Legislature(2023 - 2024)ADAMS 519
03/14/2023 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB39 || HB41 | |
| Presentation: Alaska Mental Health Trust Authority Budget Proposal | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 39 | TELECONFERENCED | |
| += | HB 41 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED | ||
HOUSE BILL NO. 39
"An Act making appropriations for the operating and
loan program expenses of state government and for
certain programs; capitalizing funds; amending
appropriations; making reappropriations; making
supplemental appropriations; making appropriations
under art. IX, sec. 17(c), Constitution of the State
of Alaska, from the constitutional budget reserve
fund; and providing for an effective date."
HOUSE BILL NO. 41
"An Act making appropriations for the operating and
capital expenses of the state's integrated
comprehensive mental health program; and providing for
an effective date."
1:34:19 PM
^PRESENTATION: ALASKA MENTAL HEALTH TRUST AUTHORITY BUDGET
PROPOSAL
1:34:25 PM
STEVE WILLIAMS, EXECUTIVE DIRECTOR, ALASKA MENTAL HEALTH
TRUST AUTHORITY, provided a PowerPoint presentation titled
"House Finance Committee" dated March 14, 2023 (copy on
file). The presentation provided an update on the Alaska
Mental Health Trust Authority (AMHTA) items in the
governors proposed amended budget. He began with slide 2
titled Trust Beneficiaries:
Trust beneficiaries include Alaskans who experience:
• Mental illnesses
• Intellectual and/or developmental disabilities
• Alzheimer's disease and related dementia
• Traumatic brain injuries
• Substance use disorders
1:35:43 PM
Mr. Williams turned to a table on slide 3 titled FY 24
AMENDED GF/MH Recommendations (and Associated MHTAAR
Grants) [General Fund (GF), Mental Health (MH), Mental
Health Trust Authority Authorized Receipts (MHTAAR)]. The
tables displayed the governor's amended FY 24 Mental Health
budget, the Trustee Approved Recommendations for GF/MH,
MHTAAR, and the differences between them. He pointed to the
project columns that showed the department the money would
be appropriated to in parenthesis. The blue shaded columns
reflected the items and budget approved by the AMHTA Board
of Trustees and the yellow columns reflected the governor's
amended budget. The updated items contained in the amended
budget was represented in blue. He appreciated that the
administration reviewed AMHTAs recommendations and
reconsidered some of the requests that were included in the
amended budget. There were six departments implicated for
receiving the trusts funds or GF Mental Health funding.
They included the Department of Health (DOH), Department
of Education and Early Development (DEED), University of
Alaska (UA), Department of Family and Community Services
(DFCS), Department of Transportation and Public Facilities
(DOT), and the Department of Revenue (DOR) for the Alaska
Housing Finance Corporation (AHFC). The far right column
presented the differences between the trustee
recommendations and the governor's amended budget. He
pointed to the differences beginning with the Crisis Now
Continuum of Care grants for DOH's Division of Behavioral
Health (DBH) that were board recommended at $1 million. The
governors amended budget included $667 thousand comprising
a difference of $330 thousand. The second line that
included Crisis Now Continuum of Care grants for DOHs
Division of Public Health (DBH) indicating the difference
between the recommendation and amended budget amounting to
$167 thousand. The Aging and Disability Resource Centers
recommended amount was $250 thousand and the funding was
excluded in the amended budget. He noted that the IT
Application/Telehealth Service System Improvements (DOH)
recommendation of $63 thousand was also not funded in the
amended budget. He highlighted that the Alaska Training
Cooperative (UAA) received a $50 thousand increase to
reflect the trustees' recommendation of $150,000. He added
that the Peer Support Certification (DOH) of $100,000 GF
was not included in the governor's amended budget. He moved
to the Capital Budget items and reviewed the Special Needs
Housing Grant (DOR/AHFC). He indicated that the board
recommended $1.75 million and $750 thousand was left
unfunded in the amended budget. Finally, the Housing
Assistance Program (DOR/AHFC) lacked $2 million from what
was requested by the board and what was included in the
amended budget. He calculated that between the operating
and capital funds there was a $3.66 million deficit between
the requested amounts and the amended budget.
1:40:56 PM
Representative Josephson highlighted the Special Needs
Housing grant with MHTAAR funding of $200 thousand, with an
additional recommendation of $1.75 million GF. He reported
that the amended budget included only $1 million GF. He
asked if the trust would still fund the $200 thousand
amount even though the item had not received the total
requested funding from the governor. Mr. Williams replied
that in that situation the trust would determine the impact
of the reduction on the proposed project. The trust may
have to scale something back or may not provide trust
funding for a particular project if the funding was
inadequate enough to carry the project forward. He did not
recall that the last option had ever occurred.
Representative Josephson asked how AMHTA communicated its
amount of funding for reduced projects to the legislature.
Mr. Williams replied that at the current point the trustees
would not take any action on reductions of MHTAAR funding.
Any reductions would be considered after the budget was
enacted.
1:43:08 PM
Co-Chair Foster asked for FY 23 numbers for items where
there was a shortfall in GF funding for FY 24. He
specifically requested the GF FY 23 number for the Housing
Assistance Program. Mr. Williams responded that in FY 23
the amount was $850 thousand, which was the amount
currently included in the FY 24 budget. The $2 million was
intended to expand services. Co-Chair Foster asked if Mr.
Williams had the other FY 23 numbers. Mr. Williams would
follow up with the information.
Co-Chair Edgmon observed that a bigger takeaway from the
slide was the trusts focus on housing. He asked if it was
the largest budget item.
Mr. Williams affirmed that the combined total was the
largest budget item. He added that the next highest funded
items were related to the Crisis Now Continuum of Care
initiatives. He reported that the trust was heavily
invested in Crisis Now through its authority grant funds
[MHTAAR] that went directly to communities to support the
Crisis Now work.
1:45:21 PM
Co-Chair Edgmon stated that another takeaway was that the
budget recommendations were prevention oriented. Mr.
Williams agreed. He elaborated that the trust was focusing
intervention upstream to avoid community disruptions and
any acute higher level of care.
Representative Coulombe recalled that AMHTA had been big
proponents of the Crisis Now program. She asked why the
trust had not funded it and it was funded by GF. Mr.
Williams answered that he had referred to the Trusts heavy
investment in the program moments ago. The trustees had
approved and granted over $7 million in the last 2 years
specifically for Crisis Now work. He reiterated that the
trustees had the authority to grant funding directly from
the trust to community organizations. Representative
Coulombe asked if the funding requested by the governor was
still going to the same program that was being funded by
the community grants. Mr. Williams replied that it could be
used for the same services. However, the funds could also
be used to start up new services in a community. The
initiative was coordinated through DOH and DFCS with AMHTA.
1:47:34 PM
Representative Hannan asked about Crisis Now and special
Needs Housing. She asked whether there were entire programs
that would not be stood up due to the reductions. She
assumed that AMHTA had evaluated the need to make the
programs operational. She asked if there were programs that
would not start due to the reduced funding. Mr. Williams
answered that the impacts of not having the full increment
would be as one expected. He detailed that reduced funding
may delay implementation of a program or reduce services
from existing programs or deter other communities or
organizations from funding services to implementing the
full continuum of care.
Representative Hannan asked when the last time an increase
to the Special Needs Housing grants had been. Mr. Williams
thought it was around ten years, but he would follow up.
Co-Chair Edgmon stated that housing in many rural
communities was a top issue. Additionally, there were
workforce and supply chain shortage issues. He recalled
that deferred maintenance was highly funded in the prior
budget, but the governor vetoed two/thirds of the
appropriation. He asked why the state would opt not to fund
special needs housing grants that leveraged a lot of other
money and created a multiplier effect. He wondered whether
a rational argument for the reduction existed.
Co-Chair Johnson requested to hold questions until the end
of the presentation along with the answer to the prior
question.
1:51:32 PM
Mr. Williams turned to slide 4 titled Crisis Now Continuum
of Care Grants (DOH/DBH):
These grants will be awarded to organizations that are
partnering with the community to provide less
restrictive options for people having a behavioral
health crisis.
Trustee Recommendation: $1,000,000 GF/MH
FY24 Amended Budget: $667,000 GF/MH
Mr. Williams addressed slide 5 titled Crisis Now Continuum
of Care Grants (DOH/DPH):
These grants support Mobile Integrated Health (MIH)
teams operating in Alaska. MIH teams consist of a
paramedic/EMT and a behavioral health professional who
together are tasked with responding to beneficiaries
in crisis in the community.
Trustee Recommendation: $500,000 GF/MH
FY24 Amended Budget: $333,000 GF/MH
Mr. Williams expounded that there were three communities
operating or implementing MIH teams: Copper River Native
Association, Juneau, and Ketchikan. He reiterated that if
the program was not fully funded it would have impacts on
the ability to fully expand to Ketchikan or reduce existing
programs.
Mr. Williams moved to slide 6 titled Aging & Disability
Resource Centers (DOH):
Aging and Disability Resource Centers (ADRCs) serve as
a visible, trusted place for people to go to for
information and assistance about aging and disability
related topics. They provide screenings for state
funded home and community based services.
Trustee Recommendation: $300,000 MHTAAR
$250,000 GF/MH
FY24 Amended Budget: $300,000 MHTAAR
$0 GF/MH
Mr. Williams furthered that the centers were funded through
the Division of Senior and Disability Services (DSDS) and
the additional $50 thousand would open an additional
center.
1:54:41 PM
Mr. Williams discussed slide 7 titled IT
Application/Telehealth Service System Improvements (DOH):
This project funds a position to build the capacity of
the Senior and Disabilities Services (SDS) to
implement the use of technology both internally and
externally to positively impact beneficiaries.
Trustee Recommendation: $63,000 GF/MH
FY24 Amended Budget: $0 GF/MH
Mr. Williams indicated that there were over 1,800
assessments completed over the last year. He summarized
slide 8 titled: Peer Support Certification (DOH):
The Peer Support Certification program is managed
through DBH which uses funds to award grants and
contracts for peer support training, oversight of the
program by the Commission for Behavioral Health
Certification and supporting a statewide peer support-
focuses conference.
Trustee Recommendation: $100,000 MHTAAR
$100,000 GF/MH
FY24 Amended Budget: $100,000 MHTAAR
$0 GF/MH
Mr. Williams elucidated that in FY 22 there were a little
over 130 individuals who were certified in peer support and
engaged in providing peer support services. The elimination
of GF would restrict oversight and training by the
commission.
1:56:51 PM
Mr. Williams discussed slide 9 titled Special Needs
Housing Grant (AHFC):
The SNHG provides AHFC and Alaska Mental Health Trust
funds through competitive grants to nonprofit service
providers and housing developers for construction and
operation of housing for Alaskan special needs
populations.
Trustee Recommendation: $200,000 MHTAAR
$1,750,000 GF/MH
$1,750,000 AHFC Dividend
FY24 Amended Budget: $200,000 MHTAAR
$1,000,000 GF/MH
$1,750,000 AHFC Dividend
Mr. Williams added that in FY 22 the funding expanded the
bed capacity of Forget Me Not an organization in Juneau and
expanded housing capacity in the Matanuska-Susitna (MAT-SU)
Valley. The reduction would reduce the ability to expand
housing capacity.
1:58:08 PM
Mr. Williams spoke to slide 10 Housing Assistance Program
(AHFC):
HAP provides AHFC and Alaska Mental Health Trust funds
to agencies that provide homeless prevention services,
emergency or transitional housing, and rapid rehousing
services.
Trustee Recommendation: $950,000 MHTAAR
$2,850,000 GF/MH
$6,350,000 AHFC Dividend
FY24 Amended Budget: $950,000 MHTAAR
$850,000 GF/MH
$6,350,000 AHFC Dividend
Mr. Williams expounded that the program targeted
populations of youth, families, veterans, and single
adults. The $2 million GF would allow for expansion. In
addition in FY 22, there were 8 rural communities that
applied for funds and were not able to access the funding.
1:59:35 PM
Co-Chair Edgmon pointed to slides 9 and 10 related to
special needs housing. He did not understand why the state
would not fully fund the housing programs. It struck him as
odd. Mr. Williams replied that when the AMHTA board made
the recommendations for state GF, they were merely
recommendations. He commented that the trust attempted to
build budgets that reflected the need and also considered
the state's financial situation. Co-Chair Edgmon asked what
Mr. Williams would tell the appropriating body about why it
was good to provide funding for the AMHTA requests. Mr.
Williams recapped that there were 8 rural communities that
were not able to access the funding as well as the ability
to intervene earlier. He specified that rapid rehousing
provided early intervention that enabled a person to work,
receive treatment, and helped reduce their stress and
anxiety. He stated that housing was an important factor in
preventing a recipient from experiencing a crisis.
2:03:25 PM
Co-Chair Foster referenced the 8 rural communities hoping
to receive the housing assistance funding. He asked if the
full increment requested would cover the entire projects in
the communities. Mr. Williams would follow up with the
answer. Co-Chair Foster asked if any of the $850,000 from
the previous year had gone to any rural communities. Mr.
Williams would follow up with the information.
2:04:23 PM
Representative Stapp looked at slide 3 and recalled that
some of the MHTAAR funding was directly appropriated
through the trust. He wondered if the same was true for the
Home Modifications program. Mr. Williams responded that the
authority grants or MHTAAR funding did provide money to
communities for accessibility for items like making a
bathroom ADA accessible, or ramps, etc.
Representative Hannan announced that she was very
interested in fully funding the Crisis Now Continuum of
Care Grants and Special Needs Housing Grants. She cited the
costs for housing someone at the Alaska Psychiatric
Institute (API) at $ 1.1 thousand per day and $142.00 per
day in the prison system, versus $51.00 per day in
supportive housing. She believed in early intervention and
that it reduced costs for the state. She wanted to grow the
programs to meet the demand and deduced that the funding
was insufficient to meet the demand.
2:07:47 PM
Representative Galvin echoed comments by Representative
Hannan. She mentioned the Peer Support Certification
program and could not think of a better way to efficiently
grow the state's workforce. She asked for more budgetary
information regarding the program. Mr. Williams shared that
it was critical for individuals in recovery to access
people with lived experience and it was considered a best
practice.
Representative Coulombe asked what the Beneficiary Mental
Health Status Data Collection (DOH) was. Mr. Williams would
follow up with more detail.
Mr. Williams appreciated the follow up dialogue. He urged
the committee to consider the recommendations of the
trustees.
HB 39 was HEARD and HELD in committee for further
consideration.
HB 41 was HEARD and HELD in committee for further
consideration.
Co-Chair Johnson reviewed the schedule for the following
day.
| Document Name | Date/Time | Subjects |
|---|---|---|
| AMHTA -HFIN GF-MH Presentation March 2023_Final.pdf |
HFIN 3/14/2023 1:30:00 PM |
HB 41 |
| AMHTA Trust Follow up GF H FIN 3.17.23_031423.pdf |
HFIN 3/14/2023 1:30:00 PM |