Legislature(1999 - 2000)
04/14/2000 09:04 AM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 413 - INTENSIVE FAMILY PRESERVATION SERVICES Number 0088 COLLENE BRADY-DRAGOMIR, Director, Mental Health Services, The Arc of Anchorage, testified via teleconference from Anchorage. She has worked with families and children for the past 15 years; the last eight years have been focused on children with extreme needs such as mental illness and severe emotional disturbance in the Anchorage area. The increase of children being placed in out-of-home placement the past five years has alarmed her. Unfortunately, many of those children are in out-of-state residential treatment facilities. Many might argue that this increase is due to the growing severity [of the problems] of these children, which many people believe require an institutional setting. MS. BRADY-DRAGOMIR urged the committee to think differently than that perception. Although this population exhibits many needs, a good portion of out-of-state placements, and out-of-school placements, could be prevented if families had resources available to them prior to the decision of removing the child from the environment. She believes that HB 413 begins to fill that void and provides an opportunity to address a missing piece in the child delivery system. Intensive intervention promotes family self-sufficiency and minimizes dependency on outside intervention by emphasizing family strengths, increasing parenting life skills, increasing family communication and structure, and enhancing stress and anger management techniques as well as developing linkages to community resources. MS. BRADY-DRAGOMIR explained that at the Arc of Anchorage there is an intensive home-based prevention program targeted at working with parents that experience a disability. Since the inception of this program, the support of the parenting project has demonstrated its effectiveness in providing prevention services as shown through measurable and successful outcomes. It is very similar to the Homebuilders program in Washington state. It is truly an effective program; intensive intervention works. It is not only fiscally smart, but it is the right thing to do for Alaska's children and families. She encouraged the committee to support HB 413 which will begin to improve the quality of life for Alaska's children and families and will assist in preventing long-term out-of-home placement. Number 0324 VIAN NATIONS, Director, Family Services Division, Cook Inlet Tribal Council, testified via teleconference from Anchorage. She expressed strong support for HB 413. The Family Services Division currently has three programs that are similar to HB 413. The Cook Inlet Tribal Council has a federally funded family preservation program, a healthy home program for child abuse prevention and a healthy families of Alaska program. She likes the fact that HB 413 provides services in the family's home. Those services can certainly be culturally sensitive which help families be more open. Providing intensive home-based services helps establish a trusting relationship with families; many families do not get the needed help because they lack trust. Building a relationship is one of the first steps toward getting the needed help. Home visitors are able to engage the family in services. MS. NATIONS noted several years ago a study was done with the Healthy Families of Alaska program known as New Beginnings, and she has sent copies of that study to members of the Children's Caucus. The intervention group in the study received intensive home-based service visits weekly or more; the other group received quarterly visits. The results showed there was increased social support in the families so the families learned to access other services and increase their own support system through the program. There were fewer out-of-home placements in the intervention group so having a home visitor in the home allowed children to stay in the home. There were no emergency visits indicating harm to any of the children in the intervention group whereas there was in the control group. There was less violence and aggression in the home where there was a home visitor on a weekly basis. MS. NATIONS indicated there were standardized tools used to measure these things. There was decreased family stress, and family stress is an issue that can lead to child abuse and neglect. Families learned to reach out and access services through family preservation services. Recently an in-take worker in the Anchorage Division of Family and Youth Services (DFYS) told her there were several families where children were being kept in the home and not being taken into state custody because they were working with Cook Inlet Tribal Council Family Preservation Program which provides home visits in the home, case management, access to counseling and so on. MS. NATIONS reported in a previous study, several families that would have had their infants removed at birth were given the choice of having their children removed or accessing intensive home-based services. These services help families in a time of crisis. Through the services offered by Cook Inlet Tribal Corporation (CITC), there has been success; the services work, but there are not enough people to do the intensive work that needs to be done. Currently 140 families are being served by CITC, and that could be doubled or tripled based on the need in Anchorage. She urged the committee to support HB 413. Number 0675 REPRESENTATIVE GREEN referred to the federally funded program that Ms. Nations mentioned and asked how the state program would interact with the federal program. MS. NATIONS answered the family preservation money they and some other tribes in the state get are not as definitive; it talks about helping families in their own homes, family reunification, helping find permanent places and so on. The CITC has developed its own program that meets the standard of being intensive. Based on the family's needs, an intensive home-based service program has been developed. The bill is fairly structured with guidelines which she likes better, but she believes that the programs could certainly dovetail and use the money together to reach the same outcomes. Number 0784 BLAIR McCUNE, Deputy Director, Central Office, Public Defender Agency, Department of Administration, testified via teleconference from Anchorage. He said that HB 413 seems like a logical step as far as the state's child protection and child welfare is concerned. With passage of legislation which became effective in 1998, the foster homes in the Anchorage area, especially the emergency homes, have been very crowded. His office is concerned that the cure is worse than the disease. It makes little sense to take children out of homes where there certainly are problems, but to place children in overcrowded foster homes doesn't make much sense either. MR. MCCUNE commented that his agency has enjoyed working with the Cook Inlet Tribal Council which has been a great addition to child protection and working with families in the Anchorage area. The Anchorage Center for Families has been another program that has helped out a lot in the area. The Healthy Families Program is working and doing the best to try to preserve families. He spoke in favor of intensive home-based services as an alternative to removing children from the home. Number 0923 REPRESENTATIVE COGHILL referred to page 3, Section 4, where there is an effectiveness percentage required. He wondered if the 70 percent of effectiveness is a realistic number. MR. MCCUNE answered from the testimony heard yesterday, it seems realistic from the experience in Michigan and Washington. In order to achieve that success rate, it would seem some pretty careful screening would have to be done about the cases. REPRESENTATIVE BRICE asked Mr. McCUNE about his statement "the cure is worse than the disease." He wondered if that was meant to imply that the Public Defender Agency believes it is better to leave a child in a situation that the courts have found to be dangerous to that child. MR. MCCUNE answered no. There have been times when his agency has objected to probable cause in temporary custody findings in certain cases. In many of the cases, his agency stipulated to probable cause. There are a number of other cases where probable cause is fought. In a certain percentage of those cases, his agency is successful in having children returned to the home even though the Department of Health & Social Services objects to it. There are a small number of cases where the court decided the child should return home. If it goes to a hearing, and the court determines that the child should be removed, his agency would accept the court's ruling. He did not mean to say that removal is always worse, but there are some cases that it is better for a child to remain in the home. REPRESENTATIVE COGHILL asked Mr. McCUNE if he believes this bill would give some degree of comfort to the department so there is not an either/or but some degree of accountability. Number 1232 MR. MCCUNE said he believes that trying, when possible, to give these services would help things. If a child is removed, a lot of that family's ability to stay together and function is taken away. Often people's low-income housing is dependent upon the children living there. There is a long rebuilding process that is difficult. It makes a lot of sense to have things work if possible before the child is taken out of the home. Number 1300 MS. NATIONS said she thought Mr. McCUNE was trying to say that trying to work with children in their home is better than the trauma of removing them and putting them in overcrowded crisis centers. A lot of times if someone is in the home and monitoring the situation and providing intensive care, the parents are able to make the changes in the home without the trauma of the removal of the child. Obviously everyone wants a child removed if he/she is in imminent harm. Many times that is not the case. The child may not be in imminent harm, but there is a lot of dysfunction in the family. Number 1375 TIM SPENGLER, Development Specialist, Division of Family and Youth Services (DFYS), Department of Health & Social Services, came forward to testify in support of HB 413. He noted that HB 413 is in line with the goals of the DFYS of keeping families together. If this passes, HB 413 would be a great tool for the families. It wouldn't be a panacea, and it wouldn't eliminate removal of a huge percentage of children from the homes, but it would be a wonderful tool for a significant percentage of children. In the last decade there has been an increase in reports of harm and children in out-of-home placements. REPRESENTATIVE COGHILL asked Mr. Spengler if he felt comfortable with the 70 percent effectiveness number or would it be better to wait for the study. MR. SPENGLER agreed it is a significant number. He would defer this question to the testimony from the states that have done it and apparently have achieved this total. The study will certainly tell if it is an achievable goal. In order to reach that number, the access to services has to be screened. The people have to be in crisis and willing to accept the services. That would increase the chance of a high percentage of success. REPRESENTATIVE COGHILL asked Mr. Spengler if he could foresee any time where the department might become adversarial with a tool such as HB 413. Number 1500 MR. SPENGLER said he cannot see the department being anything but supportive of this. The department would love to have the resources to plug in the intensive up-front services. The resources to do it are not there now. REPRESENTATIVE GREEN asked Mr. Spengler if he saw this as being exclusive to the point of trying to reach more emphasis on the 70 percent success than on the helping of children where it may drop to 60 percent. MR. SPENGLER answered in his mind, 60 percent would be success, but apparently the 70 percent is a legitimate number that has come out of other states that have been able to maintain that. This program would not work with the number of sexual abuse or bad physical abuse cases where the children have to be removed, but with families that are willing to work and acknowledge they are in crisis and don't want the state to come into their lives, then it would be highly successful. REPRESENTATIVE COGHILL asked Mr. Spengler if he has determined what area might be studied to give the best cross section for this type of program. MR. SPENGLER said the fiscal note is for a coordinator position which would do two things: making sure the pilot program is developed very solidly and well and finding federal and private funding streams to expand this beyond the pilot. The site to do the pilot program has not been determined. Number 1650 REPRESENTATIVE CISSNA referred to the 70 percent. She said the public is requiring more and more of government and demands real results. Other states have had better than 70 percent effectiveness rate. The service itself has to be top notch. It really has to be 70 percent at the bottom because it has to be done well. Number 1730 REPRESENTATIVE BRICE made a motion to move HB 413 out of committee with individual recommendations and attached fiscal note. There being no objection, HB 413 moved from the House Health, Education and Social Services Standing Committee.
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