Legislature(2009 - 2010)HOUSE FINANCE 519
04/14/2010 08:30 AM House FINANCE
Audio | Topic |
---|---|
Start | |
SB230 | |
SB144 | |
SB269 | |
SB235 | |
HB317 | |
HB69 | |
SB305 | |
HB69 | |
HB421 | |
SB219 | |
Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
+ | SB 230 | TELECONFERENCED | |
+ | SB 144 | TELECONFERENCED | |
+ | SB 219 | TELECONFERENCED | |
+ | SB 235 | TELECONFERENCED | |
+ | SB 269 | TELECONFERENCED | |
+ | SB 305 | TELECONFERENCED | |
+ | HB 69 | TELECONFERENCED | |
+= | HB 317 | TELECONFERENCED | |
+ | TELECONFERENCED | ||
+= | HB 421 | TELECONFERENCED | |
CS FOR SENATE BILL NO. 219(FIN) "An Act establishing a traumatic or acquired brain injury program and registry within the Department of Health and Social Services; and relating to medical assistance coverage for traumatic or acquired brain injury services." 4:20:30 PM SENATOR LESIL MCGUIRE, SPONSOR, spoke to the subject of traumatic brain injury (TBI). She reported that Alaska has the highest incidence of TBI in the nation. There are a variety of causes, including accidents, snow machine crashes, and domestic violence; in addition, many senior citizens have brain injuries as a result of stroke, aneurism, and tumors. She highlighted that the numbers increase as veterans return from service in Iraq. She reminded the committee of a past presentation where soldiers with TBI had testified. She noted that Alaska Natives in particular have been affected by TBI. Senator McGuire informed the committee that SB 219 would establish a new brain injury program within the Department of Health and Social Services (DHSS) as well as a registry for TBI. Alaska has not had such a program in its history. She added that Alaska leads the nation in TBI, especially in the categories of veterans, the elderly, and Alaska Natives. Senator McGuire pointed out that the fiscal note was fairly minimal. She felt the program was sustainable. The goal is to have a place for citizens to go to access resource and information about TBI. The Alaska Brain Injury Network, Inc. (ABIN) was founded by people who were affected by TBI. She hoped the new program in DHSS would allow access to federal Medicaid dollars in the form of matching money. She referred to an earlier plan to create a waiver; she had come up with a solution with less fiscal impact in response to concerns. She noted that the program coordinator would access other Medicaid funds already in existence and harness them for families who cannot afford treatment for TBI; federal funds matched 50/50 with state funds. 4:25:49 PM Senator McGuire hoped that Alaska could become part a larger information and resource network. She hoped that the DHSS coordinator for the program would network with other groups, including the Department of Military and Veterans Affairs (DMVA), the Native corporations, and the survivor network. She concluded that TBI is a permanent, life- altering injury; there is no way to re-generate brain cells. However, with early intervention and treatment, people can live productive lives. Co-Chair Stoltze asked whether the bill was endorsed by veterans. ESTHER CHA, STAFF, SENATOR LESIL MCGUIRE, replied that the sponsor had been in contact with veterans who suffer from TBI; the ATBI has been working with DMVA and hoped to increase cooperation. Vice-Chair Thomas asked whether Fetal Alcohol Spectrum Disorder (FASD) and Alzheimer's disease were covered under the bill. Ms. Cha replied that FASD and Alzheimer's and other degenerative diseases are not covered under the program because they are covered under other Medicaid waiver services. Vice-Chair Thomas queried a letter by the Department of Corrections stating that 42 percent of the population has a diagnosable mental health disorder. Ms. Cha thought the statistic was correct. Vice-Chair Thomas was concerned about co-mingling in the prisons. 4:30:31 PM Co-Chair Stoltze opened public testimony. STEVE WILLIAMS, PROGRAM OFFICER, ALASKA MENTAL HEALTH TRUST AUTHORITY (via teleconference), testified on behalf of Jeff Jesse in support of the legislation. He reported that the Alaska Mental Health Trust Authority (AMHTA) in partnership with DHSS, ABIN, and other community stakeholders and providers have worked for several years towards the improvement of service for Alaskans with traumatic or acquired brain injuries. Unfortunately, a significant number of Alaskans suffer from TBI; DHSS reports that there are 800 cases per year that result in either death or hospitalization. It is estimated that 3,000 Alaskans visit a hospital emergency room each year with a mild TBI and over 10,000 Alaska are estimated to be living with a disability resulting from a TBI. Mr. Williams stated that AMHTA supports SB 219 and sees it as an integral step for Alaska towards the development of an integrated system of care for Alaskans with traumatic or acquired brain injuries, including partnering with tribal organizations, DMVA, and community and non-profit partners who are providing services and support to these individuals. The trust does not think that it is efficient for different entities develop their own systems of care for folks with TBI; SB 219 is an integral step towards pulling the groups together to increase efficiency. Mr. Williams noted that the 42 percent statistic mentioned by Representative Thomas regarding the number of prison inmates with mental health disorders came out of a study done in December 2007. He offered to send the results of the study. 4:34:30 PM JILL HODGES, EXECUTIVE DIRECTOR, ALASKA BRAIN INJURY NETWORK (via teleconference), spoke in support of the bill. She explained that ABIN has traveled to many communities and heard from thousands of Alaskans who have experienced brain injury. She relayed that every brain injury is unique, but the needs and concerns have been consistent across the state. There is not an official home in Alaska state government to address the concerns; there is also no rehabilitation program. Ms. Hodges noted that there are both long-term goals and short-terms components of the legislation. She highlighted the case management aspect of the bill, which she believed to be a good starting point for state government; it utilizes a significant number of federal receipts and provides a service that can be accessible to both rural and urban Alaskans. The services would be put in the hands of community providers. Ms. Hodges continued that the military has brought attention to brain injury and also the development of case management. Studies have shown that the approach reduces emergency room visits and deters more costly care. Most importantly, the approach increases readiness for employment and vocational rehabilitation efforts. The network has consistently heard that people with TBI want to return to work, military personnel want to return to duty, and Alaska Natives want to participate in subsistence activities again. Case management can help build the ability to do these things. Ms. Hodges referred to research showing the amazing abilities and the elasticity of the brain. She informed the committee that ABIN strongly supports SB 219. DR. CHRISTIE ARTUSO, DIRECTOR, NEUROSCIENCE SERVICES, PROVIDENCE ALASKA MEDICAL CENTER, ANCHORAGE (via teleconference), testified in support of SB 219. She told the committee that Alaska has outstanding acute care services but there is a shortage of the services needed. She noted that Alaskan youth, athletes, and military personnel are affected. She relayed the story of a 41-year- old man who suffered TBI who was re-hospitalized 27 times in 18 months; there were no appropriate services for him. Dr. Artuso reported that the Providence Alaska Medical Center neuroscience services department wants to partner with the state, the AMHTA, and ABIN to develop the needed services. She urged the committee to support the legislation. 4:41:30 PM KRISTIN ENGLISH, CHIEF OPERATING OFFICE, COOK INLET TRIBAL COUNCIL (via teleconference), spoke in support of SB 219. She explained that the tribal council provides social services for many in the Anchorage area, but also provide services to primarily Alaska Natives throughout the state. She pointed to a correlation between substance abuse and TBI; 46 percent of clients in the residential and de-tox center have self-reported TBI and 36 percent have reported TBI in outpatient services. She pointed out that the numbers are probably low. Ms. English noted that TBI has been linked to mood, stress, and behavior disorders, which are in turn linked to substance abuse. The tribal council believes the bill will provide support to the substance abuse community. MARTHA MOORE, CHAIR, ALASKA BRAIN INJURY NETWORK, testified in support of the legislation. Co-Chair Stoltze closed public testimony. Representative Fairclough queried the two positions in the fiscal note. ANGELA SALERNO, DIVISION OF SENIOR & DISABILITY SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, replied that the department did not request the positions because they believed existing staff could do the work. Representative Fairclough MOVED to report CSSB 219(FIN) out of Committee with individual recommendations and the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CSSB 219(FIN) was REPORTED out of Committee with a "do pass" recommendation and with attached previously published fiscal notes: FN1 (DHS), FN2 (DHS). 4:47:24 PM RECESSED