Legislature(2011 - 2012)BUTROVICH 205

02/21/2011 01:30 PM HEALTH & SOCIAL SERVICES


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01:31:19 PM Start
01:31:49 PM SB27
02:33:17 PM Presentation by Akeela Inc.
03:03:27 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 27 FLAME RETARDANTS AND TOXIC CHEMICALS TELECONFERENCED
Heard & Held
+ Presentation: TELECONFERENCED
AKEELA Organization, Rosale Nadeau, Exec Dir
          SB  27-FLAME RETARDANTS AND TOXIC CHEMICALS                                                                       
                                                                                                                              
1:31:49 PM                                                                                                                    
CHAIR DAVIS  announced the  first order of  business would  be SB
27.                                                                                                                             
                                                                                                                                
SENATOR  BILL  WIELECHOWSKI, sponsor  of  SB  27, said  the  most                                                               
important  role of  government  is to  protect  our children  and                                                               
families. He  said that SB 27  was an opportunity to  do that. It                                                               
would phase  out the  use of flame  retardants (PBDEs)  which are                                                               
known  to cause  numerous  health problems.  These chemicals  are                                                               
found  in  higher  concentrations  here in  Alaska  because  they                                                               
concentrate  in the  soluble fats  of subsistence  animals. Also,                                                               
the problem  is particularly bad  in Alaska because  people spend                                                               
the  winter indoors  in unventilated  spaces.  Most people  don't                                                               
realize  that contact  with mattresses,  children's pajamas,  and                                                               
household dust is exposing them  to PBDEs. This is an opportunity                                                               
to take action  to protect the people of the  state. Other states                                                               
have done this.                                                                                                                 
                                                                                                                                
CHAIR DAVIS noted there is a committee substitute (CS) for the                                                                  
committee to consider.                                                                                                          
                                                                                                                                
1:38:04 PM                                                                                                                    
SENATOR EGAN moved to adopt CSSB 27( ), labeled 27-LS0300\M, as                                                                 
the working document of the committee. Chair Davis objected for                                                                 
discussion purposes.                                                                                                            
                                                                                                                                
KARLA  HART,  staff  to  Senator  Wielechowski,  said  she  would                                                               
introduce  SB   27  by   reading  a   speech  delivered   to  the                                                               
Commonwealth Club  of San  Francisco by  Environmental Protection                                                               
Agency (EPA) Administrator Lisa Jackson in September 2009:                                                                      
                                                                                                                                
     A child born  in America today will grow  up exposed to                                                                    
     more chemicals  than a child from  any other generation                                                                    
     in history. A 2005  study found 287 different chemicals                                                                    
     in  the cord  blood of  ten newborn  babies. They  were                                                                    
     found in  children in their most  vulnerable stage. Our                                                                    
     kids  are   getting  steady  infusions   of  industrial                                                                    
     chemicals before we even give  them solid food. As more                                                                    
     and  more chemicals  are found  in our  bodies and  the                                                                    
     environment, the  public is understandably  anxious and                                                                    
     confused. Many are turning  to government for assurance                                                                    
     that  chemicals  have  been  assessed  using  the  best                                                                    
     available science  and that unacceptable  risks haven't                                                                    
     been ignored. Right now we  are failing to get this job                                                                    
     done.                                                                                                                      
                                                                                                                                
     Our oversight of the 21st  century chemical industry is                                                                    
     based on the 1976 Toxic  Substances Control Act. It was                                                                    
     an important  step forward  at the  time, but  over the                                                                    
     years  it  has  been  proven  an  inadequate  tool  for                                                                    
     providing a protection against  chemical risks that the                                                                    
     public  rightly  expects.   Manufacturers  of  existing                                                                    
     chemicals  aren't  required  to  develop  the  data  on                                                                    
     toxicity and exposure needed  to assess potential risks                                                                    
     and demonstrate  to EPA that chemicals  meet risk-based                                                                    
     safety standards.  On new chemicals, companies  have no                                                                    
     legal obligation  to develop  new information,  only to                                                                    
     supply data  that may already  exist. As  with existing                                                                    
     chemicals,   the  burden   of  proof   falls  on   EPA.                                                                    
     Manufacturers aren't  required to show  that sufficient                                                                    
     data exists to fully assess a chemical's risks.                                                                            
                                                                                                                                
     If  EPA has  adequate  data and  wants  to protect  the                                                                    
     public against  known risks, the law  creates obstacles                                                                    
     to  quick and  effective  action. Since  1976, EPA  has                                                                    
     issued  regulations  to   control  only  five  existing                                                                    
     chemicals determined  to present an  unreasonable risk;                                                                    
     five from  a total  universe of almost  80,000 existing                                                                    
     chemicals. In  1989, after years  of study,  EPA issued                                                                    
     rules   phasing  out   most   uses   of  asbestos,   an                                                                    
     exhaustively  studied  substance   that  has  taken  an                                                                    
     enormous toll on the health  of Americans. Yet, a court                                                                    
     overturned EPA's  rules because it had  failed to clear                                                                    
     the  many  hurdles  for action  under  the  1976  Toxic                                                                    
     Substances Control  Act. Today, advances  in toxicology                                                                    
     and analytical chemistry are  revealing new pathways of                                                                    
     exposure.  There are  subtle and  troubling effects  of                                                                    
     chemicals  on  hormone   systems,  human  reproduction,                                                                    
     intellectual  development  and   cognition.  Every  few                                                                    
     weeks we read about  new potential threats. Many states                                                                    
     have stepped  in to address these  threats because they                                                                    
     see inaction at the national level.                                                                                        
                                                                                                                                
MS. HART then  addressed the changes in the proposed  CS. On page                                                               
2,  line   6,  the  original   version  created  a   loophole  by                                                               
specifically mentioning brominated PBDEs.  This change allows the                                                               
Department  of Environmental  Conservation (DEC)  to look  at any                                                               
fire retardant,  not just  specific ones.  On page  4, line  2, a                                                               
section  was deleted  under the  high  volume challenge  program.                                                               
This was  done to  allow DEC  to use whatever  data EPA  has. The                                                               
change  on  page  5,  lines  13 -  15,  made  the  definition  of                                                               
bioaccumulative more scientifically accurate.                                                                                   
                                                                                                                                
CHAIR DAVIS asked for clarification.                                                                                            
                                                                                                                                
MS.  HART answered  that on  page  5, lines  13-15, the  original                                                               
definition  for bioaccumulative  was not  scientifically correct.                                                               
This new  language explains that bioaccumulative  means an animal                                                               
has a  toxicity greater than  the environment in which  it lives.                                                               
The change  on page 5 lines  16 - 17 addresses  the definition of                                                               
persistence  to acknowledge  that all  toxins transform  or break                                                               
down  in  the environment  over  time,  and that  some  chemicals                                                               
degrade into even more toxic forms.                                                                                             
                                                                                                                                
CHAIR  DAVIS  asked  if  she   would  go  through  the  sectional                                                               
analysis.                                                                                                                       
                                                                                                                                
MS. HART stated  that she would highlight the main  points of the                                                               
sectional  analysis  provided   by  legislative  legal  services.                                                               
Section 1  bans three types of  PBDEs, and provides DEC  with the                                                               
ability  to  ban  other  fire   retardants  if  they  are  deemed                                                               
dangerous  and acceptable  alternatives exist.  It also  provides                                                               
exemptions   to    address   specific   concerns    relating   to                                                               
transportation  and   industrial  concerns.  This   section  also                                                               
provides enforcement by requiring  manufacturers and importers of                                                               
goods  to provide  information showing  that  their products  are                                                               
safe.  It  directs  the  state   to  review  risks  and  possible                                                               
alternatives  to brominated  fire  retardants, and  to develop  a                                                               
list  of  persistent  bioaccumulative  toxins that  are  used  in                                                               
products used by the public.                                                                                                    
                                                                                                                                
1:43:04 PM                                                                                                                    
MS.  HART  explained  this  section  also  allows  the  state  to                                                               
participate  in an  interstate clearinghouse  on  toxins to  pool                                                               
information  and resources.  Sections 2  and 5  allow the  DEC to                                                               
begin adopting  regulations immediately.  Section 3  directs that                                                               
the  first list  of toxins  be established  by February  1, 2014.                                                               
Section  4  is revisor  notes,  and  section  6 adds  an  overall                                                               
effective date of January 1, 2013.                                                                                              
                                                                                                                                
She  noted that  SB 27  follows model  legislation that  has been                                                               
enacted in other  states. There is information  from the National                                                               
Conference  of   State  Legislatures   (NCSL)  in   the  material                                                               
distributed  to   committee  members.   The  science   exists  to                                                               
demonstrate  the danger  of these  toxins. Alternatives  to these                                                               
dangerous chemicals  do exist. The Washington  state fire marshal                                                               
has  approved these  alternatives  as  providing acceptable  fire                                                               
protection.  Firefighters'   organizations  across   the  country                                                               
support this  legislation because toxic flame  retardants present                                                               
additional risks to them.                                                                                                       
                                                                                                                                
1:45:58 PM                                                                                                                    
SENATOR DYSON said he believes EPA is phasing out these toxins.                                                                 
                                                                                                                                
MS. HART  said they are  taking some action within  their ability                                                               
to take  action. The EPA has  a draft plan to  address PBDEs, but                                                               
in the  best case scenario there  might be action in  nine months                                                               
and it  is based  on voluntary  compliance by  the manufacturers.                                                               
Also, it does not address  importation of products. Because there                                                               
is no ability to address imports,  the EPA feels it can't protect                                                               
the public.                                                                                                                     
                                                                                                                                
JEFFERSON WOOD,  Seward, testifying on his  own behalf, testified                                                               
against  SB  27.  He  said  that every  day  we  are  exposed  to                                                               
chemicals. The beneficial effects  of these chemicals are greater                                                               
than the  potential side effects.  PBDEs may be damaging,  but we                                                               
don't really  have conclusive evidence,  so this bill  might take                                                               
action  with no  basis  in fact.  Fire has  an  effect. The  bill                                                               
contains no  specifics regarding alternatives. In  conclusion, he                                                               
feels that SB 27 does not look  out for the health and welfare of                                                               
Alaskans.                                                                                                                       
                                                                                                                                
SENATOR DYSON noted  that all testifiers should  disclose if they                                                               
have any financial interest in SB 27.                                                                                           
                                                                                                                                
MR. WOOD responded that he was not financially invested at all.                                                                 
                                                                                                                                
DR.  TED SCHETTLER,  Science  Director,  Science &  Environmental                                                               
Health  Network, Anchorage,  testified in  support of  SB 27.  He                                                               
said  he is  a  physician  with a  degree  in  public health  and                                                               
training  in toxicology,  and has  no financial  interest in  the                                                               
bill. Dr.  Schettler explained  that PBDEs  are present  in food,                                                               
wildlife,  human blood,  human milk,  placentas, and  fat tissue.                                                               
Deca  BDE has  ten bromine  atoms  on the  molecule; other  flame                                                               
retardants from  the same family  have fewer. A number  of states                                                               
have  banned  these chemicals  from  commerce  because of  health                                                               
concerns.  People   are  exposed   to  these   chemicals  through                                                               
contaminated  food,  house  dust inhalation,  and  possibly  skin                                                               
absorption. These  chemicals have  adverse effects on  the liver,                                                               
kidneys,  and reproductive  systems  in animal  studies. Deca  is                                                               
classified by the EPA as a possible carcinogen.                                                                                 
                                                                                                                                
Most  human  concerns  focus  on  the effects  of  PBDEs  on  the                                                               
developing brain, since  these effects occur at  far lower levels                                                               
of  exposure.   Octa,  penta  and  deca   BDEs  cause  persistent                                                               
hyperactivity after  administration of  a single,  relatively low                                                               
dose. Normal  thyroid hormone levels and  function are disrupted.                                                               
In 2010  the first large study  of the impacts of  PBDEs on human                                                               
brain  development was  published in  the scientific  literature.                                                               
The  scientists  measured  PBDE  levels  in  maternal  blood  and                                                               
umbilical cord blood of several  hundred participants at the time                                                               
of  birth,  and  followed  the neurological  development  of  the                                                               
children for six years. For  every measure of psychomotor skills,                                                               
attention,  learning,  and memory,  the  children  who were  most                                                               
highly exposed  to PBDEs  performed worse  than the  children who                                                               
were least exposed.  Many of these differences  were large enough                                                               
to achieve strong statistical significance.                                                                                     
                                                                                                                                
1:56:15 PM                                                                                                                    
DR.  SCHETTLER emphasized  it  is important  that  deca PBDEs  be                                                               
removed from commerce as well as  penta and octa. He concluded by                                                               
saying that human exposure to  PBDEs has been rapidly increasing.                                                               
As long as  we continue to use  them in products, we  will add to                                                               
the environmental  burden and insure  ongoing exposure  in people                                                               
and wildlife.  We now  know that  these chemicals  interfere with                                                               
normal   human   brain   development.  Safer   alternatives   are                                                               
available.                                                                                                                      
                                                                                                                                
CHRIS HALL, Arc  of Anchorage, testified in support of  SB 27. He                                                               
said the  Arc serves people  with developmental  disabilities and                                                               
mental  health issues.  Learning  and developmental  disabilities                                                               
influence the  quality of  life for  affected children  and their                                                               
families,  and  impose a  heavy  financial  burden on  the  state                                                               
through required special education,  increased health care costs,                                                               
and loss  of time  at work for  parents. Scientific  evidence has                                                               
demonstrated that  some chemicals, including deca  BDE, can cause                                                               
learning and developmental disorders. He  said we must not expose                                                               
our children  to toxins that  we know  or suspect can  harm their                                                               
developing brains  and bodies. We  know safe  alternatives exist.                                                               
Developing children  are more susceptible to  toxic exposure than                                                               
adults.  He  also  noted  that  PBDE  residues  have  been  found                                                               
consistently in  tissue samples of  mothers and infants,  as well                                                               
as breast  milk. This trend  has been  found to occur  around the                                                               
globe, and the highest levels are  in Yupik women from the Yukon-                                                               
Kuskokwim Delta.                                                                                                                
                                                                                                                                
1:59:38 PM                                                                                                                    
GREG  PATTERSON,   retired  volunteer   firefighter,  Petersburg,                                                               
testified on his own behalf in  opposition to SB 27. He said that                                                               
after reading the Center for  Disease Control report, he believes                                                               
that  these   studies  are  inconclusive.   There  is   still  no                                                               
definitive answer on  these chemicals. He asked  the committee to                                                               
make sure that  what they are doing will not  increase the number                                                               
of  burned children.  If  we  ban these  chemicals,  let's do  it                                                               
correctly  and make  certain that  we have  something to  replace                                                               
them with.                                                                                                                      
                                                                                                                                
2:02:10 PM                                                                                                                    
PETER  THARING,   Anchorage,  testifying   on  his   own  behalf,                                                               
testified in opposition  to SB 27. From his  reading and prepared                                                               
statements, he feels that studies  are inconclusive, but he knows                                                               
from personal experience that fire  retardants work. He urged the                                                               
committee  to  be judicious,  and  to  make  sure we  have  solid                                                               
alternatives.                                                                                                                   
                                                                                                                                
PETER BRIGHAM, a  member of the burn  injury community, testified                                                               
on  his own  behalf in  support of  SB 27.  He said  he has  been                                                               
active for 35 years in the  burn injury community, including as a                                                               
member  of various  boards.  This is  a  difficult issue  because                                                               
anyone who treats  severely burned patients would  be inclined to                                                               
support  the use  of fire  retardant chemicals.  He first  became                                                               
aware four or five years ago  of the increasing public health and                                                               
environmental threat posed by PBDEs.  We can't conclude the value                                                               
of  the  fire  retardant  chemicals   other  than  by  occasional                                                               
anecdotes, and we  have found many ways to reduce  fire death and                                                               
injury  without  negative  side effects.  The  major  decline  in                                                               
smoking as well as the transition  in home cooking from the stove                                                               
to  the microwave  has both  contributed to  lower rates  of fire                                                               
injuries and death; the growing  threat of these chemicals is new                                                               
knowledge. The ability to enact  legislation at the federal level                                                               
is lacking. Hopefully, the state will take action.                                                                              
                                                                                                                                
2:08:10 PM                                                                                                                    
DR. DAVID HEIMBACH, testifying on his  own behalf and as a member                                                               
of  the burn  injury  community, said  for 35  years  he was  the                                                               
director  of the  burn injury  center at  Harborview Hospital  in                                                               
Seattle. As a  burn doctor, he said, these chemicals  do work. We                                                               
all want our environment  to be clean, but we also  want it to be                                                               
safe. It is appropriate to look  for safer retardants, but not to                                                               
throw  away  the  ones  we  have. He  hopes  that  especially  in                                                               
children's clothing and mattresses, we would be circumspect.                                                                    
                                                                                                                                
2:12:34 PM                                                                                                                    
SENATOR  DYSON  asked  if  Dr.  Heimbach  was  familiar  with  an                                                               
organization called  Citizens for Fire  Safety, and does  he know                                                               
if they are credible.                                                                                                           
                                                                                                                                
DR. HEIMBACH said he thinks they are.                                                                                           
                                                                                                                                
CAITLIN   HIGGINS,   Executive  Director,   Alaska   Conservation                                                               
Alliance,  Anchorage, testified  in support  of SB  27. She  said                                                               
this  is one  of  their  three priorities  for  the session.  The                                                               
Alaska Conservation Alliance believes this  is a smart first step                                                               
in making our homes safer and  our families healthier. It is time                                                               
for Alaska to phase out the sale of outdated toxic chemicals.                                                                   
                                                                                                                                
PAMELA  MILLER, Executive  Director, Alaska  Community Action  on                                                               
Toxins, testified in support of SB 27.  She said that SB 27 is an                                                               
important  measure  to  protect  public  health,  especially  the                                                               
health  of  children  and  firefighters.  PBDEs  are  similar  in                                                               
structure to PCBs  which were banned more than 30  years ago, and                                                               
have similar harmful  effects on the body.  PBDEs accumulate, are                                                               
long-lasting, and  interfere with  proper thyroid  function. They                                                               
cause  problems  with  brain development  and  disrupt  learning,                                                               
memory, and behavior.  These chemicals leach out  of products and                                                               
we are  exposed through indoor  air and dust. Levels  in wildlife                                                               
and  people  are increasing.  Levels  in  human breast  milk  are                                                               
doubling every 2-5 years. These  chemicals are persistent and can                                                               
travel long  distances. Alaskans are  more vulnerable due  to our                                                               
higher  levels of  consumption of  fish and  marine mammals,  and                                                               
homes  that  are closed  in  for  a  greater  part of  year.  New                                                               
scientific evidence compels urgent action.                                                                                      
                                                                                                                                
2:19:21 PM                                                                                                                    
GERAN  TARR,  Alaska  Community   Action  on  Toxins,  Anchorage,                                                               
testified  in support  of  SB  27. She  said  a  growing body  of                                                               
research links PBDEs to many  adverse health effects. The adverse                                                               
effects  include  more  than  just  health  problems,  as  health                                                               
problems  affect families.  The committee  should not  forget the                                                               
cost  of care  associated with  these illnesses.  SB 27  would be                                                               
good for our  families and our pocketbooks. It  strikes the right                                                               
balance  between  protecting   public  health,  protecting  local                                                               
businesses, and the interests of  Alaskans. We used to think that                                                               
lead was  safe, and then we  found ways to make  products without                                                               
lead. We can be innovative when we need to.                                                                                     
                                                                                                                                
2:22:22 PM                                                                                                                    
DR.  KRISTIN  COX,  naturopathic  doctor,  Juneau,  testified  in                                                               
support  of SB  27. She  said that  PBDEs are  persistent in  the                                                               
environment and  in human tissues. These  chemicals are currently                                                               
not regulated  with regard  to human health.  PBDEs are  found in                                                               
household products,  furniture, and baby products;  the chemicals                                                               
settle in house dust, which  results in exposure to our children.                                                               
She  sees a  lot  of  thyroid problems,  as  well as  infertility                                                               
problems. PBDEs  leach out  of landfills  into coastal  areas and                                                               
ocean  sediments, causing  high levels  in bivalves.  Atmospheric                                                               
and  ocean  currents concentrate  toxic  chemicals  in the  Polar                                                               
Regions. Alaska  Native women's breast  milk is toxic.  A nursing                                                               
pillow and rocking chair can contain  up to 10 percent dry weight                                                               
of  these  chemicals.  We  shouldn't   have  to  worry  that  our                                                               
household dust is toxic.                                                                                                        
                                                                                                                                
2:25:56 PM                                                                                                                    
LAUREN Heine,  PhD., Science  Director, Clean  Production Action,                                                               
testified in support  of SB 27. She  said that a lot  of her work                                                               
is with  businesses who  work to produce  products that  are safe                                                               
for  human health  and  the environment.  A  good alternative  to                                                               
PBDEs is  one that  provides fire  safety but  does not  have the                                                               
negative  human  health  and   environmental  effects.  The  U.S.                                                               
manufacturers  of PBDEs  have volunteered  to stop  manufacturing                                                               
them in the U.S, and are in  the process of fazing them out. They                                                               
are  already making  chemical alternatives.  The ban  will affect                                                               
imports  as well.  She emphasized  that  we need  to support  the                                                               
manufacturers of alternative  chemicals here in the  U.S. EPA has                                                               
hosted  a series  of  flame retardancy  partnerships.  This is  a                                                               
multi-stakeholder  partnership   based  on  the   best  available                                                               
science. Walmart  has recently prohibited PBDEs  in its products,                                                               
and  will not  be buying  any  products from  its suppliers  that                                                               
contain  PBDEs. This  shows that  companies  do want  to move  to                                                               
safer alternatives,  and they  need the  states to  support them.                                                               
Mattress  manufacturers now  use  a barrier  technology, a  flame                                                               
retardant fabric to  cover the mattress. We can  use good science                                                               
to identify safer alternatives.                                                                                                 
                                                                                                                                
2:30:29 PM                                                                                                                    
SENATOR DYSON  asked if other  states have done something  to ban                                                               
importation  or stop  the use  of  imported materials  containing                                                               
these chemicals.                                                                                                                
                                                                                                                                
MS. HEIN  said if you ban  the sale of products  containing flame                                                               
retardants, it  would not  matter where  the products  came from.                                                               
This is  driving a  movement for  people to know  what is  in the                                                               
products they sell.                                                                                                             
                                                                                                                                
SENATOR  DYSON asked  if we  would then  be putting  a burden  on                                                               
retailers or wholesalers.                                                                                                       
                                                                                                                                
MS. HEIN  said yes, retailers  would be responsible.  Walmart has                                                               
already decided  to do this. This  movement is driven in  part by                                                               
Europe. Any global  company has to do this. It  is responsible to                                                               
know what is in the products you are selling.                                                                                   
                                                                                                                                
CHAIR DAVIS closed public testimony  on SB 27. She announced that                                                               
SB 27 would be held in committee.                                                                                               
                                                                                                                                
^Presentation by Akeela Inc.                                                                                                    
                                                                                                                                
                  Presentation by Akeela Inc.                                                                               
                                                                                                                                
2:33:17 PM                                                                                                                    
CHAIR  DAVIS announced  the next  order  of business  would be  a                                                               
presentation  by Rosalie  Nadeau,  Executive  Director of  Akeela                                                               
House [Akeela Inc.].                                                                                                            
                                                                                                                                
ROSALIE  NADEAU said  that Akeela  House  is now  one program  of                                                               
Akeela  Inc. Each  year what  happens with  behavioral health  is                                                               
that  grants stay  about the  same, but  the cost  of living  has                                                               
increased by  65 percent since  1992. Akeela Inc. has  grown over                                                               
the past  20 years. It  is now  a full service  behavioral health                                                               
organization  with   both  substance  abuse  and   mental  health                                                               
programs. Its budget has grown from  $3.1 million in 2006 to $7.2                                                               
million in 2010. This year they  are projecting a budget of $12.5                                                               
million.  Akeela Inc.  has grown  by combining  administration of                                                               
programs  in  order   to  make  them  more   efficient  and  cost                                                               
effective.  They   have  merged   with  the  Alaska   Council  on                                                               
Prevention  Programs and  have  taken over  the  programs of  the                                                               
Alaska  Women's Resource  Center. In  2006 they  bought a  small,                                                               
for-profit private  company and  pulled that  into their  mix. In                                                               
2010 the  city of Ketchikan asked  Akeela Inc. to look  at taking                                                               
on the programs in Ketchikan.                                                                                                   
                                                                                                                                
2:39:09 PM                                                                                                                    
MS. NADEAU  said those programs constitute  a complete behavioral                                                               
health treatment system.  It was a big change for  Akeela, as the                                                               
location  is small  and hard  to reach.  But the  result is  they                                                               
brought  the  Ketchikan program  under  their  wing. She  further                                                               
noted  that  if the  legislature  makes  funding cuts,  community                                                               
programs will be  destroyed. She wants to  encourage the Division                                                               
of  Behavioral Health  and the  legislature  to look  at ways  of                                                               
combining the  administration of small programs.  There are there                                                               
some  ways  that  larger organizations  can  have  administrative                                                               
coordination  with these  small  programs. Akeela  Inc knows  how                                                               
funding sources operate, and she  believes they can work together                                                               
with the  state to save  programs in small communities  and still                                                               
do quality service.                                                                                                             
                                                                                                                                
2:42:49 PM                                                                                                                    
MS.  NADEAU further  noted that  by  2013, all  providers in  the                                                               
state must be using electronic  medical record systems. Akeela is                                                               
in the  process of making this  change. It is a  painful process.                                                               
Akeela is  in 18 communities in  this state, and they  have to be                                                               
able  to access  records.  Also,  the state  has  built into  new                                                               
regulations a  required national certification  or accreditation.                                                               
Akeela  was  already  accredited.  The state  has  mandated  this                                                               
change,  and  becoming  accredited is  extremely  expensive.  She                                                               
asked  how  providers can  cover  the  additional costs  of  this                                                               
mandate, when  the state is  not covering the cost.  The division                                                               
also says it  wants to measure outcomes. The  state of Washington                                                               
says  that  treatment in  the  community  is cost  effective  far                                                               
beyond prison. Alaska  needs to find better ways  of dealing with                                                               
people. Eighty percent of domestic  violence cases have substance                                                               
use involved. It is a major driver of social ills in the state.                                                                 
                                                                                                                                
2:49:02 PM                                                                                                                    
She explained  that outcome  measurement is  especially difficult                                                               
with  substance abuse  cases. We  need better  studies, and  that                                                               
means  spending money.  It  is  important to  see  if people  are                                                               
really  getting  better. This  can't  be  done cheaply.  Half  of                                                               
Akeela house  beds are empty because  of lack of funding  to fill                                                               
them. Akeela Inc. also runs  prison programs in nine institutions                                                               
in the state.  She feels we need to be  looking at getting people                                                               
out of  prison into community  programs with  monitoring devices.                                                               
This would  be cheaper than prison  beds and the people  would be                                                               
receiving   needed  treatment.   Programs   are  operating   with                                                               
inadequate resources.                                                                                                           
                                                                                                                                
CHAIR DAVIS said  Akeela Inc. was impressive, and  she noted that                                                               
DSHS would like  to do some of the things  that Akeela is already                                                               
achieving.                                                                                                                      
                                                                                                                                
MS. NADEAU  said in  social services  we get  caught up  with our                                                               
clients,  and those  are the  people  we serve.  But really,  our                                                               
clients  are our  funders. We  should work  to achieve  what they                                                               
want  to see.  There are  many unfunded  mandates. Programs  need                                                               
better  staff, but  there is  no  money to  hire them.  Substance                                                               
abuse treatment  came out of 12  step programs. As we  learn more                                                               
about behavioral health, we need staff with more training.                                                                      
                                                                                                                                
2:59:59 PM                                                                                                                    
SENATOR DYSON asked  if there was enough money  in the governor's                                                               
budget this year.                                                                                                               
                                                                                                                                
MS.  NADEAU  said there  was  misunderstanding  on the  substance                                                               
abuse   side.  The   DSHS  commissioner   during  the   Murkowski                                                               
administration  thought   that  Medicaid   would  take   care  of                                                               
everything, but most of their  clients are not Medicaid eligible.                                                               
She emphasized that  she was not blaming this  governor, there is                                                               
a long history.  Everyone involved is looking at ways  to do this                                                               
better and more cheaply.                                                                                                        
                                                                                                                                
SENATOR DYSON asked what she wanted from the committee.                                                                         
                                                                                                                                
MS. NADEAU answered take a look  at helping DSHS and the division                                                               
of behavioral  health come  up with  a better  way of  looking at                                                               
this. Don't  give providers unfunded  mandates, because  they are                                                               
already struggling.                                                                                                             
                                                                                                                                
SENATOR DYSON asked if she would  recommend a task force or study                                                               
group on the issue.                                                                                                             
                                                                                                                                
MS. NADEAU responded that would  be a great idea. Especially with                                                               
moving into behavioral health, we  need a new method of operating                                                               
these programs.                                                                                                                 
                                                                                                                                
SENATOR DYSON  asked if there  are other jurisdictions  that have                                                               
done this well.                                                                                                                 
                                                                                                                                
MS. NADEAU said she would get back to the committee with that                                                                   
information.                                                                                                                    
                                                                                                                                
3:03:27 PM                                                                                                                    
CHAIR DAVIS adjourned the meeting at 3:03 p.m.