Legislature(2017 - 2018)CAPITOL 106
03/29/2018 03:00 PM House HEALTH & SOCIAL SERVICES
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| HB193 | |
| SB174 | |
| SB108 | |
| Confirmation Hearing(s) | |
| HB358 | |
| HJR32 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 174 | TELECONFERENCED | |
| += | SB 108 | TELECONFERENCED | |
| += | HB 358 | TELECONFERENCED | |
| *+ | HJR 32 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 193 | TELECONFERENCED | |
SB 174-PROGRAMS FOR PERSONS WITH DISABILITIES
3:26:18 PM
CHAIR SPOHNHOLZ announced that the next order of business would
be SENATE BILL NO. 174, "An Act relating to the duties of the
Department of Health and Social Services; and relating to the
administration of programs for persons with physical and mental
disabilities."
3:26:44 PM
SENATOR PETER MICCICHE, Alaska State Legislature, paraphrased
from the Sponsor Statement [Included in members' packets], which
read:
When Alaskans with physical and mental disabilities
are able to actively participate in the system of
their care, a higher quality of life is achieved as
well as a sense of independence. SB 174 will provide a
clear pathway to achieve both of these things by
allowing the Department of Health and Social Services
to take a more flexible approach to administering
programs. A positive, person-centered approach should
be embedded within all decisions made at both systems
design and service delivery levels.
So why establish an avenue for participation? All
persons deserve the right to be treated with respect
and dignity. Higher quality of life is achieved by
encouraging individuals with physical and mental
disabilities to participate fully in the social and
economic environment of their homes, communities, and
the State.
Improved stewardship of public monies requires
stakeholder input from a broad cross-section of
Alaskan urban and rural communities to ensure
effectiveness of program redesign efforts. Five
project teams comprised of over 70 people are already
working to make this a reality by focusing on areas of
person-directed culture change, workforce enhancement,
community awareness, legislative engagement, and
measuring success.
SB 174 does not create the right to self-direct care
or supersede laws related to eligibility programs. It
will not have a financial impact on the State. SB 174
does provide a long overdue unifying vision to assure
that the available resources, whether great or small,
are allocated and applied in a manner that maximizes
the contributions to community that Alaskans
experiencing disabilities can make, and the
flexibility of systems to utilize those resources with
responsible stewardship now and in perpetuity.
3:28:34 PM
SENATOR MICCICHE emphasized that Alaskans experiencing
disabilities were not cattle, they were not a number, but that
they were individual, amazing Alaskans who had hopes and dreams
and wanted to accomplish the very most they could in their
lives. He noted that when past services had been delegated
without their participation, they had sometimes felt more like
numbers than amazing individuals. He offered his belief that we
would all want the same input.
3:29:47 PM
KAITLEEN STANSBERRY, Intern, Senator Peter Micciche, Alaska
State Legislature, paraphrased from the Sectional Analysis
[Included in members' packets], which read:
Section 1
AS 47.80.095. Legislative Findings Related to Person
with Disabilities. Adds a new section titled
Legislative Findings Related to Persons with
Disabilities. It presents how Alaskans with physical
and mental disabilities quality of life is enhanced
when allowed to actively participate in their support
services.
Section 2
Adds new language allowing the Department of Health
and Social Services to take a flexible approach in
allowing active participation for those with physical
and mental disabilities.
3:30:47 PM
CHAIR SPOHNHOLZ opened invited testimony on SB 174.
3:31:09 PM
MAGGIE WINSTON, Chair, Governor's Council on Disabilities and
Special Education, shared her background as an individual who
had experienced a disability at 21 years of age which took away
functional use of her arms and her legs. She said that the
services she received allowed her to live in her own home, to be
a mom, to go to her job at a center for independent living, and
to be an advocate for other individuals that experienced
disabilities. She asked for support for the proposed bill as it
would make individuals feel supported with this flexible shared
vision for services and it solidified the spirit of self-
determination, as things can often seem chaotic and out of
control. She declared that this offered her support toward a
meaningful life, something that we all wanted.
3:33:18 PM
REPRESENTATIVE SULLIVAN-LEONARD asked how the proposed bill
would assist her in the Medicaid process.
MS. WINSTON offered her belief that the bill language solidified
something more sustainable for service provision in the future,
so that individuals looking for services in the future would
have a language to empower and enable them to be self-
determining.
REPRESENTATIVE SULLIVAN-LEONARD mused that it would allow better
communication with a health care professional or other support
services for inclusion in the decision-making process.
MS. WINSTON said that it would establish a foundation of self-
directedness, so that she did not need to accept something that
would not work for her. The proposed bill would declare support
for her in her individuality and her needs.
3:35:21 PM
REPRESENTATIVE ZULKOSKY asked whether the proposed bill would
allow statutory support for individuals to opt out of services
they might not need, and have self-directed conversations with
the department for the services they desired.
MS. WINSTON expressed her agreement.
3:36:20 PM
MICHELLE GIRAULT, Board Member, Key Coalition, stated that the
Key Coalition was very supportive of the proposed bill to put
into statute a foundational language that was value driven and
upheld and supported those primary stakeholders across Alaska.
She declared that the proposed bill would enable departments to
work together to provide more synchronous delivery systems.
3:38:29 PM
LIZETTE STIEHR, Executive Director, Alaska Association on
Developmental Disabilities, paraphrased from a letter, dated
March 13, 2018, which read: [Included in members' packets]
AADD, the Alaska Association on Developmental
Disabilities, is the professional association
representing the voice of forty-six organizations in
Alaska that provide home and community-based services
to individuals who experience intellectual and
developmental disabilities. The Association has been
an active and strong supporter of the development of
the Shared Vision. The Vision brings a renewed energy
and excitement to the work the provider community. The
Shared Vision reminds each of us why we have dedicated
our professional life to this field and where we want
the focus of services to be, on the individual being
supported.
We are so appreciative of Senator Micciche's SB174
that embeds the Shared Vision in statue. In statue
this Shared Vision will provide a consistent and
strong platform for individuals to lead their own
services, rather than a bureaucracy. It enriches their
lives and the fabric of the community in which they
participate. Services matching the Shared Vision will
provide for a more independence life and greater
personal confidence for individuals. This will help
stretch limited funds farther with greater
participation in the community involving unpaid
natural supports.
Having the Shared Vision in stature will assure that
the underlying philosophy of dignity, respect and
choice doesn't change with shifts in funding or
political leaders. Thank you again for your time,
attention and efforts on behalf of so many individuals
in Alaska both providing and receiving services and
supports.
3:41:03 PM
CHAIR SPOHNHOLZ opened public testimony on SB 174.
3:41:26 PM
COREY GILMORE, Governor's Council on Disabilities and Special
Education, shared that he was a recipient of services. He
explained that services were provided based on a document of
care for what other people think they may need. These plans of
care were decided in a large conference while "people talk about
you." Right at the end of the meeting, these people would ask
him what he would like to work on. He declared that it was
necessary "to turn that on its head," make these plans of care
about what the individual wants to do, and that the individual
needed to be control of that. He pointed to the difficulties
for his staff as they tried to follow the plan, even though he
stated that he had not agreed to that goal. If he refused to
work on a goal, he would receive less service. He emphasized
that the plan of care should be the individual's plan, and that
"we can all stand to work on" these goals. He pointed out that
he hated to work on goals that were not his own.
3:45:36 PM
REPRESENTATIVE TARR said that she did not know that by not
working on the goals in the plan of care, an individual could
lose those services. She asked if this was based on non-
participation for those services.
MR. GILMORE declared that he was all for participation, that
life required audience participation. He stated that currently
the goals were not participatory, they were meant to be
habilitative, which was often difficult for individuals. He
noted that, as he was 42 years old and had cerebral palsy, his
philosophy was that if he could be habilitated, none of his
staff would need to be here. He expressed support for goals
that he could live with, pointing out that currently he did not
have the ability to say "no, I didn't agree to that goal. We
have to do it because it's in our plan of care. If we don't do
it, we can lose services." He explained that habilitation was a
means to justify the cost.
3:48:19 PM
CHAIR SPOHNHOLZ closed public testimony on SB 174.
3:48:27 PM
REPRESENTATIVE EASTMAN offered Conceptual Amendment 1, as
follows:
Delete "can achieve a meaningful life"
Replace with "can be more active"
REPRESENTATIVE EASTMAN said that would remove the question for
the philosophical components for the meaning of life.
3:49:53 PM
SENATOR MICCICHE offered an example for activity and opined that
he was unsure that this activity would lead to a more active, or
meaningful, life. He declared that this was not about activity,
but was about self-determination for personal treatment, and the
"most value out of life how you see fit." He declared that this
was not about physical activity, but was about accomplishment,
opportunity, and fulfillment.
CHAIR SPOHNHOLZ expressed her agreement.
REPRESENTATIVE EASTMAN moved to adopt Conceptual Amendment 1.
CHAIR SPOHNHOLZ objected for discussion. She pointed out that
the proposed bill had been drafted in collaboration with the
Governor's Council on Disabilities and Special Education.
3:51:25 PM
REPRESENTATIVE TARR directed attention to the top of page 2 of
the proposed bill. She offered her belief that "having a
meaningful life" was language often used per the reasons stated
by Senator Micciche. She declared that recognition, no matter
the physical or intellectual challenges or limitations, for the
opportunity to have a full and meaningful life should be
supported.
3:52:23 PM
REPRESENTATIVE EASTMAN said that he supported the idea of more
and increase and other words; however, the current wording
indicated that, without this program, a person cannot achieve a
meaningful life. He offered his belief that, as the proposed
bill was not intended to give a meaningful life when the person
did not otherwise have a meaningful life, philosophically, it
was more than could be achieved through the program. He
acknowledged that, although there were many good things that
could "come of this program, but giving someone meaningful life,
even if we were just talking about more meaningful life, I think
that would be an entirely different concept." He said that the
proposed bill was currently written in such a way that a person
could not achieve a meaningful life without this program, and
that he did not agree with that.
3:53:20 PM
CHAIR SPOHNHOLZ maintained her objection.
3:53:31 PM
A roll call vote was taken. Representative Eastman voted in
favor of Conceptual Amendment 1. Representatives Spohnholz,
Kito, Tarr, Sullivan-Leonard, and Zulkosky voted against it.
Therefore, Conceptual Amendment 1 failed by a vote of 1 yea - 5
nays.
3:54:23 PM
REPRESENTATIVE TARR expressed her pleasure that this proposed
bill and another bill regarding supportive decision making were
both moving forward, as they seemed long overdue.
CHAIR SPOHNHOLZ declared that the concept of self-determination
was one of the most important concepts that we have, as
individuals, to allow control of our own bodies and our own
destinies. She stated that most of us don't like to be told
what to do, and that we should be able to make the choices for
our own lives that best fit with our values. She added that we
should be able to build our skills in ways that are meaningful
to us, and not necessarily to other people.
3:55:48 PM
REPRESENTATIVE ZULKOSKY moved to report SB 174, Version 30-
LS1258\D, out of committee with individual recommendations and
the accompanying zero fiscal notes. There being no objection,
SB 174 was moved from the House Health and Social Services
Standing Committee.