Legislature(1995 - 1996)

03/13/1996 08:35 AM House HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
           JOINT HOUSE & SENATE HOUSE, EDUCATION AND                           
                   SOCIAL SERVICES COMMITTEE                                   
                         March 13, 1996                                        
                           8:35 a.m.                                           
                                                                               
                                                                               
 HOUSE MEMBERS PRESENT                                                         
                                                                               
 Representative Cynthia Toohey, Co-Chair                                       
 Representative Con Bunde, Co-Chair                                            
 Representative Tom Brice                                                      
 Representative Caren Robinson                                                 
                                                                               
 HOUSE MEMBERS ABSENT                                                          
                                                                               
 Representative Al Vezey                                                       
 Representative Gary Davis                                                     
 Representative Norman Rokeberg                                                
                                                                               
                                                                               
 SENATE MEMBERS PRESENT                                                        
                                                                               
 Senator Lyda Green, Chairman                                                  
 Senator Johnny Ellis                                                          
 Senator Judy Salo                                                             
                                                                               
 SENATE MEMBERS ABSENT                                                         
                                                                               
 Senator Loren Leman, Vice Chairman                                            
 Senator Mike Miller                                                           
                                                                               
 ALSO IN ATTENDANCE                                                            
                                                                               
 Representative Kim Elton                                                      
                                                                               
 COMMITTEE CALENDAR                                                            
                                                                               
 Presentation by "Key Campaign"                                                
                                                                               
 WITNESS REGISTER                                                              
                                                                               
 The following Key Campaign members related their personal                     
 experiences with various programs:                                            
                                                                               
 MARY JANE MICHAEL                                                             
 2421 Wellington                                                               
 Anchorage, Alaska 99517                                                       
                                                                               
 LYNETTE HAAS                                                                  
 PO Box 2434                                                                   
 Soldotna, Alaska 99669                                                        
                                                                               
 HONNEN MCLEOD                                                                 
 6908 E 16th #A                                                                
 Anchorage, Alaska 99504                                                       
                                                                               
 EMILY ENNIS                                                                   
 5743 Chilkoor Drive                                                           
 Fairbanks, Alaska 99709                                                       
                                                                               
 JOHN MINANO                                                                   
 805 Airport Road                                                              
 Fredricks, Alaska                                                             
                                                                               
 P. J. CARPENTER                                                               
 PO Box 84392                                                                  
 Fairbanks, Alaska 99708                                                       
                                                                               
 KRISTY POLLARD                                                                
 PO Box 1715                                                                   
 Ward Cove, Alaska 99928                                                       
                                                                               
 ROB KLEE                                                                      
 401 Windfield                                                                 
 Anchorage, Alaska 99515                                                       
                                                                               
 TERRY LANDALL                                                                 
 3781 Cottonwood Way                                                           
 Wasilla, Alaska 99654                                                         
                                                                               
 JOHN STREET                                                                   
 6486 Laser                                                                    
 Anchorage, Alaska 99504                                                       
                                                                               
 LOIS WELCH                                                                    
 PO Box 835                                                                    
 Kenai, Alaska 99611                                                           
                                                                               
                                                                               
 ACTION NARRATIVE                                                              
                                                                               
 TAPE 96-18, SIDE A                                                            
                                                                               
                Presentation by "Key Campaign"                               
                                                                               
 Number 001                                                                    
                                                                               
 CHAIRMAN GREEN called the Joint House & Senate Health, Education              
 and Social Services (HESS) Committee to order at 8:35 a.m. and                
 invited the first speaker forward to begin the presentation.                  
                                                                               
 MARY JANE MICHAEL, Key Campaign member, began by noting that this             
 is the ninth year of the Key Campaign.  She believed that community           
 based programs for people with developmental disabilities have a              
 proven record of making a difference in the way government                    
 operates.  State government wants services to be delivered to                 
 people throughout communities, stimulating rural economies and                
 community involvement.   Currently, 33 nonprofit organizations                
 provide services and support to over 2,100 people with                        
 developmental disabilities as well as their families in over 170              
 communities throughout Alaska.  Ms. Michael pointed out that 100              
 percent of the community developmentally disabled programs support            
 708 non-state positions in rural and urban Alaska.  Today people              
 can remain with their families in their own communities while                 
 receiving the necessary and critical supports and daily life skill            
 opportunities.  She acknowledged that state government is                     
 constantly seeking quality and cost effective services and                    
 programs; community based programs have achieved that.                        
                                                                               
 MS. MICHAEL informed the committee that costs have decreased from             
 a high of over $25,000 per person to $13,827 per person which is no           
 comparison to institutional costs that exceed $150,000 per year.              
 She noted that state government wants welfare reform,  "get people            
 off the dole," which could happen with community based programs.              
 If families are assisted in staying together, costs are reduced,              
 the family is healthier and allowed to continue to work.                      
 Furthermore, the community grows and expands with the richness of             
 diversity and the community's economy is stimulated with community            
 based programs.  Over the past nine years, Key Campaign has                   
 advocated system change which has contributed to savings for                  
 Alaska.  The development and implementation of the Medicaid waiver            
 programs has allowed Alaska to recapture valuable federal dollars             
 to finance what was once funded entirely by Alaska.  Moreover, the            
 closure of Harborview Developmental Center will result in the                 
 savings of millions for Alaska.                                               
                                                                               
 MS. MICHAEL believed that the legislature and the Key Campaign have           
 made progress in these issues while providing families the quality            
 supports they need and want.  However, there are still 658 people             
 on the waiting list for community services.  For no additional                
 funding, these individuals on the waiting list can be served by the           
 savings realized from the closure of Harborview Developmental                 
 Center.  Ms. Michael emphasized that the closure of Harborview                
 illustrates the continuous efforts to deinstitutionalize Alaska               
 while providing a higher quality of life in the community.  Also,             
 the savings realized through the process of refinancing home and              
 community based waivers could be used to serve those on the waiting           
 list.  Ms. Michael explained that federal funds offset the cost of            
 services which were once funded entirely by the state; this can               
 save the state one half of the current cost of services.  The state           
 money that is freed by the federal funding can be used to serve               
 those on the waiting list.                                                    
                                                                               
 MS. MICHAEL stressed that the 658 on the waiting list for community           
 services is the highest in Alaska's developmental disability                  
 history.  Many of those waiting have been on the list for over four           
 years.  If families are diverted from the wait list or need is met            
 when it first surfaces, the cost for services would be                        
 significantly cheaper than responding to a crisis driven system.              
 Ms. Michael pointed out that the estimated savings for this year              
 could serve 100 of those on the waiting list.  Ms. Michael asked              
 for a maintenance of effort of 2 l/2 percent for existing community           
 programs and services.  Ms. Michael quoted the following from a               
 letter from the Mental Health Trust Authority:  "A double standard            
 has been set when certain cost increases for state agencies are               
 funded, while no cost increase for nonprofit organizations that               
 provide direct services to people are funded and in some cases                
 decrements are taken.  Additionally, when Medicaid waivers came on-           
 line in Alaska the state work force expanded by over 10 positions             
 to handle the new system while community agencies who are                     
 responsible for assimilating the system, getting people refinanced            
 on the waiver, and constructing a new billing system with increased           
 demands were given no new personnel."  Ms. Michael reiterated that            
 no additional money would be necessary with the 2 l/2 percent                 
 maintenance effort.  Community makes sense fiscally and                       
 programmatically, we all win with community.                                  
                                                                               
 Number 175                                                                    
                                                                               
 LYNETTE HAAS introduced her 14-year-old daughter, Katie, to the               
 committee.  She discussed her daughter's success with the programs            
 in which she has been involved.  Katie's first success was with the           
 Infant Learning Program.  Currently, Katie is receiving services              
 from Difficulty in Care.  Ms. Haas pointed out that because of the            
 services offered, her family has stayed together.  Katie began                
 using the services when she was three.  Ms. Haas felt very                    
 fortunate and yet guilty for receiving services when so many others           
 in need were waiting.  She hoped that the committee could see that            
 returning the savings from the closure of Harborview to the                   
 programs would be in the state's best interest.                               
                                                                               
 REPRESENTATIVE TOOHEY mentioned the response to the first                     
 announcement of the closure of Harborview three years ago.  There             
 are a few people in Harborview who will continue to need special              
 care.  Representative Toohey emphasized that the closure of                   
 Harborview is necessary and the financial savings will be                     
 tremendous.  LYNETTE HAAS reiterated that the savings from the                
 closure of Harborview could help many more people in the meantime.            
 REPRESENTATIVE TOOHEY emphasized that change is difficult to                  
 accept.  LYNETTE HAAS agreed and said that for this population,               
 time is very important.  Ms. Haas was certain that if Katie had to            
 wait four years, her family would not have survived.                          
                                                                               
 Number 224                                                                    
                                                                               
 HONNEN MCLEOD from Anchorage, said that she was representing                  
 parents in need of respite care.  Ms. McLeod indicated that                   
 Catholic Social Services has helped greatly with her baby and her             
 18-year-old.  Catholic Social Services take the stress off of                 
 families; the stress of caring for a disabled child is an                     
 incredible burden.  The statewide waiting list for Catholic Social            
 Services' respite care is approximately 216 families of which 40              
 are in Anchorage.  Ms. McLeod noted that her daughter is one of the           
 40 from Anchorage on the waiting list.  Quality respite care is               
 difficult to find because these children cannot be sat by a next              
 door teen-ager.  Respite care allows parents to have time alone; it           
 keeps families together.  Ms. McLeod wished that the legislators              
 could see the work that Catholic Social Services does.  With the              
 savings from Harborview and the waiver refinancing, the quality               
 respite care could be continued without any additional cost.                  
                                                                               
 Number 270                                                                    
                                                                               
 SENATOR ELLIS pointed out that the savings from the closure of                
 Harborview are not automatically applied to the waiting list and              
 services for the DD community.  The legislature must specify in the           
 budget that those savings will be used for the DD community.                  
                                                                               
 MS. MCLEOD echoed Representative Toohey's statement that change               
 takes time, but someone should come forward to make that change.              
 With this group of legislators, it can be done.                               
                                                                               
 REPRESENTATIVE ROBINSON asked Ms. McLeod to discuss the waiting               
 list.  MS. MCLEOD, speaking from her own experience, said that her            
 18-year-old has been on a waiting list for Independent Living with            
 minimal supervision since she was 16.  After going to the                     
 Department of Mental Health and Developmental Disabilities in order           
 to determine why the process was taking so long, Ms. McLeod had her           
 reassessed.  Her 18-year-old was bumped up to a wait of 27 months             
 after the assessment.  Ms. McLeod offered to provide the committee            
 with the actual number of people on each waiting list.                        
                                                                               
 Number 309                                                                    
                                                                               
 EMILY ENNIS, Fairbanks Resource Agency (FRA), informed the                    
 committee that FRA realized the need to employ persons with                   
 developmental disabilities about 30 years ago.  The organization              
 sought funds to provide support, funding from the Division of                 
 Vocational Rehabilitation was obtained as well as the Division of             
 Mental Health and Developmental Disabilities.  Vocational services            
 has proven that the employment of those with disabilities has a               
 positive outcome; it is welfare reform.  Vocational services have             
 proven that individuals with disabilities can learn and hold                  
 responsible jobs.  Such services have helped these people obtain              
 good wages and eliminate the need for financial support in many               
 cases.  Ms. Ennis emphasized that vocational services provide                 
 dignity and status for these people.  Vocational services are cost            
 effective, the state has saved thousands with such services.  Ms.             
 Ennis pointed out that inadequate funding in communities has                  
 prevented vocational services from achieving full potential.                  
 Currently, 336 adults are on a waiting list for vocational                    
 supports.  This is the state's largest waiting list.  Ms. Ennis               
 asked the committee to remember that 336 are waiting for jobs and             
 could be working with vocational supports.  Savings from the                  
 waivers and the closure of Harborview could provide the necessary             
 funds for vocational services.  Ms. Ennis asked that these savings            
 be kept in DD community services and that work, not welfare, is               
 supported.                                                                    
                                                                               
 Number 370                                                                    
                                                                               
 JOHN MINANO from Fairbanks, informed the committee that he had been           
 with FRA for 10 or 11 years.  He emphasized that those on the                 
 waiting list should not wait any longer.  All those on the waiting            
 list should have jobs to earn a little spending money to have some            
 fun.  Mr. Minano wanted all those on the vocational services                  
 waiting list to be helped and the children to be well and grow up.            
 He thanked the committee.                                                     
                                                                               
 P.J. CARPENTER introduced her son, Josh, to the committee.  Her son           
 has cerebral palsy and cannot walk.  Ms. Carpenter was told to                
 institutionalize her son when he was one-day-old because there                
 would be less stress on her daughter.  If Ms. Carpenter had not               
 been strong at that time, her son would be one of the 658 on the              
 waiting list.  She informed the committee that her son had been on            
 a waiting list to modify the house by constructing a ramp into the            
 house.  This ramp gave her son independence to enter and exit the             
 house as desired.  The services her son has received from FRA,                
 Access Alaska and Hope Cottage have allowed Josh to live as normal            
 a life as possible.  If she could, Ms. Carpenter said she would               
 invite all the legislators to her house.  Ms. Carpenter informed              
 the committee that her son is also on a waiting list for                      
 independent living because she has been informed that the process             
 could take anywhere from two to four years.  The closure of                   
 Harborview is estimated to save $150,000 per person per year.                 
 Allowing that money to return to such services to modify homes                
 could help.  Without the legislature's help, Josh will be another             
 statistic, another name on the waiting list.                                  
                                                                               
 Number 460                                                                    
                                                                               
 KRISTY POLLARD from Ketchikan, thanked the committee for their                
 support of the TEFRA option to Medicaid.  The TEFRA option helps              
 with medical and travel expenses.  Her daughter had six surgeries             
 in the first year and a half of her daughter's life.  Ms. Pollard             
 informed the committee that her daughter incurred a quarter million           
 dollars in medical expenses.  She and her husband were both                   
 working, but taking so much time off for all the surgeries left her           
 fearful of losing her job as well as the medical insurance received           
 through that job.  She discussed the tremendous stress involved               
 with having a disabled child.  Ms. Pollard referred to the first              
 year and a half as the first house the couple could have purchased.           
 The TEFRA option sounded wonderful and a huge burden was lifted               
 when her daughter received the TEFRA option.  A few months after              
 receiving the TEFRA option, she was able to quit her job and stay             
 home with her daughter who has only been sick once this year and              
 the medical expenses have decreased.  Her daughter receives                   
 services from the Infant Learning Program which has helped.  Ms.              
 Pollard reiterated that the TEFRA option has saved her family.                
                                                                               
 Number 512                                                                    
                                                                               
 ROB KLEE, from Anchorage, introduced his daughter, Jordan.  She has           
 Down's Syndrome.  At first, the diagnosis of his daughter's                   
 disability shattered many of the dreams for her.  Eventually, Mr.             
 Klee realized that his daughter would reach most of her dreams,               
 even if those dreams took time.  The hospital informed Mr. Klee               
 about the Infant Learning Program which has been a very successful            
 experience.  Mr. Klee believed that his daughter is advancing much            
 quicker due to the Infant Learning Program.  The Infant Learning              
 Program consists of a one hour visit with a therapist each week.              
 The program has taught Mr. Klee and his wife how to help Jordan               
 reach her dreams.  Mr. Klee noted that he and his wife were able to           
 contribute payments on a sliding scale to the program because both            
 of their employers offer health insurance.  He expressed concern              
 for the future and for others who are not as lucky as his daughter.           
 In conclusion, Mr. Klee urged the committee to accept the                     
 Governor's recommendation to keep the Infant Learning Program                 
 intact and increase the budget by $150,000.                                   
                                                                               
 TERRY LANDALL thanked the committee for last year's budget, but               
 increased funding is needed.  There are 29 on the Infant Learning             
 Program waiting list in Wasilla alone.  In the Valley, 54                     
 developmentally disabled are on the waiting list and 254 in                   
 Anchorage.  Mr. Landall pointed out that teachers in these programs           
 are being paid less than those in public schools.  These teachers             
 are working with their hearts.  If a child is worked with at an               
 early age, the child will become a productive member of the                   
 community.  Without the teachers or the funding for the program, a            
 portion of the community is lost.  Mr. Landall discussed the cost             
 effectiveness of keeping children at home versus institutions.                
 With extra funding, the teachers would not have to save items that            
 others throw away in order to teach the children.  With extra                 
 funding, motor skill toys could be purchased.  Mr. Landall                    
 emphasized that Alaska should be the first frontier in taking care            
 of the children in the community.  He urged the committee's support           
 of all budget increases in all disabled programs.                             
                                                                               
 JOHN STREET informed the committee that his three-year-old                    
 daughter, Annie, was born with Fetal Alcohol Syndrome (FAS).                  
                                                                               
 TAPE 96-18, SIDE B                                                            
 Number 001                                                                    
                                                                               
 MR. STREET said the early intervention that his daughter received             
 will probably allow her to eventually live on her own.  The Infant            
 Learning Program was the first program Mr. Street's daughter                  
 utilized.  Mr. Street emphasized the lack of education for normal             
 students regarding what really causes some of these disabilities.             
 FAS should not exist.  Through 1974, doctors were saying that                 
 drinking would not hurt an unborn child.                                      
                                                                               
 Number 564                                                                    
                                                                               
 MR. STREET discussed respite care.  For the first 18 months, Mr.              
 Street's wife could not leave their daughter.  When alcohol is                
 present in the womb, no bonding takes place.  His daughter's liver            
 was born accustomed to living on the sugar in alcohol and therefore           
 was not performing properly.  His daughter was not expected to                
 live.  Respite care was necessary.  Currently, his daughter will              
 not sleep alone and sleeps with he and his wife every night.  Mr.             
 Street reiterated that no extra money is needed, just the money               
 that is already available.  If this money needs to be designated              
 for this then lets do that.  With early intervention, education and           
 more community homes, the costs will be decreased.                            
                                                                               
 LOIS WELCH informed the committee that her daughter, Angie, was               
 born with Cerebral Palsy.  Ms. Welch and her family lived in Texas            
 before moving to Alaska.  Her daughter was at home until the age of           
 12 when she was placed in an institution which was six hours away.            
 Ms. Welch became depressed.  During that time, her mother-in-law              
 invited her to Alaska.  When she visited Alaska, she also visited             
 various agencies and programs.  Ms. Welch returned to Texas ready             
 to move to Alaska.  The family moved to Alaska hoping to move Angie           
 as soon as possible, only to discover that there was a waiting                
 list.  She discussed her daughter's time in the institution where             
 she was confined to a wheelchair for about 10 hours a day.  Her               
 daughter slept in a caged bed in an institution with 80 other                 
 nonambulatory children.  After much effort, Ms. Welch's daughter              
 was moved to Alaska.  When her daughter arrived in Alaska she could           
 no longer stretch out her legs.  Since her daughter has moved to              
 Alaska, she has grown by leaps and bounds.  The services of Alaska            
 have given Ms. Welch hope for her daughter.  However, there are 658           
 others who do not have hope.  She noted that this was the first               
 time she had been face-to-face with legislators; she was pleased to           
 see they were attentive to the witnesses.  On behalf of those                 
 families that could utilize the services provided by the savings              
 from the closure of Harborview and the waiver refinancing, think of           
 giving them hope for the future.                                              
                                                                               
 CHAIRMAN GREEN thanked everyone for their testimony.                          
                                                                               
 ADJOURNMENT                                                                   
                                                                               
 There being no further business before the committee, the meeting             
 was adjourned at 9:37 a.m.                                                    
                                                                               
                                                                               

Document Name Date/Time Subjects