02/24/2004 03:06 PM House HES
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
February 24, 2004
3:06 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Carl Gatto, Vice Chair
Representative John Coghill
Representative Kelly Wolf
Representative Sharon Cissna
MEMBERS ABSENT
Representative Paul Seaton
Representative Mary Kapsner
COMMITTEE CALENDAR
HOUSE BILL NO. 394
"An Act extending the Alaska Commission on Aging."
- MOVED CS HB 394(HES) OUT OF COMMITTEE
HOUSE BILL NO. 197
"An Act relating to intensive family preservation services and
intensive family reunification services; and providing for an
effective date."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 394
SHORT TITLE: COMMISSION ON AGING
SPONSOR(S): REPRESENTATIVE(S) HOLM
01/20/04 (H) READ THE FIRST TIME - REFERRALS
01/20/04 (H) STA, HES
02/10/04 (H) STA AT 8:00 AM CAPITOL 102
02/10/04 (H) Heard & Held
02/10/04 (H) MINUTE(STA)
02/17/04 (H) STA AT 8:00 AM CAPITOL 102
02/17/04 (H) Moved Out of Committee
02/17/04 (H) MINUTE(STA)
02/18/04 (H) STA RPT 6DP 1NR
02/18/04 (H) DP: GRUENBERG, SEATON, HOLM, LYNN,
02/18/04 (H) BERKOWITZ, WEYHRAUCH; NR: COGHILL
02/18/04 (H) FIN REFERRAL ADDED AFTER HES
02/24/04 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 197
SHORT TITLE: INTENSIVE FAMILY PRESERVATION SERVICES
SPONSOR(S): REPRESENTATIVE(S) CISSNA
03/17/03 (H) READ THE FIRST TIME - REFERRALS
03/17/03 (H) HES, FIN
02/24/04 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
BARBARA COTTING, Staff
to Representative Jim Holm
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the bill on behalf of
Representative Holm, sponsor of HB 394.
STEVE ASHMAN, Director
Division of Senior and Disability Services
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 394 and answered
questions from the members.
MARIE DARLIN, Coordinator
Capital City Task Force
AARP Alaska
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 394.
REPRESENTATIVE SHARON CISSNA
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified before the committee as sponsor
of HB 197.
MARCI SCHMIDT, volunteer
Family First Partnership
Wasilla, Alaska
POSITION STATEMENT: Testified in support of HB 197.
SHELLEY LEAVITT, Ph.D., Associate Director
Institute of Family Development;
Board Member, National Family Preservation Network
Federal Way, Washington
POSITION STATEMENT: Testified in support of HB 197 and answered
questions from the members.
MARCIE KENNAI, Deputy Commissioner
Office of Children's Services
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified on HB 197 and answered questions
from the members.
ACTION NARRATIVE
TAPE 04-14, SIDE A
Number 0001
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:06 p.m.
Representatives Wilson, Gatto, Wolf, Coghill, and Cissna were
present at the call to order. Chair Wilson announced for the
record that Representative Seaton has been excused.
HB 394-COMMISSION ON AGING
Number 0050
CHAIR WILSON announced that the first order of business would be
HOUSE BILL NO. 394, "An Act extending the Alaska Commission on
Aging."
Number 0092
REPRESENTATIVE GATTO moved to adopt CS HB 394, 23-LS1534\D,
Mischel, 2/19/04, as the working document. There being no
objection, HB 394, version D, was adopted as the working
document before the House Health, Education and Social Services
Standing Committee.
Number 0155
BARBARA COTTING, Staff to Representative Jim Holm, Alaska State
Legislature, presented the bill on behalf of Representative
Holm, sponsor of HB 394. She explained that the committee
substitute that the members just adopted as the working document
adds sections 2 and 3 to the original bill. The original bill
was very short because it consisted of one section that extended
the sunset [of the Alaska Commission on Aging].
MS. COTTING explained that in 2003, Executive Order 108 moved
many commissions to different departments. It is important to
note that at that time the Commission on Aging was moved from
the Department of Administration to the Department of Health and
Social Services. Legislative Legal and Research Services
believes that it is important to clarify that point and that is
the purpose of sections 2 and 3, she said. It is just a
housekeeping measure.
Number 0260
STEVE ASHMAN, Director, Division of Senior and Disability
Services, Department of Health and Social Services, testified in
support of HB 394 and answered questions from the members. He
explained that the division administers grant programs under the
Older Americans Act. These programs used to be administered by
the Commission on Aging, he added. The division has been
working very closely with the Commission on Aging as the
reorganization progresses, Mr. Ashman stated. He explained that
since the Alaska Commission on Aging was created in the late
1970s, it has done a great job of meeting the needs of the
elderly, and [the administration] supports its continuation.
Number 0302
REPRESENTATIVE COGHILL commented that he read the legislative
audit report [on the Alaska Commission on Aging, dated October
1, 2003] which was done before the commission was moved from
[the Department of Administration to the Department of Health
and Social Services]. Representative Coghill said that he is
concerned with the grant making process and asked Mr. Ashman to
explain the changes that have been made to that process. He
told the committee that he had the auditor come to his office
and discuss the report with him. Representative Coghill noted
that the auditor is at the meeting today should there be need
for clarification.
Number 0372
MR. ASHMAN replied that he has also read the audit report. He
said he believes the problems that Representative Coghill is
referring to occurred in fiscal year 2002, when the program was
over at the Division of Senior Services in the Department of
Administration. The first problem pertains to the Senior
Employment Program, [which was authorized] under federal law.
The program was supposed to be providing temporary training
services to older Alaskans, 55 years old or older, to enable
them to reenter the workforce, he said. However, what happened
was that many of the grantees were using those employees to fill
long-term positions within its organizations. This [practice]
was clearly against federal legislation, he stated. The
division has changed that practice, although some latitude has
been extended in rural areas where there is a lack of employment
opportunities. Mr. Ashman commented that approximately 80
percent of the seniors [in this program] are [moving from
training to employment] within six months, which means the state
is now in compliance with federal laws. There are still some
grantees that are administering the program, he acknowledged;
but assured the committee that the division is keeping an eye on
them.
Number 0501
MR. ASHMAN said he believes another problem the report cited was
the lack of reporting to ensure that the use of federal funds
was in compliance with federal program requirements. He
commented that the issue was the lack of on-site audits. A plan
was put together two years ago to focus on those two areas and
he told the members that he believes the division is on target.
REPRESENTATIVE COGHILL asked Mr. Ashman to confirm that [$13]
million in federal funds are administered through this program.
He asked what portion of those funds are general funds dollars.
Number 0574
MR. ASHMAN replied that historically the state's match is about
24 percent in general funds. The minimum match requirement is
15 percent. He pointed out that in the division's budget this
fiscal year there is a $200,000 reduction in general fund
contributions because grantees will be asked to pay 10 percent.
Mr. Ashman explained that currently between 95 percent and 98
percent of the grantees do have a 10 percent cash match. The
state picks up 15 percent and the federal government covers the
balance.
REPRESENTATIVE COGHILL asked if the movement of the division
from one department to another has changed its mission.
MR. ASHMAN responded that there is no change [in the mission] of
the Alaska Commission on Aging because the mission was
established under the Older Americans Act which created the
Commission on Aging, formerly the Older Alaskans Commission.
The only change that has occurred in this reorganization is the
removal of grant making ability from the Alaska Commission on
Aging and transferring those duties to the Division of Senior
and Disability Services. The Department of Health and Social
Services has some very well defined procedures in how the grant
process works, whereas the Department of Administration did not
have that type of process in place, he added.
REPRESENTATIVE COGHILL asked if there will be a change in
accountability.
MR. ASHMAN explained that while the Commission on Aging will not
be making any grants, the state plan is developed by the
Executive Director of the Commission on Aging, and then is
presented in a series of public meetings. The Commission on
Aging finalizes the plan and presents it to the governor for
approval. In that plan is the intra-state funding formula which
says how the funds will be distributed statewide, so the
commission is key in that respect, he said. Mr. Ashman
emphasized that the commission will not be [awarding] any
grants. The division will work with the commission closely to
ensure that the grants are being managed consistently with the
desires of the Commission on Aging and the state plan, he added.
REPRESENTATIVE COGHILL commented that he misunderstood a
commission member's testimony in the House State Affairs
Standing Committee [on that point]. He asked if the commission
members look at allocation parameters.
MR. ASHMAN responded that the commission members look at the
intra-state funding formula that is included in the state plan,
and which identifies the priorities and areas where funding will
go.
REPRESENTATIVE COGHILL asked if the commission members are made
up of regional representatives or are the members appointees.
Number 0784
MR. ASHMAN responded that according to Alaska law the commission
members are appointed by the governor. No geographical
representation is required, he added. However, over the past 15
years that he has been associated with the commission, there
have always been representatives from both the rural and urban
areas of Alaska. One requirement for appointment is that
members must be a user of services either under the home
community-based Older Americans Act programs and/or the Medicaid
programs. In summary, he said there is good representation
statewide.
Number 0833
MS. COTTING directed the members' attention to the handout in
the members' packets from the Office of Boards and Commissions
which highlights the requirements of members. She said part of
those requirements read as follows:
Appointments shall be made to assure representation of
low-income and minorities and rural/urban areas and
statewide geographical representation.
MS. COTTING stated that the requirements are well defined in the
Boards and Commission statute.
CHAIR WILSON referred to the Legislative Audit report [dated
October 1, 2003, page 17, paragraph two] which read:
We continue to recommend the agency establish and
follow procedures to ensure that costs reported by
subrecipients comply with federal requirements ...
CHAIR WILSON said one point that was noted [in the report] was
that there was a lack of periodic site visits. She asked Mr.
Ashman what specific steps he has taken to ensure that concern
is being addressed.
Number 0915
MR. ASHMAN responded that under the corrected plan the division
put together, desk audits are being done. He noted it was not
being done before. He agreed that the last two audit reports
cited the lack of periodic site visits as a problem. Mr. Ashman
explained that there are 78 grantees and the division has a
staff of 3, so it is not physically or financially possible to
visit every grantee every year. The visits are being done on a
rotation basis; however, desk audits are being done [regularly].
He told the members that whenever someone else from the Division
of Senior and Disability Services happens to be in a particular
community, the division is making an effort to visit the
grantees while there. There may not be a review of the books at
that time, he commented. Mr. Ashman emphasized that there have
been increased audits over what was done in previous years.
Number 0963
CHAIR WILSON commented that there have been several statements
made that in the grant process there was a bias in the awarding
of grants. She asked Mr. Ashman to address those [charges].
MR. ASHMAN explained that in FY 04 and FY 05 a new state plan
needed to be developed. Part of that plan is the intra-state
funding formula which is based on census information. The
previous census information and plans were based upon the 1990
census. When the new census came out there was a redistribution
of [funding based on] senior citizen [populations]. For
instance, there may have been a higher growth of seniors in one
region over another region, so the funding formula changed.
There were winners and losers financially. He surmised that
there could have been some grantees who had been receiving more
funding under the 1990 census, but then lost funding with the
new census report. Mr. Ashman emphasized that the number of
seniors has increased in all areas. The Commission on Aging
requested that rather than having communities take the whole hit
in one year, it was requested that the federal government allow
a phase-in of that [redistribution in a] three-year plan. He
summarized that he does not believe the grantees had a problem
with the process, but rather with [the way the census impacted]
the outcome.
CHAIR WILSON asked Mr. Ashman if he could confidently tell her
that there will be improvement.
MR. ASHMAN assured Chair Wilson that there will be improvement.
Number 1097
REPRESENTATIVE CISSNA told Mr. Ashman that an hour or two ago
she listened to seniors who had teleconferenced in to a meeting
from ten or more communities. She was told that Alaska has the
second fastest growing aging population in the United States,
second to Nevada. Seniors now make up something like 6 percent
of the population, she said. Representative Cissna commented
that in not many years it will grow to 12 percent. These
seniors told of the gaps in services for conditions such as
Alzheimer's disease. She asked how Mr. Ashman views this
growing problem.
Number 1188
MR. ASHMAN agreed with Representative Cissna's comments. The
Alaska Commission on Aging and the local senior networks are
looking at what level of services are being provided currently.
Once that assessment is made, the [program] can be tailored to
meet the needs of the community. The division will be looking
to see where the funds are being spent and pointing out that,
for example, 52 percent of funds are being spent on
transportation services and then assure that is where the need
is for a particular community. Some of the senior networks may
not be aware of the way funds are being spent. Mr. Ashman said
that the division and the commission will be having those
discussions on a local level.
REPRESENTATIVE COGHILL noted that it is helpful to understand
that this is an evolving plan and a change of administration.
He asked how these changes impact the scrutiny of grants. Are
there any major changes in the delivery of the plan.
Representative Coghill stated that based on what he has heard,
he is still not satisfied that he understands what the changes
will be.
MR. ASHMAN responded that he is not sure what Representative
Coghill is asking. He commented that when working with the
grantee agencies, the division will be saying historically here
is where the funds have been used and the types of services
[provided] in this particular market. The division will be
asking if these services have been meeting the needs of the
community. Mr. Ashman noted that many of the grantees are
Medicaid waiver providers and the division will work to ensure
that they are maximizing the funds received. He assured
Representative Coghill that the division has regulations that
will be followed to ensure that those receiving the grants
administer them appropriately, and that the grantees are
submitting reports on time before any advances are provided.
Number 1559
REPRESENTATIVE COGHILL asked how this plan fits with the home
and community-based waiver program, assisted-living homes, and
the huge network of agencies out there. Obviously, he said,
this group is very attuned to the needs of the communities. He
told Mr. Ashman he would like to have some clarity in how the
needs are being identified and how the grants meet those needs.
For example, doesn't the commission look at the number of people
and the limited number of dollars to meet those needs, and then
evaluate what is the wisest expenditure of those funds. He
asked if there is any change in the way these points are
examined.
MR. ASHMAN responded that the division will take a look at what
services are being provided currently in a community and make
sure the services that are needed [are met], and if not, what
kind of changes need to be made [to address those deficiencies].
Mr. Ashman commented that he believes that is a local issue that
the division will be working on to assure the right services are
being provided. This will be done in conjunction with the
division and the commission because while the division
administers the grant programs; it is the commission that puts
together the state plan, reviews it, does the public comment,
and works with the local communities. The commission will work
side-by-side with [the division]. Ultimately, the state plan is
the plan that is submitted by the governor, he stated. He added
that the division will ensure that the administration of grants
are in compliance with that state plan.
REPRESENTATIVE COGHILL said he would like some clarification on
where the commission's [duties] start, where the
administration's [duties] start, and at what point it converges.
How do to the two work together, and is there tension between
the two, he asked.
MR. ASHMAN told the committee that under Alaska statutes the
executive director prepares the state plan. The Older American
Act requires a state plan and a senior advisory committee, which
in Alaska is the Alaska Commission on Aging. The executive
director works for and is hired by the Alaska Commission on
Aging, subject to the governor's appointment because it is a
partially exempt position. He reiterated that the executive
director puts together the plan in conjunction with the desires
of the commission. After the plan is developed, the commission
spends approximately six months conducting public hearings on
that plan. The comments and feedback received in those public
hearings are incorporated into the plan, he said.
REPRESENTATIVE COGHILL asked if the division's move from the
Department of Administration to the Department of Health and
Social Services affects how the plan works. Has the move
impacted how different agencies work together. Representative
Coghill asked how the plan affects people at home. Are there
changes in the categories that are being offered, he asked.
MR. ASHMAN responded that the reorganization does make sense
because the division is the "one-stop-shop" for all long-term
care services. The Division of Senior and Disability Services
not only manages the Medicaid Waiver Program, but also the other
three long-term care options. He said the division is looking
at the broader picture of how all these programs fit together to
make sure the needs are being met with whatever types of
programs are available. He said that he would not want to see
the division go into a community and tell it that it needs
respite [care], for example. He said he wants the division to
say to a community here's what is currently offered; here's
what's available; ask what is working and what is not; and offer
some programs that are available to meet the needs of seniors in
the community.
Number 1678
REPRESENTATIVE COGHILL said that he still needs further
clarification on the grants issue before he can vote for the
reauthorization of the Alaska Older Alaskans Commission.
MR. ASHMAN replied that, for example, when there are Title III
funds [available] for nutrition transportation services (NTS),
it is the grantees that comes to the division with a proposal.
The division knows how much money is available based on the
inter-state funding formula. So regionally it is known how much
money can go into that particular region, he said. It is the
grantee that tells the division how much it wants to spend on
transportation, information referral, and other categories.
Within the big picture, it is the grantee that is deciding what
level of services are being made. He told the members that the
question the division has is when there are multiple grantees
within a particular region, do the grantees all know what's
going on, and are the dollars that are being spent the best use
of those funds.
Number 1743
REPRESENTATIVE COGHILL said that the need is great and he wants
to ensure that he has a clear understanding of the plan. He
said he has one other question which he believes cannot be
answered in this committee, but which he would welcome
suggestions from Mr. Ashman. He said he is aware of the fact
that there is a huge federal dollar contribution, and a huge
amount of federal money that does not go through the state, but
goes directly to the community. Representative Coghill said his
concern is that many of these dollars are going into the same
service market for similar needs. He said he wants to make sure
that one funding source is not competing with another source in
the same market.
Number 1797
CHAIR WILSON commented that she is concerned because funds are
so limited and seniors are so precious to Alaska. She asked Mr.
Ashman where the lieutenant governor's faith-based initiatives
fits into this. Chair Wilson said that what neighbors and
family use to do for each other, is no longer being done on a
volunteer basis because it is being paid for. She added that
she is concerned that something is driving this machine. Chair
Wilson asked if the division is looking at encouraging
volunteerism. For example, there are many things such as
grocery shopping, babysitting, and household chores which could
be done free of charge by a volunteer. She encouraged this kind
of volunteerism so that the things that really need to be paid
for can be funded in a larger scope. In some cases, grandma use
to baby-sit for free, but now she's being paid. Chair Wilson's
said it is not that she doesn't want grandma to have some extra
spending money, but that when money is spent on things that
could be accomplished through volunteerism it may not be
possible to fund things that are really needed.
MR. ASHMAN replied that one of his staff is assigned to the
lieutenant governor's faith-based initiatives. He said he
believes that many would be surprised at the number of grantees
that are working with the same [faith-based] organizations. For
example, if it is known that a particular person does not have
any food in their cupboard, a faith-based organization will
provide that. Faith-based organizations, through the 501(c)(3)
or nonprofit status, will participate in some of these same
programs that the division has.
Number 1922
MR. ASHMAN shared his concern that what [families and neighbors]
use to do for each other seems to be shifting somewhere else.
He said that he believes that many have heard about the
regulatory changes that reflect cost-containment measures in the
division's budget to eliminate some of those expenses. There
are instances where the division is paying for respite services
to a paid family member, so they can go out and provide services
to someone else. The division is saying that it will not
respite a paid care provider, he commented. There is a higher
dependence on family members, in that the division is
eliminating the use of respite and chores services and saying
that if there is someone in that household who can provide those
services, then he/she needs to be doing them. Our proposed
regulations [which reflect those changes] have gone out to the
public for comment, and should be adopted shortly.
CHAIR WILSON reiterated that she is not saying that people do
not need a break, but that perhaps a neighbor could come in and
help out and it would not cost anything.
MR. ASHMAN responded that the division is limiting respite to 10
hours per week or 520 hours per year. He said he believes that
is fair and consistent with what other states have been
providing. He agreed that there certainly should be respite
[assistance].
MS. COTTING told the members that she has a copy of the draft
plan for the next four years, which was obtained from the
Department of Health and Social Services.
Number 2018
REPRESENTATIVE WOLF replied that he would like a copy. He asked
Mr. Ashman to elaborate on the regulations that are being
proposed.
MR. ASHMAN asked if he and one of his staff, who is very
knowledgeable, could meet with him to discuss the regulations in
detail.
REPRESENTATIVE WOLF shared that this past summer his mother-in-
law had a stroke, and said that he was surprised by the
discouraging attitude his family encountered in choosing to care
for her at home. He said this was a family stepping-up to care
for her; it was not going to cost anyone anything. He asked Mr.
Ashman to comment on that prevailing attitude.
Number 2086
MR. ASHMAN commented that his response would be dangerous. He
shared that his family recently did the same thing. His father
passed away in his own home, he said. When his wife's mother
was dying, during the last six months of her life his wife cared
for her for four months. He said he believes that it is the way
a person is raised, more than anything else. Mr. Ashman said
that is where personal beliefs come in. He said he could not
say why [Representative Wolf's family was discouraged from
caring for his mother-in-law]. He reiterated that he believes
it is how a person is raised.
REPRESENTATIVE WOLF shared that his mother-in-law taught school
for 36 years in California. She's 74 years old now and upset
that this is happening to her. He said it took a while for him
to convince her that she is on the biggest teaching assignment
that she ever encountered, because now she's teaching her kids
compassion. It is a very valuable lesson.
Number 2168
MARIE DARLIN, Coordinator, Capital City Task Force, AARP Alaska,
testified in support of HB 374. She told the members that AARP
Alaska fully supports the continuation of the Commission on
Aging. Over the years AARP Alaska has worked with the
commission on may issues and looks to them, and hopes to
continue to look to them, as a group that will be working with
organizations such as AARP to ensure that there is a plan that
will meet the needs of communities. Ms. Darlin explained that
currently AARP Alaska is one of the groups the commission works
with in determining what the needs are. Many of the issues that
have been discussed today are concerns of AARP Alaska as well.
She added that she served on the Juneau Commission on Aging for
about six years, and said that it is important for the state
commission to go to the local commissions on aging when
determining the needs of the community. Some communities do not
have a local commission, but most communities are interested in
having one, she added.
Number 2255
REPRESENTATIVE COGHILL commented that he believes every member
should attend at least one commission debate.
Number 2263
REPRESENTATIVE CISSNA moved to report CS HB 394, 23-LS1534\D,
Mischel, 2/19/04, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection, CS HB 394(HES) was reported out of the House
Health, Education and Social Services Standing Committee.
HB 197-INTENSIVE FAMILY PRESERVATION SERVICES
Number 2324
CHAIR WILSON announced that the final order of business would be
HOUSE BILL NO. 197, "An Act relating to intensive family
preservation services and intensive family reunification
services; and providing for an effective date."
REPRESENTATIVE SHARON CISSNA, Alaska State Legislature,
testified before the committee as sponsor of HB 197.
TAPE 04-14, SIDE B
Number 2394
CHAIR WILSON said that an individual is on-line that must leave
at 4 p.m. and would like to give that person an opportunity to
speak.
Number 2323
REPRESENTATIVE CISSNA told the members that this legislation
introduces a model which is described in the language of the
bill. Section 9 [page 9, lines 23 through 25] inserts language
that reads:
The department or agency shall also consider the
eligibility of the child and family for intensive
family preservation services or intensive family
reunification services, or both, under AS 47.10.550.
REPRESENTATIVE CISSNA explained that Section 10 lists the
requirements and steps that workers will use in identifying
clients, collecting data, and accessing the tools necessary to
submit a report to the governor by November 30, 2004. The
report will describe the study, conclusions, and
recommendations. Representative Cissna summarized that the
study will determine if intensive family preservation [and
reunification] services are needed and if needed, look for
funding to implement it.
REPRESENTATIVE CISSNA commented that Dr. Shelley Leavitt is at
the meeting today to share what other states have done. She
noted that there are some identifiable sources of funding for a
pilot model to make sure this plan will work for Alaska.
REPRESENTATIVE CISSNA shared her personal experiences. In 1963
she worked in the social services field with some of the
population that is being discussed today. She said that "up
stream" is where the work needs to be done. Representative
Cissna emphasized that she believes prevention should be the
first priority. Having been a foster parent of more than 14
kids in the late 1980s, she said she found that the Division of
Youth and Family Services had more than 1,000 kids in foster
care at that time. In a decade that number has doubled, she
stated. During that next decade she shared that she worked as a
therapist in a program that worked with that same population of
kids. This is a toxic problem that has a huge cost. One of
those costs is not just financial; there are faces that go with
this program, and that is why she said she has such intense
feelings about it. Representative Cissna explained that this
program steps in at the juncture of where the child is about to
be removed from the family. It is not the big fix, she added,
it is a little fix that is relatively inexpensive if looking at
the big picture. These services have been extraordinarily
successful in the places that it has been implemented.
Number 2146
MARCI SCHMIDT, volunteer, Family First Partnership, testified in
support of HB 197. She told the members that she believes the
pendulum has moved to the point that [children are removed from
the home] and nothing is done to get families back together.
Ms. Schmidt said that she knows of some instances where families
could have been put back together if services had been provided.
Number 2090
SHELLEY LEAVITT, Ph.D., Associate Director, Institute of Family
Development; Board Member, National Family Preservation Network,
testified in support of HB 197 and answered questions from the
members. She told the members that the bill provides for
intensive family preservation services and intensive
reunification services, which are short-term in-home crisis
intervention; skill-building services, which are designed to
keep children safe, strengthen families, keep families together,
and reduce the reliance and over-reliance on out of home
placement. Intensive family reunification services have been
widely used and replicated in 20 to 30 states and nine other
countries for close to 30 years, she stated. There has been a
great deal of research done on the services in tracking the
effectiveness of keeping children safe, improving family
functioning so that children can thrive and survive, and for
potential cost savings for states.
DR. LEAVITT told the members that many states, including
Washington, have chosen to spend money to offer services to
prevent [out of home] placement so families can be strengthened,
instead of spending it on child welfare, mental health, juvenile
justice, and out of home placement. Strong families are
critical to the healthy development of children and teenagers,
she said.
Number 2011
DR. LEAVITT commented that it was interesting listening to the
discussion on the earlier bill [HB 393] because many of the
issues that are effecting the elder population are also
effecting families. Intensive family preservation or
reunification services is not the total fix; however, it is a
critical piece of a system to keep children safe and strengthen
families, she said. These services would enhance informal
support within the family including relatives, neighborhoods,
faith-based organizations, and churches, she added. Once the
intensive services are completed, it is important to have
someone there to provide support. It may be an elderly person
helping to watch the children and in turn receive some kind of
reciprocal help, she added.
DR. LEAVITT told the members that the latest most dramatic
research available is out of the state of Michigan. This study
was done on a controlled group through the courts, who received
short-term service of four to eight weeks. After one year, over
90 percent of the families remained together safely. Before
being included in this study less than half, close to 40
percent, of the control group had their children removed from
their homes and in some cases many times.
DR. LEAVITT commented that one impetus across states in
implementing this program is the cost savings. In state after
state, when collecting data it is found that out of home
placement costs much more than preserving the family. She
emphasized that this does not mean that every family will remain
together or that there is not a need for out of home placement;
however, she said the need can be reduced. In Washington State
the cost of these services is about $2,700 per child, compared
to basic foster care which is about $12,000, $30,000 or more for
therapeutic care, and $100,000 or more for residential
treatment, Dr. Leavitt stated. The state of North Carolina,
which implemented intensive family preservation and
reunification services statewide for many years, has
demonstrated that for every dollar that is spent on preservation
services, the state saved $2 to $3 in placement costs. In the
state of Alabama, which has been under a consent decree in the
child welfare system for nearly 10 years has also demonstrated
an enormous cost savings in their state's placement costs.
Number 1865
CHAIR WILSON asked why this isn't already being done [in
Alaska]. It appears to be a "no-brainer." This kind of program
seems to be a common sense [approach to what needs to be] done.
She asked if states other than Alaska are not doing this?
DR. LEAVITT responded that these services have been very common
in states for at least a decade. The pendulum swings, she said.
There may be an interest in strengthening families, and then
there may be situation which changes [that trend]. For example,
there may be a death [of a child] that is publicized and is one
death out of hundreds of thousands; however, the pendulum swings
to removing children [from their families] and relying on these
more expensive alternatives, she said.
Number 1817
REPRESENTATIVE COGHILL pointed out that the wrong effective date
is in this bill and suggested it be changed before the bill
leaves committee. One struggle that he has with this bill is
that a program is created that treats some people more special
than others. That is hard to deal with, he said. It is
difficult to provide special treatment to some people, but not
to others. He said he believes this service will end up costing
the state more. Representative Coghill said that he would
prefer to have a policy set forth that says the family is to be
preserved, [and intervention should take place] at the point
where [a problem] is discovered.
DR. LEAVITT told the members that federal law under the Adoption
and Safe Families Act of 1997 and an earlier law has emphasized
preservation and reasonable efforts for families. The act also
emphasizes permanency for children because it is known that
permanent and stable homes are related to good outcomes for
kids. The federal law also pushes states to have shorter
timeframes for making decisions about children and reunifying
families. Dr. Leavitt summarized that the focus and heart of
the federal law is in trying to strengthen and preserve
families.
Number 1714
REPRESENTATIVE COGHILL responded that is where his heart is in
this issue as well. He said he agrees with the concept and
would push for laws that would protect the family at a higher
level, because the children are being protected. Representative
Coghill said the struggle he has is how to mandate it. Every
social worker has a different set of eyes, he said. He
questioned whether these services would provide social workers
with enough tools to [preserve the family].
Number 1668
DR. LEAVITT said one service is not a quick fix or the only fix,
and when changing child welfare practice in the field, there
needs to be a much more involved process. She told the members
that what underpins the family preservation movement are the
values and perspective that puts safety as the highest priority
and focuses on empowering the family to ensure safety [of the
children].
REPRESENTATIVE CISSNA acknowledged that there are parts of the
continuum of services that are needed in prevention, which would
prevent the family from requiring services to begin with or the
first time a family needs services. These services, however,
are only used when the courts are ready to remove the children
from the home, she said. This is the last effort to keep the
children with the family, Representative Cissna emphasized.
REPRESENTATIVE COGHILL said he understands what Representative
Cissna is saying. He pointed out that with this bill the state
is creating a hurdle for that group only. He stated that he is
not sure that this is the way to address [the problem].
DR. LEAVITT commented that many states have tried to revamp
their child welfare system by putting a lid on this huge
bleeding of money into the foster care system. She said most
kids that go into foster care, eventually go home with
attachment problems and many other problems. As a great
example, she said, the state of Alabama started with the
intensive family preservation services to prevent placement
[outside of the home] and have moved those same services and
philosophy much earlier onto family support. Dr. Leavitt said
that her goal has always been to work herself out of a job.
There needs to be a stop in the flow of children [being removed
from their home].
CHAIR WILSON suggested that Representative Cissna get the
effective date changed and the bill can come back before the
committee at another time. She said she would like to hear from
the department on this bill.
Number 1419
MARCIE KENNAI, Deputy Commissioner, Office of Children's
Services, Department of Health and Social Services, testified on
HB 197 and answered questions from the members. She told the
members that the department is taking a neutral position on this
bill because it believes that the division is already moving in
this direction. She said that while this is a good [idea], it
does not need to be legislated. There are an array of family
preservation services available to clients. Intensive family
services is not available yet, but there is movement in that
direction, she added. Ms. Kennai reminded the members of the
discussions before the committee last week and told of the
Family-to-Family initiative that is being brought to the state.
She said she believes that out of this initiative the state
would eventually get the intensive family services.
MS. KENNAI told the members that another study would be
difficult for the department to begin. The child welfare
evaluation project is going on through the University of Alaska.
It is currently evaluating all of the family preservation
programs and will make some recommendations on how those can be
refueled. She said that she is aware of the fact that the
division is not doing all that it should be doing with that
source of money. Ms. Kennai stated that she's pleased this
legislation is being introduced, but explained that the
difficult part of intensive family preservation services is that
it requires a very small caseload, such as four to six cases.
Even with the 20 new positions that the division will get [this
year], there will never be only four to six caseloads [per
worker]. It is possible to look for contract money to fund a
pilot program for this. She said this would work best in urban
areas. Ms. Kennai offered that it would be feasible to do this
in Anchorage late this year or early next year through the
Family-to-Family initiative.
MS. KENNAI told the members that the Teen Decision-making
Initiative will begin within the next two months. She explained
that the division will need to refer to a family preservation
provider for many of those families. The families will be asked
to go to a model that is similar, but one that will work best
for Alaska. She noted that in most states workers have to be
available 24-hours per day and at this point the division does
not have that capacity in Alaska, particularly in rural
communities. This model would have to be used in an urban site,
she reiterated. It would take a while to adopt it in the rural
villages.
Number 1243
MS. KENNAI summarized her comments by saying that she believes
in intensive family preservation services, time limited
reunification services, and intensive reunification services.
She assured the members that the division is on its way and is
reviewing the contracts now [in place] because they are not
accomplishing what needs to be done. Having said that, she said
she sees no reason to legislate this program.
CHAIR WILSON asked about the contracts she mention [with respect
to intensive family preservation].
MS. KENNAI explained that the division gets money from two
sources. One is from the general fund and the other is federal
funding from the Family Support and Preservation Act. She told
the members that she has been in her job just six months and the
division is working toward revamping all the contracts. Ms.
Kennai said that prevention is her focus, the division is moving
in this direction, but the intensive family prevention model is
expensive.
MS. KENNAI pointed out that if the members were to look at what
has happened in other states, it would be found to show that
there are actually very few families that will fit the criteria
to benefit from a six to eight week model of intensive family
preservation services. The division knows that many families
have alcohol and drug addiction problems and six or eight weeks
is not enough [time] for those families, she said. Ms. Kennai
emphasized that there is a population that this works for and
would like to see it implemented.
Number 1152
MS. KENNAI told that members that she is also working with Bill
Hogan, [Director, Division of Behavioral Health, Department of
Health and Social Services]. She said that she and Bill feel
that the Child and Youth Needs Assessment may be out within the
next month. It identifies intensive family services as one of
the pieces of the service array. Ms. Kennai commented that it
might be funded through the Medicaid state plan. She added that
this is a program that not only works for children who are at
risk of coming into custody because of abuse or neglect, but
also works very well with children who have mental health
issues. For example, when a parent calls and says that he/she
can no longer handle his/her child. She summarized that she
does not disagree with anything in the bill, but that she is not
sure it needs to be legislated because the division is already
moving in that direction.
CHAIR WILSON noted that Ms. Kennai did not plan on speaking
today, and appreciates her willingness to comment on this bill.
MS. KENNAI thanked Representative Cissna for caring so much for
[Alaska's families].
Number 1077
REPRESENTATIVE WILSON asked that a committee substitute be done
and brought back before the committee for action. The bill was
held in committee.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:25 p.m.
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