Legislature(2017 - 2018)BARNES 124

03/13/2018 08:00 AM House COMMUNITY & REGIONAL AFFAIRS

Note: the audio and video recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.

Download Mp3. <- Right click and save file as

Audio Topic
08:03:22 AM Start
08:04:08 AM SB174
09:09:46 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Heard & Held
-- Public Testimony <Time Limit May Be Set> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
    HOUSE COMMUNITY AND REGIONAL AFFAIRS STANDING COMMITTEE                                                                   
                         March 13, 2018                                                                                         
                           8:03 a.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Representative Justin Parish, Co-Chair                                                                                          
Representative Tiffany Zulkosky, Co-Chair                                                                                       
Representative Harriet Drummond                                                                                                 
Representative George Rauscher                                                                                                  
Representative Dan Saddler                                                                                                      
Representative David Talerico                                                                                                   
MEMBERS ABSENT                                                                                                                
Representative John Lincoln                                                                                                     
Representative DeLena Johnson (alternate)                                                                                       
Representative Jonathan Kreiss-Tomkins (alternate)                                                                              
COMMITTEE CALENDAR                                                                                                            
SENATE BILL NO. 174                                                                                                             
"An Act relating to the duties of the Department of Health and                                                                  
Social Services; and relating to the administration of programs                                                                 
for persons with physical and mental disabilities."                                                                             
     - HEARD & HELD                                                                                                             
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: SB 174                                                                                                                  
SHORT TITLE: PROGRAMS FOR PERSONS WITH DISABILITIES                                                                             
SPONSOR(s): SENATOR(s) MICCICHE                                                                                                 
02/02/18       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/02/18       (S)       HSS                                                                                                    
02/21/18       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
02/21/18       (S)       Moved SB 174 Out of Committee                                                                          
02/21/18       (S)       MINUTE(HSS)                                                                                            
02/22/18       (S)       HSS RPT 5DP                                                                                            
02/22/18       (S)       DP:    WILSON,   BEGICH,    VON   IMHOF,                                                               
                       MICCICHE, GIESSEL                                                                                        
03/01/18       (S)       TRANSMITTED TO (H)                                                                                     
03/01/18       (S)       VERSION: SB 174                                                                                        
03/05/18       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/05/18       (H)       CRA, HSS                                                                                               
03/13/18       (H)       CRA AT 8:00 AM BARNES 124                                                                              
WITNESS REGISTER                                                                                                              
SENATOR PETER MICCICHE                                                                                                          
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, introduced SB 174.                                                                     
KAITLYN STANSBERRY, Intern                                                                                                      
Senator Peter Micciche                                                                                                          
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented SB 174 on behalf of Senator                                                                    
Micciche, prime sponsor.                                                                                                        
LIZETTE STIEHR, Executive Director                                                                                              
Alaska Association on Developmental Disabilities (AADD)                                                                         
Chugiak, Alaska                                                                                                                 
POSITION STATEMENT:  Provided invited testimony during the                                                                    
hearing on SB 174.                                                                                                              
JIMAEL JOHNSON, Program Officer                                                                                                 
Alaska Mental Health Trust Authority (AMHTA)                                                                                    
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Provided comment in support of the SB 174                                                                
MICHAEL BAILEY, Chief Financial Officer                                                                                         
Hope Community Resources Inc.                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 174.                                                                          
MICHELE GIRAULT                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 174.                                                                          
MAGGIE WINSTON, Chair                                                                                                           
Governor's Council on Disabilities and Special Education                                                                        
Kenai, Alaska                                                                                                                   
POSITION STATEMENT:  Testified during the hearing on SB 174.                                                                  
RIC NELSON                                                                                                                      
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Gave verbal testimony in support of SB 174,                                                              
which was then interpreted by Charles Hudson.                                                                                   
DUANE MAYES                                                                                                                     
Anchorage Office                                                                                                                
Division for Senior and Disability Services (DSDS)                                                                              
Department of Health and Social Services (DHSS)                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered questions  during the hearing on SB
COREY GILMORE                                                                                                                   
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of SB 174.                                                                          
ACTION NARRATIVE                                                                                                              
8:03:22 AM                                                                                                                    
CO-CHAIR JUSTIN  PARISH called the  House Community  and Regional                                                             
Affairs  Standing  Committee  meeting   to  order  at  8:03  a.m.                                                               
Representatives  Saddler,   Talerico,  Zulkoski,   Drummond,  and                                                               
Parish  were  present  at  the call  to  order.    Representative                                                               
Rauscher arrived as the meeting was in progress.                                                                                
         SB 174-PROGRAMS FOR PERSONS WITH DISABILITIES                                                                      
[Contains discussion of HB 336.]                                                                                                
8:04:08 AM                                                                                                                    
CO-CHAIR PARISH announced  that the only order  of business would                                                               
be SENATE  BILL NO. 174,  "An Act relating  to the duties  of the                                                               
Department of  Health and  Social Services;  and relating  to the                                                               
administration of  programs for persons with  physical and mental                                                               
8:04:42 AM                                                                                                                    
SENATOR  PETER  MICCICHE,  Alaska  State  Legislature,  as  prime                                                               
sponsor, introduced  SB 174.   He noted that during  testimony on                                                               
SB  174 before  the Senate  Health and  Social Services  Standing                                                               
Committee, someone he referred to  as "Clair's mom" had testified                                                               
that anyone with  children is "one catastrophe  away from needing                                                               
services."   He  explained  that a  life-changing experience  can                                                               
come on quite  suddenly and result in the need  for services from                                                               
the Department  of Health  and Social  Services (DHSS).   Senator                                                               
Micciche said  SB 174  would allow DHSS  to partner  more closely                                                               
with  persons with  physical or  mental  disabilities "to  enable                                                               
active participation in their support  service."  He said this is                                                               
a shared vision  of over 200 people  and organizations, including                                                               
the Governor's Council on Disabilities  and Special Education and                                                               
the Key  Coalition of Alaska.   Giving persons  with disabilities                                                               
more  control over  their support  services enhances  their lives                                                               
and enables their  full participation in the  social and economic                                                               
aspects of their  communities.  Further, the  state benefits from                                                               
the cost reduction  that results from providing  services for the                                                               
specific  needs of  individuals  instead  of providing  "standard                                                               
service  bundles."   Senator Micciche  said SB  174 would  enable                                                               
support  services  programs  to  consider  the  paid  and  unpaid                                                               
support  of   individuals  and  would  provide   "a  long-overdue                                                               
unifying  vision to  allocate and  apply resources"  in a  manner                                                               
that  maximizes  the  experience  of  community  involvement  for                                                               
Alaskans  with disabilities.   Senator  Micciche asked  committee                                                               
members to  remember that individuals  with disabilities  are not                                                               
"cattle"; "they  are not a  number"; but are  "amazing individual                                                               
Alaskans with  the same hopes, dreams,  and plans as the  rest of                                                               
us."  He said SB 174  recognizes that, and he urged the committee                                                               
to support the proposed legislation.                                                                                            
8:07:34 AM                                                                                                                    
KAITLYN STANSBERRY, Intern, Senator  Peter Micciche, Alaska State                                                               
Legislature,  presented SB  174  on behalf  of Senator  Micciche,                                                               
prime sponsor.  She said  the proposed legislation is the product                                                               
of  input from  over 200  individuals in  organizations including                                                               
the two listed by Senator Micciche,  as well as the Alaska Mental                                                               
Health Trust and other members  of the community.  Ms. Stansberry                                                               
stated that  all persons deserve  to be treated with  respect and                                                               
dignity.   The  quality of  life  and treatment  is enhanced  for                                                               
those persons  with disabilities who  are able to  participate in                                                               
the  programs  [that benefit  them]  because  those programs  can                                                               
encourage  those Alaskans  to  fully engage  in  their lives  and                                                               
fully  participate  in the  economic  and  social environment  of                                                               
their  homes, communities,  and state.    She said  SB 174  would                                                               
allow persons  with disabilities to more  actively participate in                                                               
their  systems of  care,  which  they use  daily.   The  proposed                                                               
legislation  would  ensure  that   the  available  resources  are                                                               
allocated  and  applied  "in  such   a  manner  to  maximize  the                                                               
contributions of Alaskans  experiencing disabilities within their                                                               
8:09:32 AM                                                                                                                    
REPRESENTATIVE SADDLER noted that he  was co-sponsor of [HB 336],                                                               
the House companion  bill.  He asked what the  best term would be                                                               
to describe those  who are "the subject of  a supported decision-                                                               
making agreement."   For example, he  asked if they would  be the                                                               
principle, the person, the individual, or the client.                                                                           
SENATOR MICCICHE suggested using "the client."                                                                                  
REPRESENTATIVE  SADDLER  asked  about  the legal  status  of  the                                                               
SENATOR MICCICHE  answered there  would not  be a  formal system.                                                               
The proposed  legislation would not  authorize the  department to                                                               
apply for  a waiver to  provide medical assistance,  payments, or                                                               
self-directed personal  assistance.   He emphasized  there should                                                               
be equal  treatment as with  any other  client.  He  said clients                                                               
have traditionally  been "handed  a treatment package,  which may                                                               
or  may not  fit  their  particular lifestyle."    He offered  an                                                               
example of  Maggie Winston, who is  raising twins, has a  job, is                                                               
productive, and  advocates statewide for persons  with mental and                                                               
physical  disabilities.    He  said Ms.  Winston  does  not  have                                                               
physical use of anything below her  chest.  He reiterated that SB
174 would not  require a formal agreement but  requests that DHSS                                                               
allow  autonomy  when  deciding on  services  that  clients  will                                                               
REPRESENTATIVE  SADDLER  asked what  the  current  number is,  in                                                               
terms of people with disabilities in Alaska.                                                                                    
SENATOR MICCICHE answered he does not have that number.                                                                         
8:13:18 AM                                                                                                                    
REPRESENTATIVE  DRUMMOND questioned  the  use of  the word  "and"                                                               
between "mental  and physical disabilities".   She asked  if that                                                               
meant a  person had  both, because  not everyone  has both.   She                                                               
further inquired as to the meaning of "IDB."                                                                                    
SENATOR MICCICHE answered  that SB 174 would  affect persons with                                                               
physical disabilities  and persons with mental  disabilities.  He                                                               
added, "It's not one  in the same; it affects both  of them."  He                                                               
explained  that IDB  stands  for  individuals with  developmental                                                               
disabilities.    He noted  that  a  term  used  in the  past  was                                                               
"disabled  Alaskans"; however,  now  the term  used is  "Alaskans                                                               
with   disabilities,"   which   he   opined   is   an   important                                                               
differentiation because  the person comes  first.  He  added, "We                                                               
are all people; some of us have disabilities."                                                                                  
8:15:48 AM                                                                                                                    
REPRESENTATIVE   SADDLER  opined   that  providing   services  in                                                               
cooperation with  clients instead  of to  or for  them is  a good                                                               
thing.  He asked how this distinction would "play out."                                                                         
SENATOR MICCICHE deferred to others  who may have a better stance                                                               
from which to offer an explanation.                                                                                             
8:17:51 AM                                                                                                                    
LIZETTE  STIEHR,   Executive  Director,  Alaska   Association  on                                                               
Developmental  Disabilities (AADD),  explained that  AADD is  the                                                               
voice  of  the  providers  of  services  to  the  clients.    The                                                               
association currently has 49 dues-paying  members and is a direct                                                               
provider  of services  and care  coordinators,  who also  provide                                                               
direct  services.   She said  AADD supports  the "shared  vision"                                                               
represented  under  SB 174,  which  would  provide for  "flexible                                                               
service array" and "services that  are directed and driven by the                                                               
person receiving  the services rather  than a bureaucracy."   She                                                               
expressed  gratitude  for the  support  of  Senator Micciche  and                                                               
Representative  Saddler for  this legislation,  because it  would                                                               
provide  "a consistent  and strong  platform  for individuals  to                                                               
lead their  own services."   She echoed  the remarks of  the bill                                                               
sponsor  and  Ms.  Stansberry  about  the  lives  that  would  be                                                               
enriched under  SB 174.   In addition to providing  confidence to                                                               
clients, the  plan would stretch  limited funds further.   Having                                                               
the  shared  vision  in  statute,  she  said,  would  ensure  the                                                               
underlying philosophy  does not change  when there are  shifts in                                                               
funding or political focus.                                                                                                     
MS.   STIEHR,  in   response  to   the  previous   question  from                                                               
Representative Saddler,  offered the  following numbers  of those                                                               
who would  be directly impacted by  [SB 174]:  222  children with                                                               
complex  conditions; 2,085  people who  receive the  intellectual                                                               
with  developmental disabilities  waiver;  and  88 with  physical                                                               
disabilities, but who may not also have a mental disability.                                                                    
8:22:04 AM                                                                                                                    
MS.  STIEHR,  in  response  to  a  question  from  Representative                                                               
Drummond,  explained  that unpaid  natural  support  refers to  a                                                               
"natural"  friend   of  an   individual  with   intellectual  and                                                               
developmental disability, who, for  example, drives the person to                                                               
a church they both attend.                                                                                                      
8:23:50 AM                                                                                                                    
REPRESENTATIVE SADDLER offered his  understanding that Ms. Stiehr                                                               
had  mentioned 2,085  people get  the waiver.   He  remarked that                                                               
certainly  there are  more people  on  the waiting  list for  the                                                               
MS. STIEHR affirmed there currently are 700 on the waiting list.                                                                
8:24:26 AM                                                                                                                    
REPRESENTATIVE  DRUMMOND   asked  for  clarification   about  the                                                               
MS.  STIEHR answered,  "A waiver  is a  Medicaid service  that is                                                               
expanded  beyond  the  medical  limited to  doctor  and  hospital                                                               
appointments; a waiver is services  that allow for support within                                                               
the  community  through  Medicaid  reimbursement.    She  offered                                                               
examples,   including   family  support,   respite,   residential                                                               
services, group home living, and independent living.                                                                            
MS.  STIEHR,  in response  to  Representative  Saddler, said  she                                                               
believes that in  the long term, as people are  given the ability                                                               
to increasingly direct their own  services, natural supports will                                                               
be enhanced,  which will reduce  the need for paid  support, thus                                                               
saving the state money.                                                                                                         
REPRESENTATIVE SADDLER  said people  with disabilities  are often                                                               
entitled  to a  high level  of care  at great  cost; the  waivers                                                               
allow people who deserve a high level of care to receive home-                                                                  
based support,  which keeps  them out  of institutions  and saves                                                               
the state money.  He said, "Waivers are savers for Alaska."                                                                     
8:27:36 AM                                                                                                                    
JIMAEL  JOHNSON,  Program  Officer, Alaska  Mental  Health  Trust                                                               
Authority  (AMHTA),   stated  that  AMHTA  advocates   for  trust                                                               
beneficiaries,  including those  with mental  illness, addiction,                                                               
Alzheimer's,  dementia, traumatic  injury,  and intellectual  and                                                               
developmental  disabilities.    She   said  AMHTA  advocates  for                                                               
crucial  services  to  the  state's  most  vulnerable  population                                                               
through  community-based  services.    When  those  services  are                                                               
"person-centered and directed," they  effectively reduce the need                                                               
for costlier institutional  care.  She said the goal  of AMHTA is                                                               
to serve  as a  catalyst for change  and improvement  in Alaska's                                                               
health  care.  The  trust  continues   to  support  the  work  of                                                               
developmental  disabilities  collaboratives, which  designed  the                                                               
vision  on  which SB  174  is  based.    Ms. Johnson  said  AMHTA                                                               
recognizes   SB  174   as  framework   to  support   people  with                                                               
disabilities in  a way that  increases quality of life  for those                                                               
individuals,  their   families,  and  their  communities.     The                                                               
proposed  legislation would  do  this by  helping the  individual                                                               
with a  disability to  more actively  determine his/her  level of                                                               
community-based care.  She thanked  the sponsor and committee for                                                               
supporting SB 174.                                                                                                              
8:30:00 AM                                                                                                                    
REPRESENTATIVE  SADDLER asked  again  for the  numbers of  people                                                               
statewide with mental or physical developmental disabilities.                                                                   
MS. JOHNSON said  she does not have an answer  now, but could get                                                               
8:30:46 AM                                                                                                                    
MICHAEL   BAILEY,  Chief   Financial   Officer,  Hope   Community                                                               
Resources  Inc.,  stated  that   Hope  Community  Resources  Inc.                                                               
provides  many of  the services  previously mentioned.   He  said                                                               
many  systems   of  service  delivery   are  often   "siloed  and                                                               
traditionalized."   Under  SB 174,  a system  of paid  and unpaid                                                               
support would  be utilized to  enhance the abilities  of Alaskans                                                               
rather than  solely address their  disabilities.  He  said, "This                                                               
bill  promotes  flexibility  and greater  inclusion,  which  then                                                               
results in  ... better stewardship  with state funds  and greater                                                               
opportunity  for  individuals  to   experience  stability."    He                                                               
offered the  example of  his daughter,  who participated  in "The                                                               
Battle of  the Books"  in middle  school, as part  of a  team, on                                                               
which was  a girl with a  disability.  He said  the girl's friend                                                               
supported her  and the  team took  the state  title.   Mr. Bailey                                                               
talked  about inspiration  resulting from  the girl  on the  team                                                               
with a developmental disability  and moving away from traditional                                                               
medical  models.    He  mentioned  directives  from  the  federal                                                               
government to actively maintain Medicaid  funds.  Mr. Bailey said                                                               
SB 174 is  not "an open checkbook" but  promotes partnerships and                                                               
new models  of support  via a value-driven  philosophy.   He said                                                               
Hope  Community  Resources  Inc.  asks for  the  support  of  the                                                               
legislature.  He said people say,  "It takes a village to raise a                                                               
child."   He submitted,  "It takes a  community to  help Alaskans                                                               
with disability live meaningful lives."                                                                                         
8:33:58 AM                                                                                                                    
MICHELE GIRAULT imparted  that she is the guardian  of two adults                                                               
with  disabilities,  as  well  as  a  board  member  of  the  Key                                                               
Coalition of  Alaska.  She  concurred with the comments  that had                                                               
been  made  thus far  in  previous  testimony.    She said  as  a                                                               
guardian of  one individual  who receives  a Medicaid  waiver and                                                               
one  who  is  on  a waiting  list,  she  wholeheartedly  supports                                                               
putting into  statute a  vision of state  support for  all people                                                               
regardless of  disability.  She  said SB 174 sets  a value-driven                                                               
structure for how Alaska treats  people and designs service.  Ms.                                                               
Girault said a service system  can be challenging for people with                                                               
disabilities;  it  is highly  regulated  and  can be  exhausting,                                                               
especially when mental  illness is added to the mix.   She said a                                                               
service  delivery   system  based   on  flexibility   results  in                                                               
community-based services  that cost  far less  than institutional                                                               
care.    She  talked  about  collaboration  and  determining  how                                                               
decisions impact the  provider and receiver of the  service.  She                                                               
said the  Key Coalition  of Alaska  had this  issue as  its first                                                               
platform and appreciates the sponsorship  of Senator Micciche and                                                               
the  time  the  House  Community and  Regional  Affairs  Standing                                                               
Committee  is  taking to  consider  the  issue.   She  urged  the                                                               
committee to support SB 174.                                                                                                    
8:37:02 AM                                                                                                                    
REPRESENTATIVE SADDLER requested  that "aspirational language" be                                                               
translated into "some hard, practical applications."                                                                            
MS. GIRAULT said  it is difficult to  answer specifically because                                                               
people  are just  starting  to  think about  how  it could  work.                                                               
Notwithstanding that, she said the  woman she supports, who is on                                                               
the waiting  list, has some  grant services  that will end  as of                                                               
June 30, [2018], for fiscal  reasons and because of [budget] cuts                                                               
that have been  made to help stabilize other services.   She said                                                               
a flexible service would allow  consideration of varied services,                                                               
such as  a companionship service  that would allow her  to access                                                               
community safely.   She said  perhaps there  is a way  to deliver                                                               
services outside  of the Medicaid waiver  specifically or perhaps                                                               
a  waiver  could  be  added  within the  Medicaid  waiver.    She                                                               
mentioned  mental illness  that  older  people with  disabilities                                                               
sometimes experience, and she indicated  one consideration is how                                                               
those people  can access [mental  health] services  easily within                                                               
their environment.  She explained  that some regulations restrict                                                               
how those  services are delivered.   She said the idea  is to set                                                               
the  vision that  would allow  departments to  come together  and                                                               
share the funding sources to  benefit individuals - to reduce the                                                               
complexity  of services  and "ease  the path  for people  who are                                                               
asking for help."                                                                                                               
REPRESENTATIVE   SADDLER   mentioned   [daytime   rehabilitation]                                                               
("dayhab")  and asked  if there  was a  change under  IDB waivers                                                               
that would result in money saving.                                                                                              
MS.  GIRAULT answered  that dayhab  has been  a service  that has                                                               
been  somewhat individualized.    She said  she thinks  guardians                                                               
partnering with providers  are looking for ways  to create bigger                                                               
group service  for activities rather than  individual activities.                                                               
She said  that is more  natural for people  who go bowling  or to                                                               
church with other people; however,  people with disabilities need                                                               
assistance  to  be  safe,  to   access  transportations,  and  to                                                               
communicate their needs.                                                                                                        
8:42:45 AM                                                                                                                    
MAGGIE  WINSTON, Chair,  Governor's Council  on Disabilities  and                                                               
Special Education,  referred to Senator Micciche's  opening quote                                                               
about  people being  just  one  step away  from  a calamity  that                                                               
necessitates a  need for services.   She said that is  her story.                                                               
She was struck with  a virus at age 21 that  left her with spinal                                                               
chord injury  and no  use of her  arms and legs.   She  said this                                                               
threw her  into an entirely  new life, in  which she had  to find                                                               
services that would enable her to  live in her home and community                                                               
as a  young person and mother.   She said she  receives a package                                                               
of  services,  but sometimes  the  size  of  the package  is  not                                                               
appropriate.  She advised that  SB 174 would allow individuals to                                                               
receive services that are more fitting to them.                                                                                 
8:45:44 AM                                                                                                                    
MS. WINSTON,  in response to Representative  Saddler, named types                                                               
of  services that  individuals can  receive, including  supported                                                               
employment,  supported living,  and group  home living.   All  of                                                               
them provide  different reimbursement  rates and  regulations and                                                               
different agencies  that cover them.   A broad scope  of services                                                               
can  be  complicated in  terms  of  receiving in-home  care,  for                                                               
example.   In response to  a request for clarification,  she said                                                               
[SB  174]  would  make  it  easier  for  individuals  to  receive                                                               
services  by  making it  easier  for  the  person who  needs  the                                                               
services to direct how he/she would like to receive them.                                                                       
8:49:13 AM                                                                                                                    
RIC NELSON gave verbal testimony in  support of SB 174, which was                                                               
then interpreted by Charles Hudson, as follows:                                                                                 
     My name  is Ric Nelson,  and I work for  the Governor's                                                                    
     Council  on Disabilities  and Special  Education.   ...                                                                    
     So, I would like to mention  a couple of things.  March                                                                    
     is  disability  awareness month.    And  we have  about                                                                    
     11,500 people  with disabilities  in Alaska  right now.                                                                    
     So, for my  own story:  I've received a  waiver for the                                                                    
     past 12 years,  and if I didn't have a  waiver, I don't                                                                    
     think that  I would be  where I am  right now.   I have                                                                    
     three degrees,  and the  latest of  those degrees  is a                                                                    
     Master's  in  Public Administration.      And after  my                                                                    
     Master's  in Public  Administration,  after I  received                                                                    
     that degree, I was hired to  work for the council.  And                                                                    
     I make decisions  on the services that I  receive.  And                                                                    
     I think  the people that are  receiving services should                                                                    
     have  the same  opportunity,  because  we're all  human                                                                    
     beings, and  we should  have the same  opportunities as                                                                    
     anybody  else.   And I  think that  we should  have the                                                                    
     final decision  to have  the care that  we need  at the                                                                    
     right time and  at the right place.  So,  I urge you to                                                                    
     pass this bill, please.                                                                                                    
8:54:27 AM                                                                                                                    
The committee took a brief at-ease at 8:54 a.m.                                                                                 
8:54:54 AM                                                                                                                    
CO-CHAIR  PARISH  noted  that  Duane   Mayes  was  available  for                                                               
CO-CHAIR  PARISH  opened  public  testimony on  SB  174.    After                                                               
ascertaining  that there  was no  one who  wished to  testify, he                                                               
closed public testimony.                                                                                                        
8:55:41 AM                                                                                                                    
REPRESENTATIVE SADDLER asked Mr.  Mayes for information regarding                                                               
the  number  of people  with  disabilities  of various  types  in                                                               
8:56:01 AM                                                                                                                    
DUANE MAYES, Director, Anchorage  Office, Division for Senior and                                                               
Disability  Services  (DSDS),  Department of  Health  and  Social                                                               
Services (DHSS),  said there  are just  under 12,000  people with                                                               
disabilities [in Alaska].   There are roughly  120,000 to 125,000                                                               
seniors 65 years of age and older with disabilities.                                                                            
REPRESENTATIVE  SADDLER asked  how  the provisions  under SB  174                                                               
would help DSDS reach its goals in serving the people of Alaska.                                                                
MR.  MAYES prefaced  his answer  by sharing  his background.   He                                                               
said both his  parents are deaf and  communicate through American                                                               
Sign Language and  struggle to understand English.   He explained                                                               
that American  Sign Language has  a grammar and  syntax different                                                               
from English,  and he had  to help his parents  interpret English                                                               
so that they  were able to make sound decisions.   Mr. Mayes said                                                               
when  he  was  in  high  school, he  worked  with  students  with                                                               
developmental disabilities to create a support system.                                                                          
MR. MAYES opined that SB 174 is  "a very defining bill."  He said                                                               
it makes  sense.  The  division would train care  coordinators to                                                               
understand the person with disabilities  is in the driver's seat.                                                               
Further, the division would work  to build natural supports, such                                                               
as the  example of a  person with  disabilities going to  a movie                                                               
with others.   He said natural  support is not going  to cost the                                                               
state  money.   He  predicted  that  over  time the  state  would                                                               
realize an efficiency on this  model, which he opined should have                                                               
been tried a long time ago.                                                                                                     
REPRESENTATIVE SADDLER asked  Mr. Mayes to talk about  how HB 336                                                               
and SB 174 compare and how they would interact.                                                                                 
MR.  MAYES said  both  bills complement  a person-centered  model                                                               
where  there  is  supported decision-making,  much  like  how  he                                                               
helped his parents when  he was in high school.   He said SB 174,                                                               
in particular,  "puts the individual  back in the  driver's seat,                                                               
helping them  to kind  of craft  their plan,  looking to  some of                                                               
those natural  supports that  can be  built into  the plan."   He                                                               
opined that the marriage between the two bill is important.                                                                     
REPRESENTATIVE SADDLER noted that SB  174 has a zero fiscal note.                                                               
He  asked Mr.  Mayes to  give  his perspective  on the  long-term                                                               
financial implications of SB 174.                                                                                               
MR. MAYES replied that  he does not see SB 174  as being a burden                                                               
on  the  state, because  there  would  be efficiencies  in  state                                                               
9:01:50 AM                                                                                                                    
REPRESENTATIVE DRUMMOND said as a  former school board member and                                                               
current  chair of  the House  Education  Standing Committee,  she                                                               
sees many services provided in  the preschool and K-12 system for                                                               
children  with  special  needs.     She  asked  if  there  is  an                                                               
intersection between  the numbers of  people served in  the state                                                               
in the K-12  system and adults beyond the system  and whether Mr.                                                               
Mayes  expects any  impact on  the K-12  system with  "the shared                                                               
vision of this ... bill."                                                                                                       
MR. MAYES answered  that he does not see that  as being an issue.                                                               
In response to a follow-up  question regarding the 12,000 figure,                                                               
he said a  small percent of that number is  comprised of those in                                                               
K-12.   He repeated  the information from  Ms. Stiehr  that 2,080                                                               
individuals  are currently  receiving  services  through the  IDB                                                               
waiver,  and a  small percent  of  those individuals  are in  the                                                               
education system.                                                                                                               
REPRESENTATIVE DRUMMOND added, "As  well as children with complex                                                               
medical conditions."                                                                                                            
MR. MAYES responded in the affirmative.                                                                                         
9:03:53 AM                                                                                                                    
COREY  GILMORE testified  that he  receives services  through the                                                               
waiver  mentioned by  Mr. Mayes.   He  said he  supports SB  174,                                                               
because currently  "everything is  about us  but not  directed by                                                               
us."   He said  a plan  of care  for a  person with  a disability                                                               
states everything that  the person with the  disability agrees to                                                               
do.   He indicated there  may be an  hour to  an hour and  a half                                                               
where people talk  about the person with the  disability and then                                                               
maybe five minutes when they ask  the person what he/she wants to                                                               
do.   He said,  "We need  to turn that  on its  head."   He said,                                                               
"Some people need  help with that, and that's fine  - that's okay                                                               
- but  as much  as possible, those  of us who  have to  live with                                                               
this kind of chair need to be  directing it."  In response to Co-                                                               
Chair  Parish, he  said he  works in  the community  and has  the                                                               
honor of  serving on the  Governor's Council on  Disabilities and                                                               
Special Education, although he was testifying on his own behalf.                                                                
9:06:44 AM                                                                                                                    
REPRESENTATIVE SADDLER noted that  Mr. Gilmore was working toward                                                               
becoming a youth  pastor, and he asked if SB  174 aligns with any                                                               
of the spiritual principals he teaches.                                                                                         
MR.  GILMORE   responded  that  he  always   says  life  requires                                                               
participation and  he teaches that more  important than believing                                                               
in God is for us  to do our best for God and  to help others.  He                                                               
said part of  SB 174 is about  living better.  He  said a typical                                                               
goal  of someone  with a  disability  might be  to brush  his/her                                                               
teeth every day.   He said one of his goals is  to get to school.                                                               
He indicated  that SB 174  is about learning  to write a  plan of                                                               
care  that   addresses  what  [a  person   with  a  developmental                                                               
disability]  wants and  needs.   Mr. Gilmore  concluded, "I  feel                                                               
called to make a difference."                                                                                                   
9:08:49 AM                                                                                                                    
CO-CHAIR PARISH announced that SB 174 was held over.                                                                            
9:09:46 AM                                                                                                                    
There being no  further business before the  committee, the House                                                               
Community  and Regional  Affairs Standing  Committee meeting  was                                                               
adjourned at 9:10 a.m.                                                                                                          

Document Name Date/Time Subjects
SB 174 Supporting Documents - Written Testimony - Laura Bonner - 3.13.2018.pdf HCRA 3/13/2018 8:00:00 AM
HHSS 3/29/2018 3:00:00 PM
SB 174