Legislature(1997 - 1998)
04/23/1998 03:45 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
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+ teleconferenced
= bill was previously heard/scheduled
HB 434 - DRUG TESTING OF WELFARE RECIPIENTS Number 0005 CHAIRMAN BUNDE announced the first item on the agenda was HB 434, "An Act requiring drug testing for applicants for and recipients of assistance under the Alaska temporary assistance program; and providing for an effective date" sponsored by Representative Norm Rokeberg. He asked Randy Lorenz, staff intern to Representative Rokeberg to come before the committee to present HB 434. Number 0010 RANDY LORENZ, Staff Intern to Representative Norm Rokeberg, Alaska State Legislature, directed the committee's attention to the proposed committee substitute. REPRESENTATIVE TOM BRICE made a motion to adopt proposed committee substitute, 0-LS0495\K, Lauterbach, 3/30/98, as the working draft. There being no objection, that version was before the committee. Number 0095 MR. LORENZ said the proposed committee substitute brings HB 434 into alignment with the Division of Public Assistance which has already started working in the area of dealing with substance abuse in welfare recipients by doing an assessment of each person that comes in, and individuals showing a possibility of being substance abusers are required further evaluation at a treatment center. It makes it a part of the family self-sufficiency plan which is already in place. Basically, this legislation places the division's policy in statute. Number 0160 REPRESENTATIVE JOE GREEN asked if a recipient has any recourse to testing positive. MR. LORENZ responded the committee substitute does not require drug testing on any recipient; it is only an assessment which is primarily a questionnaire that's completed at the time of application for public assistance. He said there are a number of available screenings that are nonintrusive to the individual and give an indication whether a person could have a substance abuse problem or not at that time. Then as part of the family plan, the person is requested to get a more in-depth screening at a drug treatment center. The committee substitute does not require a urine analysis; it's only a questionnaire-type assessment. REPRESENTATIVE GREEN inquired about the other sanctions if the family fails to comply with the family plan being in existing statute. MR. LORENZ confirmed it is in statute; the only thing that's been added is that benefits may be eliminated, which is at the discretion of the Division of Public Assistance. REPRESENTATIVE GREEN expressed concern about the discretionary authority to withhold benefits. MR. LORENZ said it's not a problem. Basically, it's up to the drug treatment center to decide if the person does have a problem and what the treatment should be. Number 0320 REPRESENTATIVE FRED DYSON said based on a comparison of the original bill and the committee substitute, he suspected the sponsor started out to do something simple and ended up getting a lot of argument that just doing testing on all the perspective recipients was problematic and couldn't be done. MR. LORENZ said, "No sir, that wasn't the case. Representative Rokeberg had originally written the first bill and I looked at it and I made some suggestions because I've already gone through the training for drug certification - I only lack actually applying through the state to be a certified drug counselor myself - and national statistics have shown that if you take the total population across the United States, only 20 percent of those people in the United States have a substance abuse problem. It doesn't mean that it affects their normal life, but of all those people, only about 5 percent of them actually have it to the severity that it prevents - their unable to function in society. We find that's the exact same breakout in those people that are receiving public assistance, so it's a misnomer that everybody on public assistance has a problem; we're only taking about a small majority of those people. So, drug testing - in fact, even in the literature that's - I just handed out an item here - it just came out from the National Conference on State Legislation - this particular item here also comes out with the fact that drug testing doesn't meet what you planned for it. If you test everybody, you're not going to pick up alcohol; there's a lot of drugs you're not going to pick up. But if you do a screening, it will pick up that possibility and then you can go into it deeper and you're only aiming at those people that really have the problem with alcohol or substance abuse and you're looking at it as a barrier to them having self-sufficiency. And we're also looking at it as a disease model rather than a behavioral problem." REPRESENTATIVE DYSON asked if the Administration was sympathetic to this? MR. LORENZ replied that representatives from the Division of Public Assistance were available to testify. REPRESENTATIVE DYSON questioned the lack of a fiscal note. MR. LORENZ said a fiscal note was not available, but it was Representative Rokeberg's understanding this was already being implemented as part of the division's normal operation, so it should be included in the appropriation for division operations. Number 0500 CHAIRMAN BUNDE announced he would take public testimony at this time. He asked Valerie Therrien to come before the committee. Number 0555 VALERIE THERRIEN, Legislative Chair, Advisory Board on Alcohol and Drug Abuse, testified in support of the proposed committee substitute for HB 434. She said the Advisory Board on Alcohol and Drug Abuse opposed the original bill which required testing for all recipients. The board does however, believe that screening is very important and supports the committee substitute because the screening would be done by the department and the participant is then referred for further evaluation by a professional. Number 0615 REPRESENTATIVE GREEN asked if there was any conflict with either state or federal law regarding the right to refuse a screening test. MS. THERRIEN said, "I don't think that this bill requires a screening test; it just requires screening to a rehabilitation program where you can get a professional to talk to them - whether or not, as a result of that recommendation, they go into a program and then they have to have maybe some UAs (urine analysis) or some drug tests as a result of that plan, is beyond what this bill deals with and I'm not really prepared to address that. We were not in favor of random UAs for everybody that applied for this assistance. Plus, I think it would be very discriminatory, myself." Number 0672 REPRESENTATIVE J. ALLEN KEMPLEN asked Ms. Therrien to explain how the department would screen a person, particularly if a person looks like an alcoholic or a drug dealer. MS. THERRIEN said as an alcoholic and member of Alcoholics Anonymous, she didn't think she looked like an alcoholic. She felt it was important to dispel those myths and for people to admit they've successfully overcome the problem. She explained the workers conduct what is known as a "cage screening" during the course of the interview in which there are four buried questions: Do you ever feel guilty about your drinking; have you ever had to have a drink in the morning to get you through the morning; has anyone expressed concern; and anxiety, attention, et cetera. An individual determined to have answered yes to any two of those questions or to another subtle screening program used by the worker will be sent on to a professional for an evaluation. CHAIRMAN BUNDE asked if he was correct in assuming that everyone will answer these questions. MS. THERRIEN surmised the division would ensure these questions were asked of everyone to avoid prejudice toward any one person. CHAIRMAN BUNDE thanked Ms. Therrien for her comments and called Mr. Kreher forward to present his testimony at this time. Number 0835 RON KREHER, Special Assistant, Division of Public Assistance, Department of Health and Social Services, testified in support of the proposed committee substitute for HB 434. He directed the committee's attention to a draft service delivery model the division hopes to soon be piloting in the Mat-Su area. In response to an earlier question, he said there will be universal screening but the division hasn't yet determined which screening tool will be used. While the division in essence has the regulatory authority to do screenings and assign people to assessments, this legislation gives the statutory authority which the division may need when individuals request a fair hearing or appeal an adverse action resulting from assignment to assessment or screening. Number 0895 REPRESENTATIVE KEMPLEN asked Mr. Kreher to explain how the division plans to implement it. MR. KREHER said the division plans to do universal screening with all clients using a screening tool yet to be defined, and the staff who will receive training, will be able to identify whether or not an individual may have a substance abuse issue that may impede their ability to be self-sufficient. At that point in time, the individual's family self-sufficiency plan would be developed requiring participation in an in-depth assessment process. The assessment process would then be able to determine if the individual had a significant problem with chemical or alcohol abuse. The treatment program would then be developed and included in the family self-sufficiency plan and the individual would be required to comply with the condition of that plan to avoid sanctions against their program benefits. REPRESENTATIVE KEMPLEN asked if this would be done in writing or orally. MR. KREHER said it depends on what assessment tool is chosen; the cage can be incorporated into an interview, while other assessment tools are written. At this time, he wasn't sure what tool had been selected by the team developing the service model. Number 1005 REPRESENTATIVE KEMPLEN said it is his understanding that a number of public assistance recipients have difficulty with the English language and he wondered what impact that would have on the department's ability to adequately screen. MR. KREHER said he is hopeful those sorts of problems will be identified in the pilot project so methods for addressing them can be developed. In addition, there will be issues regarding the cultural appropriateness of some of these tools in particular areas, so the division will need to be fairly inventive once the assessment from the pilot project is received. REPRESENTATIVE GREEN said, "I'm wondering if there isn't an affidavit - if there isn't some sort of a 'you sign this at the risk of perjury' or something. How would you, for example, the prior testifier with that angelic face that she had, said that she was a member of AA and was apparently an alcohol abuser - you ask her or anyone - 'Now you realize that if you answer these questions two of four yes, we're likely to cut off your support' - the chances are quite good that you're going to cause someone that you ask - even if they're users, to not give you the right answers. How will this law without any kind of teeth in it, gain us anything?" MR. KREHER said first, individuals will not be penalized through the screening process unless they fail to comply with conditions once they're in the family self-sufficiency plan which is the step after the initial screening. He stated all clients realize that as a condition of eligibility, they must comply with the family self- sufficiency plan. It's up-front, it's in writing, it's on their application and it's also specified as a condition of the family self-sufficiency plan. He noted that many of the screening tests are subtle tests and the responses interpreted by trained staff, are such that capture potential false or manipulated answers. He frankly didn't suspect that would be an issue. Most of the individuals in treatment now have self-identified and are very interested in becoming self-sufficient. There are still some people feeling challenged by that issue, but people are realizing that welfare reform is a very real event in their lives and are making very honest efforts to move toward self-reliance. Number 1192 REPRESENTATIVE GREEN remarked he has read statistics that an alcohol abuser will deny having a problem and would most likely answer no to the four questions even if they had a significant problem. He asked if this type of a voluntary indictment-type program has worked in any other state. MR. KREHER replied other states that have operated these programs and have been operating them for some time, have had mixed success; however, many of them have had some very positive successes. He directed the committee's attention to the information in committee packets regarding the high success rates other states have been having with screenings, assessment and treatment. He noted one of the requirements of Alaska's program involves up-front work search. Whether or not an individual is less than honest when completing an assessment form, oftentimes their success in the job market is an indicator of a substance abuse issue. If an individual passes the screen, but still has an issue in that substance abuse or chemical dependency is impairing their ability to achieve self-sufficiency, get off of assistance, find a job and keep a job, that person will be required to go through a more in-depth assessment. Number 1296 REPRESENTATIVE GREEN said, "And I can understand what you're saying, if I were one of these individuals and I had -- like stopping smoking -- before I could stop smoking I had to want to stop smoking and until that time, I talked about it - I even tried a couple of times, but I really didn't want to bad enough to quit. So, I'm wondering how many of the people will take the screening test and those who really truly, truly want to quit, will answer reasonably, but those who don't think they have a problem and continue to want to have some welfare help, will not be answered honestly. And if the statistics are on those who answer, and that recovery rate is pretty good, you've already screened I guess -- you've screened five or ten percent of the people who really want to get off this and their success ratio is 50 percent -- that's pretty high. But it's only 50 percent of the people that said yes, and that may only be 10 percent, so you've got a 5 percent cure rate and that's pretty bad. So, I'm wondering what these statistics are and .... it just seems to me that without some sort of penalty or teeth you're not going to get the purpose who doesn't already want to comply and already want to shake the habit." MR. KREHER said while there may be some problems with getting all the people with a substance abuse problem into the treatment program, once those individuals have established treatment as part of the family self-sufficiency plan, the division has plenty of teeth to penalize that individual for noncompliance with those requirements. Noncompliance will be defined by the treatment program, not by the case manager and any individual refusing to comply with the assigned treatment or assessment will be subject to a penalty severe enough to make most people give it a second look. Number 1415 REPRESENTATIVE BRIAN PORTER asked if Mr. Kreher was familiar with the unresolved Fourth Amendment legal issues around search and seizure. MR. KREHER responded no, but it's his understanding the issue has to do with invasion of privacy. REPRESENTATIVE PORTER said, "In terms of search and seizure for a drug test, you're not demanding to search, you're saying 'you should waive your concern about searching and if you don't then we will not provide this benefit to you,' so I don't think that's a substantial issue." MR. KREHER said it would only be a substantial issue if the division was pursuing drug testing as an eligibility criteria, I believe. The only time that drug testing might be a requirement is if it's a requirement of a treatment program. Number 1480 REPRESENTATIVE PORTER asked if there was an intermediate assessment between the screening and treatment. MR. KREHER explained that once an individual is screened and there is a determination that this is a person with a high likelihood of having a substance abuse issue, the person will go then to a professional for assessment to determine the proper course of treatment. CHAIRMAN BUNDE noted there were individuals waiting to testify via teleconference. He asked Patricia Arnold to present her comments at this time. Number 1552 PATRICIA ARNOLD, Social Worker, testified via teleconference from Homer stating her belief that a urinalysis as a part of any application process short of a DWAI is discriminatory. She is more open to a questionnaire which takes into account the fact that humans apply for welfare assistance because of both medical and employment problems which are often outside of their control. Therefore, it remains important to respect both that self esteem and the feelings of self-worth the applicant carries upon his/her request for temporary financial assistance. Number 1575 REPRESENTATIVE KEMPLEN referred to the penalties that were previously mentioned by Mr. Kreher for individuals not fulfilling their self-sufficiency plan and asked what type of penalty Mr. Kreher was talking about - denial of benefits, violation of a misdemeanor or felony? MR. KREHER replied it's a reduction in benefits. Basically, the person who is noncompliant, loses their temporary assistance benefit and the associated Medicaid benefits. He estimated it was a $300-$400 reduction in benefits for the household. CHAIRMAN BUNDE asked Martha Hodson to testify at this time. Number 1666 MARTHA HODSON, Representative, Guardian for Family Rights, testified via teleconference from Kenai. She foresees a lot of problems with the bill in that it's real hard to even get judges to order a urine analysis or a blood test for drugs and alcohol. She said in terms of noncompliance and reducing benefits, it's the children who will suffer. Not all parents who drink or do drugs are necessarily neglecting their children. She is of the opinion there are still too many issues that need to be ironed out and it could be challengeable in a courtroom. CHAIRMAN BUNDE thanked Ms. Hodson for her comments and announced that HB 434 would be held in committee for further consideration.
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