ALASKA STATE LEGISLATURE  JOINT MEETING  HOUSE EDUCATION STANDING COMMITTEE  HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  March 14, 2018 8:04 a.m. MEMBERS PRESENT  HOUSE EDUCATION STANDING COMMITTEE Representative Harriet Drummond, Chair Representative Justin Parish, Vice Chair Representative Tiffany Zulkosky Representative Ivy Spohnholz Representative Jennifer Johnston Representative Chuck Kopp Representative Geran Tarr (alternate) HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE Representative Ivy Spohnholz, Chair Representative Tiffany Zulkosky, Vice Chair Representative Geran Tarr Representative Jennifer Johnston Representative Colleen Sullivan-Leonard MEMBERS ABSENT  HOUSE EDUCATION STANDING COMMITTEE Representative David Talerico Representative Sam Kito Representative Lora Reinbold (alternate) HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE Representative David Eastman Representative Matt Claman (alternate) Representative Dan Saddler (alternate) OTHER LEGISLATORS PRESENT  Senator Tom Begich COMMITTEE CALENDAR  PRESENTATION: INTRO TO THE ALASKA EARLY CHILDHOOD COORDINATING COUNCIL - HEARD PRESENTATION: EARLY CHILDHOOD IN ALASKA WHAT THE DATA & RESEARCH TELL US - HEARD PRESENTATION: "KIDS COUNT ALASKA: ECONOMIC WELL-BEING OF ALASKA'S FAMILIES" - HEARD HOUSE BILL NO. 339 "An Act relating to the base student allocation; and providing for an effective date." - MOVED HB 339 OUT OF COMMITTEE PREVIOUS COMMITTEE ACTION BILL: HB 339 SHORT TITLE: INCREASE BASE STUDENT ALLOCATION SPONSOR(s): REPRESENTATIVE(s) GARA 02/09/18 (H) READ THE FIRST TIME - REFERRALS 02/09/18 (H) EDC, FIN 02/16/18 (H) EDC AT 8:00 AM CAPITOL 106 02/16/18 (H) Heard & Held 02/16/18 (H) MINUTE(EDC) 02/21/18 (H) EDC AT 8:30 AM CAPITOL 106 02/21/18 (H) Heard & Held 02/21/18 (H) MINUTE(EDC) 02/28/18 (H) EDC AT 8:00 AM CAPITOL 106 02/28/18 (H) -- MEETING CANCELED -- 03/07/18 (H) EDC AT 8:00 AM CAPITOL 106 03/07/18 (H) Heard & Held 03/07/18 (H) MINUTE(EDC) 03/14/18 (H) EDC AT 8:00 AM CAPITOL 106 WITNESS REGISTER ANJI GALLANOS, Executive Director Early Learning Administrator Juneau, Alaska POSITION STATEMENT: Provided a presentation on Introduction to the Alaska Early Childhood Coordinating Council. SANA EFIRD, Deputy Commissioner Department of Education and Early Development (DEED) Juneau, Alaska POSITION STATEMENT: Provided an introduction to the presentation on the Alaska Early Childhood Coordinating Council. PATRICK SIDMORE Health and Social Services Planner Alaska Mental Health Trust Board Juneau, Alaska POSITION STATEMENT: Provided a presentation on Early Childhood in Alaska What the Data & Research Tell Us. TREVOR STORRS, Executive Director Alaska Children's Trust Juneau, Alaska POSITION STATEMENT: Provided a presentation on Kids Count Alaska Economic Well-Being of Alaska's Families. ACTION NARRATIVE 8:04:00 AM CHAIR DRUMMOND called the joint meeting of the House Education Standing Committee and House Health and Social Services Standing Committee to order at 8:04 a.m. Representatives Kopp, Sullivan- Leonard, Zulkosky, Spohnholz, Parish, Tarr, Johnston and Drummond were present at the call. ^Presentation: Intro to the Alaska Early Childhood Coordinating Council Presentation: Intro to the Alaska Early Childhood Coordinating  Council  8:05:10 AM CHAIR DRUMMOND announced that the first order of business would be a presentation on Intro to the Alaska Early Childhood Coordinating Council [included in committee packet]. She explained the aim of the presentations to be heard in the meeting. REPRESENTATIVE SPOHNHOLZ added the hearing looked to examine whether there are redundancies. She said the chairs had decided to spend three committee hearings exploring the approach to early childhood education. 8:09:05 AM SANA EFIRD, Deputy Commissioner, Department of Education and Early Development (DEED), provided an introduction to the presentation. She spoke to the statutory focus of the department and the importance of reaching across departments to see the whole span of early childhood development. 8:11:14 AM ANJI GALLANOS, Executive Director, Early Learning Administrator, provided a presentation: Intro to the Alaska Early Childhood Coordinating Council. She spoke to the collaboration between Department of Health and Social Services (DHSS) and Department of Education and Early Development (DEED). She informed she serves as staff to the Alaska Early Childhood Coordinating Council (AECCC). She said the goal of the presentation was to present some discussion points to the legislature and to provide an overview of the how early childhood advisory councils operate throughout the states and of the structure of the AECCC. MS. GALLANOS began her presentation on slide 4, "Overview of Advisory Councils across the States", which read as follows [original punctuation provided]: Nearly all Governors have designated a state advisory council to advise policymakers. Policy Councils are organized differently in each state. Several federal initiatives require state advisory councils. 8:14:32 AM REPRESENTATIVE SULLIVAN-LEONARD asked about the graphic on the slide. MS. GALLANOS answered the graphic on slide 4 is not representative. She said she could provide one that is. MS. GALLANOS progressed to slide 5, "Federal Initiative that require a state advisory council," which read as follows [original punctuation provided]: Head Start • Section 642 B(b)(1)(A)(i) of the Head Start Act requires the Governor of each State to designate or establish a council to serve as the State Advisory Council on Early Childhood Education and Care for children from birth to school entry. MIECHV (Maternal Infant Early Childhood Home Visiting) • Recipients should ensure that home visiting is part of a continuum of early childhood services through project planning and service coordination at state, territory and/or local levels with entities, such as those listed below, and/or their local affiliates, as applicable: • The State Advisory Council on Early Childhood Education and Care authorized by ?642B(b)(1)(A)(i) of the Head Start Act, if applicable Child Care Development Fund • The State Advisory Council on Early Childhood Education and Care authorized by ?642B(b)(1)(A)(i) of the Head Start Act, if applicable 8:17:21 AM MS. GALLANOS advanced to slide 6, "AECCC History", which read as follows [original punctuation provided]: Governor Sean Parnell issued an Administrative Order on October 6th, 2010 designating the Interdepartmental Early Childhood Coordinating Council (IECCC) as the Advisory Council on Early Childhood Education and Care An MOA was signed by the previous Commissioners of DHSS and DEED clarifying roles and responsibilities for the Council. The Council will be jointly facilitated by the Department of Education and Early Development and the Department of Health and Social Services. This Council previously included only state representatives. Subcommittees formed. Current work: Next meeting April 2018 8:19:09 AM MS. GALLANOS advanced to slide 7, "AECCC Structure." She described the make-up of the council, which includes the commissioners of DEED and DHSS and their departmental staff, as well as standing committees, which read as follows [original punctuation provided]: • Healthy Start and Strong Families • Data and Systems Alignment • High Quality Early Care and Education • Innovation and Long Term Investment • Public Engagement & Community Partnerships MS. GALLANOS spoke to slide 8, entitled "AECCC Alaska Early Childhood Coordinating Council." MS. GALLANOS advanced to slide 9, "AECCC Members," which read as follows [original punctuation provided]: Public • Office of the Governor • Commissioner of DEED • Commissioner of DHSS • Commissioner of DOL • Commissioner of Public Safety • DEED Director of Student Learning • Head Start Collaboration Director • Part C/Early Intervention Program Manager • Child Care Program Manager • Early Childhood Comprehensive Systems Program Officer • Representative from UAA • Alaska Mental Health Board Private • Alaska Association of School Administrators • Alaska Association of School Boards • Association for Infant Learning Programs • Alaska's Child Care Resource and Referral • Alaska Head Start Association • Alaska Native Health • Alaska Libraries Association • Alaska Children's Trust Mental Health Representative • Best Beginnings Representative • Parent Representative • Business Community Representative REPRESENTATIVE ZULKOSKY asked for clarification of who represents Alaska Native Health. MS. GALLANOS answered that Matt Hirschfeld from the All Alaska Pediatric Partnership is the current representative. REPRESENTATIVE PARISH asked why the university is only listed as UAA and not the entire University of Alaska (UA) system. MS. GALLANOS answered that it should represent the entire UA system. 8:23:20 AM MS. GALLANOS advanced to slide 10, entitled "AECCC Sub-Committee Chairs," which read as follows [original punctuation provided]: • Healthy Start and Strong Families - Alaska Native Health Association for Infant Learning Programs • Data and Systems Alignment - Alaska Mental Health Board • High Quality Early Care and Education - Representative from UAA, Child Care Program Manager • Innovation and Long Term Investment - Alaska Head Start, Association Business Community Representative • Public Engagement & Community Partnerships - Alaska Association of School Boards, Alaska Children's Trust, Best Beginnings Representative MS. GALLANOS advanced to slide 11, "AECCC Subcommittee Priorities", and briefly addressed the priorities. She said that another task of the subcommittees is to identify stakeholders as well as priorities. MS. GALLANOS addressed slide 12, "AECCC Alaska Early Childhood Coordinating Council," showing how the components of the council fit together. 8:27:37 AM REPRESENTATIVE JOHNSTON returned to slide 11 and suggested the priorities regarding "Innovation and Long-Term Investment," which include "oppose Medicaid block grants, repeal of Affordable Care Act," would appear to be more political in nature. MS. GALLANOS answered the council doesn't have the role of requesting funding. She underlined part of the council is made up of public agency groups. She said those priorities were defined by the groups at the time. REPRESENTATIVE JOHNSTON asked for confirmation that the groups are public. MS. GALLANOS said that at the time, the two subcommittees felt those priorities were the true focus of their work. REPRESENTATIVE JOHNSTON asked for confirmation that the information was three years old. MS. GALLANOS answered in the affirmative and said that priorities need to be updated. She stated the group looks for guidance from the various entities, including the legislature. 8:32:13 AM REPRESENTATIVE SPOHNHOLZ spoke to the priorities on slide 11. She suggested narrowing the goals and using community-based partnerships to achieve those goals. CHAIR DRUMMOND commented the presentation was revealing of partnerships between departments. MS. GALLANOS said she thinks it is important to understand the council and how it works. She added that other states have advisors for policymakers. She stated the council has done the best it could have done. She encouraged the committee to use the presentation as a draft for moving forward. ^Presentation: Early Childhood in Alaska What the Data & Research tell us Presentation: Early Childhood in Alaska What the Data & Research  tell us  8:37:45 AM CHAIR DRUMMOND announced that the next order of business would be a presentation on "Early Childhood in Alaska What the Data & Research tell us" [included in committee packet]. 8:38:02 AM PATRICK SIDMORE, Health and Social Services Planner, Alaska Mental Health Trust Board, provided a presentation entitled "Early Childhood in Alaska What the data & Research tell Us", [included in committee packet]: MR. SIDMORE began by addressing slide 3, "Questions," which read as follows [original punctuation provided]: At what age are children in the U.S. most likely to be expelled from school? What percentage of Alaskan children age 6 and under receive care by someone other than their parent or guardian? By age eight, what percentage of Alaskan children have had a first report of harm made to OCS? What percentage of Alaskan children at the start of Kindergarten regulate their feelings and impulses? What skills can mitigate the health impact of toxic levels of stress in childhood? MR. SIDMORE continued to slide 4, "Outline- what the research tells us," which read as follows [original punctuation provided]: 1) The Importance of Early Childhood 1) Heckman Equation 2) The Brain Science 2) The Data 1) Population 2) Sources of Information 3) Prenatal 4) Birth and Infancy 5) Pre-School Age 6) School Age 3) Analysis 1. What Hurts 2. What Works MR. SIDMORE spoke to slide 5, "Early Childhood Development is a smart investment," displaying a graph by James Heckman, Nobel Laureate in Economics. 8:43:27 AM MR. SIDMORE continued to slide 7, "Building blocks of the brain," which read as follows [original punctuation provided]: Abstract thought Planning for future Decision-making Self-awareness & insight Balancing emotions Empathy Memory Attention Emotions Motor Regulation Sleep Digestion "Staying alive" ? respiration, heartrate? *Slide Courtesy of Linda Chamberlain, Ph.D. MR. SIDMORE described the progression of brain development from birth through to the development of abstract thought. MR. SIDMORE spoke to slide 8, "Wired Up-Wired Down," displaying the neurons of the brain at birth, at 7 years old, and at 15 years old. 8:46:29 AM REPRESENTATIVE SULLIVAN-LEONARD mentioned her work in the prenatal unit at Providence Hospital and asked whether the wiring in babies of mothers with addiction could be shown in a similar image. MR. SIDMORE said he would follow up with the information. MR. SIDMORE presented a quote from James Heckman: "Self-control, openness, the ability to engage with others, to plan and to persist - these are the attributes that get people in the door and on the job, and lead to productive lives." MR. SIDMORE advanced to slide 10, "Seven Key Principles of Self- regulation," which read as follows [original punctuation provided]: • SELF-REGULATION: serves as the foundation for lifelong functioning • is defined from an applied perspective as the act of managing cognition and emotion • enactment is influenced by a combination of individual and external factors • can be strengthened and taught • is dependent on "co-regulation" provided by parents or other caregiving adults • can be disrupted by prolonged or pronounced stress and adversity including poverty and trauma experiences • develops over an extended period from birth through young adulthood and beyond [Source] Murray, Desiree W., Rosanbalm, Katie, Christopoulos, Christina, and Hamoudi, Amar (2015). SelfRegulation and Toxic Stress: Foundations for Understanding Self- Regulation from an Applied Developmental Perspective. OPRE Report #2015-21, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. 8:51:37 AM MR. SIDMORE continued to slide 11, "How many Alaskans Aged Eight and Under," which read as follows [original punctuation provided]: Ages Birth through 8 Number of Alaskans: 95,669 Percentage of Population 13.0 percent How Does it Compare Ages 65 Plus: Number of Alaskans: 82,686 Percentage of Population 11.2 percent [Source] Alaska Department of Labor and Workforce Development, Research and Analysis Section; and U.S. Census Bureau, July 2017 Estimates MR. SIDMORE addressed slide 12, "Birth to Age Nine," showing the demographic around the state. He remarked that in some areas of the state, the group makes up 20 percent of the population, while in other areas it is as low as 5 percent. *Sources: Alaska Department of Labor and Workforce Development, Research and Analysis Section; and U.S. Census Bureau, July 2017 Estimates MR. SIDMORE continued to slide 13, "Key Data Sources," listing the programs from which the data had been collected: • Alaska PRAMS - Pregnancy Risk Assessment Monitoring System • Alaska CUBS - Childhood Understanding Behavior Survey • ABADA/AMHB - Advisory Board on Alcoholism and Drug Abuse/ Alaska Mental Health Board • DEED - Alaska Department of Education and Early Development • CDC - Centers for Disease Control • The Economics of Early Care and Learning in Alaska REPRESENTATIVE JOHNSTON asked whether the CUBS and PRAMS systems are voluntary. MR. SIDMORE answered in the affirmative. 8:54:14 AM MR. SIDMORE moved to slide 14, "Searchable Data Sources", which read as follows [original punctuation provided]: • Alaska PRAMS • Alaska CUBS • Health Maps InstantAtlas • Health Data AK-IBIS MR. SIDMORE addressed the checklists for "Alaska PRAMS" in slides 15-17 for the stages of Before Pregnancy, During Pregnancy, and After Pregnancy. 8:57:30 AM MR. SIDMORE advanced to slide 19, "Smoked during last three months of Pregnancy". He stated that around 13,500 of the children monitored had mothers who smoked. MR. SIDMORE spoke to slide 20, "Interpersonal Violence and Pregnancy," which read as follows [original punctuation provided]: • During the 12 months before you got pregnant with your new baby, did your husband or partner push, hit, slap, kick, choke, or physically hurt you in any other way? • During your most recent pregnancy, did you husband or partner push, hit, slap, kick, choke, or physically hurt you in any other way? • During the 12 months before you got pregnant with your new baby, did you ever call the police because you felt threatened by your husband or partner? (Include calls to 911, AST, VPSO) • During the 12 months before I got pregnant: your husband or partner threaten you, limit your activities against your will or make you feel unsafe in any other way? • During my most recent pregnancy: your husband or partner threaten you, limit your activities against your will or make you feel unsafe in any other way? Yes to at least one - 7.6% - ~7,270/95,669 *Based on 3-year sample 2009-2011, Jared Parrish, Ph.D. 8:59:25 AM MR. SIDMORE advanced to slides 21-22 on "The Mechanism of Change Epigenetics," which read as follows [original punctuation provided]: • Compelling new science showing how nurture can affect nature Molecular biological methods to change gene expression without changing the gene itself Done by changing the chemical composition of regulatory segments of the gene • DNA methylation • Modification of histones Epigenetics Passed from Moms to Children • Fetal exposure to maternal stress influences future stress responses in a negative way Moms who are stressed (stressful event, increased anxiety, depression) during pregnancy are more likely to have kids with: • Preterm birth • Poor emotional coping skills • Decreased cognitive abilities • Increased fear response to stimuli ? Increased anxiety These effects are mediated by histone modification and DNA methylation [Source] Matt Hirschfeld, M.D., Ph.D. 9:01:21 AM MR. SIDMORE advanced to slide 24, "Nutrition" regarding breastfeeding rates as well as soda consumption. He stated that Alaska "does incredibly well" in breastfeeding rates compared to other states. REPRESENTATIVE SULLIVAN-LEONARD commented she grew up drinking Tang and said her grandchildren are allowed only milk and water. MR. SIDMORE remarked other sugary drinks are also an issue and there is another measure for those. CHAIR DRUMMOND mentioned a conference in the 1990s about dental health and commented that there were images of children's teeth emerging rotten due to sugar consumption. REPRESENTATIVE ZULKOSKY remarked that if water were not so expensive, there may not be the disparity that is seen currently in consumption. MR. SIDMORE advanced to slide 24, "Benefits of Breastfeeding" and "Benefits of Reducing Soda Consumption," which read as follows [original punctuation provided]: • Psychosocial Effects • Economic Effects • Environmental Effects • Endorsement of Breastfeeding as the Best Nutrition for Infants [Source] Office of the Surgeon General (US); Centers for Disease Control and Prevention (US); Office on Women's Health (US). Frequent ingestion of soda has been identified by Tribal health programs as a factor contributing to increased dental decay in Alaska Natives. Frequent ingestion of soda contributes to dental decay through two mechanisms: • Non-diet sodas are a major source of sugar; and • Most sodas, like citrus drinks, have a relatively low pH (acidic) These factors result in increased acid production by the bacteria causing dental decay as well as demineralization of teeth due to the low pH of these drinks. [Source] Alaska Oral Health Plan 9:05:02 AM MR. SIDMORE addressed slide 25, "Days per week read book or a story with young child" showing a graph of the percentage of mothers of 3-year-olds reading to their children. The graph showed an increase in reading "Every day" from 50.5 percent in 2015 to 58.1 percent in 2016. MR. SIDMORE advanced to slide 26, "Types of Early Care and Learning Services Utilized". He gave the percentages of children under 6 years of age in care by types of care. He highlighted 55 percent of children under age 6 receive care by someone other than their parent or guardian. 9:07:12 AM MR. SIDMORE advanced to slide 27, "Attends Preschool", which shows a table, "3-year-old child currently attends preschool by region". He remarked that at 3 years old, the number is 28.5 percent. CHAIR DRUMMOND remarked that 6,500 child care workers in the state is an interesting figure. She asked for confirmation that the figure includes public and private sector workers. MR. SIDMORE answered in the affirmative, adding he had heard that a child will spend more time in childcare than in education. MR. SIDMORE moved to slide 28 containing a quote from James Heckman, "High quality birth-to-five programs for disadvantaged children can deliver a 13 percent return on investment." MR. SIDMORE addressed slide 29, "Expulsion Rates (per 1,000)" giving the rate of expulsion for K-12, PreK, and Child Care. He said the age children are most likely to be expelled is 4 years of age. REPRESENTATIVE SPOHNHOLZ asked what the pupils are expelled for. REPRESENTATIVE JOHNSTON shared personal experience with her young children being expelled. REPRESENTATIVE SPOHNHOLZ asked whether the children were being expelled for non-conforming behavior. MR. SIDMORE replied he thinks the answer is yes. He added he thinks it has to do with the adults' ability to handle the range of behavior of children. 9:12:38 AM MR. SIDMORE continued to slide 30, "State PreK Expulsion Rates" showing a map from the Yale School of Medicine of the U.S. with a color-coded rates and states with no PreK program. MR. SIDMORE addressed slide 31, "Many Factors Predict Preschool Expulsion," which read as follows [original punctuation provided]: • Child-Teacher Ratio • Program Length of Day • Teacher Job Stress • Access to Behavioral Supports 9:14:30 AM MR. SIDMORE advanced to slide 32, "Who gets Expelled?" which read as follows [original punctuation provided]: • 4-year-olds 50 percent more likely than 3's • Black preschoolers more than 2 times as likely as white preschoolers • Boys more than 4 times as likely as girls MR. SIDMORE moved to slide 33, "Statewide 2017-2018 results" from the developmental profile done for kindergarteners in the first 4 weeks of school. The pie chart shows that 17.6 percent of pupils "Consistently demonstrated all 13 goals"; 12.7 percent "Consistently demonstrated 11 or 12 goals"; and 69.6 percent "Consistently demonstrated 10 or fewer Goals." 9:16:43 AM MR. SIDMORE continued to slide 34, "Types of Early Care and Learning services utilized," showing 42 percent of children age 6 to 12 are in non-family childcare. MR. SIDMORE spoke to slide 37, "Annual prevalence - 3 estimates" showing Dr. Justin Parrish's data linking the Permanent Fund Dividend with PRAMS data and OCS data on reports of harm, which read as follows [original punctuation provided]: On average ~ 15,000 children are reported ~ 8,000 children are screened in ~ 2,000 children are substantiated to/by OCS annually • The number of reports and screen ins has significantly increased since 2008 CHAIR DRUMMOND asked for definitions of the terms used. MR. SIDMORE explained that report means there was a report to OCS; screened in means that enough information came in to suggest that an investigated needed to be done; and substantiated means a harm was found. REPRESENTATIVE PARISH asked for a report including the proportion of false negatives and false positives. REPRESENTATIVE JOHNSTON added it would be interested to receive information on the "1-3 reporting" data, including time limits for investigations and results. 9:22:06 AM MR. SIDMORE advanced to slide 43, "New emerging data resources." He explained that mothers taking part in the PRAMS survey had signed a release for the data to be linked. In this way, the OCS outcomes could be seen via the Alaska Longitudinal Child Abuse and Neglect Linkage Project (ALCANLink). MR. SIDMORE moved to slide 44, "Maltreatment burden: Alaska Longitudinal Child Abuse and Neglect Linkage Project". He pointed out that around 10 percent of the child population is reported to OCS annually in Alaska. 9:25:01 AM MR. SIDMORE advanced to slide 46, "Linking Data to Policy". He said it is hard to diagnose a child of 1 or 2 years of age with a disturbance, but severe emotional disturbance is the criterion that is examined. He said the 1115 Medicaid Waiver allows states to "bend the rules" and the data can be used to obtain federal funds. MR. SIDMORE advanced to slide 48-50, defining types of stress, which read as follows [original punctuation provided]: • Positive stress" - moderate, short-lived stress responses, such as brief increases in heart rate or mild changes in stress hormone levels • Tolerable Stress- could disrupt brain architecture but is buffered by supportive relationships that facilitate adaptive coping • Toxic Stress- strong and prolonged activation of the body's stress management systems in the absences of the buffering protection of adult support MR. SIDMORE addressed slides 51-52 by Josh Arvidson on brain processes, which read as follows [original punctuation provided]: • under typical conditions - observe - input - interpret - process - evaluate options - plan - act • Alarm system "Express Route" - observe - interpret - react - (flight - fight- freeze) • With repeated stress, the Alarm System "Express Route" becomes the main road 9:28:52 AM MR. SIDMORE moved to slide 56, "Self-Regulation," which read as follows [original punctuation provided]: 1. Finishes tasks and follows through on commitments 2. Stays calm and in control when facing a challenge 3. Shows interest and curiosity in learning new things MR. SIDMORE spoke to slide 57, "Average Number of CSHCN condition by ACE score and Number of Self-Regulation skills (Age 6-17)." He explained that the taller columns on the graph (red) indicate worse health levels. 9:31:11 AM MR. SIDMORE addressed slide 58 containing the answers to the initial presentation questions, which read as follows [original punctuation provided]: • At what age are children in the U.S. most likely to be expelled from school? - 4 years old • By age eight, what percentage of Alaskan children have had a first report of harm made to OCS? - 32 percent or about 30,614 • What percentage of Alaskan children age 6 and under receive care by someone other than their parent or guardian? - 55 percent • What percentage of Alaskan children at the start of Kindergarten regulate their feelings and impulses? - 45.5 percent • What skills can mitigate the health impact of toxic levels of stress in childhood? - Self-Regulation Skills 9:31:51 AM MR. SIDMORE advanced to slide 59, "Priorities for Prevention," which read as follows [original punctuation provided]: • Support quality early childhood programs. • Ensure access to health care including behavioral health care. • Strengthen capacity for social emotional learning throughout Alaska's schools. • Maintain and expand prevention efforts that have proven to be effective. ^Presentation: "Kids Count Alaska: Economic Well-Being of Alaska's Families" Presentation: "Kids Count Alaska: Economic Well-Being of  Alaska's Families"  9:32:52 AM CHAIR DRUMMOND announced that the next order of business would be a presentation on "Kids Count Alaska: Economic Well-Being of Alaska's Families" [included in committee packet]. 9:33:04 AM TREVOR STORRS, Executive Director, Alaska Children's Trust, presented a PowerPoint, "Kids Count Alaska: Economic Well-Being of Alaska's Families"[included in committee packet]. He began by addressing slide 2, "Resilient Family". He suggested when a family has employment, it has access to health services and education. He said one of the key elements is economics. 9:36:01 AM MR. STORRS advanced to slide 3, "Children make up a quarter of Alaska population" showing child population by region. The number of children in the state is 207,131. *Source: Kids Count Alaska Economic Well Being 2018 MR. STORRS advanced to slide 4, "Income is not equal" showing the difference from Median Family Income by Race / Ethnicity, 2015. The slide shows the state Median Family Income at $75,500 and the Median Family income for Non-white families is $48,700. REPRESENTATIVE KOPP remarked that charts showing the economic reality in the villages do not take into account the cash economy versus subsistence living. He mentioned that his neighbors growing up in the village certainly did not consider themselves poor. He suggested it is like comparing apples and oranges and not a direct comparison. MR. STORRS stated his agreement. He clarified that the information given provides a picture for the conversation that is needed. 9:40:27 AM MR. STORRS moved to slide 5, "Having both parents in the workforce is a financial advantage" showing household types 2011-2015. The graph indicated 68 percent are in Married Couple households. Of the 32 percent in Single-Parent households, 68 percent are Mother only households, and 32 percent are in Father only households. MR. STORRS advanced to slide 6, "Where you live has a big impact on how much families struggle" which shows families with incomes below the federal poverty level 2011-2015. He commented that, as pointed out by Representative Kopp, the numbers did not account for subsistence lifestyles. CHAIR DRUMMOND asked about the age range of the children covered in the study. MR. STORRS answered he would have to supply the information; however, it was the group from zero to either 17, 18, or 19 years of age. CHAIR DRUMMOND surmised it includes the K-12 population as well as preschool. MR. STORRS answered in the affirmative. REPRESENTATIVE SULLIVAN-LEONARD asked where the income level was taken from. MR. STORRS answered poverty level for a family of 2 is $16,240, and for a family of 3, the level is $20,424. 9:44:22 AM MR. STORRS advanced to slide 8 entitled "Alaska is leading the country in housing burden" In Alaska an individual must earn at least $24.10 to for a 2-bedroom rental at fair market rate. He directed attention to the column listing nonmetropolitan counties (or county equivalents) which shows the required wage much higher, from $27.19 in Skagway, Alaska, to $32.52 in the Aleutians West Census Area, Alaska. MR. STORRS moved back to slide 7, "Hard working families are struggling to keep up with housing costs." The table shows wage and rental costs rates, with the conclusion that a renter would have to work 77 hours per week at the minimum wage to pay rent on a modest 1-bedroom home at fair market value. He pointed out that the standard is 30 percent or less of one's income for housing and paying over that 30 percent puts one in jeopardy. 9:47:07 AM MR. STORRS advanced to slide 9, "Families are going hungry," which read as follows [original punctuation provided]: • In 2014, 20 percent of all children, approximately 38,000 children, lived in households where there was not enough food because of insufficient resources. • In 2015, 81,000 individuals participated in Supplemental Nutrition Assistant Program (SNAP). MR. STORRS continued to slide 10, "Transportation is an issue for some families," which read as follows [original punctuation provided]: 10 percent of children, approximately 19,000 children, lived in homes where there was not a vehicle available for household members. Regionally, particularly off the road system, individuals may have less need for a truck or car and rather rely on ATVs *Source: Kids Count Alaska Economic Well Being 2018 MR. STORRS advanced to slide 11, "Families are major contributors to early care and learning" which states that, in total, Alaska's early care and learning sector accounts for $343 million in annual spending. Household spending accounts for $223 million, $84 million is covered by the federal government, and $36 million by state government spending. The source read as follows [original punctuation provided]: *Source: Economic Impact of Early Care and Learning in Alaska, Alaska Early Childhood Coordinating Council, 2015 9:50:15 AM REPRESENTATIVE TARR asked whether extracurricular activities are included in the figures. MR. STORRS said he would have to find that information. REPRESENTATIVE TARR mentioned a bill for afterschool programs that was in the pipeline. MR. STORRS continued to slide 13, "Cumulative effect of stressors". The slide lists healthcare costs and access, high housing burden, lack of transportation, low income, food insecurity, and early childhood supports as primary stressors. 9:54:53 AM MR. STORRS advanced to slide 16, "Early childhood education reduces negative and costly outcomes" which read as follows [original punctuation provided]: 1. Decrease Crime 2. Improved Graduate Rates 3. Teenage Birth Drop 4. Increase Employment 5. Decrease welfare and health care costs 6. Academic and Earnings Outcomes 7. Increased Workforce *Source: Economic Impact of Early Care and Learning in Alaska, Alaska Early Childhood Coordinating Council, 2015 9:56:32 AM REPRESENTATIVE ZULKOSKY requested confirmation of her summary of the presentation as follows: financial and economic and household stressors can lead to family stressors that impact early childhood experience, resilience, and ability to self- regulate which impacts early childhood education. MR. STORRS answered he thought it was a "great summary." The committee took an at-ease from 10:01 a.m. to 10:02 a.m. [The joint House Health and Social Services Standing Committee and House Education Standing Committee meeting ended. House Health and Social Services Standing Committee took up HB 339.] HB 339-INCREASE BASE STUDENT ALLOCATION  10:02:48 AM CHAIR DRUMMOND announced that the final order of business would be HOUSE BILL NO. 339, "An Act relating to the base student allocation; and providing for an effective date." CHAIR DRUMMOND commented that since 2013, the Anchorage, Alaska, school district has cut nearly 400 positions. She mentioned a list presented to the committee from the Cordova School Board. She encouraged an increase in the base student allocation. 10:05:10 AM REPRESENTATIVE PARISH moved to report HB 339 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, it was so ordered. The committee took an at-ease from 10:05 a.m. to 10:07 a.m. 10:07:19 AM ADJOURNMENT  There being no further business before the committee, the House Education Standing Committee meeting was adjourned at 10:07 a.m.