOWSKI said this bill is supported by the Vietnam
Veterans of America, who made it one of their top legislative
priorities in Alaska for 2010, and by the Director of the Office
of Veterans Affairs.
2:05:11 PM
DAVE COTE, Director, Alaska Division of Pioneer Homes, Juneau,
Alaska, said they are neutral on this bill. SB215 has a zero
fiscal note and should have no impact because they are allowing
veterans who are eligible to receive medications from the VA, or
residents of Pioneer Homes who are eligible to receive
medications through Indian Health Service, to obtain those
medications and bring them into the Pioneer Homes, where the
medications will be administered by their staff.
2:05:52 PM
RIC DAVIDGE, President, Vietnam Veterans of America (VVA);
Chair, Municipal Commission on Military and Veterans Affairs,
Anchorage, Alaska, said he was delighted when the members of the
legislature of both the House and the Senate came together and
called meetings to find a way out of this maze. He specifically
thanked Senator Wielechowski, Representative Dahlstrom and
Representative Gara and their staffs for stepping up and
following through with this. SB 215 has the total support of the
Vietnam Veterans of America; they have sent a copy of this bill
and the House bill to their national office, as other states are
facing the same kind of problem and are interested in Alaska's
solution.
2:07:14 PM
SENATOR ELLIS thanked Mr. Davidge for his involvement in this
bill and for his work on behalf of Alaska's veterans.
2:07:33 PM
CHAIR DAVIS closed public testimony.
2:07:55 PM
SENATOR DYSON commented that only government can be so foolish,
and he appreciates his colleagues for working to resolve this
problem.
2:08:38 PM
SENATOR PASKVAN moved to report SB 215 from committee with
individual recommendation(s) and attached zero fiscal note(s).
There being no objection, SB 215 moved from the committee.
2:09:26 PM
There being no further business to come before the committee,
Chair Davis adjourned the meeting at 2:09 p.m.
| Document Name | Date/Time | Subjects |
|---|