Legislature(1993 - 1994)
01/19/1994 03:00 PM House HES
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
January 19, 1994
3:00 p.m.
MEMBERS PRESENT
Rep. Cynthia Toohey, Co-Chair
Rep. Con Bunde, Co-Chair
Rep. Gary Davis, Vice Chair
Rep. Al Vezey
Rep. Pete Kott
Rep. Harley Olberg
Rep. Irene Nicholia
Rep. Tom Brice
MEMBERS ABSENT
Rep. Bettye Davis (excused)
OTHER LEGISLATORS PRESENT
Rep. Jim Nordlund
COMMITTEE CALENDAR
Overview: Department of Health and Social Services
Commissioner Margaret Lowe
Jay Livey, Deputy Commissioner
Kim Busch, Director, Division of Medical
Assistance
Jan Hansen, Director, Division of Public
Assistance
WITNESS REGISTER
COMMISSIONER MARGARET LOWE
Department of Health and Social Services
P.O. Box 110601
Juneau, Alaska 99811-0601
Phone: (907) 465-3030
DR. PETER NAKAMURA, Director
Division of Public Health
Department of Health and Social Services
P.O. Box 110610
Juneau, Alaska 99811-0610
Phone: (907) 465-3090
KIM BUSCH, Director
Division of Medical Assistance
Department of Health and Social Services
P.O. Box 110660
Juneau, Alaska 99811-0660
Phone: (907) 456-33552
JAN HANSEN, Director
Division of Public Assistance
Department of Health and Social Services
P.O. Box 110640
Juneau, Alaska 99811-0640
Phone: (907) 465-3347
SUZANNE PERRY, Regional Program Coordinator
Division of Alcoholism and Drug Abuse
Department of Health and Social Services
P.O. Box 110607
Juneau, Alaska 99811-0607
Phone: (907) 465-2071
SHARON LOWE, Admistraive Officer
Division of Public Health
Department of Health and Social Services
P.O. Box 110610
Juneau, Alaska 99811-0610
Phone: (907) 465-3090
ACTION NARRATIVE
TAPE 94-02, SIDE A
Number 000
CHAIR TOOHEY called the meeting to order at 3:03 p.m., noted
the members present, announced the calendar, and introduced
the Department of Health and Social Services members.
(NOTE: Due to accidental erasure, tape count numbers 036-
199 have not been transcribed. This portion of the meeting
contained testimony from Commissioner Margaret Lowe, whose
prepared statement is on file. Her testimony has been
pieced together from the prepared statement.)
Number 200
COMMISSIONER MARGARET LOWE, Department of Health and Social
Services (DHSS), read a prepared statement to the committee.
(Attachment 1). In it, she informed the committee of
legislation that the Department of Health and Social
Services (DHSS) supports and also a summary of status in
regards to specific programs within the department. She
stated that health care reform, alcohol and tobacco excise
tax, Governor Hickel's crime package, and senior services
legislation were of particular interest to the department at
that time.
COMMISSIONER LOWE said that the Division of Mental Health
and Developmental Disabilities (DMHDD) Medicaid refinancing
for mental health services had proven successful. As of
January, Medicaid revenues collected by grantees were
greater than the entire previous year, and through Medicaid
all grantees will have made up for funding cuts in fiscal
1994. Also, programs such as Project CHOICE waivers and Tax
Equity Fiscal Responsibility Acts of 1982 (TEFRA) will help
to reduce costs for facility or in-patient treatment by
increasing home-based and community services for clients.
COMMISSIONER LOWE said that the DHSS (the department)
endorsed Governor Hickel's legislation to increase the
excise tax on alcoholic beverages by 50%, expressing that
the increase would reduce alcohol consumption among youths
and not affect Alaskans who do not drink alcohol. She also
supported the automatic waiver of juveniles 16 and over and
stated that all five juvenile correctional facilities had
been accredited.
COMMISSIONER LOWE stated that protection and licensing for
adults and children has been reorganized. The Division of
Family and Youth Services (DFYS) will be responsible for
protection and licensing for children, and adult concerns
will be handled by the Division of Senior Services.
COMMISSIONER LOWE talked about the replacement of Alaska
Psychiatric Institute (API) in Anchorage. The plan is to
provide designated treatment beds in existing facilities
around the state and to replace API with a 90-bed facility
and a 24-bed forensic facility.
COMMISSIONER LOWE felt, in the area of public assistance,
that the recipients were the result of the of lack of other
preventative and supportive programs that prevent people
from initially entering into the system. She suggested that
they needed more staffing to assure containment and payment
accuracy.
COMMISSIONER LOWE commented on various successful programs
and programs in need. Women, Infants, and Children (WIC) is
expected to bring more federal funds into the state as the
program grew by approximately 50%. Through Medicaid, Alaska
Youth Initiative serves 130 youths which previously
accommodated 100. Decline in suicide is the most
significant in the villages that have grants from the
department's rural program, Commissioner Lowe stated. Also,
she cited the decreased reliance of foster care due to
serving children in their own homes and shortening out-
placement length of stay.
COMMISSIONER LOWE expressed concern for severely emotionally
disturbed children statewide, as research proved that there
was a "great unmet need for mental health services."
Number 531
(Rep. Brice arrived at 3:07)
Number 538
REP. BUNDE asked the department about the teen pregnancy
problem.
Number 554
COMMISSIONER LOWE stated that she did not know of a
concentrated effort that was taking place to curb teen
pregnancy and referred to Dr. Nakamura.
Number 567
DR. PETER NAKAMURA, Director, Division of Public Health,
DHSS, said that the department agreed that teen pregnancy
was a major area of concern that could be addressed through
family planning and family health education programs.
Number 583
REP. BUNDE asked if the rate of teen pregnancy was slowing.
Number 586
DR. NAKAMURA could not give accurate numbers, but
volunteered the statistic that better than 10% of births in
Alaska are born to teen parents.
Number 605
REP. BUNDE asked if single, pregnant teens received a
monthly stipend from the state.
Number 617
DR. NAKAMURA stated that the Women, Infants, and Children
(WIC) program supplied supplemental food for pregnant woman,
and the program was not limited to teens.
REP. BUNDE felt it was inappropriate to give a cash stipend
to teens and encouraged a coupon of sorts (i.e., food
stamps). He asked if the state paid for sonograms for
teens.
Number 643
KIM BUSCH, Director, Division of Medical Assistance, DHSS,
stated that under the Healthy Baby Initiative teen
pregnancies are considered high risk, and if the teen is on
Medicaid she is eligible for certain services through the
state.
REP. BUNDE asked again if there was a stipend for teens.
MS. BUSCH replied she was unaware of any stipend through the
state.
Number 718
CHAIR BUNDE asked again if there was a "financial reward"
for teens getting pregnant.
Number 720
JAN HANSEN, Director, Division of Public Assistance, DHSS,
stated that there was no available cash stipend through DHSS
until the third trimester when the teen meets the
requirements through Aid to Families with Dependent Children
(AFDC) and a grant is allowed.
Number 737
CHAIR TOOHEY said that a teen would not automatically be
sent a stipend; they would have to apply through Medicaid or
AFDC.
Number 749
In reply to Rep. Bunde's question, MS. HANSEN stated that a
teen in her first or second trimester does not receive a
cash stipend.
Number 756
(Rep. Kott arrived at 3:25)
Number 763
REP. BUNDE asked the department's reaction to legislation in
other states regarding state funding for teens to live on
their own away from their family.
Number 782
MS. HANSEN said that a task force in 1988 recommended that
Alaska not adopt the requirement for teens to live in the
home of the parent; the mind-set being that the state would
not force a teen to live in an abusive environment. She
stated that the Clinton Administration was proposing
legislation to make pregnant teens live at home, and
subsequent to national debate, would look again at the
issue.
Number 856
REP. G. DAVIS asked Dr. Nakamura if there would be any cost
reductions in services provided by the state upon completion
of the new Native hospital in Anchorage.
Number 864
DR. NAKAMURA felt there would not be any significant
changes.
Number 880
REP. G. DAVIS asked Ms. Hansen about her opinion on welfare
reform in Alaska in regards to legislation in Wisconsin.
Number 888
MS. HANSEN answered that whatever demonstration projects
that were being tested in Wisconsin and other states that
had merit would be seriously considered by the department.
Number 939
REP. BUNDE inquired as to whether or not the DHSS had an
opinion on "two years and out" for Alaska, referring to
present legislation in other states that allows for
recipients to participate in the system for two years, exit
the system, and then after only a brief period rejoin the
system.
Number 950
MS. HANSEN answered that she felt Alaska would not "just put
people out" after two years, stating as a supporting factor
that there are 12,500 families on AFDC and that there are
not 12,500 jobs available. She supported an expectation of
a time limit in the form of a contract between family and
state and the utilization of the JOBS program.
Number 022
CHAIR TOOHEY reminded the department of her "HEALTHY
STUDENT" bill, stating that the bill addressed all the
aforementioned youth problems (i.e., teen pregnancy, alcohol
and tobacco consumption, and an increase in HIV) and asked
for support from the department.
CHAIR TOOHEY asked why there was a 30% increase of women and
children in Aid to Families with Dependent Children (AFDC).
Number 040
DR. NAKAMURA stated that WIC was given an additional
$1,000,000 last year to serve more individuals, and the
program was serving 40% of the eligible population.
Number 050
CHAIR TOOHEY was reminded that it was the rebate process
discussed in the subcommittee that made the additional
$1,000,000 of no cost to the state.
Number 063
CHAIR TOOHEY questioned the department about the criteria
for participating in TEFRA.
MS. BUSCH said the eligibility criteria was based on the
child's income, regardless of the parent's income.
Number 090
COMMISSIONER LOWE stated that TEFRA only covered children 18
and under for mid-level to severe level care for the
developmentally disabled.
Number 100
CHAIR TOOHEY asked the cost of the outcome study.
Number 104
SUZANNE PERRY, Regional Program Coordinator, Division of
Alcoholism and Drug Abuse, DHSS, stated that the contract
was for $150,000.
Number 123
CHAIR TOOHEY asked if there would be chronic beds at the new
API.
Number 128
COMMISSIONER LOWE said that there would be no chronic beds
at the new facility, but API 2000 would facilitate tertiary
care (care for the most complex cases necessitating a staff
of psychiatrists). Primary and secondary care would be
provided in regional hospitals around the state.
TAPE 94-02, SIDE B
Number 006
CHAIR TOOHEY asked how many beds API presently has.
COMMISSIONER LOWE responded that there were 130 beds.
CHAIR TOOHEY asked if the other beds would be taken up by
the surrounding hospitals (ANS, Providence, etc.).
Number 015
COMMISSIONER LOWE replied that there were still a fair
number of long-term psychiatric or "nursing home" type of
dementia patients. The department was looking to place some
of those patients at Harbor View Developmental Center.
Number 080
REP. NICHOLIA asked if there was data that showed the impact
of the Rural Human Services program (also known as Village
Counsellor program).
Number 091
COMMISSIONER LOWE stated that the training program at the
University of Alaska, Fairbanks for Rural Human Services had
moved up to the certification level, and as it continues to
grow, it benefits the villages. She said the data clearly
reflected changes in alcohol habits and a lower suicide rate
within the villages involved in the grant program.
Number 141
REP. NICHOLIA asked for comment on the length of time on
waiting lists for the rural communities for infant learning
programs.
Number 152
COMMISSIONER LOWE explained that there were waiting lists
and acknowledged that the department was not meeting the
needs of the program with the current budget.
Number 160
SHARON LOWE, Regional Program Director, Division of
Alcoholism and Drug Abuse, DHSS, remarked that hopefully the
waiting list was not increasing, and cited the need for
grantees and third party payers to apply to Medicaid for
reimbursement to offset the $200,000 program receipts.
Number 200
CHAIR TOOHEY asked if it was a statewide program or a Native
program only. She was told by a number of participants that
it was statewide and that there were waiting lists virtually
everywhere.
Number 208
REP. NICHOLIA asked if there were other crime bills besides
SB 54 that the department was supporting.
Number 215
COMMISSIONER LOWE responded that the department was working
specifically with Senator Halford on youth waivers.
Number 231
REP. BUNDE inquired as to the success/failure rate of
treatment centers for alcoholism and drug abuse, commenting
that there should be effective documentation evaluating
treatment performance.
Number 259
COMMISSIONER LOWE said treatment evaluation research was a
difficult study as it must be done over a long period of
time and there is no existing funding presently to
facilitate a study over the span of time required for
accurate assessment.
Number 145
CHAIR TOOHEY briefly related her childhood struggle with
family dysfunction and growing up with Alcoholics Anonymous
(A.A.). She stated that recovery is such an "ongoing"
process that one could not qualify an outcome until they die
sober or from alcohol abuse. She stated further that the
$125,000 should be put towards A.A. meetings and
counselling.
Number 340
CHAIR TOOHEY reminded the department of the state's fiscal
status and said there would be future input needed from the
department.
Seeing no further questions or discussion, Chair Toohey
adjourned the meeting at 3:56 p.m.
| Document Name | Date/Time | Subjects |
|---|