Legislature(2003 - 2004)

02/24/2004 03:06 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
HB 197-INTENSIVE FAMILY PRESERVATION SERVICES                                                                                 
Number 2324                                                                                                                     
CHAIR WILSON announced that the  final order of business would be                                                               
HOUSE  BILL  NO.  197,  "An  Act  relating  to  intensive  family                                                               
preservation   services   and  intensive   family   reunification                                                               
services; and providing for an effective date."                                                                                 
REPRESENTATIVE   SHARON   CISSNA,   Alaska   State   Legislature,                                                               
testified before the committee as sponsor of HB 197.                                                                            
TAPE 04-14, SIDE B                                                                                                            
Number 2394                                                                                                                     
CHAIR WILSON said  that an individual is on-line  that must leave                                                               
at 4  p.m. and would like  to give that person  an opportunity to                                                               
Number 2323                                                                                                                     
REPRESENTATIVE  CISSNA told  the  members  that this  legislation                                                               
introduces  a model  which is  described in  the language  of the                                                               
bill.  Section  9 [page 9, lines 23 through  25] inserts language                                                               
that reads:                                                                                                                     
     The  department  or  agency  shall  also  consider  the                                                                
     eligibility  of  the  child and  family  for  intensive                                                                
     family  preservation   services  or   intensive  family                                                                
     reunification services, or both, under AS 47.10.550.                                                                   
REPRESENTATIVE  CISSNA  explained  that   Section  10  lists  the                                                               
requirements  and  steps that  workers  will  use in  identifying                                                               
clients, collecting  data, and accessing  the tools  necessary to                                                               
submit  a report  to  the governor  by November  30,  2004.   The                                                               
report    will    describe    the   study,    conclusions,    and                                                               
recommendations.    Representative  Cissna  summarized  that  the                                                               
study  will  determine  if  intensive  family  preservation  [and                                                               
reunification]  services  are  needed  and if  needed,  look  for                                                               
funding to implement it.                                                                                                        
REPRESENTATIVE CISSNA  commented that  Dr. Shelley Leavitt  is at                                                               
the meeting  today to  share what  other states  have done.   She                                                               
noted that there  are some identifiable sources of  funding for a                                                               
pilot model to make sure this plan will work for Alaska.                                                                        
REPRESENTATIVE CISSNA  shared her personal experiences.   In 1963                                                               
she  worked  in  the  social  services field  with  some  of  the                                                               
population  that is  being discussed  today.   She said  that "up                                                               
stream"  is where  the work  needs  to be  done.   Representative                                                               
Cissna  emphasized that  she believes  prevention  should be  the                                                               
first priority.   Having  been a  foster parent  of more  than 14                                                               
kids in the  late 1980s, she said she found  that the Division of                                                               
Youth  and Family  Services had  more than  1,000 kids  in foster                                                               
care at  that time.   In  a decade that  number has  doubled, she                                                               
stated.  During that next decade  she shared that she worked as a                                                               
therapist in a  program that worked with that  same population of                                                               
kids.   This is a  toxic problem  that has a  huge cost.   One of                                                               
those costs is  not just financial; there are faces  that go with                                                               
this  program, and  that is  why she  said she  has such  intense                                                               
feelings  about it.   Representative  Cissna explained  that this                                                               
program steps in  at the juncture of where the  child is about to                                                               
be removed from  the family.  It  is not the big  fix, she added,                                                               
it is a  little fix that is relatively inexpensive  if looking at                                                               
the  big  picture.   These  services  have  been  extraordinarily                                                               
successful in the places that it has been implemented.                                                                          
Number 2146                                                                                                                     
MARCI SCHMIDT, volunteer, Family  First Partnership, testified in                                                               
support of  HB 197.  She  told the members that  she believes the                                                               
pendulum has moved  to the point that [children  are removed from                                                               
the  home] and  nothing is  done to  get families  back together.                                                               
Ms. Schmidt said that she  knows of some instances where families                                                               
could have been put back together if services had been provided.                                                                
Number 2090                                                                                                                     
SHELLEY LEAVITT,  Ph.D., Associate Director, Institute  of Family                                                               
Development; Board Member,  National Family Preservation Network,                                                               
testified in  support of HB  197 and answered questions  from the                                                               
members.    She told  the  members  that  the bill  provides  for                                                               
intensive    family   preservation    services   and    intensive                                                               
reunification  services,  which  are  short-term  in-home  crisis                                                               
intervention;  skill-building  services,  which are  designed  to                                                               
keep children safe, strengthen  families, keep families together,                                                               
and  reduce  the  reliance  and  over-reliance  on  out  of  home                                                               
placement.   Intensive  family reunification  services have  been                                                               
widely used  and replicated  in 20  to 30  states and  nine other                                                               
countries for  close to 30 years,  she stated.  There  has been a                                                               
great  deal of  research done  on  the services  in tracking  the                                                               
effectiveness   of  keeping   children  safe,   improving  family                                                               
functioning  so that  children can  thrive and  survive, and  for                                                               
potential cost savings for states.                                                                                              
DR.  LEAVITT  told  the  members   that  many  states,  including                                                               
Washington,  have chosen  to  spend money  to  offer services  to                                                               
prevent [out of home] placement  so families can be strengthened,                                                               
instead of spending it on  child welfare, mental health, juvenile                                                               
justice,  and  out  of  home  placement.    Strong  families  are                                                               
critical to  the healthy development  of children  and teenagers,                                                               
she said.                                                                                                                       
Number 2011                                                                                                                     
DR. LEAVITT  commented that it  was interesting listening  to the                                                               
discussion  on the  earlier bill  [HB  393] because  many of  the                                                               
issues  that   are  effecting  the  elder   population  are  also                                                               
effecting   families.      Intensive   family   preservation   or                                                               
reunification services  is not  the total fix;  however, it  is a                                                               
critical piece of  a system to keep children  safe and strengthen                                                               
families,  she  said.   These  services  would  enhance  informal                                                               
support  within the  family  including relatives,  neighborhoods,                                                               
faith-based  organizations, and  churches, she  added.   Once the                                                               
intensive  services  are  completed,  it  is  important  to  have                                                               
someone there  to provide support.   It may be an  elderly person                                                               
helping to  watch the children and  in turn receive some  kind of                                                               
reciprocal help, she added.                                                                                                     
DR.  LEAVITT  told the  members  that  the latest  most  dramatic                                                               
research available is  out of the state of Michigan.   This study                                                               
was done on  a controlled group through the  courts, who received                                                               
short-term service of four to eight  weeks.  After one year, over                                                               
90  percent of  the families  remained together  safely.   Before                                                               
being  included  in  this  study  less than  half,  close  to  40                                                               
percent, of  the control  group had  their children  removed from                                                               
their homes and in some cases many times.                                                                                       
DR.  LEAVITT   commented  that  one  impetus   across  states  in                                                               
implementing this  program is the  cost savings.  In  state after                                                               
state,  when  collecting  data  it  is found  that  out  of  home                                                               
placement  costs  much more  than  preserving  the family.    She                                                               
emphasized that this does not  mean that every family will remain                                                               
together or that  there is not a need for  out of home placement;                                                               
however, she said  the need can be reduced.   In Washington State                                                               
the cost  of these services  is about $2,700 per  child, compared                                                               
to basic foster care which is  about $12,000, $30,000 or more for                                                               
therapeutic   care,  and   $100,000  or   more  for   residential                                                               
treatment,  Dr. Leavitt  stated.   The state  of North  Carolina,                                                               
which    implemented    intensive   family    preservation    and                                                               
reunification   services   statewide    for   many   years,   has                                                               
demonstrated that for every dollar  that is spent on preservation                                                               
services, the  state saved $2 to  $3 in placement costs.   In the                                                               
state of  Alabama, which has been  under a consent decree  in the                                                               
child welfare  system for nearly  10 years has  also demonstrated                                                               
an enormous cost savings in their state's placement costs.                                                                      
Number 1865                                                                                                                     
CHAIR  WILSON  asked  why  this  isn't  already  being  done  [in                                                               
Alaska].  It appears to be  a "no-brainer."  This kind of program                                                               
seems to be  a common sense [approach to what  needs to be] done.                                                               
She asked if states other than Alaska are not doing this?                                                                       
DR. LEAVITT responded  that these services have  been very common                                                               
in states for at least a  decade.  The pendulum swings, she said.                                                               
There  may be  an interest  in strengthening  families, and  then                                                               
there may be situation which  changes [that trend].  For example,                                                               
there may be a  death [of a child] that is  publicized and is one                                                               
death out of hundreds of  thousands; however, the pendulum swings                                                               
to removing children  [from their families] and  relying on these                                                               
more expensive alternatives, she said.                                                                                          
Number 1817                                                                                                                     
REPRESENTATIVE COGHILL pointed out  that the wrong effective date                                                               
is  in this  bill and  suggested it  be changed  before the  bill                                                               
leaves committee.   One struggle  that he  has with this  bill is                                                               
that a  program is created  that treats some people  more special                                                               
than  others.   That  is hard  to  deal  with, he  said.   It  is                                                               
difficult to  provide special treatment  to some people,  but not                                                               
to others.  He said he  believes this service will end up costing                                                               
the  state  more.   Representative  Coghill  said that  he  would                                                               
prefer to have a  policy set forth that says the  family is to be                                                               
preserved,  [and intervention  should  take place]  at the  point                                                               
where [a problem] is discovered.                                                                                                
DR. LEAVITT told the members  that federal law under the Adoption                                                               
and Safe Families  Act of 1997 and an earlier  law has emphasized                                                               
preservation and reasonable  efforts for families.   The act also                                                               
emphasizes  permanency  for children  because  it  is known  that                                                               
permanent  and stable  homes  are related  to  good outcomes  for                                                               
kids.    The federal  law  also  pushes  states to  have  shorter                                                               
timeframes  for making  decisions about  children and  reunifying                                                               
families.   Dr. Leavitt  summarized that the  focus and  heart of                                                               
the  federal  law  is  in   trying  to  strengthen  and  preserve                                                               
Number 1714                                                                                                                     
REPRESENTATIVE COGHILL  responded that is  where his heart  is in                                                               
this  issue as  well.   He said  he agrees  with the  concept and                                                               
would push  for laws that  would protect  the family at  a higher                                                               
level, because the children are  being protected.  Representative                                                               
Coghill said  the struggle he  has is how  to mandate it.   Every                                                               
social  worker  has  a  different  set of  eyes,  he  said.    He                                                               
questioned whether  these services  would provide  social workers                                                               
with enough tools to [preserve the family].                                                                                     
Number 1668                                                                                                                     
DR. LEAVITT said one service is not  a quick fix or the only fix,                                                               
and  when changing  child welfare  practice in  the field,  there                                                               
needs to be  a much more involved process.   She told the members                                                               
that  what underpins  the family  preservation  movement are  the                                                               
values and perspective  that puts safety as  the highest priority                                                               
and focuses  on empowering  the family to  ensure safety  [of the                                                               
REPRESENTATIVE CISSNA  acknowledged that  there are parts  of the                                                               
continuum of services that are  needed in prevention, which would                                                               
prevent the family  from requiring services to begin  with or the                                                               
first time  a family  needs services.   These  services, however,                                                               
are only  used when the courts  are ready to remove  the children                                                               
from the  home, she said.   This is the  last effort to  keep the                                                               
children with the family, Representative Cissna emphasized.                                                                     
REPRESENTATIVE  COGHILL said  he understands  what Representative                                                               
Cissna is saying.   He pointed out that with  this bill the state                                                               
is creating a hurdle  for that group only.  He  stated that he is                                                               
not sure that this is the way to address [the problem].                                                                         
DR.  LEAVITT commented  that  many states  have  tried to  revamp                                                               
their  child  welfare  system  by  putting a  lid  on  this  huge                                                               
bleeding of  money into the  foster care  system.  She  said most                                                               
kids  that  go   into  foster  care,  eventually   go  home  with                                                               
attachment  problems  and  many  other  problems.    As  a  great                                                               
example,  she  said,  the  state  of  Alabama  started  with  the                                                               
intensive  family  preservation  services  to  prevent  placement                                                               
[outside  of the  home] and  have moved  those same  services and                                                               
philosophy much  earlier onto family  support.  Dr.  Leavitt said                                                               
that  her goal  has always  been to  work herself  out of  a job.                                                               
There needs to  be a stop in the flow  of children [being removed                                                               
from their home].                                                                                                               
CHAIR  WILSON  suggested  that   Representative  Cissna  get  the                                                               
effective  date changed  and the  bill can  come back  before the                                                               
committee at another time.  She  said she would like to hear from                                                               
the department on this bill.                                                                                                    
Number 1419                                                                                                                     
MARCIE   KENNAI,  Deputy   Commissioner,  Office   of  Children's                                                               
Services, Department of Health and  Social Services, testified on                                                               
HB 197  and answered questions  from the  members.  She  told the                                                               
members that the department is  taking a neutral position on this                                                               
bill because it  believes that the division is  already moving in                                                               
this direction.   She said that  while this is a  good [idea], it                                                               
does not  need to be  legislated.  There  are an array  of family                                                               
preservation  services available  to clients.   Intensive  family                                                               
services  is not  available yet,  but there  is movement  in that                                                               
direction, she  added.   Ms. Kennai reminded  the members  of the                                                               
discussions  before  the committee  last  week  and told  of  the                                                               
Family-to-Family initiative  that is being brought  to the state.                                                               
She  said she  believes that  out  of this  initiative the  state                                                               
would eventually get the intensive family services.                                                                             
MS.  KENNAI  told  the  members   that  another  study  would  be                                                               
difficult  for  the  department  to begin.    The  child  welfare                                                               
evaluation project is going on  through the University of Alaska.                                                               
It  is  currently  evaluating  all  of  the  family  preservation                                                               
programs and will  make some recommendations on how  those can be                                                               
refueled.   She  said that  she  is aware  of the  fact that  the                                                               
division  is not  doing all  that it  should be  doing with  that                                                               
source  of money.   Ms.  Kennai  stated that  she's pleased  this                                                               
legislation  is   being  introduced,   but  explained   that  the                                                               
difficult part of intensive family  preservation services is that                                                               
it requires  a very small  caseload, such  as four to  six cases.                                                               
Even with the  20 new positions that the division  will get [this                                                               
year],  there will  never  be  only four  to  six caseloads  [per                                                               
worker].   It is possible  to look for  contract money to  fund a                                                               
pilot program for  this.  She said this would  work best in urban                                                               
areas.  Ms.  Kennai offered that it would be  feasible to do this                                                               
in  Anchorage late  this  year  or early  next  year through  the                                                               
Family-to-Family initiative.                                                                                                    
MS.  KENNAI  told  the  members  that  the  Teen  Decision-making                                                               
Initiative will begin within the  next two months.  She explained                                                               
that the  division will  need to refer  to a  family preservation                                                               
provider for many of those families.   The families will be asked                                                               
to go  to a model  that is similar, but  one that will  work best                                                               
for Alaska.   She noted  that in most  states workers have  to be                                                               
available 24-hours  per day and  at this point the  division does                                                               
not  have   that  capacity  in  Alaska,   particularly  in  rural                                                               
communities.  This model would have  to be used in an urban site,                                                               
she reiterated.  It  would take a while to adopt  it in the rural                                                               
Number 1243                                                                                                                     
MS. KENNAI  summarized her comments  by saying that  she believes                                                               
in   intensive  family   preservation   services,  time   limited                                                               
reunification  services,  and intensive  reunification  services.                                                               
She assured  the members that the  division is on its  way and is                                                               
reviewing  the contracts  now  [in place]  because  they are  not                                                               
accomplishing what needs to be done.   Having said that, she said                                                               
she sees no reason to legislate this program.                                                                                   
CHAIR WILSON asked about the  contracts she mention [with respect                                                               
to intensive family preservation].                                                                                              
MS.  KENNAI  explained that  the  division  gets money  from  two                                                               
sources.  One  is from the general fund and  the other is federal                                                               
funding from the  Family Support and Preservation Act.   She told                                                               
the members that she has been in  her job just six months and the                                                               
division  is working  toward revamping  all the  contracts.   Ms.                                                               
Kennai said that prevention is  her focus, the division is moving                                                               
in this direction,  but the intensive family  prevention model is                                                               
MS. KENNAI pointed  out that if the members were  to look at what                                                               
has happened  in other  states, it  would be  found to  show that                                                               
there are actually  very few families that will  fit the criteria                                                               
to benefit  from a six  to eight  week model of  intensive family                                                               
preservation  services.   The division  knows that  many families                                                               
have alcohol and  drug addiction problems and six  or eight weeks                                                               
is not  enough [time] for those  families, she said.   Ms. Kennai                                                               
emphasized that  there is  a population that  this works  for and                                                               
would like to see it implemented.                                                                                               
Number 1152                                                                                                                     
MS. KENNAI told  that members that she is also  working with Bill                                                               
Hogan, [Director,  Division of  Behavioral Health,  Department of                                                               
Health and  Social Services].   She said  that she and  Bill feel                                                               
that the Child  and Youth Needs Assessment may be  out within the                                                               
next month.   It identifies  intensive family services as  one of                                                               
the pieces  of the service array.   Ms. Kennai commented  that it                                                               
might be funded through the Medicaid  state plan.  She added that                                                               
this is  a program that  not only works  for children who  are at                                                               
risk  of coming  into custody  because of  abuse or  neglect, but                                                               
also  works  very  well  with children  who  have  mental  health                                                               
issues.   For example, when a  parent calls and says  that he/she                                                               
can  no longer  handle his/her  child.   She summarized  that she                                                               
does not disagree with anything in  the bill, but that she is not                                                               
sure it  needs to be  legislated because the division  is already                                                               
moving in that direction.                                                                                                       
CHAIR  WILSON noted  that Ms.  Kennai  did not  plan on  speaking                                                               
today, and appreciates her willingness to comment on this bill.                                                                 
MS. KENNAI thanked  Representative Cissna for caring  so much for                                                               
[Alaska's families].                                                                                                            
Number 1077                                                                                                                     
REPRESENTATIVE WILSON  asked that a committee  substitute be done                                                               
and brought back  before the committee for action.   The bill was                                                               
held in committee.                                                                                                              

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