Legislature(2015 - 2016)HOUSE FINANCE 519

03/17/2015 07:30 AM House LEGISLATIVE BUDGET & AUDIT

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Audio Topic
07:37:30 AM Start
07:37:54 AM Hearing: Public Input on the Department of Health and Social Services Performance Review.
08:03:01 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Location Change from Beltz 105 --
+ Dept. of Health & Social Services Performance TELECONFERENCED
-- Public Testimony -- Limited to 3 minutes
Public comment on the performance of DHSS in the
delivery of its behavioral health & long-term
care services & on the department's overall
organizational & administrative structure
                    ALASKA STATE LEGISLATURE                                                                                  
             LEGISLATIVE BUDGET AND AUDIT COMMITTEE                                                                           
                         March 17, 2015                                                                                         
                           7:37 a.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Representative Mike Hawker, Chair                                                                                               
Representative Lance Pruitt                                                                                                     
Representative Sam Kito                                                                                                         
Senator Cathy Giessel                                                                                                           
MEMBERS ABSENT                                                                                                                
Senator Anna MacKinnon, Vice Chair                                                                                              
Senator Lyman Hoffman                                                                                                           
Senator Bert Stedman                                                                                                            
Senator Click Bishop                                                                                                            
Senator Pete Kelly (alternate)                                                                                                  
Representative Kurt Olson                                                                                                       
Representative Steve Thompson                                                                                                   
Representative Mark Neuman (alternate)                                                                                          
OTHER LEGISLATORS PRESENT                                                                                                     
Representative Lora Reinbold                                                                                                    
COMMITTEE CALENDAR                                                                                                            
HEARING: PUBLIC INPUT ON THE DEPARTMENT OF HEALTH AND SOCIAL                                                                    
SERVICES PERFORMANCE REVIEW.                                                                                                    
PREVIOUS COMMITTEE ACTION                                                                                                     
No previous action to record                                                                                                    
WITNESS REGISTER                                                                                                              
JIM WALDINGER, Manager                                                                                                          
Public Consulting Group (PCG)                                                                                                   
Boston, Massachusetts                                                                                                           
POSITION STATEMENT:  Introduced his group during the public                                                                   
comments on the Department of Health and Social Services                                                                        
performance review.                                                                                                             
SHARI HOLLAND                                                                                                                   
Public Works                                                                                                                    
Austin, Texas                                                                                                                   
POSITION  STATEMENT:   Introduced  her  group  during the  public                                                             
comments  on  the  Department  of   Health  and  Social  Services                                                               
performance review.                                                                                                             
GAYLE TRIVETTE                                                                                                                  
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified during  the public comments on the                                                             
Department of Health and Social Services performance review.                                                                    
SAM TRIVETTE                                                                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified during  the public comments on the                                                             
Department of Health and Social Services performance review.                                                                    
PATRICK CUNNINGHAM, Chair                                                                                                       
Denali Family Services                                                                                                          
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during  the public comments on the                                                             
Department of Health and Social Services performance review.                                                                    
ACTION NARRATIVE                                                                                                              
7:37:30 AM                                                                                                                    
CHAIR  MIKE  HAWKER  called  the  Legislative  Budget  and  Audit                                                             
Committee meeting to  order at 7:37 a.m.   Representatives Hawker                                                               
and  Kito were  present at  the  call to  order.   Representative                                                               
Pruitt  and  Senator  Giessel  arrived  as  the  meeting  was  in                                                               
progress.  Also in attendance was Representative Reinbold.                                                                      
^HEARING: Public  Input on  the Department  of Health  and Social                                                             
Services Performance Review.                                                                                                    
  HEARING: Public Input on the Department of Health and Social                                                              
                  Services Performance Review.                                                                              
7:37:54 AM                                                                                                                    
CHAIR HAWKER announced  that the only order of  business would be                                                               
a  hearing for  public  input  on the  Department  of Health  and                                                               
Social   Services  performance   review   of  behavioral   health                                                               
services, long-term  care services, and the  department's overall                                                               
organizational  and administrative  structure.    He pointed  out                                                               
that it  was not required for  the committee to have  a quorum to                                                               
conduct  this  testimony,  as  it   was  not  taking  any  formal                                                               
legislative action.                                                                                                             
CHAIR HAWKER  explained that the passage  of House Bill 30  a few                                                               
years  prior  had  placed  into  statute  a  provision  that  the                                                               
Division of  Legislative Audit shall conduct  performance reviews                                                               
of appropriate  programs and  agencies of  state government  on a                                                               
recurring basis.  He noted that  the statute provided for a cycle                                                               
of the  state agencies,  with the first  being the  Department of                                                               
Corrections, which had  been reviewed in 2014.   He reported that                                                               
the current  performance review  would be  for the  Department of                                                               
Health  and  Social Services,  and  in  2016, the  Department  of                                                               
Education and Early Development would  be reviewed.  He explained                                                               
that the process for these  performance reviews as provided in AS                                                               
44.66.020(b) was  for the Division  of Legislative Audit  to hire                                                               
individuals  and contract  with individuals  or firms  to form  a                                                               
review team or  teams to complete these reviews.   He shared that                                                               
the  legislative auditor  had arranged  for two  organizations to                                                               
work  on  the review  of  the  Department  of Health  and  Social                                                               
Services.   He  directed  attention to  AS 44.66.040(a)(2)  which                                                               
detailed  the  duties  of  the  review  team,  that  through  the                                                               
Legislative  Budget  and  Audit  Committee,  the  Senate  Finance                                                               
Committee, or  the House Finance Committee  public hearings shall                                                               
be  scheduled   in  Juneau,   Fairbanks,  Anchorage,   and  other                                                               
locations  as  determined  by the  committees  to  review  agency                                                               
activities and identify problems and  concerns.  He reported that                                                               
this  meeting had  been noticed  a few  weeks prior  in order  to                                                               
satisfy the statutory requirement for  a public hearing in Juneau                                                               
to allow the  opportunity to comment on  activities, problems, or                                                               
concerns with the  Department of Health and Social  Services.  He                                                               
stated  that  similar  public  hearings  would  be  conducted  in                                                               
Anchorage and  Fairbanks sometime shortly  after the end  of this                                                               
current legislative session.                                                                                                    
7:41:39 AM                                                                                                                    
JIM  WALDINGER, Manager,  Public Consulting  Group (PCG),  shared                                                               
(via teleconference)  that his consulting  firm had  been "around                                                               
for about 28 years now  focusing almost exclusively on government                                                               
work,  mostly  in the  health  and  human  services arena."    He                                                               
reported that his group worked  closely with Medicaid, behavioral                                                               
health, and  long term care systems.   He reported that  both the                                                               
long term care  and the behavioral health system  teams were also                                                               
participating  in  the meeting  today,  via  teleconference.   He                                                               
reported  that his  consulting group  had been  travelling around                                                               
Alaska  for  the  past  month,   meeting  with  state  staff  and                                                               
providers in  urban, rural, and  remote rural areas, in  order to                                                               
get a  good cross section analysis  of these systems.   He stated                                                               
that the  group had more trips  planned for late March  and April                                                               
to meet with  additional staff and providers.   He explained that                                                               
the  group would  then take  this information  and formulate  its                                                               
recommendations.   He shared that  the state staff  and providers                                                               
had been "extremely  co-operative with us both  in scheduling and                                                               
meetings  and they've  been  quite  forthcoming with  information                                                               
about the programs."                                                                                                            
7:44:39 AM                                                                                                                    
SHARI  HOLLAND, Public  Works,  shared that  her  group had  been                                                               
hired to  do a  review on  the administrative  and organizational                                                               
structure of the  Department of Health and Social  Services.  She                                                               
stated that Public Works worked  exclusively with state and local                                                               
governments  throughout   the  country   doing  these   types  of                                                               
performance  reviews.   She  reported  that  they had  "extensive                                                               
experience with health and human  services" and they were also in                                                               
the  process of  conducting  its field  work, interviewing  staff                                                               
throughout the department and reviewing this information.                                                                       
7:45:37 AM                                                                                                                    
CHAIR HAWKER clarified that this  was a performance review of the                                                               
organization,  activities, quality  of services,  and ability  to                                                               
deliver the  expected services  by the  Department of  Health and                                                               
Social Services,  and it was  not a  budget hearing.   He offered                                                               
for anyone  to submit written testimony  regarding the Department                                                               
of Health and Social Services.                                                                                                  
7:47:16 AM                                                                                                                    
CHAIR HAWKER opened public testimony.                                                                                           
7:47:59 AM                                                                                                                    
GAYLE  TRIVETTE  reported  that, although  she  was  representing                                                               
herself,  she  was  a  volunteer member  of  the  Juneau  Suicide                                                               
Prevention Coalition.   She  stated that she  was "a  survivor of                                                               
Alaska suicide," and had participated  in the coalition since its                                                               
formation  as a  voluntary,  grass roots  organization, in  2008.                                                               
She declared  it to be  a vibrant coalition dedicated  to suicide                                                               
prevention, and its participants  included Juneau Youth Services,                                                               
Juneau  Alliance  for  Mental   Health,  Inc.  (JAMHI),  Catholic                                                               
Community  Services,   Rotary  Club,  Tlingit  &   Haida  Central                                                               
Council, and Bartlett Hospital.   She shared her experiences with                                                               
grant  and  technical support  from  the  Division of  Behavioral                                                               
Health.  She  said that the first three years  of funding for the                                                               
coalition  were   supported  by  a  prevention   grant  from  the                                                               
division, and administered  by the Juneau School  District with a                                                               
primary  goal for  establishing  and administering  the signs  of                                                               
suicide, education, and screening  programs which were considered                                                               
to be  the most effective  program of its  type.  She  pointed to                                                               
the      website      developed       by      the      coalition,                                                               
JuneauSuicidePrevention.org,  which  educated  the  public  about                                                               
suicide and the  local resources, followed by  a broader website,                                                               
generalmentalhealth.org, which  included a comprehensive  list of                                                               
information regarding mental  illness, as well as  all the mental                                                               
health  providers in  Juneau.    She stated  that  the volume  of                                                               
traffic  on  these  websites had  increased  dramatically.    She                                                               
reported that a  wide array of public  service advertisements and                                                               
the Alaska  Careline phone  number had  been distributed  on city                                                               
buses,  in   activity  booklets,  on  theater   screens,  and  on                                                               
brochures, pins, wallet cards, and  sport bags.  She relayed that                                                               
the  council  had  developed  and  offered  free  public  suicide                                                               
education  and  prevention  training and  collaborated  with  the                                                               
SEARCC suicide  prevention coalition.   She shared that  they had                                                               
helped  develop an  extensive process  for a  community plan  for                                                               
effective response  following a suicide.   She reported  that the                                                               
group had  published a brochure,  Surviving After a  Sudden Loss.                                                               
She explained  that their second three-year  prevention grant had                                                               
been administered  by the Juneau  Youth Services, and  had helped                                                               
continue the  work started  under the  first grant,  while adding                                                               
the Sources  of Strength Youth Resilience  Building program, work                                                               
in the middle  schools, and increasing its  training programs and                                                               
advertising.  She lauded the  excellent help and advice which the                                                               
coalition had  received from the  Division of  Behavioral Health.                                                               
She shared that  the coalition had been  recognized statewide for                                                               
its  widespread  community  collaboration and  its  creative  and                                                               
effective suicide  prevention efforts.   She expressed  shock for                                                               
the latest prevention  grant parameters, which did  not allow the                                                               
use  of grant  funds to  support the  ongoing suicide  prevention                                                               
initiatives, until  a complex and  time consuming  community wide                                                               
research project was  completed.  She reported that  the work had                                                               
been submitted and the coalition  was waiting for a response from                                                               
the division.   She  noted that  the coalition  had been  able to                                                               
secure private, one-time funding to  keep the Sources of Strength                                                               
program going in  the high schools, although  currently there was                                                               
not a  presence in  the middle schools  or any  financial support                                                               
for the Signs of Suicide program.   She concluded that these once                                                               
thriving  initiatives were  "languishing and  limping along  with                                                               
volunteer efforts."                                                                                                             
SAM TRIVETTE shared  that he was also a survivor  of suicide and,                                                               
although he  was an active  participant in the coalition,  he was                                                               
speaking on  his own behalf  and not  as a representative  of the                                                               
coalition.  He  reported that, as he had worked  for more than 10                                                               
years  as  a manager  in  the  Department  of Health  and  Social                                                               
Services, he was  quite familiar with the department.   He lauded                                                               
the  successful collaboration  with  the  Division of  Behavioral                                                               
Health for the  past six years, but he  expressed his frustration                                                               
with  the  management  to  the   current  2015  prevention  grant                                                               
program.   He  reported  that his  requests  for information  had                                                               
brought him  very little satisfaction.   He explained  that there                                                               
were about 20  different grantees during this  funding cycle, and                                                               
there  had not  been  any distinction  between  new grantees  and                                                               
those who  had functioned  for many  years at a  high level.   He                                                               
stated  that the  coalition, even  with its  extensive successful                                                               
history, had to start at ground  zero for this grant funding.  He                                                               
reported that his  request for acknowledgement of  the prior work                                                               
by the  council and allowance  to move forward had  been refused.                                                               
He  expressed understanding  that  new  information and  research                                                               
would become  available from time to  time, and that it  would be                                                               
necessary  to modify  services using  this new  information.   He                                                               
pointed out that this had been  a regular system for the past six                                                               
years.   He declared that  the group applauded  performance based                                                               
management  and funding,  but opined  that the  division had  not                                                               
been utilizing the data submitted  by the coalition over the past                                                               
six  years in  making an  evaluation for  its current  work.   He                                                               
suggested that the current requirements  by the division were for                                                               
process, and not progress or outcomes.   He offered an example of                                                               
a required memorandum  of agreement with the  Careline, a suicide                                                               
prevention   telephone  hot   line,  which   the  coalition   had                                                               
successfully  worked  with  for  many years.    He  relayed  some                                                               
background  regarding the  five step  planning process  for grant                                                               
applications, and the seven month lag  in receiving a copy of the                                                               
process.    He  offered  his  belief that  the  imposition  of  a                                                               
management structure that did not  reflect a daily reality set up                                                               
the suicide prevention  coalition for failure.   He reminded that                                                               
the coalition was  staffed by volunteers from  the community, and                                                               
that  roadblocks would  lead to  its  collapse.   He stated  that                                                               
support  and treatment  as  a mature  coalition  would allow  for                                                               
continuance  of  quality  prevention   and  support  services  to                                                               
Alaskans.  In response to  Chair Hawker, he acknowledged that the                                                               
anecdotal paperwork  he offered  for exhibit did  not need  to be                                                               
entered into the public record.                                                                                                 
7:58:20 AM                                                                                                                    
PATRICK  CUNNINGHAM,  Chair,  Denali Family  Services,  explained                                                               
that  Denali Family  Services provided  services to  mentally ill                                                               
children and  their families.   He  shared that  he was  also the                                                               
president of  the Narcotic Drug Treatment  Center, which provided                                                               
services to individuals addicted to  opium or heroin.  He relayed                                                               
that both of  his agencies worked very closely  with the Division                                                               
of Behavioral  Health.   He declared  that the  relationship with                                                               
the  division  had  always  been  "outstanding,"  with  excellent                                                               
cooperation in the  award of numerous grants.  He  shared that he                                                               
was  also a  professor of  social  work at  University of  Alaska                                                               
Anchorage (UAA).   He explained that  there was an issue  for the                                                               
reimbursement for  services.   He stated  that Xerox  had created                                                               
havoc  within  the agencies,  noting  that  his agency  had  $1.5                                                               
million  in accounts  receivable,  and that  there were  constant                                                               
requests by  Xerox to resubmit  and send  additional information.                                                               
He expressed hope  that money from the  supplemental budget would                                                               
allow  Xerox  to  catch  up,  while  sharing  that  many  smaller                                                               
agencies had been  forced to close.  He stated  that his agencies                                                               
also had waiting lists.  He  reported that his agency could serve                                                               
"a great  deal more people that  are addicted to opium  that want                                                               
treatment, that are  on our list for treatment,  but can't afford                                                               
the services."   He declared that  it would be wonderful  if they                                                               
could be covered under Medicaid,  noting that current support for                                                               
their habit was most likely from  illegal activity.  He said that                                                               
almost 60  percent of  the people in  the methadone  program were                                                               
also working  full time  jobs because  the methadone  helped them                                                               
become functional.   He allowed that it would  be very beneficial                                                               
if  the  reimbursement  could  be  improved.    He  stated  that,                                                               
although it was improving a  little bit, it was still problematic                                                               
for both  of his  agencies.   He noted, as  both of  the agencies                                                               
provided state of  the art services, it would  be most beneficial                                                               
for them to continue.                                                                                                           
8:02:20 AM                                                                                                                    
CHAIR HAWKER closed public testimony.                                                                                           
8:03:01 AM                                                                                                                    
There  being  no  further  business  before  the  committee,  the                                                               
Legislative Budget  and Audit Committee meeting  was adjourned at                                                               
8:03 a.m.                                                                                                                       

Document Name Date/Time Subjects
Agenda_LBA_17Mar15_Location Change.pdf JBUD 3/17/2015 7:30:00 AM