Legislature(2025 - 2026)BUTROVICH 205
04/10/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SJR16 | |
| Presentation(s): Citizen's Review Panel | |
| Presentation(s): Office of Children's Services Response to Fy 2024 Citizen Review Panel Report | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SJR 16 | TELECONFERENCED | |
| += | SB 45 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 10, 2025
3:31 p.m.
MEMBERS PRESENT
Senator Forrest Dunbar, Chair
Senator Cathy Giessel, Vice Chair
Senator Matt Claman
Senator Shelley Hughes
MEMBERS ABSENT
Senator Löki Tobin
COMMITTEE CALENDAR
SENATE JOINT RESOLUTION NO. 16
Urging the United States Congress to pass the Ensuring Lasting
Smiles Act; and urging lawmakers to advocate for policies that
guarantee equitable access to vital healthcare.
- HEARD & HELD
PRESENTATION(S): CITIZEN'S REVIEW PANEL
- HEARD
PRESENTATION(S): OFFICE OF CHILDREN'S SERVICES RESPONSE TO FY
2024 CITIZEN REVIEW PANEL REPORT
- HEARD
SENATE BILL NO. 45
"An Act relating to medical assistance services; relating to
parity in mental health and substance use disorder coverage in
the state medical assistance program; and providing for an
effective date."
- SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: SJR 16
SHORT TITLE: FEDERAL ENSURING LASTING SMILES ACT
SPONSOR(s): SENATOR(s) GRAY-JACKSON
04/02/25 (S) READ THE FIRST TIME - REFERRALS
04/02/25 (S) HSS
04/10/25 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
SENATOR ELVI GRAY-JACKSON, District G
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SJR 16.
EMILY BRUBAKER, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SJR 16.
RETCHENDA GEORGE-BETTISWOTH, Chair
Citizen Review Panel
Anchorage, Alaska
POSITION STATEMENT: Offered the presentation Citizen's Review
Panel.
KIM GUAY, Director
Office of Children's Services (OCS)
Alaska Department of Family and Community Services
Anchorage, Alaska
POSITION STATEMENT: Offered the Office of Children's Services
Response to the FY 2024 Citizen Review Panel Report.
KIM KOVOL, Commissioner
Alaska Department of Family and Community Services
Anchorage, Alaska
POSITION STATEMENT: Provided comments on the Citizen Review
Panel presentation.
ACTION NARRATIVE
3:31:28 PM
CHAIR TOBIN called the Senate Health and Social Services
Standing Committee meeting to order at 3:31 p.m. Present at the
call to order were Senators Giessel, Hughes, Claman, and Chair
Dunbar.
SJR 16-FEDERAL ENSURING LASTING SMILES ACT
3:32:22 PM
CHAIR DUNBAR announced the consideration of SENATE JOINT
RESOLUTION NO. 16 Urging the United States Congress to pass the
Ensuring Lasting Smiles Act; and urging lawmakers to advocate
for policies that guarantee equitable access to vital
healthcare.
3:32:45 PM
SENATOR ELVI GRAY-JACKSON, District G, Alaska State Legislature,
Juneau, Alaska, sponsor of SJR 16. She introduced the
resolution, Ensuring Lasting Smiles Act, which urges Congress to
require private health insurance coverage for the diagnosis and
treatment of congenital anomalies and birth defects. She said
coverage would include medically necessary services and items
that improve, repair, or restore normal bodily function or
appearance, as determined by the treating physician, with cost-
sharing and coverage limits no more restrictive than those for
other medical and surgical benefits. She stated that although
rare, Hypohidrotic Ectodermal Dysplasia (HED) affects
approximately 1 in 20,000 newborns worldwide and nearly 200,000
individuals in the United States. Treatment often requires both
medical and dental care, yet many medically necessary dental
services are inadequately covered, placing a significant
financial burden on families. She said by passing this
resolution, the Alaska Legislature would stand with families
affected by congenital conditions and urge the Alaska
congressional delegation to champion this legislation, affirming
that access to essential medical and dental care is a right, not
a privilege.
3:35:12 PM
SENATOR HUGHES asked whether Medicaid covers these medical
services.
3:35:51 PM
SENATOR GRAY-JACKSON replied that she wasn't sure.
3:36:06 PM
CHAIR DUNBAR asked Ms. Brubaker to answer the question and offer
testimony.
3:36:16 PM
EMILY BRUBAKER, representing self, Anchorage, Alaska, testified
by invitation on SJR 16. She answered that Medicaid does not
cover the specific medical services for rare congenital
anomalies. She said these services are viewed as cosmetic and
unnecessary. She continued with her testimony stating that at
the age of two she was diagnosed with a genetic condition that
affects teeth, hair and skin.
3:37:17 PM
At ease.
3:37:26 PM
CHAIR DUNBAR reconvened the meeting.
3:37:43 PM
MS. BRUBAKER stated that she will require numerous dental
procedures, with estimated out-of-pocket costs of approximately
$100,000. The Ensuring Lasting Smiles Act (ELSA) would amend
federal law to require private insurers to cover medically
necessary procedures for individuals with rare congenital
anomalies, significantly reducing this burden. She said that she
has actively advocated for ELSA since childhood, traveling to
Washington, D.C. multiple times and engaging with Alaska's
congressional delegation. The legislation passed the U.S. House
with a bipartisan supermajority in the 117th Congress and did
not advance in the Senate. She said she hopes for reintroduction
in the 119th Congress. She said with growing national and local
support, including the Anchorage Assembly, ELSA would have a
profound impact on families across Alaska and the nation.
3:40:20 PM
SENATOR GRAY-JACKSON thanked the committee for hearing the
resolution.
3:40:38 PM
CHAIR DUNBAR held SJR 16 in committee.
3:40:44 PM
At ease.
^PRESENTATION(S): CITIZEN'S REVIEW PANEL
PRESENTATION(S): CITIZEN'S REVIEW PANEL
3:42:05 PM
CHAIR DUNBAR reconvened the meeting and announced a presentation
Citizen's Review Panel of the State of Alaska, presented by Dr.
Retchenda George-Bettisworth.
3:43:24 PM
RETCHENDA GEORGE-BETTISWOTH, Chair, Citizen Review Panel,
Anchorage, Alaska, offered the presentation Citizen's Review
Panel. She said she is in her fifth year on the Citizen Review
Panel and her second year as chair. She currently serves as a
faculty member in the Social Work Department at the University
of Alaska Fairbanks.
3:44:16 PM
MS. GEORGE-BETTISWOTH moved to slide 2, Purpose, and read the
following:
[Original punctuation provided.]
PURPOSE
Congress created Citizen Review Panels (CRPs) as part
of the Child Abuse Prevention and Treatment Act
(CAPTA) to help child protection systems be more
responsive to community needs.
A CRP is a mechanism for public participation in child
protection. It should facilitate robust and meaningful
participation by citizens to promote a healthy and
collaborative child protection system
3:44:46 PM
MS. GEORGE-BETTISWOTH moved to slide 3, Mandates, and read the
following:
[Original punctuation provided.]
MANDATES
Federal Mandate 42 U.S.C.§ 5106a.(c) Examine the
policies, procedures, and practices of state and local
child protection agencies and evaluate the extent to
which these agencies are effectively carrying out
their child protection responsibilities. Conduct
public outreach both to assess the impact of current
policies and procedures, and to solicit public comment
on the panel's recommendations.
State Mandate AS 47.14.205 The state Panel shall
evaluate the extent to which the department is
effectively carrying out its child protection
responsibilities under (1) the state plan submitted to
the United States Department of Health and Human
Services under 42 U.S.C. 5106a(b); (2) child
protection standards under federal and state laws; and
(3) any other criteria that the Panel considers
important to ensuring the protection of children
3:45:37 PM
MS. GEORGE-BETTISWOTH moved to slide 4, Principal Functions of
the CRP, and discussed the following:
[Original punctuation provided.]
EVALUATION
The Panel will evaluate OCS compliance with federal
and state laws, examining policies and procedures for
consistent statewide implementation while still being
responsive to the diversity of needs across the state
PUBLIC OUTREACH
The Panel will identify and implement means to gather
feedback on procedures and practices for delivering
child protection services in Alaska. As specified
above, the information thus collected will be utilized
in its evaluation function.
ADVOCACY
The Panel will conduct appropriate actions to help
improve Alaska's child protection services system.
MS. GEORGE-BETTISWOTH said CRP does not lobby; it educates
others about its activities and priorities as a state board.
3:46:40 PM
MS. GEORGE-BETTISWOTH moved to slide 5, Annual Report FY 24 OCS
Recruitment Practices, and stated that the Citizen Review
Panel's fiscal year begins July 1. The panel sets annual
priorities, meets monthly, and issues recommendations each May
in an annual report, to which OCS must provide a written
response. She said that the 20232024 report focused on a
healthy CPS system, particularly workforce recruitment and
retention. While OCS's new centralized hiring system has
improved efficiency, staffing challenges remain. The panel
recommends greater flexibility in HR policies, a more attractive
hiring process, and expanded flexible work options within OCS.
3:49:09 PM
MS. GEORGE-BETTISWOTH moved to slide 6, Annual Report FY 24
Prevention Efforts, and stated that the CRP examined prevention
by reviewing OCS policies and data related to intake screening
and referrals to support services. She said child welfare
reports are assessed and either screened in for investigation or
screened out if they do not meet criteria; nationally, 74.3
percent of screened-in cases involve neglect, often after
multiple reports. She stated that the panel focused on what
occurs after reports are screened out and identified barriers to
connecting families with prevention services. The panel found
that greater collaboration with community organizations is
needed and recommended learning from other states, strengthening
partnerships, and improving review of screened-out case data to
better connect families to supports.
3:51:14 PM
MS. GEORGE-BETTISWOTH moved to slide 7, Two Phase Work Plan
Cycle, and stated that the panel has adopted a new structured
two-year work plan, updated annually, to prioritize key focus
areas for improving child welfare services in Alaska. She said
each priority is addressed through a two-phase work plan cycle.
3:51:38 PM
MS. GEORGE-BETTISWOTH moved to slide 8, and discussed the
following:
[Original punctuation provided.]
Phase one: Education and Knowledge Building
-Focus Area Selection: The cycle begins with the Panel
selecting key focus areas that will guide its efforts
over the next two years.
-Expert Engagement: The Panel identifies subject
matter experts in the focus areas and requests data
and presentations.
-Knowledge Development: The Panel dedicates time to
in-depth discussions and expert consultations specific
to each focus area.
-Synthesis and Planning: As each focus area progresses
through Phase 1, the Panel reviews the information to
inform planning for Phase 2.
Phase two: Action and Implementation.
-Translate Knowledge: This phase focuses on
translating knowledge into actionable strategies and
initiatives to address identified issues within the
focus areas.
3:52:42 PM
MS. GEORGE-BETTISWOTH moved to slide 9, CRP Current Focus Areas,
and stated that the Panel's current focus areas are mandatory
reporting and out-of-home placements. Mandatory reporting has
been a cornerstone of child abuse and neglect prevention for
decades and is particularly significant in Alaska, where rates
are among the highest per capita. She said in phase one, the
Panel has worked with OCS to review data on reporting volumes,
outcomes, compliance, and training for mandatory reporters,
while engaging experts and the public to identify challenges and
improvements. In Phase two, the Panel is exploring screened-out
reports, resource allocation, and expanded community involvement
in reporting. She stated that out-of-home placements involve
temporary care for children who cannot safely remain at home and
include kinship care, therapeutic homes, foster homes, and
residential services. She stated that the Panel will analyze
data on placement stability, timeliness, and long-term outcomes;
collaborate with OCS and providers to assess placement types;
identify system strengths and gaps; and emphasize cultural and
community connections. She said phase two focuses on action and
implementation.
3:56:00 PM
MS. GEORGE-BETTISWOTH moved to slide 10, Recommendations for FY
25, and read the following:
[Original punctuation provided.]
In spring 2025, the Panel will develop a set of
recommendations based on findings from its focus areas
to be included in an annual report. This will include
actionable steps for the Office of Children's Services
(OCS) to consider, such as:
-Enhancing the mandatory reporting process to ensure
timely, accurate reporting and effective use of
resources.
-Advocating for ongoing training and education for
mandatory reporters and caregivers
MS. GEORGE-BETTISWOTH said the Panel will continue engaging
experts in subject matter to develop recommendations for its
annual report. She said improving the well-being of Alaska's
children and child welfare workforce requires collaboration
beyond OCS and a shared statewide effort.
3:56:56 PM
SENATOR GIESSEL referred to slide 9 on mandatory reporting and
asked how much the Panel interacts with the child advocacy
centers.
MS. GEORGE-BETTISWOTH replied that the Panel does not directly
interact with the child advocacy centers.
3:57:50 PM
SENATOR GIESSEL asked what impact the CRP anticipates if the
child advocacy centers were too close.
MS. GEORGE-BETTISWOTH replied that if the centers closed it
would be a major setback to the child welfare system.
3:59:47 PM
SENATOR GIESSEL asked whether CRP discussed or considered
whether the child advocacy centers (CACs) would be better
positioned under the Department of Public Safety rather than the
Department of Family and Community Services.
MS. GEORGE-BETTISWOTH replied that the CRP has not had any
discussion regarding what department CACs should belong to.
4:00:41 PM
SENATOR GIESSEL suggested the panel give more attention to CACs,
hence discussion about ongoing funding that would result in
closure.
4:00:55 PM
SENATOR HUGHES stated that there is concern about a potential
sudden loss of federal funding for child advocacy centers. She
also asked whether the panel is aware of the ROCK (Raising Our
Children with Kindness) program in the PalmerWasilla area,
which supported families with screened-out reports to prevent
system involvement. She asked whether the program was considered
successful, remained ongoing, and whether the Citizen Review
Panel has considered recommending replication of that model.
4:02:08 PM
MS. GEORGE-BETTISWOTH replied that The Citizen Review Panel may
recommend replicating best-practice models statewide, however it
does not evaluate or review individual programs. She said that
she is professionally familiar with the ROCK Mat-Su
organization. She values the organization's work; however she
cannot speak to how the Citizen Review Panel (CPR) would address
this specific situation.
4:03:00 PM
SENATOR HUGHES noted that ROCK Mat-Su partners with OCS and
suggested it may fall within the panel's purview for potential
recommendations. She asked whether the review panel has
considered alternatives to removing children from homes, such as
temporarily removing parents and placing a relative or caretaker
in the home to minimize disruption to the child's life.
4:04:11 PM
MS. GEORGE-BETTISWOTH answered that removing a parent from the
home has not been discussed as a panel. She stated her belief
that OCS does not have the ability to remove a parent from a
home they may own. She agreed that less disruption in a child's
life is best.
4:04:59 PM
SENATOR HUGHES stated that removing the parent from a home would
take statutory changes and would be a sensible approach.
4:05:14 PM
CHAIR DUNBAR reflected on constituent complaints about OCS,
noting that while improvements may be possible, the work is
often inherently difficult. He asked whether the panel reviews
comparative data from other states and how Alaska's child
welfare system is performing relative to others, based on the
panel's perspective and annual reports.
4:06:09 PM
MS. GEORGE-BETTISWOTH replied that the panel has not conducted a
formal comparison of Alaska's child welfare system with other
states, noting that while all states operate under CAPTA, each
implements it differently. She said based on national child
welfare data, Alaska appears generally comparable to other
states, though it screens out a higher percentage of cases than
the national average. The panel does not conclude that any one
state performs child protection significantly better or worse
than Alaska.
4:08:05 PM
At ease.
^PRESENTATION(S): OFFICE OF CHILDREN'S SERVICES RESPONSE to FY
2024 CITIZEN REVIEW PANEL REPORT
PRESENTATION(S): OFFICE OF CHILDREN'S SERVICES RESPONSE to FY
2024 CITIZEN REVIEW PANEL REPORT
4:08:21 PM
CHAIR DUNBAR reconvened the meeting and announced the Office of
Children's Services Response to FY 2024 Citizen Review Panel
Report.
4:08:59 PM
KIM GUAY, Director, Office of Children's Services, Alaska
Department of Family and Community Services, Anchorage, Alaska,
offered the Office of Children's Services Response to the FY
2024 Citizen Review Panel Report.
4:09:34 PM
MS. GUAY moved to slide 2, Recruitment, and referenced the bar
graph. She stated that OCS is improving recruitment and
retention through a talent acquisition team that has streamlined
hiring and reduced onboarding time. She said while applicant
education levels have shifted, training has been adjusted
accordingly. Initial implementation challenges have eased. To
retain staff, OCS is investing in paid internships and
professional development, including partnerships with the
University of Alaska to support child welfare certification.
4:11:48 PM
CHAIR DUNBAR referenced prior data showing very short average
tenure at OCS, with a small group of long-term employees and
high burnout rates compared to other state departments. He asked
whether burnout remains high and whether employee retention data
has improved.
4:12:34 PM
MS. GUAY replied that she would give information to the
committee. She said at the height of the pandemic, OCS
experienced a 51 percent turnover rate among case-carrying
staff, which has since decreased to around 37 percent. Anchorage
currently has a 45 percent vacancy rate for case-carrying
positions, with statewide vacancies at 33 percent. She said to
address staffing shortages, OCS has centralized tasks such as
placement searches and support for foster families, however high
turnover and difficulty filling positions continue to challenge
service delivery. Many workers leave quickly due to the
demanding nature of the work.
4:14:47 PM
SENATOR CLAMAN asked for clarification regarding whether the
previously mentioned percentages referred to turnover rates or
vacancy rates.
4:15:09 PM
MS. GUAY replied that both were discussed. The turnover rates
measure how often case-carrying staff leave and was 51 percent
at the peak of the pandemic and is now 37 percent. She said
although vacancy rates reflect current unfilled positions, both
metrics are important to assess staffing challenges.
4:15:41 PM
SENATOR CLAMAN asked if the 37 percent turnover rate among
frontline staff refers to annual turnover, meaning over one-
third of staff leave within the first year on the job.
MS. GUAY answered that is correct.
4:16:02 PM
CHAIR DUNBAR stated that even though all agencies eventually
experience full turnover, losing 3751 percent of staff within a
single year makes it extremely difficult to operate effectively.
SENATOR HUGHES asked whether reducing caseloads in the past
helped lower turnover and requested information on the history
and impact of that effort.
4:16:43 PM
MS. GUAY replied that House Bill 151, passed in 2018, aimed to
reduce caseloads for new OCS staff to allow for proper training
and onboarding. While OCS tries to cap caseloads during the
first six months, high turnover and staffing shortages make this
difficult. She said caseloads often exceed national
recommendations, some staff carry 33 cases versus the
recommended 1213, forcing prioritization to ensure child
safety. Despite these challenges, OCS strives to serve all
families and children effectively.
4:18:49 PM
SENATOR HUGHES noted that House Bill 151 created additional
positions. She asked whether filling current vacancies would
bring caseloads closer to the national average and more
manageable levels.
4:19:08 PM
MS. GUAY replied yes, if all vacancies were filled, caseloads
would be more manageable at 1014 cases per worker. However,
challenges remain because applicants are scarce, staff turnover
is high, and low pay and job difficulty contribute to short
tenure.
4:19:41 PM
MS. GUAY moved to slide 3, Employee Wellness and Retention, she
stated that OCS has focused on staff retention using a framework
adapted from the U.S. Surgeon General, emphasizing career
development, emotional and psychological safety, and critical
incident debriefings to support staff facing difficult
situations. She said recent surveys show a significant increase
in staff feeling valued at work, which OCS hopes will lead to
improved retention over time.
4:21:09 PM
MS. GUAY moved to slide 4, Workplace Communication, and stated
that OCS is improving workplace communication through fireside
chats, a monthly newsletter, a staff advisory board, and a
supervisor leadership council. It is also prioritizing staff
input and creating a supportive, valued work environment.
4:21:37 PM
MS. GUAY moved to slide 5, Protective Services Reports (PSR) and
Policies, and stated that OCS receives about 21,000 protective
services reports annually, with 31 percent screened in for
investigation and 69 percent screened out for reasons such as
jurisdiction. She said reports outside the household are
referred to law enforcement or other agencies. When appropriate,
reports on Alaska Native families are shared with tribes under
confidentiality agreements to support family services.
4:22:43 PM
CHAIR DUNBAR referred to slide 5 and asked whether Alaska's 31
percent screened-in and 69 percent screened-out rate is typical
compared to other states and whether Alaska screens in or
screens out cases at a higher rate than the national average.
MS. GUAY replied that Alaska screens out slightly more cases
than the national average. She said differences in state laws,
such as the number of mandated reporters required to file a
report, affect these rates and the volume of calls received.
4:24:24 PM
CHAIR DUNBAR asked how much a typical salary for a case-carrying
employee is.
MS. GUAY replied that starting salary is $25.
CHAIR DUNBAR asked what the requirements are for the entry level
position.
MS. GUAY replied that OCS uses competency-based hiring for
protective service specialists, focusing on key skills such as
communication and critical thinking. Candidates are evaluated
through interviews and reference checks instead of relying on
minimum qualifications like a bachelor's degree or prior case
management experience.
4:25:52 PM
CHAIR DUNBAR stated at $25 an hour, or roughly $52,000 a year,
protective service salaries in Anchorage are insufficient to
afford housing. He said this makes recruitment and retention
extremely difficult, especially without a pension.
MS. GUAY said staff surveys indicate pay and job opportunities
affect retention, with higher turnover in Anchorage due to other
employment options. In Western Alaska, housing and lack of local
hires are challenges, leading OCS to implement a week-on, week-
off rotation for staff flying in to work.
4:27:24 PM
KIM KOVOL, Commissioner, Alaska Department of Family and
Community Services, Anchorage, Alaska, provided comments on the
Citizen Review Panel presentation. She stated that OCS staff
work hard and are committed to supporting families, while also
improving customer service and ensuring access to needed
services. Recruitment and hiring have been strengthened through
the talent acquisition team, resulting in better staff
stabilization, with legislative support aiding these efforts.
4:28:42 PM
CHAIR DUNBAR asked about the potential impact on child advocacy
centers if federal funding is lost and whether the state could
continue supporting them, including the consequences of closure
or reduced services.
4:29:17 PM
COMMISSIONER KOVOL responded that OCS is exploring options for
child advocacy centers (CACs), including whether they should
move to DPS or remain with DFCS, while seeking additional
federal funding and reviewing practices in other states. Despite
bureaucratic challenges and new priorities, CACs provide
specialized services and training for both custodial and non-
custodial families, ensuring support even for families not
involved with OCS.
4:30:40 PM
SENATOR HUGHES asked for examples of CAC clients who aren't
coming from OCS.
COMMISSIONER KOVOL replied if a child's situation does not
involve the family, the case is referred to law enforcement, as
OCS's authority only covers familial cases.
4:31:50 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Health and Social Services
Standing Committee meeting at 4:31 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SHSS CRP Presentation 4.10.25.pdf |
SHSS 4/10/2025 3:30:00 PM |
Citizen's Review Panel Demonstration 4.10.25 |
| 2024-2025-Alaska-CRP-Citizen-Review-Panel-Work-Plan.pdf |
SHSS 4/10/2025 3:30:00 PM |
Citizen's Review Panel Presentation 4.10.25 |
| 2023-2024-Alaska-CRP-Annual-Report.pdf |
SHSS 4/10/2025 3:30:00 PM |
Citizen's Review Panel Presentation 4.10.25 |
| SJR 16 Sponsor Statement.pdf |
SHSS 4/10/2025 3:30:00 PM |
SJR 16 |
| SJR16 Support Letter - Dr. Johnson.pdf |
SHSS 4/10/2025 3:30:00 PM |
SJR 16 |
| SJR 16 Version A 4.2.25.pdf |
SHSS 4/10/2025 3:30:00 PM |
SJR 16 |
| OCS-CRP Response 4.10.25.pdf |
SHSS 4/10/2025 3:30:00 PM |