Legislature(2023 - 2024)ADAMS 519

02/07/2024 01:30 PM House FINANCE

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03:17:43 PM Adjourn
01:35:11 PM Start
01:37:00 PM Overview: Department of Family and Community Services
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 268 APPROP: OPERATING BUDGET; CAP; SUPP; AM TELECONFERENCED
Heard & Held
+= HB 270 APPROP: MENTAL HEALTH BUDGET TELECONFERENCED
Heard & Held
+ Overview: Department of Family & Community TELECONFERENCED
Services FY 25 Budget by Commissioner Kim Kovol;
Clinton Lasley, Deputy Commissioner; and
Marian Sweet, Assistant Commissioner
+ Bills Previously Heard/Scheduled TELECONFERENCED
HOUSE BILL NO. 268                                                                                                            
                                                                                                                                
     "An  Act making  appropriations for  the operating  and                                                                    
     loan  program  expenses  of state  government  and  for                                                                    
     certain   programs;    capitalizing   funds;   amending                                                                    
     appropriations;  making capital  appropriations; making                                                                    
     supplemental  appropriations; making  reappropriations;                                                                    
     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. 270                                                                                                            
                                                                                                                                
     "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."                                                                                                        
                                                                                                                                
^OVERVIEW: DEPARTMENT OF FAMILY AND COMMUNITY SERVICES                                                                        
                                                                                                                                
Co-Chair Johnson reviewed the meeting agenda. She turned                                                                        
the gavel over to Co-Chair Foster.                                                                                              
                                                                                                                                
1:37:00 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
1:38:03 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair Foster chaired the meeting.                                                                                            
                                                                                                                                
1:38:19 PM                                                                                                                    
                                                                                                                                
KIM KOVOL, COMMISSIONER, DEPARTMENT  OF FAMILY AND COMMUNITY                                                                    
SERVICES,    introduced    the    PowerPoint    presentation                                                                    
"Department of  Family and Community Services  FY2025 Budget                                                                    
Overview" dated February  7, 2024 (copy on  file). She began                                                                    
on  slide  2  titled  "Department of  Family  and  Community                                                                    
Services (DFCS):"                                                                                                               
                                                                                                                                
     Mission:                                                                                                                   
     To provide support, safety, and personal well-being                                                                        
     for vulnerable Alaskans.                                                                                                   
                                                                                                                                
     Staff: 1,866 full-time permanent                                                                                           
                                                                                                                                
     Divisions:                                                                                                                 
     Alaska Pioneer Homes                                                                                                       
                                                                                                                                
     Alaska Psychiatric Institute                                                                                               
                                                                                                                                
     Office of Children's Services                                                                                              
                                                                                                                                
     Division of Juvenile Justice                                                                                               
                                                                                                                                
     Departmental Support Services                                                                                              
     Total Budget: $478,452.4 ($ in thousands)                                                                                  
                                                                                                                                
Commissioner  Kovol turned  to the  organizational chart  on                                                                    
slide 3 and briefly  described the department's organization                                                                    
that  contained 4  divisions: Alaska  Pioneer Homes,  Alaska                                                                    
Psychiatric  Institute, Office  of Childrens   Services, and                                                                    
Juvenile Justice.                                                                                                               
                                                                                                                                
1:39:46 PM                                                                                                                    
                                                                                                                                
MARIAN SWEET,  ASSISTANT COMMISSIONER, DEPARTMENT  OF FAMILY                                                                    
AND COMMUNITY  SERVICES, continued  on slide 4  titled "DFCS                                                                    
Operating  Budget  Comparison  FY   2023  -  FY  2025    She                                                                    
explained that  the difference between the  FY 24 management                                                                    
plan and FY 25 request was  a 3.9 percent increase, of which                                                                    
the majority was technical salary  increases. She pointed to                                                                    
the  FY 23  actuals that  was significantly  reduced due  to                                                                    
high   vacancies    and   recruitment    difficulties.   She                                                                    
anticipated  via  a  new   talent  acquisition  process,  to                                                                    
expedite recruitment  and increase  new hires.  In addition,                                                                    
in FY  23 the Office  of Children's Services  (OCS) received                                                                    
funding from  the People's First  Initiative, where  not all                                                                    
the funding  could be  expended due  to staff  shortages and                                                                    
low recruitment.  However, the first division  utilizing the                                                                    
new hiring process was OCS  and it already had increased new                                                                    
hires.                                                                                                                          
                                                                                                                                
Co-Chair Foster asked for confirmation  that the 3.9 percent                                                                    
increase  in  FY 25  was  a  comparison  between the  FY  24                                                                    
management  plan  and  FY  25   budget  request.  Ms.  Sweet                                                                    
responded in the affirmative. Co-Chair  Foster asked if that                                                                    
was  in  Undesignated  General Funds  (UGF)  or  an  overall                                                                    
increase.  Ms.  Sweet  answered   that  it  was  an  overall                                                                    
increase. Co-Chair  Foster asked what the  UGF only increase                                                                    
was. Ms. Sweet would follow-up with the answer.                                                                                 
                                                                                                                                
Representative  Coulombe  asked  for  clarification  on  the                                                                    
Other Funds on the slide represented  by the gray on the bar                                                                    
graph. Ms. Sweet responded that  other funding was comprised                                                                    
of  interagency receipts  and  statutory designated  program                                                                    
receipts.                                                                                                                       
                                                                                                                                
Co-Chair Foster  noted Representative  Stapp had  joined the                                                                    
meeting.                                                                                                                        
                                                                                                                                
1:43:14 PM                                                                                                                    
                                                                                                                                
Ms. Sweet continued on slide  5 titled "Department of Family                                                                    
and Community Services - Departmental Support Services:"                                                                        
                                                                                                                                
     Mission:                                                                                                                   
     Provide quality administrative services in support of                                                                      
     the department's mission.                                                                                                  
                                                                                                                                
     Staff: 82 full-time positions                                                                                              
                                                                                                                                
     Program Improvements:                                                                                                      
     Talent Acquisition Team                                                                                                    
     Technical Innovations                                                                                                      
                                                                                                                                
Representative  Galvin cited  the  Other  Funds category  on                                                                    
slide  4   and  asked   for  more  information.   Ms.  Sweet                                                                    
reiterated  that it  was comprised  of interagency  receipts                                                                    
and statutory designated program receipts.                                                                                      
                                                                                                                                
Ms. Sweet continued on slide  6 titled "Departmental Support                                                                    
Services (DSS) Operating Budget Comparison FY2023-FY2025                                                                        
                                                                                                                                
     DSS Significant Budget Items:                                                                                              
                                                                                                                                
     Reorganize Designated Evaluation & Treatment and                                                                           
     Complex Care into new Coordinated Health & Complex                                                                         
     Care Component                                                                                                             
                                                                                                                                
     FY 2025 Increment $750.0 (GF) to support Complex                                                                           
     Placement Program                                                                                                          
                                                                                                                                
Ms.  Sweet noted  that  the  reorganization and  realignment                                                                    
combined the  Designated Evaluation and  Treatment component                                                                    
and  Complex  Care  Unit. The  second  increment  created  a                                                                    
single  point of  contact within  state  government for  the                                                                    
complex needs  due to an  insufficient number  of providers.                                                                    
The  department  worked  with the  community  providers  and                                                                    
offered  support, training,  and  funding  so the  community                                                                    
could provide step down services for youth.                                                                                     
                                                                                                                                
Co-Chair  Foster asked  for more  information regarding  how                                                                    
the  $750 thousand  would be  expended.  Ms. Sweet  answered                                                                    
that it  would mostly  be expended  for services  offered by                                                                    
the provider.                                                                                                                   
                                                                                                                                
Representative  Stapp referenced  Disproportionate Share  or                                                                    
DSH payments. He  asked for an explanation of  what they are                                                                    
and  impacts if  the payments  changed. Ms.  Sweet responded                                                                    
that  it  was  funding  received  through  the  Centers  for                                                                    
Medicare &  Medicaid Services (CMS)  in support  of hospital                                                                    
that receive  a disproportionate amount of  patients without                                                                    
insurance  or  Medicaid.  The Alaska  Psychiatric  Institute                                                                    
(API)  received the  Institution  for  Mental Disease  (IMD)                                                                    
portion of the  funding. She cautioned that  the DSH funding                                                                    
might be  reduced by the federal  government. The department                                                                    
sent an inquiry  to CMS asking for clarity  regarding how it                                                                    
would  affect Alaska's  program; 50  percent of  the program                                                                    
was funded through Medicaid.                                                                                                    
                                                                                                                                
1:48:51 PM                                                                                                                    
                                                                                                                                
Ms.  Sweet  addressed  slide 7  titled   Talent  Acquisition                                                                    
Team                                                                                                                            
                                                                                                                                
     Dedicated human resources team to improve recruitment                                                                      
     and retention                                                                                                              
                                                                                                                                
     Expedited recruitment and hiring                                                                                           
                                                                                                                                
     Personal engagement with candidates throughout process                                                                     
                                                                                                                                
     Specialized   on-boarding   support   and   orientation                                                                    
     training                                                                                                                   
                                                                                                                                
     Phased implementation - started with Office of                                                                             
     Children's Services                                                                                                        
                                                                                                                                
Ms. Sweet  reiterated that recruitment had  been a challenge                                                                    
across all  state agencies.  The department  discovered that                                                                    
the administrative  efforts for the hiring  process were too                                                                    
extreme; people  lost interest because the  process took too                                                                    
long. The  number of individuals declining  positions was 53                                                                    
percent due  to the lack  of communication from  an employer                                                                    
to  a  potential  employee. She  added  that  the  increased                                                                    
communication  and support  of  the candidates  demonstrated                                                                    
that the Department of Family  and Community Services (DFCS)                                                                    
valued them  as prospective  employees. All  divisions would                                                                    
be onboarded in the new program by 2026.                                                                                        
                                                                                                                                
Representative  Tomaszewski asked  how many  people were  on                                                                    
the talent acquisition  team. Ms. Sweet replied  that it was                                                                    
a team of 4.                                                                                                                    
                                                                                                                                
Representative  Galvin  asked  if there  was  research  done                                                                    
regarding wages  and whether it  was a factor  in recruiting                                                                    
and retaining,  especially in OCS. Ms.  Sweet responded that                                                                    
the goal  was to recruit  and retain staff. She  shared that                                                                    
the state awarded  a contract from an RFP on  a salary study                                                                    
on  state positions.  Representative  Galvin clarified  that                                                                    
there was not a specific study regarding OCS.                                                                                   
                                                                                                                                
1:53:43 PM                                                                                                                    
                                                                                                                                
Ms. Sweet  continued on slide  8 titled  "Talent Acquisition                                                                    
Team - Days  from Referral to Approval to  Hire." She shared                                                                    
some of  the successes of  the talent acquisition  team. The                                                                    
time  from  referral  of  the   candidate  to  offering  the                                                                    
position was reduced to 10 days.                                                                                                
                                                                                                                                
Ms. Sweet moved to slide 9 titled "Technical Innovations                                                                        
                                                                                                                                
     Data Lake                                                                                                                  
     Mobile Device Management Standardization                                                                                   
     Artificial Intelligence (AI)                                                                                               
     ImageSource ILINX                                                                                                          
     Electronic Health Record                                                                                                   
     Tiger Connect                                                                                                              
     WiFi in Facilities                                                                                                         
                                                                                                                                
                                                                                                                                
Ms.  Sweet indicated  that the  department was  committed to                                                                    
using data  to drive decisions and  utilizing technology was                                                                    
the  means to  its  goal.  The data  would  be  used by  the                                                                    
Complex  Care   Team  and  increase   collaboration  between                                                                    
divisions and  community stake holders  to help  analyze the                                                                    
need for  services within  the state.  In addition,  OCS had                                                                    
implemented the  electronic adoption management  program via                                                                    
ImageSource that  was digitizing  all adoption  records that                                                                    
paired with  the Mobile Device Management  allowing staff to                                                                    
access many of  the new data applications  for all digitized                                                                    
data.  She elaborated  that  the  department was  partnering                                                                    
with Net Smart  to create Electronic Health  Records for API                                                                    
and  the  Pioneer  Homes (PH).  The  department  implemented                                                                    
state  secure   WiFi  in   both  facilities   for  patients,                                                                    
residents, and their families.                                                                                                  
                                                                                                                                
Ms.  Sweet continued  that the  department  was focusing  on                                                                    
standardizing  IT  to  build efficiencies  and  for  use  in                                                                    
facility  operations. She  indicated  that DFCS  implemented                                                                    
Tiger Connect  in September 2023  that was a  HIPA compliant                                                                    
mobile device and desktop platform  used to communicate both                                                                    
internally and with external partners.                                                                                          
                                                                                                                                
1:59:37 PM                                                                                                                    
                                                                                                                                
CLINTON  LASLEY, DEPUTY  COMMISSIONER, DEPARTMENT  OF FAMILY                                                                    
AND COMMUNITY SERVICES, continued  the presentation on slide                                                                    
10 titled Alaska Pioneer Homes                                                                                                  
                                                                                                                                
     Providing elder Alaskans a home and community,                                                                             
     celebrating life through its final breath.                                                                                 
                                                                                                                                
     Locations: Anchorage, Fairbanks, Juneau, Ketchikan,                                                                        
     Palmer, Sitka                                                                                                              
                                                                                                                                
     Staff: 425 Full Time Positions                                                                                             
     Capacity: 560 residents                                                                                                    
                                                                                                                                
     Program Improvement:                                                                                                       
     Alzheimer's Disease and Dementia Services                                                                                  
     Online Waitlist and Enrollment                                                                                             
                                                                                                                                
Mr. Lasley reported  that up to 50 percent  of residents had                                                                    
a  dementia diagnosis  with  up to  approximately  75 to  85                                                                    
percent  of  residents showing  signs  of  the disease.  The                                                                    
division took a positive approach  to care by ensuring staff                                                                    
understood the  needs of those  living with  Alzheimer's and                                                                    
how to best  serve the resident. Approximately  36 staff had                                                                    
training in the positive approach  and would train all staff                                                                    
across  the  division.  He   noted  the  Dementia  Specialty                                                                    
Apprenticeship  Program in  conjunction with  the Department                                                                    
of Labor  and Workforce Development (DLWD),  that trained 84                                                                    
Certified  Nursing Assistants  over the  prior 7  years. The                                                                    
program  was voluntary  and with  completion of  the program                                                                    
the DNA's received a one-step  pay increase, which increased                                                                    
retention.                                                                                                                      
                                                                                                                                
Co-Chair Foster announced  that Representative Hannan joined                                                                    
the meeting.                                                                                                                    
                                                                                                                                
Mr.  Lasley  added  that  the   department  was  working  on                                                                    
interacting with elders and  families by offering electronic                                                                    
applications to streamline the process.                                                                                         
                                                                                                                                
2:04:31 PM                                                                                                                    
                                                                                                                                
Representative  Cronk asked  what  number  of people  needed                                                                    
care in  the state.  Mr. Lasley  responded that  currently 6                                                                    
thousand  individuals were  on the  wait list.  He furthered                                                                    
that the  system worked in  two ways:  a 60 year  old person                                                                    
could  submit a  placeholder application  and when  ready to                                                                    
move in,  the person "activated"  the application and  if an                                                                    
offer was made  had 30 days to move in.  There were over 286                                                                    
individuals  on  the  activated wait  list,  with  the  need                                                                    
continuing to  grow. Representative Cronk wondered  what the                                                                    
total number of  Alaskans in need of  elder residential care                                                                    
was. He voiced that it was a big issue for the state.                                                                           
                                                                                                                                
Commissioner   Kovol   answered   that   other   residential                                                                    
institutions in the state were  able to screen out residents                                                                    
that  needed a  higher  level of  care,  which increased  PH                                                                    
residents with  a higher intense  need of care.  She pointed                                                                    
out that the  PHs accepted all Alaskans  regardless of their                                                                    
level of care.                                                                                                                  
                                                                                                                                
Representative  Cronk asked  if the  department was  working                                                                    
with private  elder care residential entities  to help build                                                                    
more  care residences.  Ms. Sweet  replied that  DCFC worked                                                                    
with  all  partners  but  warned   that  they  were  private                                                                    
agencies.  She asserted  that the  PHs  were in  competition                                                                    
with them for  staff. The department had  heard stories from                                                                    
PH elders about forming  strong bonds and relationships with                                                                    
staff and the department wanted  to share their stories with                                                                    
the public.                                                                                                                     
2:09:45 PM                                                                                                                    
                                                                                                                                
Ms.  Sweet  continued on  slide  11  titled "Alaska  Pioneer                                                                    
Homes (AKPH) Operating Budget Comparison FY2023-FY2025                                                                          
                                                                                                                                
     AKPH Significant Budget Items:                                                                                             
                                                                                                                                
     Pharmacy Collections      FY 2024 SDPR (Statutory                                                                          
     Designated Program Receipts) Supplemental                                                                                  
     $1,000.0 (Other)                                                                                                           
                                                                                                                                
     Pharmacy Collections  FY 2025 SDPR Increment                                                                               
     - $500.0 (Other)                                                                                                         
                                                                                                                                
Ms.  Sweet explained  that SDPR  was  collected through  the                                                                    
pharmacy  program  in  the   PHs.  Higher  collections  were                                                                    
necessary   due   to   higher  utilization   and   increased                                                                    
pharmaceutical costs.  The second item was  related to Inter                                                                    
Agency (IA)  receipts and  SDPR via  Medicaid claims  and an                                                                    
RSA  with  the Division  of  Juvenile  Justice who  provided                                                                    
juvenile pharmacy needs  through the PH. She  noted that the                                                                    
majority of the  UGF was for the  Payment Assistance Program                                                                    
and a small balance was  used to provide operations. The DGF                                                                    
represented  collections   from  residents'   insurance  and                                                                    
private pay and some  federal reimbursement for the veterans                                                                    
in the  Palmer Pioneer Home.  She noted that the  only other                                                                    
budget items were for salary adjustments.                                                                                       
                                                                                                                                
Representative  Cronk asked  what the  average monthly  cost                                                                    
was  for residents  of PHs.  Mr. Lasley  responded that  the                                                                    
costs  vary widely  among 5  levels of  care. He  elucidated                                                                    
that  the lowest  level of  care  was level  one costing  $3                                                                    
thousand  per month.  The  highest level  of  care cost  $15                                                                    
thousand per month.                                                                                                             
                                                                                                                                
Mr. Lasley continued on slide  12 titled "Alaska Psychiatric                                                                    
Institute                                                                                                                       
                                                                                                                                
     Providing compassionate health care to support                                                                             
     Alaskans in living their best possible lives.                                                                              
     Capacity and Staff:                                                                                                        
                                                                                                                                
     5 inpatient units, 80 licensed beds                                                                                        
                                                                                                                                
     10 jail-based spots, 10 community spots                                                                                    
                                                                                                                                
     325 Full Time Positions                                                                                                    
     Program Improvement:                                                                                                       
                                                                                                                                
     Community and Jail Based Restoration Programs (FY 2024                                                                     
     $800.)                                                                                                                     
                                                                                                                                
     Beacon   Award-   Alaska    Hospital   and   Healthcare                                                                    
     Association                                                                                                                
                                                                                                                                
Mr. Lasley  cited the  prior challenges at  API that  was at                                                                    
the risk  of closure with  only 20 patients. He  reported on                                                                    
the  improvements made  and noted  that 73  was the  current                                                                    
average number  of patients. He elaborated  that the purpose                                                                    
of the Jail Based  Restoration Programs assisted individuals                                                                    
with  a mental  health disease  that had  been accused  of a                                                                    
felony prepare for their defense  by moving them from prison                                                                    
to  API for  restoration  services. The  Community and  Jail                                                                    
Based  Restoration  Programs  improvement doubled  the  jail                                                                    
capacity  and  created  a ten  seat  outpatient  restoration                                                                    
program for those with a misdemeanor conviction.                                                                                
                                                                                                                                
2:16:10 PM                                                                                                                    
                                                                                                                                
Representative  Josephson cited  a prior  study commissioned                                                                    
by  DHSS researched  by Agnew  Beck that  showed the  amount                                                                    
needed to build  out the jail based facility  was $2 million                                                                    
for new construction. He wondered  how the improvements were                                                                    
being accomplished  for $800 thousand. Mr.  Lasley responded                                                                    
that it  required significant  work and  collaborations with                                                                    
the  Department  of  Corrections  (DOC). He  shared  that  a                                                                    
consultant  was  hired, and  a  mod  was identified  in  the                                                                    
correctional   facility;  it   was  accomplished   for  $800                                                                    
thousand    without    additional   capital    expenditures.                                                                    
Representative Josephson   reported that  he had a  bill [HB
80 (Incompetency; Civil  Commitment)] that would necessitate                                                                    
more  screening,  which  would  result  in  more  commitment                                                                    
issues filed. He asked how  the expanded program's resources                                                                    
would  hold  up  under  the   bill's  scenario.  Mr.  Lasley                                                                    
responded that he would need to  wait to see if the bill was                                                                    
adopted to  determine an answer. However,  for both programs                                                                    
they were  contemplating on how  to expand the  services. He                                                                    
was  confident  that  the departments  could  find  ways  to                                                                    
expand services.                                                                                                                
                                                                                                                                
2:20:13 PM                                                                                                                    
                                                                                                                                
Representative Coulombe  asked about  the vacancy  rates and                                                                    
recruitment at API. Mr. Lasley  answered that the department                                                                    
was  doing  well as  far  as  vacancies except  for  nursing                                                                    
positions   and   psychiatrists   and   psychologists.   The                                                                    
psychiatrists'   positions   were   currently   filled.   He                                                                    
mentioned  that the  department utilized  the SHARP  Program                                                                    
that offered  education repayments  for API staff.  He hoped                                                                    
to  expand the  program.  Representative Coulombe  indicated                                                                    
that she  was able to visit  API and was impressed  with the                                                                    
progress made. She asked if  the number of beds were limited                                                                    
by  personnel or  physical structure.  Mr. Lasley  responded                                                                    
that it was due to physical structure.                                                                                          
                                                                                                                                
Commissioner  Kovol  interjected  that  the  department  was                                                                    
engaged in student practicum  placements from medical fields                                                                    
with 35 participants; the bulk  located at API. She hoped to                                                                    
hire all 35 participants.                                                                                                       
                                                                                                                                
2:23:30 PM                                                                                                                    
                                                                                                                                
Mr. Lasley  cited the Beacon  Award and elaborated  that API                                                                    
created  the Denali  Unit  for  patients with  comorbidities                                                                    
that resulted in a 62  percent reduction in patient on staff                                                                    
assaults.                                                                                                                       
                                                                                                                                
Ms.  Sweet turned  to slide  13  titled "Alaska  Psychiatric                                                                    
Institute  (API)  Operating  Budget  Comparison  FY  2023-FY                                                                    
2025                                                                                                                            
                                                                                                                                
     API Significant Budget Items:                                                                                              
                                                                                                                                
     Establish Alaska Psychiatric Institute as a Division                                                                       
     FY2025 UGF Increment                                                                                                       
                                                                                                                                
     $200.0 (GFMH) to support SHARP program                                                                                     
                                                                                                                                
Ms. Sweet  discussed the two  significant budget  changes in                                                                    
the  API  budget  for  FY 25.  The  department  was  seeking                                                                    
approval to move API back  into its own division once again.                                                                    
Ms. Sweet  referred to the  SHARP program and  reported that                                                                    
the request  was to fill  in the remaining  psychiatrist and                                                                    
psychologist  positions.   She  indicated  that   the  other                                                                    
category was comprised of  technical salary adjustments, IA,                                                                    
and SDPR  that was  collected from insurance  collection and                                                                    
private pay.                                                                                                                    
                                                                                                                                
2:27:53 PM                                                                                                                    
                                                                                                                                
Mr.  Lasley  continued  on  slide  14  titled  "Division  of                                                                    
Juvenile Justice                                                                                                                
                                                                                                                                
     Mission:                                                                                                                   
                                                                                                                                
        • Hold juvenile offenders accountable for their                                                                       
          behavior.                                                                                                             
                                                                                                                                
        • Promote the safety and restoration of victims and                                                                   
          communities.                                                                                                          
                                                                                                                                
        • Assist offenders and their families in developing                                                                   
          skills to prevent crime.                                                                                              
                                                                                                                                
     Shannon Dilley, Director                                                                                                   
                                                                                                                                
     Facilities / Offices / Staff:                                                                                              
        • 6 Facilities / 13 Probation Offices / 424 Full                                                                      
          Time Positions                                                                                                        
                                                                                                                                
     Program Improvement:                                                                                                       
        • Traumatic Brain Injury Project                                                                                      
        • Community Engagement                                                                                                
                                                                                                                                
Mr.  Lasley voiced  that the  Division  of Juvenile  Justice                                                                    
(DJJ)  operated   via  a   restorative  justice   model.  He                                                                    
elaborated that  evidence showed 40 percent  of juveniles in                                                                    
the  system  had  brain   injuries.  In  collaboration  with                                                                    
Southeast  Regional  Resource  Center and  the  Division  of                                                                    
Public  Health (DPH)  the  project  screened and  identified                                                                    
youths  with Traumatic  Brain  Injuries  (TBI) entering  the                                                                    
juvenile  justice  system  that ensured  they  received  the                                                                    
needed  referrals for  treatment.  The  program launched  in                                                                    
Fairbanks and  would expand in  the next year.  He furthered                                                                    
that  the  division was  always  looking  for new  ways  for                                                                    
community engagement for its  youth utilizing other services                                                                    
in state  government. One  successful program  allowed youth                                                                    
to  participate  in activities  in  the  PH. He  listed  the                                                                    
program's  benefits and  the types  of activities  the youth                                                                    
engaged in.                                                                                                                     
                                                                                                                                
Co-Chair Foster asked which  DJJ facilities recently closed.                                                                    
Mr. Lasley  answered that the Nome  and Ketchikan facilities                                                                    
were   closed.  Co-Chair   Foster  pointed   out  that   the                                                                    
facilities were  being utilized at  the time of  closure but                                                                    
were used  less than other facilities.  The communities they                                                                    
served  felt the  loss in  their communities.  He wanted  to                                                                    
explore the possibility of opening them again.                                                                                  
                                                                                                                                
2:32:59 PM                                                                                                                    
                                                                                                                                
Representative  Stapp  reported that  he  had  toured a  DJJ                                                                    
facility. He referred to the  TBI program and asked if there                                                                    
was correlative data on the  types of events that caused the                                                                    
injury.  He expressed  alarm at  the number  of youths  with                                                                    
TBIs.                                                                                                                           
                                                                                                                                
Mr. Lasley deferred the answer to a colleague.                                                                                  
                                                                                                                                
2:34:26 PM                                                                                                                    
                                                                                                                                
SHANNON  DILLEY,  DIRECTOR,  DIVISION OF  JUVENILE  JUSTICE,                                                                    
ANCHORAGE  (via teleconference),  replied  that the  state's                                                                    
data tracked national  data and she shared  his concern over                                                                    
the high  number. She  did not have  the data  regarding how                                                                    
the injuries occurred.                                                                                                          
                                                                                                                                
Representative Hannan asked what  the average population was                                                                    
in  DJJ facilities.  Mr. Lasley  responded  that there  were                                                                    
currently 141  youth in the  facilities with a  staffing and                                                                    
bed  capacity of  172. Representative  Hannan asked  whether                                                                    
part  of the  screening  identified  Fetal Alcohol  Syndrome                                                                    
(FAS) and other significant  mental illnesses and the number                                                                    
of  juveniles with  the conditions.  Mr. Lasley  deferred to                                                                    
Ms. Dilley to respond.                                                                                                          
                                                                                                                                
Ms. Dilley responded that JDD  provided a number of clinical                                                                    
assessments that  were diagnosed by the  mental health team.                                                                    
In addition,  the division conducted a  comprehensive trauma                                                                    
screening tool to access child trauma.                                                                                          
                                                                                                                                
Representative Hannan believed that  the juveniles should be                                                                    
as  close  to  home  as possible  to  enable  repairing  and                                                                    
restoring family  and community relationship. She  felt that                                                                    
creating    efficiencies   by    closing   facilities    and                                                                    
"warehousing our youth far away  form home" did not work for                                                                    
juvenile justice.                                                                                                               
                                                                                                                                
2:38:43 PM                                                                                                                    
                                                                                                                                
Co-Chair Foster supported  Representative Hannan's statement                                                                    
and  added that  the Nome  facility also  served youth  from                                                                    
other parts of Western Alaska.  He believed the youth needed                                                                    
family nearby.                                                                                                                  
                                                                                                                                
Representative Coulombe  had discussions with CDVSA  and the                                                                    
Alaska Mental  Health Trust (AMHTA))  and surmised  that the                                                                    
high  rates of  brain traumas  resulted from  high rates  of                                                                    
domestic violence. She was wondering  why the division's UGF                                                                    
was  so high  and  lacked a  significant  amount of  federal                                                                    
money. Ms.  Sweet answered that the  department had expanded                                                                    
its efforts in seeking  federal grants and recently received                                                                    
one for girls  in the juvenile justice  system. However, the                                                                    
grants were from  the federal Department of  Justice and the                                                                    
grant  pool  was  small. Representative  Coulombe  asked  if                                                                    
historically the grants were not  awarded to the state or if                                                                    
there was  a lack of grant  funding to apply for.  Ms. Sweet                                                                    
replied that she  was unaware of the  division's grant award                                                                    
history and offered to provide the information.                                                                                 
                                                                                                                                
2:42:10 PM                                                                                                                    
                                                                                                                                
Mr.  Lasley  added that  the  majority  of services  at  the                                                                    
division were  not federally eligible,  and the  majority of                                                                    
services   were   largely    the   state's   responsibility.                                                                    
Representative  Coulombe asked  whether the  AMHTA supported                                                                    
the TBI program. Ms. Sweet  answered in the affirmative, and                                                                    
added  it  was through  a  $100  thousand behavioral  health                                                                    
grant to help with behavioral health within the facilities.                                                                     
                                                                                                                                
2:43:23 PM                                                                                                                    
                                                                                                                                
Ms.  Sweet  continued  on  slide   15  titled  "Division  of                                                                    
Juvenile Justice (DJJ) Operating Budget Comparison FY 2023-                                                                     
FY  2025.)  She indicated  that  there  were no  significant                                                                    
budget  changes, and  the increase  was  specific to  salary                                                                    
adjustments. The majority of funding  was UGF, and the other                                                                    
category was strictly interagency receipts.                                                                                     
                                                                                                                                
Co-Chair Foster pointed  to the FY authorized  budget of $58                                                                    
million UGF depicted  on the graph, but the  actuals came in                                                                    
roughly $1  million less. He  wondered why. Ms.  Sweet noted                                                                    
there  had been  significant position  shortages across  all                                                                    
departments with  the division suffering a  more severe loss                                                                    
in the prior year.                                                                                                              
                                                                                                                                
Mr.  Lasley   continued  on  slide  16   titled  "Office  of                                                                    
Childrens Services                                                                                                              
                                                                                                                                
     Mission:                                                                                                                   
     Ensuring the safety, permanency and well-being of                                                                          
     children    by    strengthening   families,    engaging                                                                    
     communities, and partnering with Tribes.                                                                                   
                                                                                                                                
     Offices and Staff:                                                                                                         
        • 5 regions with 21 offices statewide                                                                                 
        • 610 Full Time Positions                                                                                             
                                                                                                                                
     Program Improvement:                                                                                                       
        • Tribal Compact Expansion                                                                                            
        • Placement Search and Support Unit                                                                                   
                                                                                                                                
Mr.  Lasley  elaborated that  the  numbers  of children  had                                                                    
reduced to  2.6 thousand down  from 3 thousand.  He referred                                                                    
to the Tribal  Child Welfare Compact and  explained that the                                                                    
compact expansion  transitioned OCS  services to  its tribal                                                                    
partners and  was able to  expand the number of  tribes that                                                                    
had entered the contract;  currently representing 170 tribes                                                                    
across the  state. He  furthered that  over the  last couple                                                                    
years  the tribal  compact funding  increased to  $5 million                                                                    
with the  majority of funding  expended for  prevention. The                                                                    
tribes were  engaged in prevention efforts.  He acknowledged                                                                    
that the  tribes could  best serve  their children  in their                                                                    
communities.                                                                                                                    
                                                                                                                                
2:48:54 PM                                                                                                                    
                                                                                                                                
Representative  Galvin shared  that  a dollar  spent in  the                                                                    
early part  of a child's  life was equated  to $8 to  $12 in                                                                    
return. She  asked what the tribal  organizations were doing                                                                    
and whether  the ideas  were generated  from them.  She also                                                                    
inquired what non-tribal prevention  efforts OCS was engaged                                                                    
in. Mr.  Lasley responded that the  compact relationship was                                                                    
one  of government  to government.  The negotiation  for the                                                                    
terms of prevention  efforts did not have  any parameters so                                                                    
the tribes could  do what worked best for  their members. He                                                                    
deferred further answer to a colleague.                                                                                         
                                                                                                                                
2:51:43 PM                                                                                                                    
                                                                                                                                
KIM GUAY,  DIRECTOR, OFFICE OF CHILDREN  SERVICES, ANCHORAGE                                                                    
(via  teleconference),  replied  that the  office  had  been                                                                    
working on  broadening prevention.  She elaborated  that the                                                                    
tribal program  focused on primary prevention  and secondary                                                                    
prevention;  community  wellness   and  individual  wellness                                                                    
aimed at  how to  prevent foster  care. She  reiterated that                                                                    
the tribes  had many  different ideas on  how best  to serve                                                                    
their    population.   She    furthered   discussed    other                                                                    
preventative efforts that  included family resource centers,                                                                    
respite care,  Parents as Teachers, among  other things. She                                                                    
offered to provide a complete list.                                                                                             
                                                                                                                                
2:54:48 PM                                                                                                                    
                                                                                                                                
Representative Josephson  recalled that OCS  had experienced                                                                    
very high turnover  for social workers. There  was an effort                                                                    
in subcommittee  to pay  retention bonuses.  He asked  if it                                                                    
had actually happened.                                                                                                          
                                                                                                                                
Mr.  Lasley  answered that  retention  bonuses  for OCS  was                                                                    
though  the governor's  People  First  Initiative. He  added                                                                    
that  the   bonuses  were  paid.   Representative  Josephson                                                                    
inquired  if   the  bonuses  were  successful.   Mr.  Lasley                                                                    
deferred the answer to the director.                                                                                            
                                                                                                                                
Ms.  Guay  responded  that  there   was  some  reduction  in                                                                    
turnover   and  some   positive   stabilization  trends   in                                                                    
retention of  front line workers. However,  she related that                                                                    
it was not sufficient, retention  improved from a high of 56                                                                    
percent  during  the  pandemic   to  46  percent  currently.                                                                    
Representative  Josephson  recounted  that a  new  clinician                                                                    
position was  created. He asked  whether the  position still                                                                    
existed and if  it had been helpful. Ms.  Guay answered that                                                                    
it had  been filled and  was very successful.  She furthered                                                                    
that the  position was the  Wellness and  Resiliency Officer                                                                    
who  engaged in  critical  incident  debriefings with  staff                                                                    
working  with  children,  office wellness  assessments,  and                                                                    
focused on  how the division  could keep the  staff healthy.                                                                    
She  added  that the  division,  in  collaboration with  the                                                                    
Department    of   Health,    implemented   a    "Reflective                                                                    
Supervision"  model called  "Facilitated Attunement,   which                                                                    
was well received by the staff.                                                                                                 
                                                                                                                                
2:58:41 PM                                                                                                                    
                                                                                                                                
Representative Coulombe  asked for information about  the $1                                                                    
million increment [on slide 17  titled "Office of Children's                                                                    
Services  (OCS)  Operating   Budget  Comparison  FY  2023-FY                                                                    
2025." Legal Services $1 million GF] for legal services.                                                                        
                                                                                                                                
Commissioner Kovol  replied that the  funding was for  the A                                                                    
Better Childhood  (ABC) lawsuit  [Jeremiah M. v.  Crum]. The                                                                    
department filed  a motion one  year ago and the  motion was                                                                    
denied.  The  case  was  in  the  discovery  phase  and  the                                                                    
calendar was accelerated. She anticipated  the court date to                                                                    
happen in 2025.                                                                                                                 
                                                                                                                                
Mr. Lasley  continued that  the final item  on slide  16 was                                                                    
the Placement  Search and Support  Unit. He  elucidated that                                                                    
it  was a  new unit  designed to  support resource  families                                                                    
with all aspects of caring for  the child. He added that the                                                                    
department only  provided a  snapshot of  their improvements                                                                    
and services.                                                                                                                   
                                                                                                                                
3:02:13 PM                                                                                                                    
                                                                                                                                
Representative   Tomaszewski  asked   about   the  PHs.   He                                                                    
referenced the  private senior home  Timber Creek  and asked                                                                    
whether  the  state  was encouraging  or  hindering  private                                                                    
sector care and  what the interaction was  between the state                                                                    
and the  private sector.  Commissioner Kovol  clarified that                                                                    
the  competition   she  previously   referred  to   was  for                                                                    
workforce.  She clarified  that she  was not  in a  business                                                                    
competition. The division focused  on best practices and who                                                                    
was  working  with  the  elders.   She  apologized  for  any                                                                    
confusion.  All care  homes were  all striving  to hire  the                                                                    
same type of  care professionals. Representative Tomaszewski                                                                    
asked  if  there  were  other  private  industries  stepping                                                                    
forward  to provide  the care  and if  the state  interacted                                                                    
with Timber Creek. Commissioner  Kovol deferred the question                                                                    
to  the  Department  of  Commerce,  Community  and  Economic                                                                    
Development.                                                                                                                    
                                                                                                                                
Representative  Tomaszewski  cited   the  Legislative  Audit                                                                    
Report  from November  21,  2023 [A  Special  Review of  the                                                                    
Department of  Family and Community Services  (DFCS), Office                                                                    
of Children's  Services Compliance  with Foster  Care Reform                                                                    
Laws, Part  2, Audit  Control Number 26-30096-24]  and noted                                                                    
that there were  six recommendations for OCS.  He pointed to                                                                    
one that  cited OCS for  3 at  risk child placements  due to                                                                    
OCS staff not following  proper background check procedures.                                                                    
He  asked   if  the   background  check  process   had  been                                                                    
reinforced  and   if  the  staff  received   more  training.                                                                    
Commissioner Kovol responded in the affirmative.                                                                                
                                                                                                                                
3:06:34 PM                                                                                                                    
                                                                                                                                
Representative  Cronk  asked  that   if  there  were  enough                                                                    
private sector senior homes would  the state eventually shut                                                                    
PHs down.  Mr. Lasley  answered that  even with  the 8  or 9                                                                    
large  new  facilities  that  had  opened  the  PH  waitlist                                                                    
numbers had  recently increased  because private  homes were                                                                    
selective in the type of  care it provided. The Pioneer Home                                                                    
system  provided  elder   Alaskans  security  regardless  of                                                                    
ability  to  pay.  He  shared   that  when  there  were  new                                                                    
facilities  interested  in   opening,  the  division  helped                                                                    
support  and  encourage  the   facilities  via  training  or                                                                    
information.   Representative  Cronk   appreciated  the   PH                                                                    
services and system.                                                                                                            
                                                                                                                                
3:10:12 PM                                                                                                                    
                                                                                                                                
Ms.  Sweet  discussed  slide 17  and  addressed  significant                                                                    
budget item  that increased the  Foster Care Base  Rate. She                                                                    
delineated that  in 2013 the department  contracted out help                                                                    
in  developing a  methodology to  appropriately determine  a                                                                    
daily rate  for foster care  that included the  average cost                                                                    
of living  in the country,  and a cost of  living multiplier                                                                    
for Alaska. She noted that the  cost of living in Alaska was                                                                    
significantly  higher  than  it  is  in  other  states.  The                                                                    
department  currently shifted  to using  the cost  of living                                                                    
for  the  United  States Department  of  Agriculture  (USDA)                                                                    
Urban  West Region  versus the  entire  country. It  allowed                                                                    
DCFS to  appropriately align  the base rate  to the  cost of                                                                    
living in Alaska.  The increase amounted to  $1.4 million in                                                                    
federal funds and $3.6 million  UGF. She reiterated that the                                                                    
$1 million GF  increase in legal services was  in support of                                                                    
the lawsuit.  She continued  that OCS  UGF was  comprised of                                                                    
GF, GF Mental  Health, and GF match. The  other category was                                                                    
made up  entirely of interagency  receipts (IA) and  OCS was                                                                    
subject to the technical salary increases.                                                                                      
                                                                                                                                
3:13:09 PM                                                                                                                    
                                                                                                                                
Representative Hannan asked  how long it had  been since the                                                                    
foster care base  rate had been adjusted.  Ms. Sweet replied                                                                    
that  it  had last  been  adjusted  in 2018.  Representative                                                                    
Hannan  shared that  she  had heard  that  many foster  care                                                                    
families  had  been  lost  for a  variety  of  reasons.  She                                                                    
wondered whether the state would  be able to meet the demand                                                                    
for   foster  care   families   with   the  rate   increase.                                                                    
Commissioner Kovol  responded that the department  felt that                                                                    
the  increase  would  sustain current  foster  families  and                                                                    
possibly  attract  new  resource families.  She  noted  that                                                                    
there  were   not  many  children   in  custodial   care  in                                                                    
institutions.                                                                                                                   
                                                                                                                                
3:14:40 PM                                                                                                                    
Representative   Coulombe  appreciated   the  work   of  the                                                                    
commissioner. She thanked them  for their honesty and owning                                                                    
their challenges. She asked for  a status update of the five                                                                    
year Mental  Health Trust plan. Commissioner  Kovol answered                                                                    
that  that plan  was in  its final  stages and  some changes                                                                    
were  made since  the  prior plan.  She  indicated that  the                                                                    
working group  redid the entire  plan. She  anticipated that                                                                    
the plan would be presented within the next few months.                                                                         
                                                                                                                                
Co-Chair Foster invited any final comments.                                                                                     
                                                                                                                                
Commissioner  Kovol   acknowledged  DFCS's   challenges  and                                                                    
thanked  the  committee for  the  opportunity  to share  the                                                                    
progress the department made in addressing them.                                                                                
                                                                                                                                
3:17:14 PM                                                                                                                    
                                                                                                                                
HB  268  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
HB  270  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
Co-Chair Foster reviewed the agenda for the following day.                                                                      
                                                                                                                                

Document Name Date/Time Subjects
DFCS HFIN- FY2025 Budget Presentation (2-7-24)- Final.pdf HFIN 2/7/2024 1:30:00 PM
HB 268
HB 268, HB 270
HB 270