Legislature(2005 - 2006)Anch LIO Conf Rm

08/30/2006 08:00 AM House HEALTH, EDUCATION & SOCIAL SERVICES


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08:09:28 AM Start
08:18:13 AM Using Alaska's Health Care Dollars Wisely: Behavioral Health and Faith-based Community Initiatives
09:56:33 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Teleconference --
Working Group: Using Alaska's Healthcare
Dollars Wisely
Presentations: Behavioral Health and
Faith Based Community Initiatives
                    ALASKA STATE LEGISLATURE                                                                                  
 HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE                                                               
                       Anchorage, Alaska                                                                                        
                        August 30, 2006                                                                                         
                           8:16 a.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Paul Seaton, Vice Chair                                                                                          
Representative Sharon Cissna                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Peggy Wilson, Chair                                                                                              
Representative Tom Anderson                                                                                                     
Representative Carl Gatto                                                                                                       
Representative Vic Kohring                                                                                                      
Representative Berta Gardner                                                                                                    
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                                
Senator Bettye Davis                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
USING ALASKA'S HEALTHCARE DOLLARS WISELY:  BEHAVIORAL HEALTH AND                                                                
FAITH-BASED COMMUNITY INITIATIVES                                                                                               
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
No previous action to record                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
CRISTY WILLER, Director                                                                                                         
Division of Behavioral Health                                                                                                   
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented a PowerPoint regarding the                                                                       
division.                                                                                                                       
                                                                                                                                
TERI KEKLAK, Medical Assistant Admin IV                                                                                         
Division of Behavioral Health                                                                                                   
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions.                                                                                        
                                                                                                                                
JERRY FULLER, Project Director                                                                                                  
Office of Program Review                                                                                                        
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Related that  work  on the  report on  the                                                               
Bring the Kids Home Initiative has just begun.                                                                                  
                                                                                                                                
STEPHANIE WHEELER, Executive Director                                                                                           
Office of Faith Based and Community Initiatives                                                                                 
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:   Presented  a  PowerPoint regarding  faith-                                                               
based and community initiatives.                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
                                                                                                                                
VICE CHAIR  PAUL SEATON, Acting  Chair, called the  House Health,                                                             
Education  and  Social  Services Standing  Committee  meeting  to                                                               
order  at  8:09 a.m.    Representatives  Seaton and  Cissna  were                                                               
present at  the call to  order.   Also in attendance  was Senator                                                               
Davis.                                                                                                                          
                                                                                                                                
^Using Alaska's  Health Care Dollars  Wisely:   Behavioral Health                                                             
and Faith-Based Community Initiatives                                                                                         
                                                                                                                                
VICE  CHAIR SEATON  announced  that the  committee  would hear  a                                                               
presentation   regarding   behavioral  health   and   faith-based                                                               
community initiatives.                                                                                                          
                                                                                                                                
8:09:28 AM                                                                                                                    
                                                                                                                                
CRISTY   WILLER,  Director,   Division   of  Behavioral   Health,                                                               
Department  of  Health  and  Social  Services  (DHSS),  began  by                                                               
pointing  out   that  the  committee  packet   should  include  a                                                               
PowerPoint entitled, "Alaska's State  of Mind:  Behavioral Health                                                               
in the Great  Frontier" as well as a  document entitled, "Serious                                                               
Behavioral  Health  Conditions  and   Social  Loss"  and  another                                                               
document  entitled,  "Behavioral Health."    She  then began  her                                                               
review  of the  division, which  she characterized  as a  complex                                                               
system.   The  slide  entitled, "Percentage  of  Deaths by  Cause                                                               
Among  Alaskans  Aged  14-19 Years  1999-2001"  relates  that  34                                                               
percent of the deaths of  the aforementioned age group are caused                                                               
by suicide.   This slide also relates the proportion  of this age                                                               
group  whose death  was  caused by  an  unintentional injury  via                                                               
motor  vehicle or  other, which  the division  believes to  be to                                                               
some degree suicidal.  The  slide entitled "Suicide Rate" relates                                                               
the suicide  rates in  Alaska, specifically  for Native  and Non-                                                               
Native groups, over  the last approximately 10  years as compared                                                               
to the  national rate.   The graph relates that  Alaska's suicide                                                               
rate has been above the national  average for some time, which is                                                               
caused by  the very  high rate  of suicide  in the  Alaska Native                                                               
population.  She then referred  to the slide entitled, "Comparing                                                               
the Health Risk Behavior of  Adults with Frequent Mental Distress                                                               
vs All Other  Adults," which uses a pie chart  to illustrate that                                                               
11 percent of the adult  population has frequent mental distress.                                                               
Those  with mental  distress are  significantly more  impacted by                                                               
poor health than all other adults  in the state as illustrated by                                                               
the bar graph.  She related  that a recent Washington State study                                                               
shows  that  having treatment  for  substance  abuse impacts  the                                                               
health and continuing  life of individuals such that  the cost of                                                               
treatment is offset by the savings  in the health care costs that                                                               
would've otherwise been engendered by  the individual.  She noted                                                               
that  the  Washington  State  study dealt  with  real  people  on                                                               
Medicaid.                                                                                                                       
                                                                                                                                
8:18:13 AM                                                                                                                    
                                                                                                                                
MS.  WILLER then  moved on  to the  slides with  charts regarding                                                               
binge and  heavy drinking in  Alaska versus that nationwide.   Of                                                               
course,  alcohol consumption  is  higher in  Alaska  than in  the                                                               
nation.    To  meet  the   challenges,  the  division  awards  to                                                               
providers and  agencies of the  state grants in order  to provide                                                               
services.   The slide  entitled "Comprehensive  Prevention, Early                                                               
Intervention &  Treatment Grants"  shows the distribution  of the                                                               
comprehensive  services  and  the  funds for  those.    She  then                                                               
highlighted  the slide  entitled, "Bring  the Kids  Home Grants,"                                                               
which relates  where the funds  were granted to  already existing                                                               
community services.                                                                                                             
                                                                                                                                
8:21:32 AM                                                                                                                    
                                                                                                                                
MS.  WILLER  continued  with the  slide  entitled,  "Rural  Human                                                               
Services System  Grants."   She characterized  this program  as a                                                               
very  useful  and  cost-effective   program.    The  Rural  Human                                                               
Services  System Grants  pay for  the salaries,  supervision, and                                                               
education for  folks in rural  villages to become  counselors for                                                               
mental illness  and substance  abuse.   The program  allows these                                                               
counselors to attack the problem in  their own village and be the                                                               
focus  of sobriety  and mental  health efforts  within the  small                                                               
communities  of  Alaska.   In  fact,  this year  the  legislature                                                               
provided funds to expand the program  such that there are 10 more                                                               
counselors.    The  slide entitled,  "Special  Behavioral  Health                                                               
Program   Grants"   highlighted    other   programs,   such   as:                                                               
independent  case  management  and flexible  supports,  evidence-                                                               
based practices,  Alcohol Safety  Action Program  (ASAP), housing                                                               
programs.    She  noted  that   the  lack  of  safe,  sober,  and                                                               
supportive housing  for clients  is more  recognized.   She noted                                                               
that  the  integrated treatment  of  children  and families  with                                                               
trauma  history  just began  last  year  as  it has  become  more                                                               
apparent that  many of the  medical, mental, and  substance abuse                                                               
issues  arise  from early  trauma  histories  of children.    She                                                               
mentioned that  there are also  multi-program grants  to regional                                                               
Native health organizations.                                                                                                    
                                                                                                                                
8:24:08 AM                                                                                                                    
                                                                                                                                
MS. WILLER moved  on the slide entitled "Societal  Costs - United                                                               
States"  The  numbers come from a document  entitled, "The Domino                                                               
Effect" put out by the State  of Oregon to show the actual impact                                                               
on Oregon's  budget due  to the drastic  cuts in  substance abuse                                                               
funding.    Clearly,  nationwide  public  programs  were  heavily                                                               
effected.   She highlighted  that states  spent $81.3  billion to                                                               
deal  with substance  abuse,  which amounts  to  13.1 percent  of                                                               
state  budgets.    Similarly, the  McDowell  report  analyzed  in                                                               
relation to alcohol  and other drug abuse, the cost  to Alaska in                                                               
terms  of productivity  losses, criminal  justice and  protective                                                               
services, health  care, traffic  crashes, and  public assistance.                                                               
The specific  costs are listed  on the slide  entitled, "Societal                                                               
Costs - Alaska."                                                                                                                
                                                                                                                                
8:26:27 AM                                                                                                                    
                                                                                                                                
MS.  WILLER then  moved  on  to the  slide  entitled, "DBH  Grant                                                               
Component  by Program  -  Percentage."   This  slide relates  the                                                               
change in funding  over time for various types of  services.  She                                                               
explained that the  reason the treatment percentages  for ADA and                                                               
Mental  Health  treatment  went  to   zero  is  because  it's  an                                                               
integrated program  now.  Therefore, those  treatment dollars are                                                               
going to the Behavioral Health  Treatment component.  The figures                                                               
relate that  in the last  3 years about  50 percent of  the total                                                               
the  Division of  Behavioral  Health (DBH)  grant  is going  into                                                               
treatment  while  much less  is  going  into prevention,  suicide                                                               
prevention, and  the Rural Human  Services Program.   She related                                                               
that this  chart represents about  $52-$53 million a  year that's                                                               
going  into  these  grantee  programs.    In  terms  of  Medicaid                                                               
billings,  from  2002-2005 the  amount  billed  for Medicaid  for                                                               
substance abuse services  has increased by 34  percent and mental                                                               
health services has increased by 28  percent.  The total of those                                                               
two  combined billings  has  risen from  $36.4  million to  $46.6                                                               
million.                                                                                                                        
                                                                                                                                
8:28:53 AM                                                                                                                    
                                                                                                                                
MS. WILLER  continued with the slide  entitled "Positive Outcomes                                                               
in  Life Domains."   This  slide represents  the 2005  summary of                                                               
client status reports, which are  questions asked of clients upon                                                               
entry and  then periodically afterwards.   The  graph illustrates                                                               
that the  essential social and  physical needs of those  who were                                                               
in substance abuse  treatment were as equipped or  better able to                                                               
face  life  after  treatment.     Ms.  Willer  opined  that  this                                                               
indicator  illustrates that  things are  happening to  change the                                                               
face of this disease in Alaska.                                                                                                 
                                                                                                                                
8:31:59 AM                                                                                                                    
                                                                                                                                
MS. WILLER moved  on to the slide entitled, "Bring  the Kids Home                                                               
Shows  Success in  2005."   The bar  chart on  the aforementioned                                                               
slide shows  that after a  couple of  years working to  fund more                                                               
local programs  and better  gate keeping  practices, there  was a                                                               
decline of  about 5 percent in  children going out of  state [for                                                               
services].   The  next slide  entitled,  "More RPTC  [Residential                                                               
Psychiatric Treatment  Center] Medicaid Dollars Stayed  in Alaska                                                               
in 2005."  She related  that the average increase in out-of-state                                                               
Medicaid spending was  59.2 percent from year to  year.  However,                                                               
from  2004 to  2005, the  increase in  out-of-state spending  was                                                               
only 1.1 percent.                                                                                                               
                                                                                                                                
8:34:02 AM                                                                                                                    
                                                                                                                                
MS. WILLER  then turned  to the slide  entitled, "What  Do Adults                                                               
Say  About Services?"   The  chart relates  the responses  of the                                                               
behavioral  health  survey  in  regard  to  access  to  services,                                                               
appropriateness of  care, outcome of the  care, and satisfaction.                                                               
She noted that  this is a nationally  developed survey instrument                                                               
and thus the  outcomes can be compared  with national statistics.                                                               
The chart  relates that approximately  82 percent  were generally                                                               
satisfied.   The next slide  entitled, "What Do Youths  Say About                                                               
Services?" is  a similar  survey that  illustrates that  about 76                                                               
percent  of those  surveyed were  satisfied overall.   The  slide                                                               
entitled,  "What  Do   Parents/Caregivers  Say  About  Services?"                                                               
relates that about 77 percent were satisfied overall.                                                                           
                                                                                                                                
8:35:48 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  drew attention to the  percentages related                                                               
to cultural  sensitivity.   She inquired  as to  who were  the 14                                                               
percent  who  didn't have  a  positive  experience in  regard  to                                                               
cultural sensitivity.   Knowing who  this population is  could be                                                               
crucial, she opined.                                                                                                            
                                                                                                                                
MS. WILLER relayed  that there is a way to  sort responses [based                                                               
on  ethnicity].   In  fact,  the  information is  collected,  and                                                               
therefore the chart could be presented with that information.                                                                   
                                                                                                                                
8:38:02 AM                                                                                                                    
                                                                                                                                
MS. WILLER  concluded with the  last three slides, which  are the                                                               
Alaska  Mental  Health Trust's  posters  entitled,  "You KNOW  me                                                               
...".   She explained that  the diseases with which  the division                                                               
deals are among the most stigmatized.   The posters are an effort                                                               
to make  people realize that  people dealing with  these diseases                                                               
are walking among us.                                                                                                           
                                                                                                                                
8:40:30 AM                                                                                                                    
                                                                                                                                
VICE CHAIR  SEATON related  his understanding  that youth  who go                                                               
outside  of the  state for  residential treatment  are considered                                                               
emancipated and  thus receive 100 percent  funding.  Furthermore,                                                               
airline tickets for family visits  are provided regardless of the                                                               
family's  ability to  pay.   Moreover, those  tickets don't  even                                                               
have  to  be  advanced  purchase  prices.   He  asked  if  that's                                                               
correct.                                                                                                                        
                                                                                                                                
8:42:05 AM                                                                                                                    
                                                                                                                                
MS. WILLER began  by commenting that the higher  cost of [out-of-                                                               
state] care  is certainly one  of the  reasons for the  Bring the                                                               
Kids Home campaign.                                                                                                             
                                                                                                                                
8:42:43 AM                                                                                                                    
                                                                                                                                
TERI KEKLAK,  Medical Assistant Admin IV,  Division of Behavioral                                                               
Health, Department  of Health and Social  Services, answered that                                                               
the children  who are institutionalized  outside the home  for 30                                                               
days are eligible  for Medicaid.  Currently,  all airline tickets                                                               
paid for  by Medicaid  are paid through  the state  travel office                                                               
and thus the cost of the  ticket is whatever the agreed upon rate                                                               
with the state is.                                                                                                              
                                                                                                                                
8:44:10 AM                                                                                                                    
                                                                                                                                
VICE  CHAIR  SEATON  requested that  the  department  investigate                                                               
whether  families are  being provided  airline  tickets to  visit                                                               
children  in  residential  treatment centers  outside  of  Alaska                                                               
without  any   advanced  purchase   requirements.     He  further                                                               
requested  that the  department investigate  whether a  change in                                                               
policy that could  be a savings could occur  while still allowing                                                               
travel.      Vice   Chair   Seaton  asked   if   there   is   any                                                               
test/requirement for  financial need before the  state provides a                                                               
family  with a  child  in residential  treatment  outside of  the                                                               
state tickets to visit that child.                                                                                              
                                                                                                                                
MS. KEKLAK  explained that  for Medicaid  travel, the  patient in                                                               
residential care is considered the  recipient.  Therefore, if the                                                               
patient is  eligible for  Medicaid, other  family members  may be                                                               
approved to  travel.   She emphasized  that Medicaid  doesn't pay                                                               
for  parents  to travel  for  social  visits to  their  children.                                                               
There  has to  be  documentation that  the  parent, guardian,  or                                                               
other  family  member  is  going to  participate  in  the  active                                                               
treatment of  the child  while present.   In further  response to                                                               
Vice Chair  Seaton, Ms.  Keklak related  that the  first question                                                               
asked is whether the treatment can be done telephonically.                                                                      
                                                                                                                                
8:47:49 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA opined that in  order to develop good state                                                               
policy  on programs  such as  Bring the  Kids Home  one needs  to                                                               
understand  what  is  required  to  help  the  child's  treatment                                                               
process,  why parents  are required,  what  happens when  parents                                                               
aren't part  of the treatment, and  the costs involved.   If this                                                               
committee  understood  all  this,  it could  make  better  budget                                                               
decisions because  there could ultimately be  savings by spending                                                               
some funds.                                                                                                                     
                                                                                                                                
MS.  WILLER said  that she  can provide  such information  to the                                                               
committee.                                                                                                                      
                                                                                                                                
8:50:20 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA  requested  more   of  the  kind  of  cost                                                               
reporting that has presented today.   She then expressed the need                                                               
for  the public  to understand  that the  drivers of  health care                                                               
costs, many of  which are addressed in the  report, increase when                                                               
upfront prevention dollars aren't spent.   She also expressed the                                                               
hope to figure out how to  be prepared for future costs of mental                                                               
health.                                                                                                                         
                                                                                                                                
8:53:23 AM                                                                                                                    
                                                                                                                                
MS.  WILLER, in  response to  Vice  Chair Seaton,  said that  the                                                               
earlier mentioned report from Washington  State was a match study                                                               
of  the  Medicaid eligible  persons  in  the  state.   The  study                                                               
analyzed  the  medical  costs of  people  who  needed  treatment.                                                               
Those who needed  treatment were defined as  certain event cases,                                                               
such  as  being  arrested  for driving  under  the  influence  or                                                               
presenting at the emergency room  with an alcohol-related injury.                                                               
The groups  were matched for  those that went into  treatment and                                                               
their costs as  compared to the others who  didn't have treatment                                                               
after the event.   The costs were significantly  higher for those                                                               
who  didn't receive  treatment after  the  event.   In fact,  the                                                               
increased  medical costs  of those  who didn't  receive treatment                                                               
were  high enough  that they  offset the  cost of  treatment that                                                               
they  would've received  had  they sought  treatment.   She  then                                                               
mentioned  an  Oregon  study  called,  "Falling  Dominos,"  which                                                               
essentially  addresses  the  same   issue.    The  aforementioned                                                               
studies are exactly the type Alaska  should do in order to obtain                                                               
the information  that would illustrate  to folks  that addressing                                                               
these  problems  at  the  initiating   point  is  a  cost-savings                                                               
mechanism.                                                                                                                      
                                                                                                                                
8:57:44 AM                                                                                                                    
                                                                                                                                
VICE  CHAIR   SEATON  requested  that  Ms.   Willer  provide  the                                                               
committee  with  the  relevant charts  and  discussion  from  the                                                               
Washington report.  With regard  to the slide entitled, "Positive                                                               
Outcomes in Life Domains," he inquired  as to the location of the                                                               
base  line.   He then  expressed the  desire for  data for  those                                                               
people  who are  not  consumers  and where  they  would rank  the                                                               
issues on the aforementioned slide.                                                                                             
                                                                                                                                
MS.  WILLER  concurred  that  this  is  not  balanced  against  a                                                               
control.  However, she noted  that a control could be effectuated                                                               
or these  questions could be  asked of individuals as  they enter                                                               
and  exit  the  system,  which could  reach  individuals  at  the                                                               
various stages of recovery.                                                                                                     
                                                                                                                                
VICE CHAIR  SEATON suggested that  asking the questions  when the                                                               
individual  comes  in for  treatment  and  after treatment  would                                                               
provide  a   base  line  and   provide  some  measure   of  these                                                               
qualitative questions.                                                                                                          
                                                                                                                                
9:01:07 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  noted that in the  treatment programs with                                                               
which she has worked, those questions are asked upon entrance.                                                                  
                                                                                                                                
MS. WILLER  clarified that these  questions are being  asked upon                                                               
entry  to  treatment and  the  data  was promulgated  from  those                                                               
answers.   For  instance,  the  chart shows  that  82 percent  of                                                               
respondents  felt  either  more productive  or  maintained  their                                                               
level  of  productivity  [prior  to  treatment]  after  receiving                                                               
treatment.   Therefore,  this chart  ["Positive Outcomes  in Life                                                               
Domains"] has  a built-in comparison  over time.   However, there                                                               
is  not a  comparison of  a group  of people  who didn't  receive                                                               
treatment at all.                                                                                                               
                                                                                                                                
9:03:21 AM                                                                                                                    
                                                                                                                                
MS. WILLER  concluded her presentation by  thanking the committee                                                               
for  asking the  division to  the table  as it  has been  a great                                                               
opportunity  to better  express the  professional world  in which                                                               
the division works and the clients it serves.                                                                                   
                                                                                                                                
9:04:20 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  expressed the need to  hear a presentation                                                               
from those who are actually trying  to keep kids in the state for                                                               
treatment and hear why the recommendations were made.                                                                           
                                                                                                                                
The committee took an at-ease from 9:06 a.m. to 9:07 a.m.                                                                       
                                                                                                                                
9:07:56 AM                                                                                                                    
                                                                                                                                
VICE  CHAIR  SEATON  mentioned  that  staff  from  Representative                                                               
Coghill's office had  pointed out that a report on  the Bring the                                                               
Children Home  Initiative is required  for the beginning  of next                                                               
session.   He inquired as  to the stage  at which that  report is                                                               
and whether it will be on time.                                                                                                 
                                                                                                                                
9:08:19 AM                                                                                                                    
                                                                                                                                
JERRY  FULLER,  Project  Director,   Office  of  Program  Review,                                                               
Department  of  Health  and Social  Services,  relayed  that  the                                                               
department  is just  beginning to  work on  that report  and thus                                                               
there  aren't any  intermediate  results that  could be  provided                                                               
today.   However, the intention is  to have that report  ready by                                                               
next session if not sooner.                                                                                                     
                                                                                                                                
9:08:57 AM                                                                                                                    
                                                                                                                                
STEPHANIE WHEELER, Executive Director,  Office of Faith Based and                                                               
Community Initiatives, Department of  Health and Social Services,                                                               
began  by  highlighting  that  the  Office  of  Faith  Based  and                                                               
Community  Initiatives  (FBCI) has  only  been  in operation  for                                                               
about 18 months.  Ms. Wheeler  emphasized that the Office of FBCI                                                               
is about  building and strengthening partnerships.   She informed                                                               
the  committee  that  the  Office  of FBCI  is  supported  by  an                                                               
advisory  council of  about 22  members statewide.   Furthermore,                                                               
Alaska is one of 32 states that have created an FBCI office.                                                                    
                                                                                                                                
MS. WHEELER opined that the Office  of FBCI is all about rallying                                                               
the  "Armies   of  Compassion."     She  highlighted   that  FBCI                                                               
[organizations] have been  in existence for a very  long time and                                                               
have been providing support services  to communities.  Therefore,                                                               
the  Office of  FBCI provides  support to  those who  provide the                                                               
support  to  communities.    Ms.  Wheeler  began  her  PowerPoint                                                               
presentation  with a  slide containing  the following  quote from                                                               
President George W. Bush:   "Starting now, the Federal Government                                                               
is adopting a new attitude  to honor and not restrict faith-based                                                               
and  community initiatives,  to accept  rather than  dismiss such                                                               
programs, and to empower rather  than ignore them."  She reviewed                                                               
the goals of the initiative, as  follows:  lift up the vital work                                                               
done by "neighborhood healers",  build the capacity of grassroots                                                               
groups,  level  the  playing  field  in  federal  social  service                                                               
programs,  and  maximize   partnerships  between  government  and                                                               
faith-based and grassroots organizations.                                                                                       
                                                                                                                                
9:13:05 AM                                                                                                                    
                                                                                                                                
MS.  WHEELER related  that  due  to the  Gulf  Coast disaster  of                                                               
Hurricanes  Katrina  and  Rita,   many  studies  were  put  forth                                                               
regarding the  contributions of  faith-based organizations.   She                                                               
then  drew   attention  to  the  slide   entitled,  "Faith  Based                                                               
Contributions."    The information  provided  on  this slide  was                                                               
derived  from   a  study  of  300,000-380,000   congregations  in                                                               
America.    The  study  found  that about  90  percent  of  those                                                               
congregations  provided one  or more  social service  programs or                                                               
ministries  to communities.   The  study also  found that  faith-                                                               
based  ministries provide  specialized help  across the  range of                                                               
needs.  Furthermore, faith communities  mobilize their members to                                                               
volunteer and give financial support  to community programs.  She                                                               
noted  that recent  disasters  in Alaska  have  resulted in  some                                                               
great partnerships.  Ms. Wheeler  moved on to the slide entitled,                                                               
"Community  Wellness Partnerships,"  which relates  a quote  from                                                               
Dr.  Robert  K.  Ross,  President   and  CEO  of  the  California                                                               
Endowment,  who has  been invited  to  speak at  the DHSS  Health                                                               
Summit in December.   She said that Dr. Ross  is about developing                                                               
community wellness partnerships within communities.                                                                             
                                                                                                                                
9:16:10 AM                                                                                                                    
                                                                                                                                
MS. WHEELER  continued with  the slide  entitled, "Vision/Mission                                                               
of  the FBCI  Office."   She explained  that last  year the  FBCI                                                               
Office worked really hard to try  to make sure that the office is                                                               
aligned  within the  department.   Therefore, the  vision of  the                                                               
FBCI Office  is to improve  the well-being of Alaskans  while the                                                               
mission of the  office is to strengthen and  expand the resources                                                               
contributed   by    faith-based   and    community   initiatives.                                                               
Continuing with  the slide  entitled, "Alaska  Office of  FBCI We                                                               
believe" reviewed  that the office  believes there is a  need for                                                               
additional  resources and  that faith-based  and other  community                                                               
organizations  can  contribute to  adding  new  resources to  the                                                               
state.  Moreover,  the Office of FBCI believes  that public funds                                                               
are  best  leveraged  through  partnerships.    The  office  also                                                               
believes  that   some  faith-based   and  community   groups  are                                                               
unnecessarily disadvantaged  in any effort to  partner with state                                                               
government.                                                                                                                     
                                                                                                                                
9:17:45 AM                                                                                                                    
                                                                                                                                
MS. WHEELER then  reviewed the slide entitled,  "Alaska Office of                                                               
FBCI We  will."   She highlighted  that the  Office of  FBCI will                                                               
foster partnerships  between and  among government and  faith and                                                               
community  groups; build  capacity in  faith-based and  community                                                               
organizations;  and educate  the  government, organizations,  and                                                               
the public  about FBCI  contributions, opportunities  and issues.                                                               
Ms.  Wheeler  related  that  she  provides  presentations  across                                                               
Alaska  and the  nation and  opined that  it's discouraging  that                                                               
Alaska  Leads  the Nation  in  many  health-related areas.    She                                                               
highlighted  that  Alaska  leads  the nation  in  the  areas  of:                                                               
substance  abuse,  fetal   alcohol  syndrome,  suicide,  domestic                                                               
violence, and child sexual assault.   Furthermore, the state has,                                                               
as specified  in the  title of the  next slide,  "Growing (Health                                                               
Related)     Concerns."           Those      concerns     include                                                               
homelessness/affordable  housing,  hunger,  gangs,  seniors,  and                                                               
prison re-entry.   A recent Food Bank of Alaska  study found that                                                               
about  70,000 Alaskans  go hungry  every  year.   With regard  to                                                               
housing,   the   Alaska   Housing  Finance   Corporation   (AHFC)                                                               
statistics  show that  about 10,000  Alaskans are  homeless every                                                               
year.   Of  those homeless  Alaskans, about  4,000 are  children.                                                               
She  then related  that  Alaska is  experiencing  an increase  in                                                               
youth and gang violence.                                                                                                        
                                                                                                                                
9:21:37 AM                                                                                                                    
                                                                                                                                
MS.  WHEELER  moved on  to  the  slide entitled,  "Seniors,"  and                                                               
related that the senior population  is the fastest growing in the                                                               
United  States.   She related  that about  one-third of  Alaska's                                                               
seniors  are living  in poverty.   She  further related  that the                                                               
national Alzheimer's  Association projects that Alaska  will have                                                               
the second  highest increase in seniors  experiencing Alzheimer's                                                               
disease, which  can be costly.   Ms. Wheeler highlighted  that in                                                               
Florida   the state and various  FBCI have partnered to  focus on                                                               
providing  adult  day care  centers.    Through this  partnership                                                               
there has been a decrease in  the number of seniors needing long-                                                               
term care,  having to go  to assisted  living, and a  decrease in                                                               
health-related costs.   These Adult Day Care  Centers provide the                                                               
necessary support services for seniors  to have a good quality of                                                               
life while living at home.                                                                                                      
                                                                                                                                
9:23:27 AM                                                                                                                    
                                                                                                                                
MS.  WHEELER  turned to  the  next  slide, "Homelessness."    She                                                               
informed  the committee  that studies  show that  homeless people                                                               
visit  emergency  rooms  frequently  because of  the  lack  of  a                                                               
regular source  of medical care.   Furthermore, homeless children                                                               
get  sick twice  as often,  are four  times more  likely to  have                                                               
asthma attacks, have  five times more stomach  problems, and have                                                               
twice as  many hospitalizations as  other children.   Ms. Wheeler                                                               
moved  on  to  the  slide   entitled,  "Prison  Re-entry."    She                                                               
reiterated that  there are record numbers  of prisoners returning                                                               
to  Alaska's  communities.   Therefore,  if  services  aren't  in                                                               
place,  these released  prisoners don't  become connected  to the                                                               
community  and  end   up  returning  to  jail  or   to  a  mental                                                               
institution.   She informed the  committee that about  37 percent                                                               
of those  in Alaska's correctional facilities  have mental health                                                               
issues.  She  then informed the committee that  the APIC Steering                                                               
Committee  in partnership  with  the  Department of  Corrections,                                                               
Social    Services   Administration,    and   the    Disabilities                                                               
Determination   Services  are   trying  to   provide  wrap-around                                                               
services for  those being  released from  prison who  have mental                                                               
health and other disabilities.   This partnership has resulted in                                                               
100 percent  success rate  in the  targeted individuals  and thus                                                               
these   individuals   aren't   returning  to   jail   or   mental                                                               
institutions.                                                                                                                   
                                                                                                                                
9:26:40 AM                                                                                                                    
                                                                                                                                
MS.  WHEELER   continued  with   the  slide   entitled,  "Suicide                                                               
Prevention,"  and  reminded the  committee  that  Alaska has  the                                                               
highest suicide  rate in  the nation as  it's twice  the national                                                               
average.  The  suicide rate for Alaska Natives is  four times the                                                               
national average.   She  mentioned that last  year the  Office of                                                               
FBCI and the  Suicide Prevention Council came  together to review                                                               
the suicide issues  in rural Alaska.  The  aforementioned lead to                                                               
discussions   with   local   communities  regarding   how   faith                                                               
communities  can  partner with  the  local  school districts  and                                                               
mental health providers in order  to garner some positive results                                                               
with  suicide  among   youth  in  rural  areas.     Just  such  a                                                               
partnership has come  together to build a  program around suicide                                                               
prevention  in the  Yukon-Kuskokwim area.   She  opined that  the                                                               
program is working wonders.                                                                                                     
                                                                                                                                
9:28:54 AM                                                                                                                    
                                                                                                                                
MS. WHEELER  moved on  to the  slide entitled,  "Veteran Outreach                                                               
(Story)"  and   related  that   the  Combat   Veteran's  Outreach                                                               
partnership has just been formed.   She explained that recently a                                                               
number of Alaska  Native men from rural areas  have been deployed                                                               
to  Iraq.   The concern,  she  further explained,  is that  there                                                               
aren't many  support services for  active duty military  in rural                                                               
Alaska.  Therefore, the  aforementioned partnership came together                                                               
to help  provide support services  and training  with faith-based                                                               
ministry leaders  to help those  military personnel  returning to                                                               
rural Alaska.                                                                                                                   
                                                                                                                                
MS. WHEELER reminded the committee  of the recent disaster in the                                                               
Hooper Bay  area.   That disaster is  considered a  health hazard                                                               
because 71  people, 16 percent  of the village,  lost everything,                                                               
which has resulted in families living  together.  In fact, in one                                                               
instance 17 people  are living in one home  without running water                                                               
and  one honey  bucket, which  is  a health  hazard.   The is  an                                                               
instance  in  which  forming  partnerships  [has  helped].    She                                                               
highlighted that the faith-based  communities have taken the lead                                                               
in  providing support  services to  the families  in Hooper  Bay,                                                               
specifically  Franklin Graham  has  pledged about  $1 million  in                                                               
aide  to  help  rebuild  five  homes  and  provide  some  of  the                                                               
necessities of the area such as four-wheelers.                                                                                  
                                                                                                                                
9:34:34 AM                                                                                                                    
                                                                                                                                
MS.  WHEELER   moved  on  to   the  slide   entitled,  "Solutions                                                               
(Interagency Collaborations)."   She reiterated that partnerships                                                               
are important, and  therefore the Office of FBCI  looks to expand                                                               
and strengthen  those partnerships  across the  state.   She then                                                               
related  the concern  that if  the pandemic  flu hits  the United                                                               
States, it may  hit Alaska first.  The Office  of FBCI has worked                                                               
in partnerships with the federal  government agencies to design a                                                               
check list  for faith-based communities throughout  the nation in                                                               
order  to help  them prepare  for  the pandemic  flu and  provide                                                               
information to those in the  community.  Ms. Wheeler related that                                                               
there are  a number  of health care  ministries across  the state                                                               
that work  with volunteers, such  as Faith  In Action.   Faith in                                                               
Action  is located  in Anchorage,  Sitka, Homer,  Girdwood, Eagle                                                               
River, and Soldotna.   Faith in Action helps  train volunteers to                                                               
provide  long-term  care  to  individuals  in  their  home.    In                                                               
Anchorage,  at this  point approximately  60  parish nurses  have                                                               
been  trained of  which  43 are  active in  some  sort of  health                                                               
ministry activity.   Furthermore,  there are  19 churches  in the                                                               
Anchorage  area  that  have initiated  a  health  ministry  team.                                                               
Furthermore,  several  churches  provide regular  blood  pressure                                                               
screening through the trained volunteers.   The aforementioned is                                                               
a great  way to  utilize volunteers in  prevention efforts.   Ms.                                                               
Wheeler then  mentioned Project Access in  Anchorage, the mission                                                               
of which is to increase access  to health care for low income and                                                               
uninsured members of  the community by using  a volunteer network                                                               
of providers.  In the first  8 months of operation, the Anchorage                                                               
Project  Access has  recruited  a provider  network  of over  300                                                               
physicians and health  care providers.  Furthermore,  to date the                                                               
program  has  screened  over 300  applicants  and  connected  150                                                               
patients  with no-cost  medical care  from community  health care                                                               
providers.    Ms. Wheeler  then  mentioned  that the  United  Way                                                               
recently performed  a survey in  the Anchorage area,  the results                                                               
of  which  will  be  reviewed   in  September.    Such  community                                                               
assessment projects  will help provide information  regarding the                                                               
health care needs in Alaska communities.                                                                                        
                                                                                                                                
9:41:04 AM                                                                                                                    
                                                                                                                                
MS.  WHEELER concluded  her  presentation with  a  review of  the                                                               
slide entitled, "Volunteers in Alaska  - 2005."  Recently a study                                                               
from  the National  Community  Service  Commission discussed  the                                                               
volunteer services in  Alaska.  In 2005, there  were over 183,000                                                               
volunteers  in the  state.   In fact,  the national  volunteerism                                                               
rate is  29 percent while in  Alaska the volunteerism rate  is 39                                                               
percent.  She noted that  about 25 percent of Alaska's volunteers                                                               
come   from   faith-based   communities.     According   to   the                                                               
aforementioned study, the  dollar value of a  volunteer's time is                                                               
about $18.04.  Therefore, Alaska  has potentially leveraged about                                                               
$690 million by utilizing volunteers.                                                                                           
                                                                                                                                
9:43:19 AM                                                                                                                    
                                                                                                                                
VICE  CHAIR  SEATON returned  to  the  Hooper Bay  disaster,  and                                                               
inquired as  to how the Office  of FBCI works with  the different                                                               
agencies to provide services.                                                                                                   
                                                                                                                                
MS. WHEELER  explained that whenever  there is an issue,  a group                                                               
can be  formed in  conjunction with the  Salvation Army,  the Red                                                               
Cross, or other government agencies  to assess needs in the area.                                                               
Such a group  will also attempt to locate resources  to help meet                                                               
the needs of  the individuals.  For instance, in  Hooper Bay [the                                                               
Office of FBCI] was involved  in a number of teleconferences with                                                               
volunteers in order to help  understand the needs while trying to                                                               
locate resources for those needs.                                                                                               
                                                                                                                                
VICE CHAIR SEATON recalled that  Ms. Wheeler had related that the                                                               
Alaska volunteerism rate is 39  percent of which about 25 percent                                                               
of  Alaska's volunteers  come from  faith-based communities.   He                                                               
asked  if  that's  an  increase  that  the  Office  of  FBCI  has                                                               
stimulated.                                                                                                                     
                                                                                                                                
9:46:47 AM                                                                                                                    
                                                                                                                                
MS. WHEELER reminded the committee  that the percentages are from                                                               
a 2005  study.  Furthermore,  since the  Office of FBCI  has only                                                               
been  in  existence for  about  18  months  there won't  be  data                                                               
regarding whether there  has been an increase  in the faith-based                                                               
community volunteerism.   The statistics reflect  that 25 percent                                                               
of  those who  volunteer [in  Alaska] come  from the  faith-based                                                               
communities.                                                                                                                    
                                                                                                                                
9:47:38 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA   returned  to   the  issue   of  military                                                               
personnel from  rural Alaska serving  in Iraq, and  expressed the                                                               
need for the home front to  welcome the returning military.  Such                                                               
a homecoming could  be made easier, if the families  left at home                                                               
are taken care of while the family member is away.                                                                              
                                                                                                                                
MS.  WHEELER related  that one  of the  issues when  rural Native                                                               
Alaskan  males are  deployed  for military  service  is that  the                                                               
family  is left  without its  provider.   The Office  of FBCI  is                                                               
working  through some  strategic planning  to determine  what the                                                               
community  can  do  for  the  family  in  providing  the  support                                                               
services.                                                                                                                       
                                                                                                                                
9:50:59 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA opined  that part  of the  conversation is                                                               
determining how much is placed  on the faith-based and community-                                                               
based  organizations  and  what  would fall  to  state  agencies.                                                               
Having  attended   many  of   the  local   faith-based  community                                                               
meetings,  Representative  Cissna  said  that  she  is  concerned                                                               
because the volunteers are often  literally putting themselves in                                                               
jeopardy.  She  emphasized the need to take care  of the families                                                               
[of  deployed military  personnel],  a task  in  which the  state                                                               
government has to play a part.                                                                                                  
                                                                                                                                
MS.  WHEELER  noted  her  agreement that  it  takes  everyone  to                                                               
address the situation resulting from military deployment.                                                                       
                                                                                                                                
9:53:32 AM                                                                                                                    
                                                                                                                                
VICE  CHAIR  SEATON announced  that  he  would suggest  to  Chair                                                               
Wilson that there  needs to be a joint meeting  between the House                                                               
Health, Education and Social Services  Standing Committee and the                                                               
House Special Committee on Military and Veterans' Affairs.                                                                      
                                                                                                                                
9:54:31 AM                                                                                                                    
                                                                                                                                
RYNNIEVA  MOSS,  Staff  to Representative  John  Coghill,  Alaska                                                               
State  Legislature,  suggested  that   perhaps  the  Joint  Armed                                                               
Services  Committee  should also  be  notified  of such  a  joint                                                               
meeting.                                                                                                                        
                                                                                                                                
9:55:35 AM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health, Education and Social  Services Standing Committee meeting                                                               
was adjourned at 9:56:33 AM.                                                                                                  

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