Legislature(2015 - 2016)HOUSE FINANCE 519
02/25/2015 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB39 | |
| Recidivism Reduction Discussion: the Pew Charitable Trust | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 39 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
CS FOR HOUSE BILL NO. 39(HSS)
"An Act establishing the Advisory Committee on
Wellness; and relating to the administration of state
group health insurance policies."
1:33:25 PM
REPRESENTATIVE PAUL SEATON, testified on HB 39; a bill
establishing the Advisory Committee on Wellness. He
reported that the intent of the bill was to create an
advisory wellness committee within the Department of
Administration (DOA). The legislation required DOA to
implement procedures to decrease the incidence of disease
in Alaska in an attempt to hold healthcare inflation to 2
percent per year for state health insurance plans. He
purported that the bill added weight to the current
wellness committee through establishing the committee in
statute, expanding the membership, and requiring DOA to
respond to its recommendations within 6 months. The bill
further mandated the department to provide a report to the
legislature on DOA's response to the committee's
recommendations. He detailed that the wellness advisory
committee was modeled after the Citizen's Review Panel for
the Office of Children Services (OCS) [Department of Health
and Social Services (DHSS)]. The Office of Children
Services was required to respond to the panel's
recommendations, which proved effective at improving
children's services. He expounded that by holding
healthcare inflation to 2 percent on the state's active and
retiree healthcare costs the state would reduce the Public
Employees' Retirement System (PERS) and Teacher's
Retirement System (TRS) unfunded liability by $3.8 billion
dollars. He added that healthcare inflation was currently
at 5 percent but was estimated at 2 percent for payments
made to the PERS/TRS system which contributed to the
unfunded liability. He related that HB 39 focused on
curbing state worker's healthcare costs because the
contractual relationship between the state and
employees/retirees could be manipulated to influence
behavior. For instance, the state could employ incentives
through co-pay or deductible changes to reach specific
health goals.
Representative Seaton drew attention to a study on
depression titled, "Vitamin D and Depression: A Systematic
Review and Meta-Analysis Comparing Studies with and without
Biological Flaws" (copy on file). He read the following
from page 14:
The effect size for Vitamin D in depression
demonstrated in this meta-analysis is comparable with
the effect of anti-depressant medication, an accepted
treatment for depression. Should these results be
verified by future research, these findings may have
important clinical and public health implications.
Representative Seaton communicated that many of the social
problems in the Alaska populace was due to depression. The
state's prison population had deficient vitamin D levels.
Vitamin D levels also contributed to a healthy immune
system. He surmised that maintaining wellness within the
correctional system through vitamin D use was one example
of how the wellness committee could work to influence
better health through DOA.
Co-Chair Thompson referred to page 2, [line 23] of the
legislation and cited the language, "legally and reasonably
practicable." He asked what the legally and reasonably
practicable standard was. Representative Seaton responded
that the language was included as a way for the department
to evaluate the advisory committee's recommendations. A
recommendation might be unlawful or violate HIPPA rules,
therefore the administration was not required to implement
the recommendation. The recommendation would also have to
meet a standard of practicality. He voiced that the
language granted the department flexibility within its
required review of the recommendations.
1:41:30 PM
Vice-Chair Saddler asked about why the advisory committee
was part of DOA and not housed within the Department of
Health and Social Services (DHSS). Representative Seaton
replied that state only had a contractual relationship with
state employees, retirees, and their dependents, which
provided a "mechanism" to incentivize outcomes. The
Department of Administration was the only department that
reviewed the health policies of the state employees and
retirees.
Representative Kawasaki referred to Section 2 of the bill
and noted that the focus was on healthcare costs. He asked
whether it was the intent of the legislation to examine the
state's health care insurance costs and coverage.
Representative Seaton responded that the purpose of the
bill was to create a healthier workforce and improve
retirees' health. He explained that the bill was not
attempting to change the health care plans' provisions. The
bill focused on prevention as a way to help control
healthcare costs.
Representative Gara relayed that the Citizens Review Panel
had a difficult time obtaining requested information from
OCS. He wanted to ensure HB 39 was written in a way that
made it easy for the advisory committee to get necessary
information from DOA. Representative Seaton responded that
there was a difference in the mission between the two
advisory entities. The panel reviewed state operations, the
wellness committee was finding ways to improve worker's
health, which did not require DOA to supply information.
1:45:36 PM
Co-Chair Neuman cited page 2, Section 2 [lines 15 through
21] of the bill and read the following:
(13) To the greatest extent legally and reasonably
practicable, the Department of Administration shall
work to hold the escalation of health care costs to
less than two percent annually by administering
policies of group health insurance obtained under this
subsection in a manner that is likely to reduce the
incidence of disease in the state's population and
that facilitates implementation of the recommendations
of the Advisory Committee on Wellness established
under 21 AS 39.30.093.
Co-Chair Neuman asked whether the department would be
required to implement the recommendations of the advisory
committee in its plans policies in order to achieve a 2
percent reduction.
Representative Seaton responded that the intent of the
legislation did not mandate the department to implement
policies. The bill required the department to review the
recommendations and respond to each recommendation via a
report. Each recommendation would be held to the standard
of legally and reasonably practicable. He summarized that
HB 39 did not mandate implementation of policies only to
review recommendations.
Co-Chair Neuman asked about Section 3 [on page 2, lines 23
through 28] and read the following:
(b) To the greatest extent legally and reasonably
practicable, the Department of Administration shall
work to hold the escalation of health care costs to
less than two percent annually by administering
policies of group health insurance obtained under this
section in a manner that is likely to reduce the
incidence of disease in the state's population and
that facilitates implementation of the recommendations
of the Advisory Committee on Wellness established
under AS 39.30.093.
Co-Chair Neuman understood that DOA was already working
hard to contain healthcare costs for the state. He asked
whether Section 3 guaranteed that if the department adopted
the recommendations of the advisory committee costs would
come down. Representative Seaton answered that a wellness
committee was in place but met infrequently and did not
carry much weight because its recommendations were not
required to be addressed. The bill facilitated that
recommendations would be addressed and those with merit
should be considered for implementation.
Co-Chair Neuman remarked that the bill packet contained a
lot of information about the benefits of vitamin D. He
asked whether it was the sponsor's intent for all Alaskan's
to take vitamin D at the recommendation of the wellness
committee to reduce the cost of healthcare. Representative
Seaton suggested the information was included as an example
of something that the wellness committee might recommend
based on sound scientific information. He emphasized that
HB 39 only addressed people who the state maintained a
contractual relationship with in order to provide health
insurance for; state employees, retirees, and their
dependents. The contractual relationship enabled the state
to provide incentives for better health outcomes through
preventive care.
1:51:12 PM
Representative Wilson expressed concern that healthcare
costs over 2 percent would be transferred to the retirees.
She wondered whether the commissioner of DOA had the
medical expertise to implement programs that would reduce
the incidence of disease. Representative Seaton responded
that the legislation could not change the cost structure of
negotiated contracts. He reiterated that a wellness
committee already existed in DOA but lacked a requirement
to review the committee's recommendations and facilitate
implementation. He commented that the bill expanded on the
work the department currently undertook; to administer the
state's health insurance. He informed the committee that
the department previously testified in favor of the bill.
Representative Wilson voiced that the state insurance
already sent recipients an abundance of wellness
information. She was bothered by the possibility of
mandates in order to reduce healthcare costs to the 2
percent inflationary level. She felt that the information
that was already available was enough to induce wellness.
She felt that the legislation was "heading down the wrong
path" by creating mandates. Representative Seaton remarked
that the bill was attempting to reduce $3.8 billion from
the unfunded liability by prompting the state's employees
and retirees towards improved health.
1:55:05 PM
Representative Munoz wondered about the contract for the
administration of the state's health insurance plans and
thought that they were currently under review. She wondered
how the committee would work with DOA to implement changes
while contract negotiations were taking place.
Representative Seaton thought that the committee would be
fully integrated with the department. He pointed out that
currently the wellness committee did offer recommendations
but they were never reviewed or acted on. He restated that
the bill was just "adding weight" to create an effective
wellness committee.
Representative Munoz mentioned that the previous DOA
administration implemented a wellness program. She asked
whether the program helped to change outcomes and lower
costs under the current contract. Representative Seaton
responded that he did not know the statistical outcomes of
the department's efforts to entice people to quit smoking
or provide state employees free vitamin D tests at the
state's health fair.
Representative Guttenberg mentioned that the state already
had a wellness committee and a healthcare commission full
of healthcare professionals and administrators. He inquired
whether the sponsor considered "rolling" the wellness
committee into the healthcare commission. Representative
Seaton answered in the negative. He explained that the
wellness committee consisted of state employees and "people
on the ground" that viewed things differently than the
medical establishment. He reiterated that the wellness
committee existed in DOA and not DHSS to specifically
address how to lower healthcare costs for employees and
retirees and not to examine the general health of all
Alaskans.
2:00:04 PM
Vice-Chair Saddler asked whether HB 39 would sunset the
existing committee and replace it with a new wellness
committee. Representative Seaton answered that the
legislation expanded the existing committee and did not
incur costs. The members participated online and on their
own time. Representative Seaton, in response to a question
by Representative Saddler, indicated that the bill only
dealt with the Advisory Committee on Wellness within the
DOA and had no connection to the healthcare commission.
Vice-Chair Saddler commented that the language in the bill,
"greatest extent legally and reasonably practicable" seemed
"firm" and he needed to ponder how much authority the
committee would actually have.
Representative Gattis requested clarity about the advisory
committee. Representative Seaton reiterated that the bill
only dealt with the Advisory Committee on Wellness
established within DOA and had nothing to do with any other
commission on healthcare. He reiterated the proposed role
of the committee.
Representative Gattis reminded the committee that the
state's employee healthcare was a benefit paid for by an
employer. She opined that the bill's provision was not a
"liberty issue." The growing cost of health care dictated
that the state implement measures to control costs. She
opined that if the state offered incentives or
disincentives to accomplish cost control, the employee had
the choice to accept the benefit or not. She asked whether
the sponsor agreed with her point of view. Representative
Seaton answered in the affirmative.
Representative Edgmon supported the concept of the bill. He
believed the intent was reformist and would achieve cost
savings and raise awareness over time to produce a
healthier working populace of state workers. He felt that
the objective of the committee to help reduce healthcare
inflation to 2 percent was ambitious. He expected that the
committee would be very active and engaged to achieve such
an ambitious goal. He wondered about its administrative
costs. Representative Seaton indicated that the committee
was voluntary and met "electronically" and consisted of
employees who cared about improved health outcomes. He
surmised that by providing more "heft" to the
recommendations made by the committee, the members would be
actively involved.
2:07:57 PM
Representative Edgmon referred to page 3, [line 8] and
read:
(d) The committee shall meet at the call of the chair
or at the request of a majority of its members.
Representative Edgmon suggested that the provision could be
strengthened by requiring that the committee met three or
four times each year to achieve its goal. He thought that
achieving the cost savings was an arduous task to burden
the committee with.
Representative Seaton pointed to page 3, line 11 and read:
(e) At intervals of six months, the committee shall
make recommendations…
Representative Seaton noted that the committee was tasked
with continuously examining healthcare and making
recommendations every six months. He detailed that the
department had to respond to the recommendations no later
than six months and once a year DOA had to report to the
legislature sometime during the legislative session.
Representative Edgmon referred to the Alaska Health Care
Commission with an annual budget of $300 thousand who also
made recommendations to the legislature that weren't acted
on. He wondered how a volunteer committee held to a
difficult cost savings task could accomplish its mission.
Representative Kawasaki asked what the current cost
escalation of healthcare was. Representative Seaton
responded that it was in the 4.5 percent to 5.5 percent
range. Representative Kawasaki commented on the boldness of
the 2 percent goal and that a difference existed between
healthcare outcomes and actual costs. Representative Seaton
responded that if diseases could be prevented costs went
down dramatically. He explained that the 2 percent goal was
a target to achieve a $3.8 billion saving in the retirement
system's unfunded liability.
Vice-Chair Saddler referred to page 2, line 8 and read the
following:
It is the intent of the legislature that, by
establishing a wellness committee and wellness
initiatives that create incentives and methods to
decrease the frequency and severity of disease…
Vice-Chair Saddler wanted to know if a scenario could
develop that required employee compliance in order to
maintain employment.
Representative Seaton responded in the negative and did not
see the bill as punitive.
2:13:36 PM
Co-Chair Thompson noted that the fiscal note (FN 1 ADM) was
zero. He referred to analysis on page two and read the
following:
The costs of specific initiatives recommended by the
advisory committee on wellness, some of which could be
substantial, cannot be estimated at this time.
Therefore, the department submits a zero fiscal note.
Co-Chair Thompson requested some specific examples of
initiatives that could lead to substantial costs.
MICHELE MICHAUD, CHIEF HEALTH OFFICER, DIVISION OF
RETIREMENT AND BENEFITS, explained that currently the
department had a wellness committee and coordinator that
were only focused on the AlaskaCare employee plan with
approximately 6,700 recipients. The department contracted
with its third party administrator to provide lifestyle and
disease management services to AlaskaCare members. She
furthered that the bill expanded the services to retirees
which added approximately 67,000 more recipients. She
stated that any initiative that was not covered under the
plan would increase costs.
Co-Chair Thompson asked whether the department had to
implement the committee's recommendations. Ms. Michaud
answered in the negative.
Representative Gara asked whether it was the department's
intention to take the committee's recommendations
seriously. Ms. Michaud answered affirmatively. She
communicated that the department's goal was also to have a
healthier workforce and retirees because it was proven to
reduce costs and DOA was interested in innovative ways to
accomplish savings. She added that the challenge would be
to implement recommendations without additional costs.
Representative Wilson asked whether the current 2 percent
target was met within the AlaskaCare program. Ms. Michaud
answered in the negative. She explained that the department
did not specify a monetary savings target for AlaskaCare.
Representative Wilson asked for a breakdown of the current
costs for the AlaskaCare wellness program.
HB 38 was HEARD and HELD in committee for further
consideration.
^RECIDIVISM REDUCTION DISCUSSION: THE PEW CHARITABLE TRUST
2:17:54 PM
Co-Chair Neuman recounted that the presentation was in
response to strategies developed by the recidivism
workgroup created under intent language in 2014 in HB 266
[Approp: Operating Budget/Loans/Funds]. One of the
workgroup's strategies was to work with the Pew Charitable
Trust to develop a recidivism reduction plan.
SUSANNE DIPIETRO, EXECUTIVE DIRECTOR, ALASKA JUDICIAL
COUNCIL, ALASKA COURT SYSTEM, explained that SB 64 [Omnibus
Crime/Corrections/Recidivism Bill] was adopted by the
legislature in 2014 and created the Alaska Criminal Justice
Commission within the Alaska Judicial Council. The council
was exploring ways to obtain resources to support the work
of the criminal justice system and discovered the Pew-
Macarthur Foundations and the technical assistance they
offered.
GARY VANLANDINGHAM, DIRECTOR, PEW-MACARTHUR RESULTS FIRST
INITIATIVE, explained that the Results First Initiative was
a partnership between the Pew Charitable Trusts and the
MacArthur Foundation, which helped state's identify what
evidence based results a program would offer a policymaker
wanting to implement change. The initiative was born out of
the "great recession" in recognition of the fiscal
difficulties states found themselves experiencing. He
shared that he previously worked as the legislative
research director for the state of Florida, which
experienced a 30 percent decrease in general funds when
emerging from the great recession due to the downturn in
the real estate market. He voiced that Florida was expected
to financially recover to its pre-recession 2006 level
sometime in 2016. He stated that other states were facing
the same challenges. He detailed that Florida engaged in
broad budget cuts due to lack of information enabling
better "strategic" choices. He thought that states needed
better tools to make more informed "tough" choices and that
more evidence based information was currently available
about the best programs that would deliver the best results
for the dollars spent.
Mr. VanLandingham turned to slide 2:
"The Policy Change."
•Though policymakers want to make strategic choices,
the process often relies on inertia and anecdote
•Limited data on:
-What programs are funded
-What each costs
-What programs accomplish
-How they compare
•Solution: bring systematic evidence into the system
Mr. VanLandingham delineated that much systematic evidence
currently existed to determine the value and outcome of
programs and needed to be "packaged." Throughout the
country, thousands of studies and "rigorous" research had
been carried out over many years on various programs.
Collectively a lot was known about "what works" and the
challenge was how to find it quickly. The benefit of
collective knowledge could be incorporated into the
legislative process. He noted that the process of
interjecting the collective knowledge into the legislative
decision-making process was called, "Evidence-Based
Policymaking."
2:25:05 PM
Mr. VanLandingham advanced to Slide 3:
"Evidence-Based Policymaking."
•Focuses on "What Works" - target funds to programs
shown to be effective by rigorous research
-Uses lists of 'proven' and 'promising' programs
identified by clearinghouses
•Outcome-oriented approach
•Asks whether programs' benefits justify their costs
Mr. VanLandingham shared that the professional baseball
team, the Oakland A's employed the same method to develop a
winning team that was 25 percent less expensive. He
believed the same approach worked for government; identify
what programs delivered the best results on a "dollar for
dollar" basis" for the citizens of Alaska. He surmised that
the evidence based approach asked whether there was a
better option that produced better, more effective results
for the money that was expended into the system without
spending additional money.
Mr. VanLandingham continued to slide 4:
"The Results First Approach."
Compare current programs to evidence
Target funds to evidence-based programs
Conduct cost-benefit analysis to compare returns on
investment
Goal: Achieve dramatic improvements without increased
spending
Mr. VanLandingham explained that the initiative asked basic
questions about what programs the state was operating in
the specific policy domain and what was known about the
program and its effectiveness. The initiative subsequently
performed a thorough analysis of programs that were
identified to have good evidenced based outcomes and
subject the programs to a "cost-benefit analysis" on a
portfolio basis in order to compare programs.
Mr. VanLandingham turned to slide 5: "Inventory Programs."
He elaborated that the initiative identified a list of the
state's programs that included the programs' costs and
percent of budget.
Mr. VanLandingham discussed slide 6: "Compare Inventory to
Database of Evidence-based Programs." He indicated that
subsequently, the list of programs were subjected to a
comparison of evidenced-based programs from a database. The
color-coded assessment identified whether programs were
well-supported, promising, effective, or not effective.
Mr. VanLandingham scrolled to slide 7: "Assess Level of
Funding for Evidence-Based Programs." The initiative
evaluated the information and ranked programs according to
their effectiveness. Often, states operated programs that
lacked any evaluative information about them. He suggested
auditing programs that did not have evidence-based data for
comparison against the national data base. He emphasized
the importance of discovering the effectiveness and value
of programs the state funded and were high risk in terms of
investment under the cost benefit analysis approach.
2:30:00 PM
Mr. VanLandingham turned to slide 8: (no title just bullet
points):
Results First provides a national database of evidence
on program effectiveness.
The state adds and analyzes their own state-specific
population and cost data.
The model calculates long-term costs and benefits for
each program.
The model ranks programs according to their return on
investment.
Policymakers consider the information during the
budget process.
Mr. VanLandingham explained that the initiative used the
national research database and applied it to Alaska
specific data. He exemplified that if a successful program
in Georgia that reduced recidivism was identified the model
would apply it to Alaska specific data to determine what
the program could accomplish in Alaska.
Mr. VanLandingham discussed the example graphed in slide 9:
"Example: Meta-analysis of Functional Family Therapy." He
indicated that typically when children were "getting into
serious trouble" they were sent to a residential facility,
where the state provided treatment and various intensive
services in order to rehabilitate the children. He
elaborated that the programs were very expensive costing
anywhere from $60 thousand to $100 thousand per year per
individual and many children were not rehabilitated after
release. He cited Washington state recidivism data that
revealed that 50 percent of the children re-offended and
were back in the system within 6 months post release. As a
result, Washington state instituted a program called
"Functional Family Therapy" which provided intensive
services but kept the child at home in a community setting.
The state also provided services to the family, in order to
address the dysfunction that caused the child to act out
and instruct the parents on better parenting techniques.
Recidivism rates were reduced by 22 percent. The model
would also determine the costs to achieving the reduction
and whether it was worthwhile for the state to implement
the program.
Mr. VanLandingham discussed slide 10: "Community-Based
Functional Family Therapy." He reported that Washington
State discerned that the 22 percent reduction equated to
over $29 thousand in benefits by avoiding tax payer costs
to prosecute and intern the offending children, lowered
victimization, victim costs, and created a safer society.
He noted that the model provided a dollar value to the
societal benefits of avoiding specific crimes by knowing
the costs associated with various crimes. He added that
over $9.5 thousand was saved in societal costs by enabling
more of the children to graduate high school and obtain
employment and health care costs were additionally reduced.
The total value of benefits of the therapy was over $37
thousand dollars at a cost of $3.3 thousand per family
which amounted to $11.28 in benefits for every dollar of
costs.
2:35:03 PM
Mr. VanLandingham discussed slide 11: "Compare Return on
Investment of Programs - Consumer Reports." He related that
the model was more "powerful" to examine the approach as a
portfolio of investment opportunities for a state. He
explained that by looking at programs as part of a whole
the cost-benefit ratio could identify "best buys;" programs
that dollar for dollar delivered strong returns and would
receive higher priority for funding considerations. He
reported that in Washington State, cognitive behavioral
therapy programs were inexpensive and produced
approximately $25 for every dollar invested. Electronic
monitoring produced approximately $22 per dollar invested,
which was not as good as cognitive therapy but much better
than others. He added that regarding juvenile programs
Washington State discovered that aggression replacement
training had a high return on investment dollars at $37 for
every dollar spent. However, the program called "Scared
Straight" which was very inexpensive at $66 per child was
very ineffective and actually increased crime and
demystified prison. He revealed that domestic violence
treatment was found to be ineffective in many states and
when replaced with a cognitive therapy type of program,
yielded much better results. He summarized that the model
allowed a state to use national research but tailor it to
state specific information to measure results versus
investment. Failed programs could be identified and
replaced.
Mr. VanLandingham advanced to slide 13: "Participation in
Results First." The map identified the 16 states that
participated in Results First. He voiced that the
initiative began four years ago. He observed that the
initiative operated in both conservative and liberal states
because bipartisan consensus supported investing money in
things that work.
Mr. VanLandingham turned to slide 14:
"Mississippi."
Developed comprehensive inventory of all correctional
programs at state institutions
•Eliminating and replacing programs in adult
corrections
•Implementing data-driven efforts to standardize
enhance, and increase accountability in drug courts
•Passed legislation that:
-Requires data reporting by local courts and law
enforcement agencies
-Requires comprehensive program inventories in 4
agencies
-Defines evidence-based, research based, and promising
programs
Mr. VanLandingham reported that the state of Mississippi
utilized the program for the past two years.
2:40:02 PM
Mr. VanLandingham reported on slide 15:
"New Mexico"
Implemented in all available policy areas
•Produced Innovative Reports including a report on the
impact of state budget cuts and
-"Cost of Doing Nothing" report: offenders released in
2011 will cost state additional $360 M over 15 years
under current policies and programs
•Used Results First approach to target $57M for
evidence-based programming in early education, child
welfare, and criminal justice
Mr. VanLandingham indicated that New Mexico adopted the
model with the help of Results First three years ago. The
state was "fairly poor" and had big social problems. The
legislature realized it needed to invest in highly
effective programs.
Mr. VanLandingham advanced to slide 17:
"Complimentary Initiatives."
Results First
Informs the budgetary process and increases investment
in evidence-based programs across many policy areas
•Not designed to address sentencing policies and
practices
Justice Reinvestment
Generates policy recommendations to promote system-
wide reform in criminal justice
Identifies policy options to manage the growth in
corrections costs and increase public safety
The Initiatives have worked together in states -both
consecutively and concurrently- to achieve
complementary and successful outcomes
Mr. VanLandingham reported that the Justice Reinvestment
project examined what was driving the costs of the criminal
justice system in a particular state. The program explored
ways to reinvest any savings achieved by reductions in the
growth of the prison population, back into proven programs
in the criminal justice system to create a virtuous cycle
of recidivism reductions while holding people accountable
and improving public safety. He continued that Results
First was more of an investments advisory service and
examined programs for maximum effectiveness and not policy.
Both programs had parallel processes but were distinct.
Mr. VanLandingham communicated how to become a Results
First state. He discussed slide 19:
"State Selection Criteria"
1) Commitment to evidence-based decision making
2) Ability to provide necessary data
3) Willingness to dedicate resources
Mr. VanLandingham shared that Results First looked for a
letter of invitation from the legislature and the governor.
He added that the initiative needed a commitment for
sufficient bandwidth and staff resources by the state to
implement the program.
2:45:06 PM
Mr. VanLandingham advance to slide 20:
"The Role of Partner States."
Secure leadership support
Appoint a policy work group
Establish a staff work group with project manager
Collaborate with Results First to strengthen the model
and build a learning community of states
Mr. VanLandingham believed that the Judicial Council would
be the proper policy work group. The work group would
communicate and provide directives to the agencies. In
addition, the University of Alaska, Anchorage (UAA)
volunteered to chair a staff work group.
Mr. VanLandingham moved to slide 21:
Services Provided by Results First
Provide software
Train staff in the approach
Provide ongoing technical assistance
Help interpret results for policymakers
Compile and share lessons learned with other
participating states
Expand and update model
Mr. VanLandingham articulated that Pew's goal was to
capture the knowledge of what works and to make the
information available to states and expand into many other
policy areas and major budget drivers. He informed the
committee that the choices the state made under the
initiative were theirs. The initiative only enabled the
process and would never lobby for a particular policy
outcome.
Co-Chair Neuman remarked that he helped organize the
recidivism reduction workgroup that had previously
testified in committee. He asked what the costs to the
state would be to partner with the initiative. Mr.
VanLandingham answered that the commitment from the state
would require one FTE (full time equivalent) spread out
over parts of existing positions and no new funding was
required.
Co-Chair Neuman asked for clarity.
Ms. Dipietro stated that one designated full-time person
was not needed and felt that wasn't a "good option" for
Alaska. She delineated that UAA could absorb the workload
with existing agency staff for the initial work of building
the model. An attorney from Department of Law (DOL) had
access to the data needed to develop the model that would
be shared with UAA. She added that other staff from other
agencies might be called upon to answer questions or
provide information for the model.
2:51:49 PM
Co-Chair Neuman reiterated what was needed from the state
to implement the initiative. He wondered what the success
rate was in other states. Mr. VanLandingham responded that
in order for the model to work, strong "buy-in" from the
legislative and executive branches were necessary. He
relayed that in the initial states a breakdown occurred
after the initial analysis was accumulated. He discovered
that where the program was "housed" was critical to its
success. Currently, in New Mexico the program was "housed"
in the legislative Finance Committee and partnered with the
appropriate agencies to build the components of the model.
Additionally, the information was easily available to the
legislators and built into the bill analysis. The
information had driven reforms in New Mexico's criminal
justice system and other policy areas as well. The
initiative had adopted the same approach to work with new
partner states and other states adopted its own innovative
process. He surmised that states that were operating the
model correctly were successful.
Vice-Chair Saddler asked what the interaction between
Results First and states that already employed evidenced
base analysis approach was. Mr. VanLandingham responded
that the approach would be "complimentary" and fed directly
into the model. The model identified what things should be
measured by the agencies and reported to the agencies on
program areas instead of the agency defining the
parameters. The tool assisted the process and integrated
traditional legislative policy processes.
Vice-Chair Saddler wondered about the data base on program
effectiveness. He asked how many different types of
programs were in the data base. Mr. VanLandingham responded
that there were approximately 100 programs in the crime
component of the model and 150 programs on substance abuse
and mental health and was building into other policy areas
as well. All total the cost benefit analysis model
contained 250 programs. He added that the model was
supplemented by the National Research Clearinghouse
database, which contained approximately 900 programs. The
clearinghouse focused on criminal justice, child welfare,
substance abuse, mental health, education, and Medicaid.
The initiative started with social policy because a lot of
evaluative information existed.
Representative Edgmon stated his support and believed that
it was a foregone conclusion that the approach worked. He
asked whether crime started as minor offences and
snowballed into major crimes. He wondered whether that was
the "subtext" for why a "measurable impact" could be
achieved on the front end. Mr. VanLandingham reported that
research pointed to certain approaches having a positive
impact. He expounded that a "swift and sure" response was
better than the length and severity of penalty. Cognitive
approaches were effective as well as choosing good programs
and targeting them to the right people. Doing a good
program badly was useless. He deduced that dramatic impacts
could be achieved by "disciplining the whole system" into
choosing what works.
3:02:10 PM
Representative Edgmon reported that in the last 10 to 12
years in Alaska the percentage of violent to non-violent
offenders rose from 48 percent in 2002 to presently 64
percent of non-violent inmates due to alcohol and substance
abuse. He asked whether that was a typical ratio. Mr.
VanLandingham responded that although he didn't have the
actual information available he believed the ratio was
generally correct. Laws like three strikes, which metered
out long sentences and employing criminal prosecution
instead of treatment for drug use violations contributed to
the increase.
Representative Edgmon expressed the geographical uniqueness
of Alaska. He supported the approach but expressed his
skepticism that the program would work in the state. He
believed it would take an incredible monetary commitment.
Mr. VanLandingham reported that the information informed
the process in a "new and powerful way." He voiced that the
"tough choices" would remain and that legislatures made
value choices that weren't always based on monetary
decisions.
Representative Gara mentioned that there were two
components to avoid building the next prison. He referenced
the proliferation of longer jail sentencing for non-violent
offences. He wondered whether the "recalibration" of
sentencing could be established more quickly than other
measures. In addition, he asked whether coordination
existed between the initiative and the Criminal Justice
Commission that was doing similar work. Mr. VanLandingham
responded affirmatively. Results First colleges, Public
Safety Performance Project would initially, work with the
state for a year to determine the drivers of the system and
provide options. The state would choose a set of reforms
for adoption by the legislature to avoid building more
prison facilities. Results First provided more long-term
options to decrease recidivism.
Ms. Dipietro responded that the Criminal Justice Commission
was staff for the Judicial Council and was working both
with Results First and the Justice Reinvestment Project.
She mentioned that the commission was looking forward to
employing the data from the Results First model if the
state chose to participate. She provided the example of
possibly predicting increased savings by reducing
sentencing as a way the commission could benefit from the
model.
Representative Gara asked about the concept of "swift
justice." He inquired whether it was more effective in
reducing long sentences. Mr. VanLandingham replied that
national research "consistently" proved the effectiveness
of swift justice. He exemplified the Hope Program in
Hawaii, which dealt with immediate response to an offense
and was more effective than traditional sentencing.
3:10:43 PM
Vice-Chair Saddler referred to "smart justice". He wondered
whether Texas had signed onto the Results First program.
Mr. VanLandingham indicated that Texas had recently signed
on but it was too early in the program to quantify results.
Vice-Chair Saddler asked whether any of the results were
available to the public domain. Mr. VanLandingham reported
that the clearinghouse research was available on the
Results First website in addition to states' case studies.
The initiative's goal was for transparency.
Representative Guttenberg asked about the consistency of
evidence and results coming out of programs already in
place. Mr. VanLandingham responded that the same set of
highly effective of programs were "generally consistent
with some interesting variations." Some states had been
able to do more with research than others. The state of
Washington had instituted a robust risk assessment process
in its criminal justice system that informed its spending
choices. Some programs were a better investment in some
states than others because of the variables in the cost of
delivering the program.
Representative Gattis was intrigued that the university
would be involved in implementing the process in Alaska.
She asked how the process happened in other states. Mr.
VanLandingham responded that it varied in different states.
He indicated that it was critical that it would be placed
somewhere with easy access during the legislative session.
Currently, in most states it was placed in the legislative
finance office, governor's budget office, or university. He
found that placing it in an agency was not very effective.
The software platform was changed to a web application so
many of the state's entities could access the database.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Results First AK HFC Presentation 2 25 15.pdf |
HFIN 2/25/2015 1:30:00 PM |
|
| HB039_Sponsor statement.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB039 Eplanation of changes_ ver A to Ver H.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB039 Sectional_Ver H.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB039 supporting document_Mayo Clinic review.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB039 Supporting Documents_Background Materials by Seaton.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB039 Wellness Presentation.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB 39 Dr Cannell on Biological flaws in RCTs_vitamin D and depression.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB 39 Supplementation and therapeutic use of vitamin D in patients with multiple sclerosis_Brazialian Academy of Neurology, Brum et al_.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |
| HB 39 Vitamin D & Depression- A systematic review and meta-analysis comparing studies_Review_Nutrients, Spedding_march 2014.pdf |
HFIN 2/25/2015 1:30:00 PM |
HB 39 |