Legislature(1999 - 2000)
02/11/1999 03:32 PM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 31 - MENTAL HEALTH APPROPRIATIONS MS. ANNALEE MCCONNELL, Director of the Office of Management & Budget (OMB), expressed appreciation for the cooperative and productive partnership between the Mental Health Trust Authority (MHTA), OMB, and several of the state agencies. She stated the MHTA recognized the need to look at the most effective expenditure of dollars, and came up with creative ways to address the key issues for the trust beneficiaries while recognizing these are difficult financial times. Number 043 MR. JEFF JESSE, Executive Director, Alaska Mental Health Trust Authority, introduced Caren Robinson, a Board Trustee present at the hearing. He stated he hoped to accomplish three results today: to explain why there is a separate appropriations bill; to provide an understanding of how the MHTA operates and its role in state government; and to inspire each committee member to come up with one issue for HESS to take up and implement in partnership with MHTA. Next week he will detail the FY 00 initiatives for the committee. (Mr. Jesse's briefing followed the format of the report titled "Alaska Mental Health Trust Authority: SB 31 presentation to the Senate HESS Committee, February 11, 1999") MR. JESSE explained the history of the trust, including the territorial mental health program and the original land grant. He discussed the history of litigation; and he explained the Breach of Trust and the Supreme Court Decision. Within the settlement framework, he described the creation of the independent board of trustees, the reconstituted land base, and the cash settlement. Number 232 MR. JESSE described the need to integrate services by putting the trust's four beneficiary groups under one umbrella to be managed as a unit under program budgeting. MR. JESSE delineated the basic trust responsibilities: to manage the land and cash assets, to provide leadership and advocacy for the beneficiaries, and to recommend the separate appropriation bill. Number 269 MR. JESSE discussed the management of the trust's assets, including land management by the Department of Natural Resources land office; cash management by the Permanent Fund; the payout system of a percentage of principle of the Permanent Fund (currently 3.5%); and the principle reserve that belongs to the beneficiaries in perpetuity. A prudent principal reserve, he said, is 400% or four times the annual payout. The net income account available to the trustees in any year comes from two sources: the payout and the income generated from the trust land office. The trust begins each fiscal year with money that is already in the bank, not money that it anticipates earning. MR. JESSE talked about where the fund income goes. Number 377 He explained the trustee philosophy that focuses on results; on changing the culture through training, consistency and accountability; and on a comprehensive, integrated service system. Number 455 He discussed transitioning problems from an institution into the community. He said that getting a person to stop drinking is not enough if he has no job or housing, no health care or transportation; he will start drinking again. Number 492 MR. JESSE brought up Harborview Developmental Center, and the partnership with AHFC; and housing initiatives to break the cycle of homelessness and people moving in and out of institutions. MR. JESSE discussed the criminalization of mental illness in this state. The trust had funded a $600.0 plan for the Department of Corrections and agreed to pay for it in FY 98, two-thirds of it in FY 99, and one-third of it in FY 00, allowing the legislature to bring the program on gradually. MR. JESSE discussed the Healthy Families program, Seniors and dementia growth. Number 590 CHAIRMAN MILLER asked why Mr. Jesse's original budget recommendation of roughly $780.0 for Assisted Living was removed by the Governor, what was the rationale for that, because that ties in directly with dementia and Alzheimers. CHAIRMAN MILLER stated he's curious...(his following remarks were lost while the tape automatically reversed to Side B) TAPE 99-04,SIDE B Number 578 CHAIRMAN MILLER repeated that he was curious about the Administration's rationale of taking that out of the (budget). MR. JESSE responded that he wouldn't speak for the Administration. CHAIRMAN MILLER asked Mr. Jesse what rationale the Administration gave him. MR. JESSE replied, "basically lack of ability in the state budget to fund the match; it was a matching program, it was part of our money matching part of their money, and they didn't feel they could come up with their part of the match." CHAIRMAN MILLER responded by asking Mr. Jesse "if the Legislature decided we could come up with our part of the match...I'm just thinking of the mechanics to reach back and pick up your part of the match." MR. JESSE replied, "there's no mechanics; if it's in the bill when it's passed by the Legislature and signed by the Governor, our match will be there." SENATOR WILKEN asked where it's located. CHAIRMAN MILLER responded it's on the spreadsheet, and he pointed out the line to Senator Wilken. MR. JESSE brought up API, which he will discuss further next week. The facility needs replacement. The trust is purchasing a smaller facility and creating an emergency psychiatric system for Anchorage and South central Alaska. The community-based system of care includes designated evaluation and treatment beds, crisis respite, and detox services. A designated evaluation and treatment bill will come through the HESS committee this year. Number 562 SENATOR ELTON questioned why the Governor did not recommend the $2.0 million that MHTA put in for the API-related community services. MR. JESSE replied the state's plan to replace API has never included demolition. The hospital sits on trust land, and once it is no longer used, it will become a toxic waste storage facility for asbestos. Senator Stevens could not get funding for the demolition, but he secured $5 million in SAMSA (Substance Abuse and Mental Health Services Administration) funds in the current fiscal year and $4 million in HUD funds, and the promise of similar funding in the next federal fiscal year. The trust planned to use the $2.0 million originally shown as operating dollars, to "jump-start" community services when people came out of API. Obtaining the SAMSA funding changed their strategy; SAMSA will be used for those operating expenses, allowing the trust money to be changed to capital to be used directly for construction, demolition or purchase. SENATOR ELTON asked if MR. JESSE agrees with the change and he replied, yes. Number 520 MR. JESSE discussed Mental Health Quality Assurance and Medicaid expenses escalating at non-sustainable levels. Multiple reviews will change to one set of surveys. The trustees feel the wisest use of funds is strategic improvements in the system. Shared funding between the trust and agencies assures objectivity and accurate information. Number 460 He discussed economic security, and strategies in helping beneficiaries get a job, employment initiatives that continue people's health coverage, and the better use of existing resources, including coordinating transportation. Number 416 MR. JESSE discussed FY 00 budget recommendations. About $200.0 a year in trust funds do not go through a legislative appropriation, and are given out in small projects or grants under $10.0 to consumer-driven activities. Next week he will cover the issues of parity, API, designated evaluation and treatment, recommendations on guardianship, Assisted Living, legislation stemming from the Long -Term Care Task Force, and mental health needs of the elderly. Number 385 SENATOR KELLY asked about results-based accounting, and if the trust requires that type of information whenever it gives out a grant. MR. JESSE replied yes, and agencies are required to deliver status reports during the year. He said the requirement is a little contentious and needs improvement. SENATOR KELLY stated he hopes the trust can develop those measures and hold people more accountable, leading to more results-oriented projects. SENATOR WILKEN thanked Mr. Jesse for the briefing, and asked him to consider adding a line item on long-term care in next year's budget. SENATOR ELTON requested a follow-up on Department of Corrections issues such as FAS, at some future time. MR. JESSE responded that those issues will be presented to the committee next week. Number 336 CHAIRMAN MILLER clarified that the follow-up will take place next Wednesday, February 17 at 1:30 p.m. He asked Mr. Jesse how many acres were sold of the million acres that were reconstituted. MR. JESSE responded it was relatively small, mostly scattered subdivision lots, totaling between 200 and one thousand acres. CHAIRMAN MILLER asked the wish of the committee regarding SB 31. SENATOR KELLY moved SB 31 from committee with individual recommendations. Without objection, it was so ordered. The committee adjourned at 4:45 p.m.
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