Legislature(2017 - 2018)GRUENBERG 120
02/08/2018 03:00 PM House STATE AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| HCR2 | |
| HB168 | |
| HCR10 | |
| HB224 | |
| HJR31 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HJR 31 | TELECONFERENCED | |
| += | HCR 2 | TELECONFERENCED | |
| += | HB 224 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 168 | TELECONFERENCED | |
| += | HCR 10 | TELECONFERENCED | |
HCR 2-RESPOND TO ADVERSE CHILDHOOD EXPERIENCES
3:06:19 PM
CHAIR KREISS-TOMKINS announced that the first order of business
would be HOUSE CONCURRENT RESOLUTION NO. 2, Urging Governor Bill
Walker to join with the Alaska State Legislature to respond to
the public and behavioral health epidemic of adverse childhood
experiences by establishing a statewide policy and providing
programs to address this epidemic. [Before the committee,
adopted as a work draft on 2/6/18, was the committee substitute
(CS) for HCR 2, Version 30-LS0277\J, Glover, 1/17/18.]
3:06:54 PM
CHAIR KREISS-TOMKINS opened public testimony on HCR 2.
3:07:08 PM
SAMANTHA SAVAGE, Fairbanks Wellness Coalition (FWC), testified
that that the mission of FWC is to foster wellness through
primary prevention advocacy. Its two current projects are
focused on suicide prevention and heroine and prescription
opioid misuse among teens and young adults. She offered that
FWC recognizes the importance of working together as a community
and as a state to prevent childhood trauma because of its
enormous impact on the issues that the coalition seeks to
prevent. She said that according to Linda Chamberlain, PhD,
Director of the Alaska Family Violence Prevention Project
(AFVPP), studies have shown that nearly two-thirds of suicide
attempts of adults can be attributed to adverse childhood
experiences (ACEs), and nearly 80 percent of suicide attempts
during childhood and adolescence are attributed to ACEs. She
stated that research gathered by the Alaska Children's Trust
(ACT) reported that a person with four or more ACEs is 12 times
more likely to attempt suicide and 10 times more likely to use
injection drugs. She relayed that FWC supports the state's
efforts to recognize childhood trauma as an important factor in
building wellness in the community.
3:08:35 PM
ELSIE BOUDREAU, Alaska Resilience Initiative (ARI); President,
Arctic Winds Healing Winds (AWHW), testified that AWHW is a non-
profit organization dedicated to bringing healing and wellness
to villages throughout Alaska. She mentioned that she is an
Alaska Native who grew up in the village of St. Mary's. She
expressed her belief that establishing statewide policy is
important considering so many Alaska Native children are in
foster care; for many, this is due to ACEs and historical
trauma. She emphasized the importance of funding to research
statewide solutions. She maintained that it is imperative at
this point in Alaska Native history that Alaska residents come
together and create effective and meaningful solutions to make a
difference in the lives of Alaska Native children so that ACEs
are no longer prevalent. She asserted that ACEs are devastating
and create havoc for all Alaskans. She urged the governor and
the committee to support HCR 2.
3:10:43 PM
REPRESENTATIVE BIRCH asked about the cultural differences as
they apply to foster children and posed two scenarios: the
first is a foster child graduating from high school after living
in a dozen different foster homes; the second is a child in
rural Alaska moving upriver or downriver with one family until
adulthood. He opined that the prevailing opinion is that a
child is always better off with his/her natural birth family, as
opposed to with a foster care family. He asked Ms. Boudreau for
her thoughts on how the state could do a better job in that
regard.
MS. BOUDREAU responded that as a social worker, she worked for
the Division of Family and Youth Services [now the Office of
Children's Services (OCS). She reported that most of the foster
care children she saw wanted to return to their families. She
maintained that children who grow up closer to their cultural
connections do better in the long run, because they are no
longer seeking "who am I in this world?"; they have a connection
to their cultures, their identities, and their origins, which is
important for all children. She opined that the state should be
more culturally "humble" when imposing foster care requirements
on rural communities. It should create safety beyond the
presentation of the home and look at other factors influencing a
child's well-being, such as cultural and spiritual factors.
3:13:38 PM
REPRESENTATIVE BIRCH responded that he agreed and referred to
"cultural continuation". He said that a child may be raised by
an extended family member in a nearby community; he/she stays
there; and there is no "big push" to remove that child to go
back into "what might not be a good environment."
3:14:20 PM
JOSH ARVISTON, Director, Alaska Child Trauma Center (ACTC),
Anchorage Community Mental Health Services, Inc. (ACMHS),
testified that the [original] ACE study data is now 20 years old
and has been supported by follow-up research highlighting the
links between ACEs and long-term health, mental health,
substance abuse, education, and occupational outcomes. He
expressed his belief that it is critical for Alaska to have a
systematic approach to addressing this issue; such an approach
would have financial health benefits for the State of Alaska and
for the state's residents. He stated that in the subsequent 20
years since the original research, the emerging science of
traumatic stress, how traumatic stress impacts behavior and
physiology, and brain imaging studies have directed us to
effective interventions and approaches that can help achieve
better outcomes for Alaskans.
3:16:05 PM
LAURA NORTON-CRUZ, Director, Alaska Resilience Initiative (ARI),
testified that she supports HCR 2 because as the director of
ARI, a former teacher, a mother, and a community member, she
shares the value that all of Alaska's children deserve to be
safe, to be cared for, and to have the opportunity to grow into
healthy contributing adults. She stated that as the director of
a statewide network of people who are actively addressing ACEs,
it is her job to learn about and connect people to the efforts
already occurring across Alaska. She relayed that there are
hundreds of groups using ACEs to guide their work in trauma and
have been doing so for decades. Alaska is at the forefront of
this movement and considered a national leader: it was chosen
as one of 14 pilot sites (indisc.); Alaskan tribes are doing
powerful work, including the Aleut community, St. Paul, that was
featured in today's issue of The Guardian; there is a coalition
in the Matanuska-Susitna ("Mat-Su") Valley that is leading
creative and innovative OSC (indisc.) improvements; the
Ketchikan Shipyard of the international company Vigor
[Industrial] is the safest shipyard in the entire company and is
the model for the Seattle Shipyard because of its implementation
of (indisc.) practices; and Alaska's Division of Juvenile
Justice (DJJ) is one of the first in the country to undergo
transformation to a "trauma-informed" agency.
MS. NORTON-CRUZ maintained that Alaskans are creative and
innovative. She said, "We've really taken this on and we're
running with it, and yet we have so far to go." She referred to
the many grim statistics about Alaska's child welfare system,
medical spending, and the opioid crisis. She relayed that to
make this effort work across all sectors as effectively as
possible, Alaska needs shared commitment and shared language
from the Alaska legislature and the governor to help set the
tone and set priorities.
MS. NORTON-CRUZ reported that the way Wisconsin has prioritized
ACEs and trauma-informed work at the state government level, led
by Wisconsin First Lady Tonette Walker, has allowed for trauma
and resilience work in Wisconsin to flourish across the state,
resulting in significant improvements in academic, health, and
social outcomes, as well as radical cost savings for state and
local government.
MS. NORTON-CRUZ maintained that the proposed resolution would
set the tone for new policy-makers and new commissioners and
make a statement that legislators care about this. The use of
ACEs is necessary to save the state money and to have a healthy
workforce; and it can result in improvements in the major
troublesome issues, such as the opioid epidemic and the child
welfare system. She concluded by saying, "You setting this
tone, you providing this leadership, can result in moving
towards an Alaska where values are manifested."
3:19:34 PM
REPRESENTATIVE BIRCH referred to ACEs, toxic stress, and
childhood trauma, and he mentioned that as a child, he was
spanked and experienced some significant events that were
traumatic. He asked for a brief explanation for how one's ACE
is measured.
MS. NORTON-CRUZ suggested that one way of thinking about it is
envisioning a teeter-totter: on one end is chronic and
persistent stress weighing a person down and having an effect on
his/her brain and body; on the other end are protective factors,
such as supportive adult relationships, meaningful work,
community engagement, and (indisc.) identity, that provide
balance, can be protective against adversity, or help build
resilience. She explained that where the fulcrum is positioned
can affect which side is weighted heavier; it may represent a
person's genetics or events that occurred during pregnancy.
MS. NORTON-CRUZ maintained that there are many factors that
determine outcomes after a person experiences adversity. She
said that the ACE study was a crude measure; it asked, "Did
these things happen to you?" and counted the number of those
things that happened. She maintained that what researchers
found was incredibly powerful epidemiology. They measured five
forms of household disfunction and five forms of child
maltreatment, abuse, and neglect; they found that the more
adversities a person had, the greater the risk of a myriad of
health and social problems. She reminded the committee that
because of the protective and environmental factors, a high ACE
score is not absolutely predictive. She stated that using the
ACE lens leads to opportunities for promoting protective factors
and preventing or reducing initial traumas.
3:22:29 PM
REPRESENTATIVE BIRCH asked whether any of the ACEs rise to the
level of being illegal, reportable, and punishable, such as
physical child abuse, or if they are lower level experiences,
such as alcoholic problems in the home. He inquired as to the
range of traumatic issues.
MS. NORTON-CRUZ responded that the original ACE study, conducted
by [health maintenance organization (HMO)] Kaiser Permanente in
California and replicated in Alaska, asks about five criminal
behaviors and five forms of household disfunction. The criminal
behaviors are: physical and emotional neglect; and physical,
sexual, and verbal abuse. The five forms of household
disfunction consist of: a household member who is incarcerated,
a household member who has mental illness or substance abuse,
domestic violence in the household, and parents who have
separated or divorced. She maintained that not all ACEs are
criminal and not all are necessarily a trauma, such as a
divorce; however, given the circumstances surrounding such an
event, it could create an environment of chronic stress for the
child. She added that there are many other forms of stress that
can affect a child's developing brain and body that are not
counted in the study, but have been identified by other
research, such as chronic bullying, chronic discrimination, or
hunger.
3:24:21 PM
CHARLES MCKEE testified that he had a traumatic experience in
Fairbanks, Alaska, when he was 14 years of age during the
Fairbanks flood [of 1967]; he was hospitalized at Bassett Army
Community Hospital, which saved his life. He relayed that later
his father hired a secretary to manage his business; the
secretary was married to an U.S. Internal Revenue Service (IRS)
agent; and she and the IRS agent set Mr. McKee's father up for a
major financial calamity. Mr. McKee's father was not aware of
what was happening until his checks started "bouncing". Mr.
McKee maintained that the IRS seized his father's account to get
him to sell the Alaska distributorship for Kirby Company of
Alaska. He summarized by saying that this situation is still
ongoing; "this structural organization is run by the Bar
Association and it's corrupt."
3:26:58 PM
ARICA PAQUETTE, Prevention Manager, Women in Safe Homes (WISH),
testified that she is a coordinator for the Revilla Island
Resilience Initiative (RIRI), which is working to prevent trauma
and promote resilience through collective action. She relayed
that the goal of her department at WISH is to prevent violence
through primary prevention strategies before it starts.
Research has shown that childhood trauma, including witnessing
domestic violence in the home, is a risk factor for violence
being experienced across the lifespan. She said that WISH's
programs typically target youth - elementary through high school
- but it often engages in primary prevention too late, because
children are being impacted by ACEs prior to entering the school
system.
MS. PAQUETTE maintained that cross sector collaboration is
instrumental in the implementation of effective strategies in
the communities; it creates a measurable reduction in both the
perpetration of violence and victimization. She offered that
through the lens of trauma-informed care, WISH can build
connections between sectors to engage in projects or implement
programs that impact multiple social problems and not just
intimate partner and sexual violence. Currently WISH is working
with the school district to support integrating a trauma-
informed approach in all the schools by helping teachers to
identify support and promote healing among the victims of
childhood trauma. Trauma is passed through generations, so that
supporting both parents and children is critical for ending the
(indisc.). She maintained that the state can further support
these efforts by officially supporting local and statewide
initiatives encouraging cross sector collaboration to prevent
all forms of childhood trauma and to build resilience in
families and communities.
3:29:09 PM
CARMEN LOWRY, Executive Director, Alaska Network on Domestic
Violence and Sexual Assault (ANDVSA), testified that ANDVSA is
constituted through 24 domestic violence and sexual assault
(DVSA) agencies across the state. It has been an active partner
with the Alaska State Legislature since 1980. She stated that
ANDVSA fully supports the proposed resolution and appreciates
the call to establish statewide policies that address the
devastating impacts of ACEs. She relayed that in fiscal year
2017 (FY 17), ANDVSA programs responded to about 7,700 women who
reached out for services; (indisc.) and approximately 1,800
children. She maintained that the multiple ACE studies
conducted since 2000 are clear: 1) there are substantiated
links between a child witnessing violence against his/her mother
and developing risk factors that have negative impacts for that
child's well-being as an adult; and 2) there are substantiated
correlations between (indisc.) domestic violence and the
likelihood of that child being physically abused. She asserted
that the bottom line is that a child's exposure to domestic
violence has a profound impact on that child, and that impact
reverberates into their adult lives; the impacts and
reverberations have social and physical implications for the
state.
MS. LOWRY stated that ANDVSA and the state can work together to
do the following: 1) continue to support and provide lifesaving
shelter and emergency services to victims and their children; 2)
expand and learn from community-based prevention activities; and
3) assess the state policies currently in place with an eye to
what needs to be revised or created to adequately address those
larger social factors that contribute to Alaska's current
condition, which is that 40 percent of Alaska's adult female
population, their children, their partners, and their
communities experience domestic violence. She offered full
support for HCR 2.
3:31:58 PM
CHAIR KREISS-TOMKINS closed public testimony on HCR 2.
3:32:17 PM
REPRESENTATIVE TUCK commented that he was unfamiliar with ACE
until his discussions with Representative Tarr and California
physician [Dr. Vincent Felitti], during which he was able to
learn what ACE is, how people are affected by ACE, and some
simple treatments to help people overcome the effects of ACE.
He maintained that he was amazed at the value of asking the ACE
questions during a physical exam for significantly improving a
person's health and reducing costs. He mentioned that he saw a
Technology, Entertainment, Design (TED) talk on YouTube in which
a physician emphasized the importance of a full physical exam,
getting a complete history, and discovering ACEs to improve the
overall health of patients. He maintained that awareness of ACE
alone will have a significant impact on communities and
families.
3:34:36 PM
REPRESENTATIVE WOOL commented that the issue is two-fold:
preventing the experiences that cause high ACE scores; and
treating people who have experienced ACEs. He agreed that
asking the ACE questions gives people the opportunity to explain
what happened to them and to understand the reasons behind the
difficulties they are having; and as a by-product, it saves on
state expenditures.
3:35:32 PM
REPRESENTATIVE WOOL moved to report the CS for HCR 2, Version
30-LS0277\J, Glover, 1/17/18, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection, CSHCR 2(STA) was reported from the House State
Affairs Standing Committee.