Legislature(2021 - 2022)BY TELECONFERENCE

01/13/2021 10:00 AM House HEALTH & SOCIAL SERVICES

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10:03:35 AM Start
10:04:29 AM Presentation: Discussion of Dhss Reorganization
11:50:08 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Testimony <Invitation Only> --
+ Presentation: Discussion of DHSS Reorganization TELECONFERENCED
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                        January 13, 2021                                                                                        
                           10:03 a.m.                                                                                           
MEMBERS PRESENT                                                                                                               
Representative Tiffany Zulkosky, Chair (via teleconference)                                                                     
Representative Matt Claman (via teleconference)                                                                                 
Representative Geran Tarr (via teleconference)                                                                                  
MEMBERS ABSENT                                                                                                                
Representative Ivy Spohnholz, Vice Chair                                                                                        
Representative Harriet Drummond                                                                                                 
Representative Sharon Jackson                                                                                                   
Representative Lance Pruitt                                                                                                     
COMMITTEE CALENDAR                                                                                                            
PRESENTATION:  DISCUSSION OF DHSS REORGANIZATION                                                                                
     - HEARD                                                                                                                    
PREVIOUS COMMITTEE ACTION                                                                                                     
No previous action to record                                                                                                    
WITNESS REGISTER                                                                                                              
AMANDA METIVIER, Director                                                                                                       
Facing Foster Care in Alaska (FFCA)                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Provided testimony about FFCA's concerns                                                                 
regarding the proposal to split the Department of Health and                                                                    
Social Services.                                                                                                                
LYNN BIGGS, Senior Director                                                                                                     
Casey Family Programs                                                                                                           
Yakima, Washington                                                                                                              
POSITION STATEMENT:  Provided a PowerPoint presentation titled                                                                
"Safe Strong Supportive," dated 1/13/21.                                                                                        
RICHARD PETERSON, President                                                                                                     
Central Council of the Tlingit and Haida Indian Tribes of Alaska                                                                
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:   Provided testimony  urging that  Tlingit and                                                            
Haida  tribes   be  included   and  consulted   in  the   proposed                                                              
reorganization of DHSS.                                                                                                         
"PJ" POLLACK B. SIMON, JR., Chief/Chairman                                                                                      
Tanana Chiefs Conference (TCC)                                                                                                  
Allakaket, Alaska                                                                                                               
POSITION  STATEMENT:   Testified  in  opposition  to the  proposed                                                            
reorganization of  the Department of Health &  Social Services and                                                              
urged that  TCC and other  Alaska tribes  be consulted on  ways to                                                              
improve current department services.                                                                                            
TAMMY SANDOVAL                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION   STATEMENT:     Testified  on   behalf  of  herself   in                                                            
opposition to the proposed DHSS reorganization.                                                                                 
JAKE METCALFE, Executive Director                                                                                               
Alaska State Employees Association (ASEA) Local 52                                                                              
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:   Provided  testimony  about ASEA's  concerns                                                            
with the proposed DHSS reorganization.                                                                                          
ACTION NARRATIVE                                                                                                              
10:03:35 AM                                                                                                                   
CHAIR  TIFFANY  ZULKOSKY  called   the  House  Health  and  Social                                                            
Services  Standing  Committee  meeting  to  order  at  10:03  a.m.                                                              
Representatives  Claman  (via teleconference)  and  Zulkosky  (via                                                              
teleconference)   were    present   at   the   call    to   order.                                                              
Representative  Tarr (via teleconference)  arrived as  the meeting                                                              
was in progress.                                                                                                                
^PRESENTATION:  Discussion of DHSS Reorganization                                                                               
        PRESENTATION:  Discussion of DHSS Reorganization                                                                    
10:04:29 AM                                                                                                                   
CHAIR ZULKOSKY  announced that  the only  order of business  would                                                              
be discussion of  Department of Health and Social  Services (DHSS)                                                              
CHAIR ZULKOSKY  related that  in December  2020 Governor  Dunleavy                                                              
and Commissioner Crum  announced plans to split DHSS  into two new                                                              
departments    a Department of Health  and a Department  of Family                                                              
and  Community  Services.   She  said  the  announcement  provided                                                              
little detail  about the  plan, what  it might  cost the  State of                                                              
Alaska,  and the  impacts to  stakeholders and  those who  utilize                                                              
DHSS programs.   The committee  invited Commissioner Crum  and the                                                              
department to  participate in today's  hearing, she  continued but                                                              
they declined  to participate.   She  announced the witnesses  and                                                              
organizations that would be providing testimony.                                                                                
10:05:51 AM                                                                                                                   
AMANDA METIVIER,  Director, Facing  Foster Care in  Alaska (FFCA),                                                              
related that  FFCA is a statewide  nonprofit comprised  of current                                                              
and former  "fosterees."  She  said she  is a foster  care alumnus                                                              
who aged  out of the system  in Anchorage, she has  bachelor's and                                                              
master's  degrees in  social work,  and  she has  been a  licensed                                                              
foster  parent for  about 13  years on  and off.   She stated  she                                                              
also works  at the  Office of Youth  Empowerment (OYE)  and serves                                                              
with other  groups at  local, state,  and national levels  working                                                              
on child welfare issues and efforts to reform.                                                                                  
MS. METIVIER thanked  the chair and committee members  for holding                                                              
today's hearing to  listen about this issue and what  it means for                                                              
children and families  across the state.  She noted  that a number                                                              
of foster  youths are listening  to today's presentations  because                                                              
this has a direct impact on their lives.                                                                                        
MS. METIVIER noted  there is the larger proposed  splitting of the                                                              
Department of Health  and Social Services with  multiple divisions                                                              
within the two new  departments.  She further noted  that there is                                                              
also a proposed  bifurcation of the Office of  Children's Services                                                              
(OCS) into  two divisions   the  Office of Early  Intervention and                                                              
the  Office  of   Family  Services.    Prior  to   discussing  the                                                              
proposals, she said  she would highlight the state  of the current                                                              
system, the challenges,  and the impact of COVID  because COVID is                                                              
relevant for what  is currently happening for  children, families,                                                              
staff, and  the legal  parties working in  child protection.   She                                                              
stressed that this  is a big proposal on the table  for people who                                                              
are just  trying to  get through the  day-to-day dealing  with all                                                              
the things that  come with the pandemic as well as  the impacts on                                                              
the state.                                                                                                                      
MS. METIVIER offered  her belief that the proposed  bifurcation is                                                              
coming  from a  place  of good  intent in  trying  to improve  the                                                              
system, but  said she doesn't  think it's  the solution or  fix in                                                              
terms of gaining  public trust, especially considering  timing and                                                              
lack of  input from  stakeholders.  She  stated it's  important to                                                              
understand what's  happing with the Office of  Children's Services                                                              
right  now since  the COVID-19  pandemic  began.   She works  with                                                              
young people  across the state  who are  in foster care  or making                                                              
their transition  out, she  explained, so she  is in  contact with                                                              
about 300  young people  a year.   Since COVID  hit it  feels like                                                              
every day  is a crisis  response to housing  and basic  needs, she                                                              
related.    Young  people  everywhere   are  struggling  with  the                                                              
challenges  of  isolation  and   all  that's  happened  since  the                                                              
pandemic hit.                                                                                                                   
MS. METIVIER  specified that  the goal  of foster  care is  to get                                                              
children out of  the foster care system and into  what is referred                                                              
to  as permanency  within 12-24  months.   She  said children  are                                                              
returned home  to their  parents when that  is possible  or placed                                                              
with relatives or  within their tribe or home  community, or moved                                                              
toward  finding an  adoptive  home or  a caregiver  who  can be  a                                                              
legal guardian long  term.  She noted that of the  more than 3,000                                                              
children currently  in foster care, 65 percent  are Alaska Native.                                                              
Since the  pandemic hit,  children are  lingering in foster  care;                                                              
everything has  been stalled.  Most  state staff are  working from                                                              
home.   Over the  past 12 months,  OCS has  lost 171 foster  homes                                                              
and that  doesn't include  the ones  that are on  hold due  to the                                                              
pandemic.   She related that as  a foster parent herself  she gets                                                              
calls  almost  daily and  she  can  hear  the desperation  in  the                                                              
voices of  the caseworkers  everywhere across  the state  that are                                                              
trying to  find homes for children.   This has  created incredible                                                              
challenge on top of their regular day-to-day casework.                                                                          
10:11:50 AM                                                                                                                   
MS. METIVIER  stated that  visits between  children, parents,  and                                                              
siblings  are  mostly  done virtually  via  the  phone,  internet,                                                              
through Face  Time, or  Zoom.  This  poses challenges  for parents                                                              
and children in  more rural areas who don't have  good access to a                                                              
phone, she continued.   All the research points  to visits between                                                              
children and their  parents early and often leading  to a timelier                                                              
reunification.    Visits  with OCS  caseworkers  and  children  in                                                              
foster care are  also mostly done virtually right  now, she added.                                                              
In-person  is  happening   somewhat  more  on  the   frontend  for                                                              
investigation,  but children  in  the system  are  not being  seen                                                              
every 30 days  by a caseworker in  their foster home.   She warned                                                              
that  this  creates  potential   for  danger  because  things  are                                                              
missed, such as  smells, sounds, and other people  possibly in the                                                              
home.   Also, children are  further isolated when  everything else                                                              
is virtual,  they have less contact  with the outside world.   For                                                              
example, right  now therapy is  typically conducted  virtually, as                                                              
is school  and doctor  visits.  These  children, she  advised, are                                                              
struggling  with the isolation  and feel  like they are  forgotten                                                              
and don't have access to the outside world.                                                                                     
MS. METIVIER said  court hearings, team meetings,  and other legal                                                              
proceedings  that   happen  in   OCS  cases  are   also  happening                                                              
virtually  or  telephonically, creating  delays  and  continuances                                                              
and further lengthening  the children's time in foster  care.  She                                                              
related  that older  youth  who are  transitioning  out of  foster                                                              
care and  into adulthood are  doing so at  a time when it  is even                                                              
harder to  secure housing,  employment, and  transportation.   She                                                              
stated that FFCA  has started a COVID-19 relief fund  to help with                                                              
rental  assistance, utilities,  and transportation,  which are  in                                                              
addition to help  that is offered by the communities  in which the                                                              
youth  live.    She  further stated  that  FFCA  has  mostly  been                                                              
supporting  young parents  who are on  the brink  in that  if they                                                              
miss one rental  payment they will  be out and then there  will be                                                              
a domino effect.                                                                                                                
10:15:07 AM                                                                                                                   
MS. METIVIER explained  she has provided this information  to help                                                              
set  the  tone for  the  challenges  that  the system  is  already                                                              
facing  related   to  COVID.     Then,   there  is  the   proposed                                                              
reorganization and bifurcation of OCS.                                                                                          
MS.  METIVIER  recalled  that  FFCA  spent  two  years  presenting                                                              
evidence  and data  to the legislature  in support  of House  Bill                                                              
151, passed  in 2018 (Thirtieth  Alaska State Legislature,  signed                                                              
into  law  6/27/2018),  because  languishing  in  foster  care  is                                                              
damaging  to children.    She said  the bill  was  rooted in  best                                                              
practice and  modeled on New  Jersey's gold standard  system where                                                              
caseworkers are  limited in their  caseloads and are  well trained                                                              
so that families  receive both the support and  services they need                                                              
to quickly move  children through the system  and into permanency.                                                              
That bill is  now in year three of implementation  and legislators                                                              
will receive  the fall [2020] annual  report.  The report  shows a                                                              
slight jump  in turnover for OCS  staff, which is currently  at 47                                                              
percent.  She said  House Bill 151 was a major  effort to overhaul                                                              
the  system  and to  do  that  the  legislature  wanted a  lot  of                                                              
evidence to  know it  was going to  work.  But,  in regard  to the                                                              
proposed bifurcation she hasn't seen much evidence.                                                                             
10:17:20 AM                                                                                                                   
MS. METIVIER  spoke to  the proposed  bifurcation.  She  explained                                                              
that  typically  child welfare  has  a culture  of  collaboration.                                                              
Experts promote  collaboration as  best practice  to bring  in the                                                              
stakeholders,  including young  people,  parents, foster  parents,                                                              
community  partners,  and tribes.    Everyone  is brought  to  the                                                              
table  to  discuss  what  works,   what  doesn't  work,  and  what                                                              
direction to  take in terms of change.   She said the  decision to                                                              
bifurcate  OCS wasn't  made in  the spirit  of collaboration;  the                                                              
stakeholders  and most  groups were  notified  after the  decision                                                              
was made  to move it forward.   The only explanation  she received                                                              
was that it would  increase public trust to separate  the division                                                              
into  two  separate  divisions.   The  many  unanswered  questions                                                              
should  be looked  at and  considered,  she suggested,  especially                                                              
since House  Bill 151 is still  being implemented.  The  state has                                                              
been  working  with the  tribes  for  a  number  of years  on  the                                                              
[Alaska  Tribal  Child Welfare  Compact]  to provide  services  to                                                              
families  and  child welfare.    Also,  the  state has  a  program                                                              
improvement plan  that it must follow for the  federal government.                                                              
So, she  continued,  a lot  is happening  with OCS  and how  it is                                                              
supposed  to  be operating  and  responding  to all  these  policy                                                              
changes and  efforts with other  agencies, organizations,  and the                                                              
federal  government,  while  there  is  also  the  impact  of  the                                                              
pandemic.   Additionally,  given  the  pandemic,  the question  is                                                              
whether this is the right time to move forward a bifurcation.                                                                   
MS.  METIVIER stated  that another  consideration is  what is  the                                                              
evidence base for  this proposal.  There is a lot  of evidence and                                                              
research,  she  advised,  about  what works  in  child  protection                                                              
systems.   This needs to  be drawn upon  as decisions are  made on                                                              
how Alaska's  system will operate.   She pointed out that  this is                                                              
going to  require families and  legal parties to  potentially deal                                                              
with two  separate agencies.   Given  the many professionals  that                                                              
are  involved, it  is already  hard  for children  and parents  to                                                              
know  whose role  is what,  what  meeting they're  going to,  what                                                              
court  hearing   they're  going  to,  what   professional  they're                                                              
talking to.   Having then to  deal with multiple systems  could be                                                              
absolutely daunting.   Child  welfare is meant  to be  a continuum                                                              
of families  coming  into the system  because  of child abuse  and                                                              
neglect, she explained,  and addressing those issues  that brought                                                              
them in in an  effort to return children to their  home of origin,                                                              
or to their parents, or into another permanent situation.                                                                       
MS.  METIVIER  noted  that the  proposed  bifurcation  would  also                                                              
return OCS to four  regions from the current five.   She recounted                                                              
that the  House Health and  Social Services Committee  created the                                                              
fifth  region, the  Western  Region, at  the  recommendation of  a                                                              
citizens' review panel.   She recommended that a look  be taken at                                                              
whether going back to four regions is the right thing to do.                                                                    
MS. METIVIER  urged that the costs  be taken into account  for two                                                              
separate   divisions,  two   separate   directors,  two   separate                                                              
deputies, and  the staff beneath  those.   She also urged  that it                                                              
be taken into  account as to what  the overall impact  is going to                                                              
be  on children  and  families.    Government systems  are  really                                                              
difficult to navigate,  she advised, so dealing  with two separate                                                              
systems is  going to be daunting  for families.  She  related that                                                              
in urban  areas OCS  already has a  sort of internal  bifurcation.                                                              
One-unit  addresses   investigation   and  assessment   ("IA")  of                                                              
families  when  reports  come  in,  and  another  unit  is  family                                                              
services that  deals with further  case planning with  parents and                                                              
trying  to  find   permanency  for  children.     In  the  smaller                                                              
communities  there are  generalist workers  that work  a case  all                                                              
the  way  from   the  initial  assessment  through   whatever  the                                                              
permanent  plan is.    She said  she therefore  isn't  sure how  a                                                              
bifurcation of  OCS into two divisions  is any different  than the                                                              
internal  split  in  urban  areas.    Ms.  Metivier  concluded  by                                                              
pointing  out that  fosterees are  listening  to today's  hearing.                                                              
She  said  the  opportunity  for  youth  to  hear  this  issue  is                                                              
important, given  all that  they are facing  with being  in foster                                                              
care right now.                                                                                                                 
10:23:08 AM                                                                                                                   
CHAIR  ZULKOSKY   thanked  Ms.  Metivier  for  her   advocacy  and                                                              
personal  time for  Alaska's youth  and families.   She  requested                                                              
Ms. Metivier to  speak to the disparity of services  felt by rural                                                              
Alaska Native youth in the system.                                                                                              
MS. METIVIER  replied that 65 percent  of children in  foster care                                                              
are Alaska  Native, which  is disproportionate  because they  make                                                              
up about  20 percent  of Alaska's  overall child  population.   In                                                              
some communities  they make  up 100 percent  of the  children that                                                              
are in foster care  or out-of-home care.  She  said the challenges                                                              
with  the  pandemic  have  been even  greater  for  Alaska  Native                                                              
children  and  the state's  ability  to  follow the  Indian  Child                                                              
Welfare Act  (ICWA).  She related  that she is getting  calls from                                                              
across the  state to  take placement of  children in  foster care.                                                              
She  pointed out  that there  is a  placement preference  standard                                                              
that is  supposed to  be followed  under ICWA  that says  to first                                                              
place with  relatives or  to look  within a  tribe or  the child's                                                              
community,  and to then  move to  stranger foster  care as  a last                                                              
ditch  effort.    The  desperation,  lack  of  homes,  and  people                                                              
overwhelmed by  all that is happening  in the system is  making it                                                              
even harder to follow that.                                                                                                     
MS.  METIVIER stated  that FFCA  sees  youth who  come from  rural                                                              
areas  into more  urban  communities  like Anchorage,  the  Mat-Su                                                              
Valley, and  Fairbanks.   They're coming  in to  live in  a foster                                                              
home or a  residential program and  it is a further  culture shock                                                              
well  beyond  separation and  the  grief  and  the loss  of  being                                                              
removed from  their family.  Now  they've been removed  from their                                                              
community and all  they know and all that they are  used to.  Once                                                              
that happens,  she specified, even  bigger challenges are  seen on                                                              
the  backend  for those  youth  who  then  become adults  and  are                                                              
transitioning out  into the world.   They have their  own children                                                              
and   family  but   are  still   dealing  with   the  trauma   and                                                              
repercussions  of what  has  happened in  terms  of being  removed                                                              
from  their community,  especially  if  they lived  a  subsistence                                                              
lifestyle or lived in a much smaller community.                                                                                 
MS. METIVIER further  related that many of the  older youth coming                                                              
into  Anchorage  are  placed  in   the  downtown  shelter  at  the                                                              
Covenant  House.  Covenant  House does  a great  job and  tries to                                                              
respond  to  the needs  of  youth,  she  said,  but in  a  shelter                                                              
setting the  youth become  even more  vulnerable, especially  when                                                              
they come from  a small community to  the city.  The  shelter is a                                                              
target of traffickers  for sex trafficking, and there  is a lot of                                                              
substance abuse  and drug use, so  these youth are made  even more                                                              
vulnerable.   This is often  seen a lot  with older youth  as they                                                              
transition  to  adulthood  because  they've lost  their  sense  of                                                              
identity and who they are related to their culture.                                                                             
10:27:45 AM                                                                                                                   
CHAIR  ZULKOSKY   recalled  Ms.  Metivier's  statement   that  the                                                              
proposal  for   bifurcation  was  not   made  in  the   spirit  of                                                              
collaboration.   She  noted that  there  is a  type of  engagement                                                              
where people  are invited in and  notified of a decision  or there                                                              
is  an opportunity  for meaningful  consultation  to talk  through                                                              
the impacts  and evaluate evidence-based  information.   She asked                                                              
Ms. Metivier  to speak  to the  type of  engagement that  occurred                                                              
prior to  the announcement and  FFCA's involvement  in discussions                                                              
following  the announcement  of  the intention  to reorganize  the                                                              
department and to bifurcate OCS.                                                                                                
MS. METIVIER  responded that  she heard  remnants that  DHSS would                                                              
be announcing reorganization.   She said Commissioner  Crum called                                                              
her  to  notify FFCA  that  the  department  would be  making  the                                                              
announcement  the next  day.   It was  during this  call that  she                                                              
first learned  of the proposed OCS  bifurcation.  She  offered her                                                              
belief that  the commissioner's  intentions were genuine  and good                                                              
in  letting her  know so  that young  people would  know this  was                                                              
coming and  it wouldn't be  a surprise.   However, she  noted, she                                                              
hasn't received  much information since  that call.  She  has seen                                                              
the   proposed   organization   chart   outlining   the   proposed                                                              
bifurcation of OCS  into two divisions.  She  said Angel Gonzales,                                                              
FFCA's board  president,  participated the  following week  in the                                                              
Tribal  State Collaboration  Group  where she  learned more  about                                                              
what it  looked like  and then shared  that information  with her.                                                              
No  effort  has been  made  [by  DHSS]  to directly  engage  young                                                              
people  or foster  parents in  the  process.   So, she  continued,                                                              
FFCA has  sent out  this information  and it  has caused  panic in                                                              
some  young people  who are  already feeling  isolated along  with                                                              
the impacts  of the pandemic.  In  the past when big  changes have                                                              
come  or  been  proposed,  the department  has  held  meetings  or                                                              
forums with  the stakeholders.   That didn't happen in  this case,                                                              
instead  notification was  received  that this  decision was  made                                                              
and is happening, so it was a shock.                                                                                            
10:31:18 AM                                                                                                                   
CHAIR  ZULKOSKY   reiterated  that   DHSS  and  the   commissioner                                                              
declined  the committee's  invitation  to  participate in  today's                                                              
meeting.   She  said  that subsequently  the  department shared  a                                                              
letter  dated  [1/6/20]  that stated  the  proposed  timeline  for                                                              
bifurcating OCS was  delayed from the [7/1/20]  timeframe and that                                                              
DHSS intends  to begin  a consultation  process in February  2021.                                                              
She  recalled   that  Ms.  Metivier   talked  about   the  current                                                              
conditions at OCS  and the significant disparity  of Alaska Native                                                              
youth in  the system, and the  challenges the department  has had.                                                              
Chair  Zulkosky  related  that   during  her  brief  time  in  the                                                              
legislature there  has been a constant struggle  around continuity                                                              
of  caseworkers,  people  who  work within  the  system,  and  the                                                              
challenging environment.   She requested Ms. Metivier  to speak to                                                              
the  impacts  of  such  a  significant   reorganization  amidst  a                                                              
department that is challenged in meeting its current mission.                                                                   
MS. METIVIER answered  that the timing is not the  best to propose                                                              
such  a  big shift  and  big  undertaking  while most  people  are                                                              
working from  home.  She said a  number of caseworkers  at OCS and                                                              
frontline  staff has  told her that  they are  worried about  this                                                              
and  want to  give input,  but are  struggling  to complete  their                                                              
daily work because  of COVID-19 impacts and the  lack of placement                                                              
options  for children  in the system.   Everything  is being  done                                                              
virtually  and  employees  are potentially  working  at  home  and                                                              
trying to homeschool  their own children.  She  stated that public                                                              
trust  was  the   reason  given  to  her  for   the  proposed  OCS                                                              
bifurcation.   It is  obvious and  known by  most people  that the                                                              
public doesn't trust  child protection, she said, but  it isn't an                                                              
Alaska specific  issue, it's  everywhere.  This  agency has  a lot                                                              
of authority over  families to make decisions around  removal, but                                                              
it also  has to  have that  authority because  of child  abuse and                                                              
neglect.  It's hard  to instill trust in the public  for an agency                                                              
that  can  come in  and  remove  someone's  child.   Most  of  the                                                              
caseworkers  and people  at OCS  don't come in  wanting to  damage                                                              
and tear apart families;  they come in because they  care, want to                                                              
make a difference,  and want to  work with families.   In terms of                                                              
public trust,  she advised, people  connect to people,  they don't                                                              
connect to programs,  and so it's really about  relationship.  The                                                              
division can  be split in two and  a fancy new name  given to each                                                              
new side, but  she doesn't know  that that is going to  change how                                                              
the  public  looks  at  it,  especially  the  arm  that  does  the                                                              
assessment  and investigation  of  child abuse  and neglect;  it's                                                              
bigger  than that.    A part  of building  trust,  she opined,  is                                                              
engaging  with  the  stakeholders  and the  community  around  big                                                              
decisions, like a bifurcation.                                                                                                  
10:35:53 AM                                                                                                                   
CHAIR ZULKOSKY invited the next speaker to provide testimony.                                                                   
10:36:45 AM                                                                                                                   
LYNN BIGGS,  Senior Director,  Casey Family  Programs, provided  a                                                              
PowerPoint  presentation titled  "Safe  Strong Supportive,"  dated                                                              
1/13/21.  She stated  she has been with Casey Family  Programs for                                                              
32 years,  and for  the past 10  years she  has worked  with state                                                              
tribes, Facing Foster  Care in Alaska, and others.   She displayed                                                              
slide 2 and noted  that the Casey Family Programs  is the nation's                                                              
largest operating  foundation focused on safely reducing  the need                                                              
for  foster care  and building  communities of  hope for  children                                                              
and families.   Created in  1966 by Jim  Casey, founder  of United                                                              
Parcel  Service,  the foundation  has  worked to  influence  long-                                                              
lasting  improvements  to  the safety  and  success  of  children,                                                              
families,  and the  communities  where they  live.   She said  the                                                              
foundation operates  in all 50  states, the District  of Columbia,                                                              
Puerto  Rico, and  the Virgin  Islands.   The foundation's  Indian                                                              
Child  Welfare  Program  has direct  agreements  with  16  tribes,                                                              
including three in  Alaska.  In addition, the  foundation has nine                                                              
field offices that provide direct services to youth in care.                                                                    
MS. BIGGS  moved to  slide 3  and said  Casey Family Programs  has                                                              
been working  and investing in Alaska  since 2000.  It  has worked                                                              
with   the  state,   tribes,  philanthropic   organizations,   the                                                              
university,  Facing Foster Care  in Alaska,  and others  to effect                                                              
positive,  improved outcomes  for  Alaska  children and  families.                                                              
Casey  Family Programs,  she  continued,  has sponsored  statewide                                                              
efforts to  address adverse  childhood experiences  in Alaska  and                                                              
to safely reduce the need for foster care.                                                                                      
MS. BIGGS spoke  to slide 4.  She related that  a presentation was                                                              
given last  week at  the Tribal  State Collaboration Group  titled                                                              
"The Mechanisms  of American Indian  and Alaska Native  Inequality                                                              
in Child Welfare  Across the United States."  She  said two pieces                                                              
of data provided  for Alaska were  striking:  1) An  Alaska Native                                                              
infant (age  1 or younger)  has a 15  percent chance of  being the                                                              
subject  of a  child  abuse and  neglect  investigation, which  is                                                              
highest in  the nation; and  2) An Alaska  Native child has  an 80                                                              
percent chance of  being the subject of a child  abuse and neglect                                                              
investigation  by age 18,  also the  highest in  the nation.   She                                                              
stated  that the  Casey  Family  Programs has  actively  supported                                                              
efforts to  reduce this disproportionality  of Native  children in                                                              
foster care  in Alaska.  The  foundation sponsored  Alaska's 2016-                                                              
2020  strategic plan,  "Transforming  Child  Welfare Outcomes  for                                                              
Alaska  Native Children."   This  was a forerunner  to the  Alaska                                                              
Tribal  Child  Welfare  Compact,   she  explained,  of  which  the                                                              
foundation believes  the full implementation  would help  with the                                                              
disproportionality  and   other  issues.    The   foundation  also                                                              
participates in Alaska's Tribal State Collaboration Group.                                                                      
10:41:18 AM                                                                                                                   
MS.  BIGGS pointed  out  on slide  5  that different  states  have                                                              
different  configurations  for   administering  child  and  family                                                              
services.    She said  one  is a  multiple  cabinet-level  agency,                                                              
another  is  a  single  consolidated  health  and  human  services                                                              
agency,  and others  consist  of  various agency  combinations  of                                                              
child  welfare,   juvenile  justice,  early   childhood  programs,                                                              
behavioral  and  mental  health, substance  abuse  prevention  and                                                              
treatment, public health, and financial assistance.                                                                             
MS. BIGGS moved  to slide 6 and  stated that there is  no research                                                              
evidence  of an  ideal organizational  structure.   Governors  and                                                              
state  legislatures have  long reorganized  state  agencies in  an                                                              
effort to  improve outcomes,  she said.   Research is  lacking and                                                              
the limited  research that  there is,  along with extensive  state                                                              
experiences tells  that:   1) there is  no ideal structure,  every                                                              
approach  has  pros  and  cons;   2)  positive  child  and  family                                                              
outcomes cannot be  attributed to a particular model;  3) there is                                                              
no  research  evidence  of  improved   accountability  or  service                                                              
quality  with reorganization;  and 4)  organizational climate  and                                                              
culture (low conflict,  cooperation, role clarity)  may contribute                                                              
more to outcomes than interagency coordination structures.                                                                      
MS. BIGGS displayed  slide 7, which outlined the pros  and cons of                                                              
a  single consolidated  health  and human  services  agency.   She                                                              
turned to  slide 8 and  related that some  states have  a cabinet-                                                              
level  child  and  family  agency.    These  states  are  Arizona,                                                              
Illinois,  Massachusetts,  Mississippi,  Indiana,  Tennessee,  New                                                              
Mexico, Rhode  Island, Washington,  and New  Jersey.   Speaking to                                                              
slide  9, she  said states  with  a child  and  family agency  are                                                              
Connecticut, Delaware,  Wisconsin, Florida, Wyoming,  and Vermont.                                                              
There  are lessons  learned from  these  examples, she  continued.                                                              
She then  showed slide  10, which  outlined the  pros and  cons of                                                              
state child and family agencies.                                                                                                
MS.  BIGGS  highlighted  the  recent  reorganization  depicted  on                                                              
slide 11 of the  Washington State Department of  Children, Youth &                                                              
Families.   She said  this reorganization began  in 2016  when the                                                              
Washington   governor  created   a  Blue   Ribbon  Commission   to                                                              
recommend  the organizational  structure for  a new  cabinet-level                                                              
department focused  solely on children  and families.   Commission                                                              
membership  included  a  key legislative  committee  chair  and  a                                                              
retired  judge as  the co-chairs,  along  with state  legislators,                                                              
tribal  representatives, administrators  of  existing programs,  a                                                              
court administrator,  a state  employee union representative,  and                                                              
issue experts.   She noted that  the commission spent  nine months                                                              
studying   the  models   of  other   states,  developing   guiding                                                              
principles  and  desired  outcomes  for the  new  department,  and                                                              
considering  the input  of tribes  and  other stakeholders,  data,                                                              
and financing approaches.                                                                                                       
10:45:05 AM                                                                                                                   
MS. BIGGS  skipped to slide 13  and discussed some of  the lessons                                                              
learned in regard  to state agency reorganization.   One lesson is                                                              
how important it  is to review existing data, she  said, and there                                                              
is a lot  of data that Alaska  could look at and use  to determine                                                              
the agency priorities  and desired outcomes for  Alaska Native and                                                              
other  Alaska children  and families.   She stated  that the  ends                                                              
determine  the  means     consider  how  the  priorities  and  the                                                              
desired  outcomes  should  drive the  structure.    Reorganization                                                              
cannot provide  support for needed  reforms, she  advised; tribes,                                                              
communities, and  those with lived  experience should  be involved                                                              
in planning  from the beginning  and throughout  [reorganization].                                                              
In  Alaska  particularly,  she   continued,  the  involvement  and                                                              
inclusion  of the tribes  at every  step of  the way is  essential                                                              
through  tribal  consultation.     At  last  week's  Tribal  State                                                              
Collaboration  Group   meeting  there  was  a   presentation  with                                                              
considerable  dialogue between  the state  and tribes about  this.                                                              
There  is  realization  about  how  much the  tribes  need  to  be                                                              
involved  at every  step  of the  way.   She  said another  lesson                                                              
learned  is  to ensure  that  agency  resources are  aligned  with                                                              
desired  outcomes.    Build  on  and  expand  existing  strengths,                                                              
successes,  and capacity,  like the [Alaska  Tribal Child  Welfare                                                              
Compact],  prevention, and  family strengthening.   Transition  to                                                              
the new structure  typically takes two to five  years, she stated.                                                              
It takes one  year or more for  planning and preparing,  and up to                                                              
five years  for implementation.   Targeted  efforts are  necessary                                                              
to sustain the momentum and support for change, she added.                                                                      
MS.  BIGGS displayed  slide  14 and  continued  her discussion  of                                                              
lessons learned  about reorganization.  Reorganization  is usually                                                              
disruptive  to some  extent,  she pointed  out,  with the  current                                                              
pandemic  adding to  the  complexity.   It  is  essential to  have                                                              
shared  vision,  clear  direction,  and  necessary  resources  for                                                              
planning and implementation.   She said another lesson  is to plan                                                              
carefully  for the separation  from a  single consolidated  health                                                              
and human services  agency.  Further, it needs to  be ensured that                                                              
resources are adequate.   There is no evidence  or experience that                                                              
new structures  save money.   Instead  there are additional  costs                                                              
associated  with the  reorganization  process and  often with  new                                                              
infrastructure.   She advised that during the  transition it might                                                              
be necessary  to allow  for possible  redundancy.  Another  lesson                                                              
learned  is   that  strong   leadership,  continuous   improvement                                                              
systems, and  accountability mechanisms  are important  regardless                                                              
of structure.                                                                                                                   
10:48:10 AM                                                                                                                   
MS.  BIGGS concluded  by stating  that there  is much  work to  be                                                              
done  in Alaska.    She said  the Casey  Family  Programs is  most                                                              
interested  in improving  outcomes for children  and families  and                                                              
to finally  see the disproportionality  reduced after  there being                                                              
so many efforts.   She offered her belief that  Alaska has strong,                                                              
capable, effective  tribes and  people that  are willing  and able                                                              
to  take care  of their  own children  in  their own  communities.                                                              
Full   implementation  of   the  [Alaska   Tribal  Child   Welfare                                                              
Compact], she  continued, would be  a very helpful  pathway toward                                                              
the kind  of transformation and  improved outcomes that  the State                                                              
of Alaska is looking for.                                                                                                       
10:49:09 AM                                                                                                                   
CHAIR ZULKOSKY  returned to slide  13 and the lesson  learned that                                                              
the  transition  usually takes  two  to  five  years.   She  asked                                                              
whether  there is  any  evidence that  identifies  the impacts  to                                                              
outcomes  for  children  and  families  that  may  be  experienced                                                              
during this transition timeframe.                                                                                               
MS. BIGGS  offered her belief that  it puts children  and families                                                              
at  more  risk.   Given  the  48  percent turnover  rate  and  the                                                              
pandemic, there is  already a lot of uncertainty  and instability,                                                              
and so  she thinks  that during  such a  transition the  impact on                                                              
children and families would be negative.                                                                                        
10:50:20 AM                                                                                                                   
CHAIR ZULKOSKY invited the next witness to testify.                                                                             
10:50:56 AM                                                                                                                   
RICHARD PETERSON,  President, Central  Council of the  Tlingit and                                                              
Haida Indian Tribes  of Alaska, noted that the  Central Council of                                                              
the  Tlingit  and Haida  Indian  Tribes  of Alaska    Tlingit  and                                                              
Haida   is the  largest tribe in Alaska with  over 32,000 enrolled                                                              
citizens  across  the state,  nation,  and  world.   He  said  the                                                              
proposed changes  to DHSS impact  the tribe significantly  in more                                                              
than just  one area.   It is  hard to talk  about the  division of                                                              
DHSS and  not discuss  negative  impacts to tribal  programs.   He                                                              
explained that  tribal programs  span across the  department, each                                                              
one connected  to the other as  children and families  are served.                                                              
He recognized that  each division has a tremendous  task, but said                                                              
Tlingit  and  Haida  families,  whether  in  a  24/7  facility  or                                                              
receiving prevention services, are all connected.                                                                               
MR.  PETERSON pointed  out that  Tlingit and  Haida has  partnered                                                              
with the Department  of Health and Social Services  and the Office                                                              
of Children's  Services (OCS) for  many years to better  serve its                                                              
children  and families.   He  related  that Tlingit  and Haida  is                                                              
proud to  be one of  the tribes that  signed the historic  compact                                                              
with  OCS in  2017,  which took  many  years  of consultation  and                                                              
cooperation to  achieve.  Tribes  have demonstrated  a willingness                                                              
to  put in  the hard  work  to develop  a  child welfare  compact,                                                              
recognizing  that  65  percent  of the  children  in  custody  are                                                              
Alaska Native.   He  expressed Tlingit and  Haida's hope  that any                                                              
changes  at OCS would  not undermine  the current  compact  or the                                                              
true  government-to-government process  in which  it was  created.                                                              
Expanded compacting  with tribes could  be a win-win for  both the                                                              
state and  for the children and  families served by OCS,  he said.                                                              
It was created  as a model  for other state departments  to follow                                                              
when working with tribes.                                                                                                       
MR. PETERSON  requested the state  to consider and  include tribes                                                              
when  planning  to  elevate  the  [Alaska  Tribal]  Child  Welfare                                                              
Compact to  the Office of the  Commissioner in the spirit  that it                                                              
was created.   He said it is  unclear whether the compact  will be                                                              
elevated  to  the  commissioner's   office,  but  that  if  it  is                                                              
elevated,  who would  oversee the  compact?   He  urged that  this                                                              
person be  familiar with working  with tribes, child  welfare, and                                                              
have direct connection to the day-to-day operations at OCS.                                                                     
MR. PETERSON  related that  the rationale given  by the  Office of                                                              
the Commissioner to  split DHSS is because the  department is huge                                                              
and  it's   hard  to  get  the   time  needed  in  front   of  the                                                              
legislature,  along  with  budget considerations  and  making  the                                                              
department  easier to manage.   He  suggested that an  alternative                                                              
is to engage  tribes and community stakeholders  familiar with the                                                              
work, and  that more  cost-efficient alternatives  could  be found                                                              
to address the  issues cited rather than splitting  the department                                                              
into two.   He said there  appears to be duplications  between the                                                              
divisions and administrative  operations in both the  DHSS and OCS                                                              
divisions, that it  likely would be far more costly,  and that the                                                              
time to find  a new commissioner,  directors, and staff  will be a                                                              
challenge.    The state  already  struggles  to fill  the  current                                                              
vacancies,  he pointed  out, leaving  many  programs and  families                                                              
not receiving  the  attention they  deserve.   He said the  tribes                                                              
are  focused on  the whole  person and  family, and  he asked  who                                                              
will be  looking at the  whole family and  the client as  more and                                                              
more departments  work singularly  and not  holistically  with the                                                              
DHSS.  He further  asked whether changes are being  made to better                                                              
serve the family or for other reasons.                                                                                          
MR.  PETERSON  stressed  the  importance  of  tribal  consultation                                                              
before significant  changes like  these are  made.  He  reiterated                                                              
that  tribes partner  with DHSS  to provide  holistic services  to                                                              
their  shared  citizens.   He  said  the  Central Council  of  the                                                              
Tlingit and Haida  Indian Tribes of Alaska stands  ready to engage                                                              
in  consultation  with  DHSS, especially  regarding  any  proposed                                                              
changes  to  how  the  state  addresses  child  welfare.    Tribal                                                              
consultation  in the creation  of such  an impactful change  could                                                              
make the  conclusion stronger and  more effective, he  stated, and                                                              
the governor  has an  obligation to consult  with tribes  based on                                                              
DHSS policy  that remains in effect.   He offered his  belief that                                                              
the current  situation is because  of systemic racism and  this is                                                              
reflected  in the  fact that  65 percent  of the  children in  the                                                              
State  of Alaska's  care  are Alaska  Native.   It  will only  get                                                              
worse  if the  tribes are  not involved,  he added.   Tlingit  and                                                              
Haida  stands committed  to partnering  with the  state and  looks                                                              
forward to engaging further in the process to fix the system.                                                                   
10:56:10 AM                                                                                                                   
CHAIR ZULKOSKY  requested Mr. Peterson  to speak to the  status of                                                              
the Alaska  Tribal Child  Welfare Compact,  particularly  what was                                                              
previously  proposed  for  expanded  scopes of  work  with  Alaska                                                              
tribes.   She further  asked whether those  have been  pursued and                                                              
whether  there have  been  related  funding agreements  to  ensure                                                              
that  there are  the levels  of support  needed for  tribes to  be                                                              
successful in those scopes of work through the compact.                                                                         
MR. PETERSON  deferred an  answer to  Mary Johnson who  represents                                                              
Tlingit and Haida  on the compact.  He said he  would speak to her                                                              
and get back to the committee.                                                                                                  
10:57:20 AM                                                                                                                   
CHAIR   ZULKOSKY  inquired   about  the   department's  level   of                                                              
engagement with Mr. Peterson's tribe in the existing compact.                                                                   
MR. PETERSON replied  that at times it was difficult,  and work is                                                              
being done to get  through those.  He related that  in last week's                                                              
working group  meeting with Commissioner  Crum he stressed  to the                                                              
commissioner  that   coming  to  the  table  and   announcing  the                                                              
decision that  has already been  made isn't at all  government-to-                                                              
government  consultation.   He  said he  further  stressed to  the                                                              
commissioner that  with 65 percent  of the children in  state care                                                              
being  Alaska  Native,   Tlingit  and  Haida  should   be  in  the                                                              
discussion at the beginning rather than being told the outcome.                                                                 
10:58:26 AM                                                                                                                   
CHAIR ZULKOSKY  recalled  Ms. Biggs' statement  that a  transition                                                              
takes two to five  years.  She requested Mr. Peterson  to speak to                                                              
his on-the-ground  experience with families that  are currently in                                                              
these  programs and  systems  and his  thoughts  about impacts  to                                                              
their experience and wellbeing through a transition process.                                                                    
MR.  PETERSON  responded  that this  division  is  being  proposed                                                              
because  it is  so difficult  to  administer now.   "Well,  what's                                                              
going  to happen  while  they are  trying to  figure  it out?"  he                                                              
asked.    He  said  he is  worried  about  the  children  and  the                                                              
families that  are going to  fall between  the cracks.   These are                                                              
the  children's  formative  years,   he  pointed  out,  and  these                                                              
children  don't have  five years  or even  one year  for it  to be                                                              
figured  out.    This  needs  to  be  figured  out  before  it  is                                                              
implemented, and he doesn't trust that it has been.                                                                             
10:59:55 AM                                                                                                                   
CHAIR  ZULKOSKY recalled  Mr. Peterson  mentioning  the impact  of                                                              
institutional  inequity  and structural  racism.    She asked  Mr.                                                              
Peterson  to talk about  what that  means and  the impact  that he                                                              
sees it having  on Alaskans through families that  need to utilize                                                              
programs like this.                                                                                                             
MR. PETERSON answered  that the systemic racism goes  back as part                                                              
of  the  inter-generational   trauma  that  was   created  through                                                              
colonization, boarding  schools, and religious  organizations, and                                                              
so that  is passed  down.  "Now,  when you have  a system  that is                                                              
not made  up of our  people, it  can continue," he  said.   "So, I                                                              
think that  the solution is to  have ... compacting and  having us                                                              
be the solution."  He continued:                                                                                                
     I think  we are the solution  and I think  compacting is                                                                   
     a way that  we can better serve our families  and assure                                                                   
     that  systemic racism  doesn't  continue.   And I  don't                                                                   
     think    sometimes    that   systemic    racism    isn't                                                                   
     intentional,  but ... it's  what happens when  you don't                                                                   
     know,  and you don't  understand.   Alaska is a  diverse                                                                   
     area, our  communities were  made up of diverse  people,                                                                   
     and I  think ... if the  institution serving  our people                                                                   
     doesn't    reflect   the    people   it   serves    that                                                                   
     unintentionally you're  going to see that  that systemic                                                                   
     racism continues.                                                                                                          
11:01:33 AM                                                                                                                   
CHAIR ZULKOSKY  concurred and recalled former  Lieutenant Governor                                                              
Davidson's mantra, "Nothing about us without us."                                                                               
MR. PETERSON replied, "Exactly."  He added:                                                                                     
     I  think there  is  an opportunity  for  us  to work  in                                                                   
     partnership   on  solutions  and   I  think  given   the                                                                   
     opportunity  we can  do that.  ... I  think having  true                                                                   
     consultation   with   the    governor's   office,   with                                                                   
     Commissioner  Crum,  I  think we  could  really  develop                                                                   
     what real  solutions look  like.   But I really  believe                                                                   
     if it  continues the way it  has, that's just  not going                                                                   
     to happen.                                                                                                                 
11:02:20 AM                                                                                                                   
CHAIR ZULKOSKY invited the next witness to testify.                                                                             
11:02:41 AM                                                                                                                   
"PJ"  POLLACK   B.  SIMON,  JR.,  Chief/Chairman,   Tanana  Chiefs                                                              
Conference  (TCC), related  that  TCC is  a nonprofit  intertribal                                                              
consortium  of  37  federally  recognized  Indian  tribes  and  41                                                              
Alaska  Native   communities  located   across  Interior   Alaska,                                                              
including Fairbanks.   He  said TCC  serves 16,000 Alaska  Natives                                                              
located in Fairbanks  and in the rural villages  located along the                                                              
1,400-mile-long  Yukon River and  its tributaries, and  that TCC's                                                              
service area encompasses 235,000 square miles.                                                                                  
CHIEF SIMON noted  that TCC's members utilize services  from every                                                              
division  of the  Department of  Health &  Social Services  (DHSS)                                                              
and  are dis-appropriately  represented as  beneficiaries of  many                                                              
of these  programs.   He pointed  out that TCC  is a co-signer  to                                                              
the Alaska  Tribal Health  Compact and  the Alaska Tribal  [Child]                                                              
Welfare Compact  and that  TCC's employees  have worked  alongside                                                              
state  personnel  through  many administrations  on  various  work                                                              
groups  and  collaborations.   He  said  TCC will  necessarily  be                                                              
impacted   by  the   administration's   proposal   to  split   the                                                              
department, and  so TCC is willing  to work with  the commissioner                                                              
to achieve the best results for Alaska.                                                                                         
CHIEF  SIMON  stressed that  TCC  does  not support  the  proposed                                                              
division of DHSS  as it would place a separation  between programs                                                              
and  services that  are  necessarily  intertwined.   The  proposed                                                              
separation  of the Office  of Children's  Services (OCS),  and the                                                              
Division  of  Public   Assistance,  and  Division   of  Behavioral                                                              
Health, is  baffling, he  said.   He asked  how OCS would  support                                                              
families in  a time of crisis  without working with  the divisions                                                              
that have the  resources to provide wraparound services.   The OCS                                                              
must  provide active  efforts  to prevent  the  breakup of  tribal                                                              
families,  he stated,  and  those  efforts nearly  always  include                                                              
counseling, support  to provide  safe homes and environments  with                                                              
the  safe homes,  and  other services  operated  by the  divisions                                                              
that would remain  in the proposed Department of Health.   He said                                                              
similar  comments could  be made  about the  Division of  Juvenile                                                              
Justice, which is  placed within DHSS, based on  the understanding                                                              
that these  youth, Alaska Native  youth, need behavioral  help and                                                              
prevention.    He further  asked  what  the justification  is  for                                                              
splitting the  Division of Alaska  Pioneer Homes and  the Division                                                              
of Senior and Disability Services.                                                                                              
11:06:20 AM                                                                                                                   
CHIEF SIMON  contended that the  proposed split of  the department                                                              
is  not at  all responsive  to the  relationship that  necessarily                                                              
exists  between  the  various  divisions  and  the  services  they                                                              
provide.   He pointed  out that  TCC is both  a health  and social                                                              
service  agency, a  one-stop shop  for  its tribal  members.   One                                                              
system makes sense,  he explained, because TCC is  able to provide                                                              
holistic,  wraparound,  and  patient-centered  services.   At  TCC                                                              
there is  more efficiency and  less bureaucracy, and  TCC achieves                                                              
less overhead  and a  reduction in  positions by keeping  services                                                              
underneath  one roof.   A patient  presenting  at the clinic,  and                                                              
who  has a  food security  issue,  can be  connected  by the  case                                                              
manager  to  TCC's  client  services  division  and  provided  the                                                              
necessary  services.   A parent  who is  a party  to tribal  child                                                              
protection can  be connected to  the necessary health  assessments                                                              
and follow-up services.   A TCC client currently  benefitting from                                                              
assistance  can  be  connected with  employment  and  training  or                                                              
educational services to step down from government assistance.                                                                   
CHIEF  SIMON  stated   that  the  department's   frequently  asked                                                              
questions  document  indicates   this  change  is  being  made  to                                                              
streamline  the focus  of the  Department  of Health  and to  make                                                              
meaningful interventions  for those Alaskans who  are experiencing                                                              
crises or are supporting  their loved ones.  He  said it's unclear                                                              
how  this proposal  will meet  either objective,  especially in  a                                                              
time when  the state    budget is  in crisis.   He further  stated                                                              
that the frequently  asked questions document explains  that there                                                              
will be  better delivery of essential  services thanks to  the use                                                              
of  statistics  and data  analysis,  and  creation of  new  health                                                              
analytics  data  and  information   systems  within  the  proposed                                                              
Department of Health.   However, he noted, there's  no information                                                              
on how  additional data  analysis or  this new  unit will  lead to                                                              
better  health care  delivery.   The  department already  collects                                                              
and maintains a  broad array of data about health  programs, Chief                                                              
Simon continued, and  has ready access to tribal  partner data and                                                              
analysis through  the tribal epicenter.   If the  department wants                                                              
to hire  a consultant  to help  analyze  that data  in a new  way,                                                              
then it can  certainly do so.   But, he argued, that  goal doesn't                                                              
seem to justify  the creation of  a new department, which  means a                                                              
new  commissioner, plus  staffing  and facility  costs related  to                                                              
that  new commissioner's  office,  a  new finance  and  management                                                              
division  to support  the  department,  additional  strain on  the                                                              
state's existing  generalized administrative  services  to support                                                              
the new  department, and  the creation of  a new health  analytics                                                              
unit.   More importantly,  all these new  units, staff,  and needs                                                              
cost money; money the state simply does not have right now.                                                                     
11:10:05 AM                                                                                                                   
CHIEF  SIMON recounted  that for  the  past few  years Alaska  has                                                              
been  in  a   crisis  due  to  declining  oil   revenues  and  the                                                              
insufficiency  of other  revenue  sources to  support basic  state                                                              
services.   Year after year  [Alaskans] have suffered  mass budget                                                              
cuts    including   large-scale    cuts    championed   by    this                                                              
administration  and have  been  told that  people  need to  accept                                                              
reductions  in services  as  a reality  given  the state's  fiscal                                                              
situation.   Yet, he  continued,  in the midst  of this  financial                                                              
environment the  administration seeks to separate  the department,                                                              
create  parallel and  duplicate administrative  structures, add  a                                                              
new unit,  and a new  commissioner's office.   This does  not make                                                              
sense and will lead to larger cuts in services down the road.                                                                   
CHIEF SIMON  stated that TCC seeks  to work with  the commissioner                                                              
to ensure that  any reorganization of DHSS benefits  Alaskans.  He                                                              
related that the  frequently asked questions document  also claims                                                              
that   the  proposed   reorganization  will   amount  to   minimal                                                              
additional cost.   All  the units already  exist, he  pointed out,                                                              
but  not existing  are  the  new  commissioner's office,  the  new                                                              
financial and  management division,  and the new  health analytics                                                              
unit.  These costs will be more than minimal, he contended.                                                                     
CHIEF SIMON  further related that  the frequently  asked questions                                                              
document   states   that  the   entire   goal  of   the   proposed                                                              
reorganization  is  to provide  services  to Alaskans  better  and                                                              
more  efficiently.    He  questioned   how  creating  a  duplicate                                                              
department  is efficient,  and further questioned  how this  would                                                              
lead  to  better  services  if  funds  were  averted  from  actual                                                              
services  to administration.   The  administration, he  continued,                                                              
says its  proposed reorganization  is meant  to improve  services,                                                              
but  it  does  not  explain  how.     It  separates  programs  and                                                              
facilities   from  divisions   that  provide   the  services   and                                                              
resources to support these programs.                                                                                            
11:12:46 AM                                                                                                                   
CHIEF SIMON  pointed out  that while the  press releases  focus on                                                              
efficiency, one  could not  help but notice  that the  programs in                                                              
the new Department  of Family and Community Service  are those the                                                              
administration  has tried to  privatize or  place on the  chopping                                                              
block in  the past.  He  said it is time  for the State  of Alaska                                                              
to provide  these programs with  the support they  need, stabilize                                                              
their  leadership   and  operations,  and  stop   trying  to  pass                                                              
responsibility  on   to  someone  else  or  expecting   a  private                                                              
operator to do better.                                                                                                          
CHIEF SIMON  concluded by  stating that  Tanana Chiefs  Conference                                                              
does  not support  the  proposed  reorganization  and believes  it                                                              
would  lead to  worse  outcomes  than the  status  quo.   He  said                                                              
Tanana Chiefs  Conference is happy  to collaborate with  the state                                                              
on ways  to actually  improve outcomes,  increase efficiency,  and                                                              
strengthen service  delivery, and hopes that TCC  and other tribes                                                              
around the  state are adequately  consulted before  future similar                                                              
proposals are announced.                                                                                                        
11:14:33 AM                                                                                                                   
REPRESENTATIVE  TARR  shared  that   she  too  noticed  the  split                                                              
includes items  that have  previously been  on the chopping  block                                                              
or  considered for  privatization.   She  suggested  that this  is                                                              
something the committee  needs to keep in mind as  it explores the                                                              
philosophy behind this proposal.                                                                                                
CHIEF  SIMON  thanked  Representative  Tarr.    He  expressed  his                                                              
concern  that with  the current  status quo of  the pandemic,  TCC                                                              
doesn't want  [the proposed division]  to happen in the  Office of                                                              
Children's  Services.  As  a First  Chief of a  tribe, he  said he                                                              
knows full  well the  tribal courts,  the meetings with  families,                                                              
and separating  families, and  that's tough  enough already.   The                                                              
proposed  division,  he  added,  only  complicates  a  complicated                                                              
service trying  to deliver  a high  level of  service in  a remote                                                              
location in a nonstandard fashion.                                                                                              
11:16:17 AM                                                                                                                   
CHAIR ZULKOSKY recalled  Chief Simon talking about  the importance                                                              
of  meaningful  consultation,  particularly  as  a  tribal  agency                                                              
provider  that  works in  tandem  with  the  State of  Alaska  and                                                              
complements much  of its work.   She asked  him to talk  about the                                                              
experience  that   TCC  had   in  consultation,  discussion,   and                                                              
deliberation with  the department and the governor  in the lead-up                                                              
to this particular announcement about the proposal.                                                                             
CHIEF  SIMON replied,  "None."   He added  that in  years past  in                                                              
dealing  with  OCS  and taking  children,  boys  and  girls,  from                                                              
homes, there were  meetings with the director of OCS.   He related                                                              
that on behalf  of the tribes  he always thanked the  director for                                                              
her  time because  OCS  is such  a  difficult  department to  run,                                                              
given it  takes kids  from family,  all they  know, and  puts them                                                              
somewhere else.   It is  a tough go all  the way around,  he said,                                                              
and this proposed split would make it even harder.                                                                              
11:18:06 AM                                                                                                                   
CHAIR ZULKOSKY invited the next witness to testify.                                                                             
11:18:29 AM                                                                                                                   
TAMMY SANDOVAL, stated  that according to OCS data,  the number of                                                              
children  in  care  this  month  is  3,057,  and  1,988  of  those                                                              
children  are  Alaska  Native.     She  said  she  is  before  the                                                              
committee as an  expert in child welfare, having  begun her career                                                              
on  the frontlines  37  years  ago.   She  noted  that  she has  a                                                              
Master's  of Social  Work, has worked  in child  welfare in  three                                                              
states, has  consulted and trained  in several states,  and served                                                              
as the OCS  director from 2005 to  2010.  Since then  she has been                                                              
the director of  the Child Welfare Academy, the  agency within UAA                                                              
that trains  all the new OCS  workers, social service  associates,                                                              
and supervisors, as well as stakeholders statewide.                                                                             
MS. SANDOVAL  explained  she has  taken time  off this morning  to                                                              
provide this  testimony.   The opinions she  is providing  are her                                                              
own, she emphasized,  and she is not testifying as  an employee of                                                              
UAA nor the Child Welfare Academy.                                                                                              
MS. SANDOVAL  stated that  like many others  outside of  the state                                                              
system, she was  shocked to learn that DHSS was  planning to split                                                              
OCS into two divisions.   While she tends to be  someone who loves                                                              
the idea  of innovation,  all she  could think  about was  how the                                                              
split would affect  children, youth, and families, as  well as the                                                              
workers who  serve those  families.   She has  given this  a great                                                              
deal of  thought, she said,  and she cannot  see a way to  make it                                                              
work for those most affected  families and frontline workers.                                                                   
11:20:28 AM                                                                                                                   
MS.  SANDOVAL  advised  that  a family  having  to  negotiate  one                                                              
system  is nearly  impossible  as it  is,  and there  would be  no                                                              
chance  if there  were  two divisions.    She  explained that  the                                                              
child  welfare system  isn't just  OCS.   It's  court parties  and                                                              
service providers,  and with 65  percent of the children  in state                                                              
custody  being Alaska  Native it's  tribal  agencies as  well.   A                                                              
family  in crisis  having  to  figure out  who  does  what in  two                                                              
divisions instead of one would be debilitating, she stated.                                                                     
MS. SANDOVAL  contended that the  worst thing about  this proposal                                                              
is that it came  out without stakeholder input,  seemingly like it                                                              
was a done deal.   She offered her belief that,  if asked, parents                                                              
and youth would  have had plenty  to say about how best  to design                                                              
a system to better  prevent the need for intervention,  serve them                                                              
when they do, and  create efficiencies in the process.   She asked                                                              
whether there was  any consumer input, because in  her vast career                                                              
she has never  heard of a state  splitting itself such  as what is                                                              
being proposed.   She related  that in  an online search  she only                                                              
found one  state that has  tried it in the  past, and in  2001 the                                                              
Nevada  State  Legislature  concluded   that  Nevada's  bifurcated                                                              
system  was  not  conducive to  promoting  positive  outcomes  for                                                              
children and families.                                                                                                          
MS. SANDOVAL  said she agrees with  wanting families to  be served                                                              
in a  respectful, efficient  way  by caring OCS  staff.   However,                                                              
she  argued, splitting  the system  would only  contribute to  the                                                              
chaos and the hoops  to jump through.  She urged  that instead the                                                              
real  issue be  dealt with,  and  stated that  the most  pervasive                                                              
reasons "OCS  doesn't work"  are not  enough resources  to prevent                                                              
the  need  for  child welfare  to  begin  with,  inequities  among                                                              
disadvantaged  people, and the  lack of a  workforce in  Alaska to                                                              
provide necessary services to those who need it.                                                                                
MS.  SANDOVAL  related  that  in  her  experience,  reorganization                                                              
almost never  works to fix the  real issues.  Bifurcation  is just                                                              
smoke and  mirrors, she  charged.   Not enough child  maltreatment                                                              
prevention effort,  lack of workforce, and racial  inequities will                                                              
still be  the elephant  sitting in  the middle  of the  state left                                                              
unaddressed.   She stated that for  the sake of those  things that                                                              
are  going well  now in  the midst  of a  worldwide pandemic,  she                                                              
sincerely hopes that this doesn't happen.                                                                                       
11:23:12 AM                                                                                                                   
CHAIR ZULKOSKY invited the next witness to testify.                                                                             
11:23:47 AM                                                                                                                   
JAKE  METCALFE,   Executive  Director,   Alaska  State   Employees                                                              
Association (ASEA)  Local 52, noted that at 8,000  members ASEA is                                                              
one  of the  largest public  employee unions  and represents  both                                                              
state and municipal  employees in Alaska.  He  said DHSS employees                                                              
make up the largest  number of ASEA members.  He  pointed out that                                                              
public  employees deliver  essential  public services  24 hours  a                                                              
day,  7 days a  week, 365  days a  year.   Further, he  continued,                                                              
public service  is more than  a job -  it's a passion,  a calling,                                                              
and a commitment to serving Alaska and Alaska communities.                                                                      
MR. METCALFE  related that ASEA  reached out to its  members about                                                              
any concerns  they might have  regarding the governor's  proposal.                                                              
Like  others,  ASEA doesn't  have  a  lot  of clarity  about  this                                                              
proposal or  how it  will impact the  dedicated public  workers in                                                              
this department.   He  said ASEA agrees  with the other  witnesses                                                              
that there  was no consultation  or bringing together of  folks to                                                              
ask  their opinions  before  this happened;  ASEA  was told  about                                                              
this after it happened.                                                                                                         
MR. METCALFE  said ASEA  is disappointed  that the  administration                                                              
chose not to  come before the committee  today.  He made  it clear                                                              
that  ASEA   supports  any   efforts  to   improve  services   and                                                              
efficiency so  long as  the changes abide  by the contract  called                                                              
the  Collective  Bargaining  Agreement,   and  so  long  as  those                                                              
changes  are  not  at  the expense  of  working  people  or,  most                                                              
importantly,  to  the detriment  of  Alaska's children,  men,  and                                                              
women who  need these  essential public  services.  These  changes                                                              
must also not come at the detriment of Alaska, he added.                                                                        
11:26:44 AM                                                                                                                   
MR. METCALFE  stated that ASEA and  its members are  concerned the                                                              
administration may  be setting up this department  for outsourcing                                                              
these  essential services,  in which  case this  work would  leave                                                              
Alaska.  It would  undoubtedly impact the quality  of services, he                                                              
argued,  which are  sensitive in  nature and  require local  based                                                              
knowledge for the administration to service it.                                                                                 
MR.  METCALFE  provided  the  background  for  why  ASEA  and  its                                                              
members have  this concern.  He  explained that ASEA  members work                                                              
at the  Alaska Psychiatric Institute  (API), Alaska  Pioneer Homes                                                              
across the state,  and the Department of Health  & Social Services                                                              
where employees  are tracking  the pandemic.   Over the  length of                                                              
this  administration,  ASEA  has seen  these  services  contracted                                                              
out.   He said ASEA  had to litigate  to stop that  from happening                                                              
at  API.   Alaska Pioneer  Homes  has seen  its cafeteria  workers                                                              
privatized and there  is concern that the administration  wants to                                                              
privatize  more of  the  services the  homes  provide to  seniors.                                                              
Most recently,  ASEA has seen  this administration  outsource work                                                              
regarding the  pandemic.  The  administration hasn't  followed the                                                              
ASEA  contract to  do any  of that,  he  pointed out,  which is  a                                                              
really  serious  concern  because  ASEA  has an  agreement,  is  a                                                              
business  partner, with  the  State of  Alaska.   Outsourcing  and                                                              
subcontracting can  happen if the  administration does what  it is                                                              
supposed to  under the contract and  has a study, gets  input, and                                                              
engages with  its stakeholders,  but the administration  has never                                                              
chosen to  do that.  He stated  that this is  especially important                                                              
when there is  a government-to-government relationship  for health                                                              
and social  services and children's  services.  That is  no longer                                                              
had  when  those  services  go  to  a  multi-national  corporation                                                              
located  outside of  Alaska.   When  this work  is outsourced,  he                                                              
continued,  the people  running  those services  do  not have  the                                                              
needed local  knowledge.   It is extremely  important to  know the                                                              
local  cultures  of  the  state  and the  ways  of  doing  things,                                                              
especially with  this kind  of family work,  which isn't  had with                                                              
MR.  METCALFE pointed  out  that in  addition  to the  outsourcing                                                              
problems,  the  work is  going  to  private companies  that  don't                                                              
provide  benefits.   In an  economy  like Alaska's,  jobs need  to                                                              
stay in  the state  and provide benefits,  so people  aren't going                                                              
on  public assistance  and have  healthcare,  especially during  a                                                              
pandemic.     There  is  no  control   over  that  when   work  is                                                              
outsourced,  he  continued, and  in  most  cases the  benefits  of                                                              
public employees  do not follow along.   This issue has  popped up                                                              
with tele-work because  tele-work opens it up  for outsourcing and                                                              
having  people provide  services  who don't  live in  Alaska.   He                                                              
said ASEA  is concerned about that  and thinks the state  needs to                                                              
police  what work  is being  done by  tele-work and  what work  is                                                              
being outsourced  because  it has significant  impact on  policies                                                              
and ability to provide services.                                                                                                
11:31:29 AM                                                                                                                   
MR. METCALFE  referenced the articles  he submitted to  the record                                                              
about  the state  of Texas,  which tried  to outsource  children's                                                              
services work.   He urged committee  members to read  the articles                                                              
and see  what happens when  a state tries  to outsource  its work,                                                              
which  usually doesn't  end  well,  if ever.    The motivation  of                                                              
public  services, he  opined,  should be  serving  the public  and                                                              
serving the public  in a way to have a healthy  and whole society.                                                              
Public  work should  never be  driven by  profit, especially  when                                                              
the  persons receiving  those  services  are the  most  vulnerable                                                              
citizens  like seniors,  children,  and Alaskans  struggling  with                                                              
behavioral and mental health conditions.                                                                                        
MR. METCALFE  expressed ASEA's concerns  about the logistics.   He                                                              
said a  specific question that  needs to  be discussed is  how the                                                              
proposed  split will impact  OCS eligibility  technicians.   These                                                              
employees  deal with  Medicaid and  community services,  including                                                              
legal,  custody, and  child  placement issues.    He said  another                                                              
concern relates  to OCS and  coordinating with tribal  governments                                                              
and  tribal  state compact  agreements.    He reported  that  ASEA                                                              
staff and  union members  are concerned about  how this  will work                                                              
since  there  wasn't  any notice,  consulting,  or  engaging  with                                                              
stakeholders, which  needs to happen for  this to work  right.  He                                                              
said  he's sorry  the administration  didn't choose  to come  talk                                                              
about this  today because  part of what  makes government  work is                                                              
when  the different  branches of  government are  talking to  each                                                              
other and to the  public.  That needs to happen  for this to work,                                                              
he continued,  and it hasn't happened,  and it seems to  be a done                                                              
deal.  It isn't  in the best interest of the  State of Alaska when                                                              
it doesn't engage its stakeholders and business partners.                                                                       
11:34:46 AM                                                                                                                   
REPRESENTATIVE TARR  said she recalls the API lawsuit.   She asked                                                              
whether there are  any currently active lawsuits  related to these                                                              
labor disputes or questionable proposals.                                                                                       
MR.  METCALFE replied  that  ASEA  has finished  some  of the  API                                                              
related litigation,  but part  of the case  is still in  the court                                                              
system.   He reported that  Wellpath, the private  contractor that                                                              
came into  API, has ended,  and that ASEA  is continuing  to watch                                                              
what API is  going to do as far  as management.  There  has been a                                                              
good organization set  up within API that is looking  at how it is                                                              
going  to  be  managed  and ASEA  continues  to  try  to  actively                                                              
participate  in that  group.  He  said there  is other  litigation                                                              
involving the  state and ASEA.   He stated  that ASEA  follows the                                                              
outsourcing  of work  and has  one  ongoing issue  with DHSS  over                                                              
outsourcing  COVID related  work,  which is  not in  court but  is                                                              
within the  dispute resolution process  of the contract.   It must                                                              
be ensured that  the contract is followed, he  explained, and ASEA                                                              
would  rather sit  down  with  the state  and  try  to work  these                                                              
issues out  ahead of time  than to find  out about them  after the                                                              
fact because that  causes all kinds of costs and  resource use and                                                              
delays processes.                                                                                                               
MR.  METCALFE continued  his answer.    He related  that ASEA  has                                                              
reached out  from the  beginning of  this administration  and said                                                              
that ASEA  wants to consult and  engage with the  state beforehand                                                              
on  any questions  or ideas  to  ensure any  change or  management                                                              
decision is  going to be done right  under the ASEA contract.   He                                                              
said ASEA knows  management has the right to do a  lot of decision                                                              
making, but  that it  works better  when management consults  with                                                              
ASEA  ahead  of   time.    It's  no  different   than  the  tribal                                                              
governments;  ASEA is a  stakeholder and  a business partner,  and                                                              
there will be fewer  problems if the state works  with ASEA rather                                                              
than informing ASEA after the fact.                                                                                             
MR. METCALFE specified  that ASEA wants the state  to operate well                                                              
and for people to  have good jobs and good benefits  and ASEA will                                                              
do everything  it can  to work with  the state  to make  sure that                                                              
that happens.   He  said ASEA  doesn't want  to get involved  with                                                              
litigation or  the dispute resolution  process because  that's not                                                              
healthy or  good for the  services that  ASEA provides or  for the                                                              
State of  Alaska.  The  goal of ASEA  is to communicate,  consult,                                                              
and engage  with its  business partner,  the  State of Alaska,  as                                                              
much as  possible.  He  urged that the  State of Alaska  engage in                                                              
that kind of process with ASEA and all other stakeholders.                                                                      
11:39:32 AM                                                                                                                   
CHAIR  ZULKOSKY noted  that what  hasn't been  discussed today  is                                                              
the impact  of splitting  health and social  services apart.   She                                                              
requested Chief  Simon, Ms. Metivier, Ms. Sandoval,  and President                                                              
Peterson  to speak  to integration  of the  current system  within                                                              
Alaska,  and  how  spitting  health   from  family  and  community                                                              
services  and putting  them into  two separate  entities would  be                                                              
cumbersome for individuals.                                                                                                     
CHIEF  SIMON replied  that  TCC  already has  a  difficult job  of                                                              
providing  services for  its children.   Whether  someone makes  a                                                              
great decision or  a terrible decision, TCC provides  the services                                                              
to take  care of these  kids.  He  said he  is a firm  believer in                                                              
being upstream or  proactive of the problem.   For example, mental                                                              
health  issues can  lead to  an individual  being traumatized  for                                                              
the  rest  of their  life.    Being downstream  of  mental  health                                                              
issues leads  to sending  people away from  their villages  to the                                                              
Alaska Psychiatric  Institute, which  he understands is  no longer                                                              
open.  He  urged the State of  Alaska to consider locating  an API                                                              
in Fairbanks, given  that 8,000 of the Athabascan  Nation's 20,000                                                              
people live  in Fairbanks  and some of  them need these  services.                                                              
This would  help the situation  tremendously, he added,  and would                                                              
serve the existing need of Native people for these services.                                                                    
11:43:55 AM                                                                                                                   
MS. METIVIER responded  that the larger implications  of splitting                                                              
DHSS fall around  the questions of evidence based and  the how and                                                              
why this  could work.  She  stated that public systems,  when they                                                              
work together,  tend to  be better in  terms of serving  families.                                                              
She  posed an  example of  a child  in the  custody of  children's                                                              
services who is  placed in a therapeutic foster  home with another                                                              
agency that  works in and bills  Medicaid.  That child  would then                                                              
be under  the guise of two  separate departments  because Medicaid                                                              
would fall on  one side and OCS  would fall on the other.   In the                                                              
same way  that bifurcation of  OCS would create  complications for                                                              
families  in terms  of  communicating  with public  agencies,  she                                                              
continued,  the same  would  happen  at a  larger  scale with  the                                                              
split of  the two  departments.   Even now,  she pointed  out, all                                                              
the  divisions within  DHSS  don't  always communicate  well  with                                                              
each  other  but they  communicate  enough  so that  families  can                                                              
still navigate and get through things.                                                                                          
MS. METIVIER further  responded that when young people  age out of                                                              
the system  and leave  foster care,  they are  eligible under  the                                                              
Affordable  Care  Act for  Medicaid  until age  26.    One of  the                                                              
challenges  for youth,  she explained,  is this  gap between  when                                                              
they  leave  foster  care  and apply  for  public  assistance  for                                                              
themselves.   Right now,  there is  a system in  place for  OCS to                                                              
communicate  directly  to  Public  Assistance.   She  said  it  is                                                              
unknown  whether [in  the  proposal] these  on-the-ground  details                                                              
within  the  department would  change,  but  she thinks  it  would                                                              
further separate  the resources and supports for  families.  There                                                              
should  be  a move  toward  more  communication, she  opined,  and                                                              
being  able to  do  early  intervention and  identifying  families                                                              
early.   For example,  an effort to  identify families  early that                                                              
are on public  assistance because those are the  families that may                                                              
eventually  come  on the  radar  of  child  protection.   So,  she                                                              
continued,   it  makes  sense   to  have   them  all   within  one                                                              
department,  but the  information and  details are  missing as  to                                                              
what this proposal looks like.                                                                                                  
11:46:55 AM                                                                                                                   
MS.  SANDOVAL  offered  her  agreement with  Ms.  Metivier.    She                                                              
related  that when  she was  in DHSS  a lot  of work  was done  on                                                              
confidentiality  and  sharing of  information  between  divisions.                                                              
She said  there was  an opportunity to  talk with other  divisions                                                              
about  families that  were shared  in common.   She expressed  her                                                              
worry that  this would  become even more  difficult if  there were                                                              
two departments.   She concurred that  DHSS is huge but  said that                                                              
being underneath  one roof creates  some relationships  that might                                                              
not otherwise be there.                                                                                                         
MS. SANDOVAL  stated that it is  important to understand  why this                                                              
is being  proposed and how  the decision  was made with  regard to                                                              
division, because there  are synergies now that may  not happen if                                                              
the  department  is split  into  two.    She reiterated  that  she                                                              
worries  about reorganization  in general,  especially now  during                                                              
the pandemic.   In her  experience, she continued,  reorganization                                                              
is really  messy and  currently it's already  a really  messy time                                                              
in the country.   She said she questions the  timing, information,                                                              
and lack of transparency in the decisions that are being made.                                                                  
11:48:46 AM                                                                                                                   
MR. PETERSON  pointed out that  resources are already  limited and                                                              
difficult to access  for children and families.   The partnerships                                                              
with Public  Health and Behavioral  Health are depended  upon, not                                                              
only to identify  at-risk families but  also to find a  way to get                                                              
people the help they need.                                                                                                      
11:49:17 AM                                                                                                                   
CHAIR ZULKOSKY said  she knows from her experience  in health care                                                              
that many  healthcare systems  are moving  into integrated  models                                                              
of  care, wrapping  services  around  patients.   She  stated  she                                                              
hears from today's  testimony the concern around  disenfranchising                                                              
Alaskans  from  essential  critical  services  that  many  of  the                                                              
witnesses  advocate for  and provide  in their  communities.   She                                                              
thanked the  witnesses for  their work and  their time  before the                                                              
committee   and  added  that   the  committee   will  invite   the                                                              
department to speak when another time presents itself.                                                                          
11:50:08 AM                                                                                                                   
There being  no further business  before the committee,  the House                                                              
Health  and  Social   Services  Standing  Committee   meeting  was                                                              
adjourned at 11:50 a.m.                                                                                                         

Document Name Date/Time Subjects
Casey AK H&SS Comte FINAL presentation for 1-13-21.pdf HHSS 1/13/2021 10:00:00 AM
House HSS 1/13/21
Updated Ltr to TSCG 1.6.2021.pdf HHSS 1/13/2021 10:00:00 AM
House HSS 1/13/21
OCS Proposed Restructure Testimony Jan 14 2021.pdf HHSS 1/13/2021 10:00:00 AM