Legislature(2021 - 2022)DAVIS 106

04/08/2021 03:00 PM House HEALTH & SOCIAL SERVICES

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Audio Topic
03:02:24 PM Start
03:09:01 PM Presentation: Alaska Early Childhood Environmental Scan
04:02:59 PM Overview: Myhouse Mat-su Homeless Youth Center
04:13:21 PM Overview: Child Welfare in Alaska
05:00:01 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation: Alaska Early Childhood TELECONFERENCED
Environmental Scan by All Alaska Pediatric
-- Testimony <Invitation Only> --
- MyHouse Mat-Su Homeless Youth Center by Justin
- Child Welfare in Alaska by Kim Guay, Director,
Office of Children Services, Dept. of Health &
Social Services
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 8, 2021                                                                                          
                           3:02 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Representative Liz Snyder, Co-Chair                                                                                             
Representative Tiffany Zulkosky, Co-Chair                                                                                       
Representative Ivy Spohnholz (via teleconference)                                                                               
Representative Zack Fields                                                                                                      
Representative Ken McCarty                                                                                                      
Representative Mike Prax                                                                                                        
Representative Christopher Kurka                                                                                                
MEMBERS ABSENT                                                                                                                
All members present                                                                                                             
COMMITTEE CALENDAR                                                                                                            
PRESENTATION: ALASKA EARLY CHILDHOOD ENVIRONMENTAL SCAN                                                                         
     - HEARD                                                                                                                    
OVERVIEW: MYHOUSE MAT-SU HOMELESS YOUTH CENTER                                                                                  
     - HEARD                                                                                                                    
OVERVIEW: CHILD WELFARE IN ALASKA                                                                                               
     - HEARD                                                                                                                    
PREVIOUS COMMITTEE ACTION                                                                                                     
No previous action to record                                                                                                    
WITNESS REGISTER                                                                                                              
TAMAR BEN-YOUSEF, Executive Director                                                                                            
All Alaska Pediatric Partnership (A2P2)                                                                                         
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:    Provided  a  presentation  reviewing  the                                                             
report  commissioned  by A2P2  in  2019  entitled, "Alaska  Early                                                               
Childhood Environmental  Scan & Baseline Report  on the Condition                                                               
of Young Children."                                                                                                             
IRIS MATTHEWS, President                                                                                                        
The Stellar Group                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Answered questions during  the presentation                                                             
on the Alaska Early Childhood Environmental Scan.                                                                               
JUSTIN PENDERGRASS, Suicide Prevention Advocate                                                                                 
Mat-Su Youth Housing                                                                                                            
MyHouse Mat-Su Homeless Youth Center                                                                                            
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Provided a  presentation on the MyHouse Mat-                                                             
Su Homeless Youth Center.                                                                                                       
KIM GUAY, Director                                                                                                              
Office of Children's Services (OCS)                                                                                             
Department of Health and Social Services (DHSS)                                                                                 
Anchorage, Alaska                                                                                                               
POSITION   STATEMENT:     Provided   a  PowerPoint   presentation                                                             
entitled, "Child Welfare in Alaska," dated 4/8/21.                                                                              
ACTION NARRATIVE                                                                                                              
3:02:24 PM                                                                                                                    
CO-CHAIR  TIFFANY ZULKOSKY  called  the House  Health and  Social                                                             
Services  Standing  Committee  meeting  to  order  at  3:02  p.m.                                                               
Representatives Prax, Spohnholz  (via teleconference), Snyder and                                                               
Zulkosky  were present  at the  call to  order.   Representatives                                                               
Fields,  McCarty,  and  Kurka  arrived  as  the  meeting  was  in                                                               
[The committee  took an at-ease  from 3:04  p.m. to 3:09  p.m. to                                                               
resolve audio issues.]                                                                                                          
^PRESENTATION: Alaska Early Childhood Environmental Scan                                                                        
    PRESENTATION: Alaska Early Childhood Environmental Scan                                                                 
3:09:01 PM                                                                                                                    
CO-CHAIR  ZULKOSKY announced  that  the first  order of  business                                                               
would  be a  presentation  regarding the  Alaska Early  Childhood                                                               
Environmental Scan.                                                                                                             
3:09:35 PM                                                                                                                    
TAMAR  BEN-YOUSEF,  Executive   Director,  All  Alaska  Pediatric                                                               
Partnership (A2P2), provided a  presentation reviewing the report                                                               
commissioned by  A2P2 in 2019  entitled, "Alaska  Early Childhood                                                               
Environmental Scan  & Baseline Report  on the Condition  of Young                                                               
Children."  She  noted that the extensive number  of funders [for                                                               
the report]  reflects an understanding  across many  sectors that                                                               
this  is  an  important  priority that  impacts  more  than  just                                                               
families or children.                                                                                                           
MS.  BEN-YOUSEF  pointed   out  that  there  is   more  than  one                                                               
interpretation of what makes up  the term "early childhood."  She                                                               
said everyone  agrees that  early childhood  is a  critical focal                                                               
point  for creating  healthier communities.   But  for some,  she                                                               
continued, it is  associated with an age range and  for others it                                                               
is   mostly  about   childcare   or  preschool   or  babies   and                                                               
developmental health.  These varying  perceptions make it hard to                                                               
be effective when  advocating or planning policies  for the early                                                               
childhood sector, which is why A2PS felt this report necessary.                                                                 
MS. BEN-YOUSEF explained  that the report is  focused on children                                                               
prenatal  through age  8 and  pregnant mothers  and is  the first                                                               
step  towards identifying  and prioritizing  statewide needs  for                                                               
this  population.   The report  was  commissioned to  serve as  a                                                               
resource  to support  stakeholders, including  policy makers,  in                                                               
efforts to better coordinate, align,  and integrate the services,                                                               
supports,  and resources  that are  needed to  build a  stronger,                                                               
more comprehensive  early childhood  system, which in  turn leads                                                               
to a healthier,  and in the long term, less  costly population of                                                               
Alaskans.   Healthy  and supported  young children  are essential                                                               
for Alaska's future.  Alaska's  children are falling behind their                                                               
peers nationally in health and  education outcomes.  The roots of                                                               
the  achievement  gap  start  well  before  children  ever  enter                                                               
school.  Early interventions work,  including family supports and                                                               
early childhood  education opportunities.   Investments  in early                                                               
childhood  are  cost-effective  and  produce  large  benefits  to                                                               
children, parents, and  society.  Many children  and families are                                                               
not receiving the services and support they need.                                                                               
MS. BEN-YOUSEF stated that in the  last few years A2PS has become                                                               
more involved  in the early  childhood arena through its  work to                                                               
implement its  Help Me  Grow Alaska  program.   She said  A2PS is                                                               
actively participating  in several committees and  groups such as                                                               
the Alaska  Early Childhood Coordinating Council  (AECCC) and has                                                               
engaged in advocacy and education  on prevention, early childhood                                                               
brain development,  and pediatrics best practices.   Being active                                                               
in this  realm of early  childhood highlighted the ways  in which                                                               
Alaska  struggles  to  work collaboratively  and  efficiently  to                                                               
improve outcomes  for children  and families.   It isn't  easy to                                                               
advocate for early  childhood to be a higher  priority in Alaska.                                                               
The state has much data showing  how badly its children are doing                                                               
compared to  other states but  has only recently  started looking                                                               
in an  organized way at  why or  how Alaska's entire  system that                                                               
should  be  supporting  children  and families  to  thrive  could                                                               
sometimes be contributing to some of the bad outcomes.                                                                          
3:14:44 PM                                                                                                                    
MS.   BEN-YOUSEF  expressed   her  hope   that  this   background                                                               
information will help  members to browse through  this report and                                                               
recognize  the connections  between  systems and  outcomes.   She                                                               
recalled that about  three years ago A2PS  attempted with several                                                               
of its  state and  nonprofit partners  to provide  information to                                                               
policy makers  on the programs  that fall within  Alaska's system                                                               
of  early childhood  services and  to map  out how  services were                                                               
delivered and  funded.  The  goal was to  identify inefficiencies                                                               
and  possible   duplications  in  response  to   early  childhood                                                               
stakeholders advocating to keep  early childhood programs off the                                                               
chopping block.  However, despite  great presentations given over                                                               
a two-day  hearing before House committees,  the biggest takeaway                                                               
was  that  ultimately  [Alaska] is  challenged  in  defining  and                                                               
framing its  early childhood system  and there is  little clarity                                                               
about the funding.   Upon thinking about this  report in response                                                               
to those questions,  A2P2 got excited about  what other questions                                                               
it could  answer and how  the report could  be used to  support a                                                               
focused systems  approach to  improving early  childhood outcomes                                                               
and healthier communities altogether.   To kick off its work A2P2                                                               
formed  a  cross-sector advisory  committee  that  has seen  this                                                               
project  through from  inception to  the end.   Input  was sought                                                               
from others  outside the  community, including  tribal healthcare                                                               
leadership, and the instrumental feedback improved the report.                                                                  
MS. BEN-YOUSEF  related several points  for committee  members to                                                               
consider when  going through  the report.   Alaska has  more than                                                               
94,000 children ages  zero through eight.  The report  is not the                                                               
end  all, many  deeper  dives  that can  be  taken  based on  the                                                               
information.  The  report highlights some big  issues that hugely                                                               
impact the ability  to create effective policies  and programs in                                                               
an equitable  way.  The data  section of the report,  "The Status                                                               
of  Young Children  and  Families," provides  a  baseline on  the                                                               
status of children zero through  eight and pregnant mothers based                                                               
on  2018 data.    This  baseline is  critical  to evaluating  the                                                               
impact  of  investments  and  programs.   The  pandemic  was  not                                                               
anticipated  in  early  2019,  but this  baseline  is  even  more                                                               
important now  while trying to  measure the impact  that COVID-19                                                               
has had on  families and young children and on  the services that                                                               
they need.   Finally, A2P2 worked hard to let  the data speak for                                                               
itself  and recommendations  are  intentionally  not included  in                                                               
this report.  Every stakeholder  will find some sections that are                                                               
more connected to  their work than others and A2P2  hopes it will                                                               
provide everyone with  some tools to advocate and plan  in a more                                                               
unified and coordinated way.                                                                                                    
3:17:56 PM                                                                                                                    
MS. BEN-YOUSEF  noted the report  is divided into  four sections,                                                               
with the  two larger sections  being the early  childhood system,                                                               
which  is  the  Environmental  Scan,  and  the  status  of  young                                                               
children and families, which is the  data section.  At the end of                                                               
the report  are individual regional  profiles based on  the seven                                                               
public health regions of the state.                                                                                             
MS. BEN-YOUSEF stated  that the timeline in  Section I identifies                                                               
significant  milestones in  early  childhood initiatives,  policy                                                               
changes,  and  program  developments   over  time  starting  with                                                               
Alaska's purchase from Russia in  1860.  While young children and                                                               
mothers lived here long before  1860, a documented datapoint from                                                               
which to start was needed.                                                                                                      
MS.  BEN-YOUSEF said  Section II  is the  early childhood  system                                                               
scan.  Early childhood systems  are defined nationally as dynamic                                                               
cross-sector collaborations  between organizations with  a shared                                                               
mission to help children and families  thrive.  To be able to dig                                                               
into the  data for this report  A2P2 first had to  determine what                                                               
made  up Alaska's  early  childhood (EC)  system.   This  section                                                               
defines the  elements/components of a high  functioning EC system                                                               
and discusses  the status  of each element  in Alaska  - funding,                                                               
data systems, quality standards,  family engagement and outreach,                                                               
workforce  and  professional   development,  and  governance  and                                                               
leadership.     For  each  of  these   components,  this  section                                                               
identifies  what is  in  place,  where the  system  has gaps  and                                                               
challenges, and  where it  has strengths.   These  components are                                                               
linked, overlapping,  and mutually  reinforcing pieces,  and when                                                               
properly  functioning these  components should  provide a  strong                                                               
infrastructure for young children and their families to thrive.                                                                 
MS. BEN-YOUSEF  said Section  III is  where most  of the  data is                                                               
reported and this  section essentially creates a  baseline on the                                                               
status of young children and  mothers.  It identifies and reports                                                               
on  a set  of research-based  indicators  that could  be used  to                                                               
measure population  level changes  and trends  over time  in four                                                               
main areas  - demographics, health and  development, child safety                                                               
and   family  supports,   and  school   readiness  and   success.                                                               
Indicators were selected based  on nationally recognized measures                                                               
of  child health,  wellbeing,  and development,  as  well as  the                                                               
availability of  data in Alaska.   This baseline  is pre-COVID-19                                                               
and  now  some   of  these  indicators  most   likely  look  very                                                               
different,  for  example,  childcare availability,  and  maternal                                                               
mental health.                                                                                                                  
3:21:19 PM                                                                                                                    
CO-CHAIR  ZULKOSKY confirmed  to  Representative  Kurka that  the                                                               
document  being  discussed  by  Ms.  Ben-Yousef  is  not  in  the                                                               
committee packet.                                                                                                               
MS.  BEN-YOUSEF clarified  her presentation  is not  a PowerPoint                                                               
presentation and is essentially the report broken into visuals.                                                                 
MS. BEN-YOUSEF resumed her presentation.   She specified that the                                                               
regional profiles  are divided into Alaska's  seven public health                                                               
regions  and  highlight  select  indicators  for  each  of  these                                                               
regions.   The indicators are  demographics, mothers  and babies,                                                               
child  safety  and  maltreatment,   family  supports,  and  early                                                               
childhood education.  The regional  profiles when compared to one                                                               
another shed  light on the  distribution of resources  across the                                                               
state.   Not surprisingly the  indicator data on  outcomes almost                                                               
always corresponds with access or lack of access to supports.                                                                   
3:23:06 PM                                                                                                                    
MS. BEN-YOUSEF  focused on  the component  of funding  within the                                                               
Environmental Scan.   She displayed  a map that many  members saw                                                               
last  month  when A2P2  made  legislative  visits and  said  that                                                               
seeing the  flow of  funding for  early childhood  illustrated in                                                               
this way  helps to  understand the level  of complexity  in these                                                               
funding  streams.   It  also  explains why  there  are no  simple                                                               
answers  when  asked  whether the  state's  investment  in  early                                                               
childhood  is   effective  or  sufficient.     She   stated  that                                                               
understanding  the sources  of funding,  how these  dollars flow,                                                               
and   all  the   attached   mandated  restrictions   is  key   to                                                               
strategically  financing the  system  and  to understanding  what                                                               
flexibility is had  to work with these  funding sources, leverage                                                               
them,  or  tailor policy  or  regulations  to  do more  with  the                                                               
funding  available.   Drawing  attention  back  to the  map,  she                                                               
explained that  this funding  analysis is  a preliminary  look at                                                               
recurring  state  and  federal  investments  within  Alaska  that                                                               
directly target  young children  and pregnant  post-partum women.                                                               
Using this  map anyone  can look up  the individual  programs and                                                               
funding sources to get a  better understanding of the complexity,                                                               
restrictions,  eligibility   barriers,  and   opportunities  that                                                               
impede or  enable these programs'  ability to serve  children and                                                               
families in the state in an equitable and efficient way.                                                                        
3:25:01 PM                                                                                                                    
MS.  BEN-YOUSEF  specified  that   in  fiscal  year  2018  Alaska                                                               
received $138.4 million in federal  investments and $26.4 million                                                               
in  state  investments  for  early  childhood  programs.    State                                                               
dollars made up  16 percent of all investments  in Alaska's early                                                               
childhood system.   Not all federal funding goes  directly to the                                                               
state:   $64.9 million  flowed through  the Department  of Health                                                               
and Social  Services (DHSS) and  the Department of  Education and                                                               
Early  Development (EED),  and $73.5  million flowed  directly to                                                               
grantees such as  Head Start, Early Head Start,  and other tribal                                                               
programs,  bypassing  the  Office   of  the  Governor  and  state                                                               
departments.  At  the local level, blending and  grading of funds                                                               
is  already occurring  to sustain  programs, so  the map  doesn't                                                               
cover those funding streams and  doesn't include the large amount                                                               
of  money that  families spend  out-of-pocket on  early childhood                                                               
services.  The report itself does touch on Medicaid.                                                                            
CO-CHAIR  ZULKOSKY noted  that the  full report  is on  BASIS and                                                               
that Ms. Ben-Yousef is discussing pages 18 and 19 of the report.                                                                
3:26:21 PM                                                                                                                    
MS. BEN-YOUSEF continued  her presentation.  She  said the report                                                               
goes through some  of the challenges and barriers  to funding and                                                               
highlights some  of the strengths  that exist.  One  challenge is                                                               
that the actual  importance of the first years of  a human's life                                                               
is not necessarily  reflected in state budgets.   Early childhood                                                               
programs are continuously put on  the chopping block.  Addressing                                                               
the   challenges  of   Alaska's  childhood   population  requires                                                               
significant  investment,  but  there  is  no  oversight  body  or                                                               
organized  way  to  identify opportunities  to  coordinate  these                                                               
complex  funding streams  or to  strategically make  system level                                                               
recommendations.   An  example  of a  strength  is that  Medicaid                                                               
expansion has  increased access to  health care for  children and                                                               
pregnant  women and  the Medicaid  1115 Behavioral  Health Waiver                                                               
increases  preventative  care  opportunities that  are  known  to                                                               
reduce costs.   Alaska  also has  several initiatives  to improve                                                               
the   early    childhood   workforce,    including   professional                                                               
development  for  infants  and   early  childhood  mental  health                                                               
providers,  which is  an identified  need.   As  well, there  are                                                               
scholarships  and incentives  for specialized  early intervention                                                               
staff,  health care  providers,  and  early childhood  educators.                                                               
There  have  been several  iterations  of  early education  bills                                                               
illustrating that there  is a strong appetite to  rethink some of                                                               
these areas  of improvements.   Finally, Alaska has a  strong and                                                               
vocal network  of engaged  stakeholders who  want a  strong early                                                               
childhood system.                                                                                                               
3:28:01 PM                                                                                                                    
MS. BEN-YOUSEF stated that the  governance component has been the                                                               
major focus of A2P2's work in  early childhood.  She related that                                                               
the report  talks about  three common  approaches to  state level                                                               
early  childhood governance  used by  most states  - coordinated,                                                               
consolidated, and creation  of an altogether new  agency.  Alaska                                                               
currently  uses  a  coordinated  model  where  multiple  agencies                                                               
coordinate  and  collaborate  with   each  other  through  formal                                                               
interagency agreements.   This  model may or  may not  have state                                                               
level task  force, committee, or  other type of  leadership body.                                                               
Alaska's  coordinated  model  has programs  and  services  housed                                                               
primarily within EED  and DHSS.  With the  recently proposed DHSS                                                               
bifurcation,  early  childhood  services would  have  potentially                                                               
been coordinated between three different departments.                                                                           
MS.  BEN-YOUSEF addressed  why Alaska's  coordinated model  is so                                                               
uncoordinated.   She related  that within  Alaska at  least seven                                                               
convening bodies  provide leadership  and direction  to different                                                               
components of the  early childhood system, with  each body having                                                               
different authority and focus and  some impacting early childhood                                                               
efforts more directly  than others.  The bodies  are Alaska Early                                                               
Childhood Coordinating Council  (AECCC), Alaska Children's Trust,                                                               
Alaska   Mental  Health   Board,  Alaska   Mental  Health   Trust                                                               
Authority, Alaska Workforce  Investment Board, Governor's Council                                                               
on  Disabilities  and  Special  Education,  and  State  Board  of                                                               
Education and Early  Development.  She pointed out  that AECCC is                                                               
the only council strictly focused  on early childhood and is also                                                               
the  only body  with no  paid staff,  no statutory  authority, no                                                               
written   mandate  to   produce   an  annual   report  or   issue                                                               
recommendations  to the  governor or  legislature, and  no formal                                                               
avenue  for  advocacy.    Many   of  AECCC's  members  are  state                                                               
employees  and therefore  they are  limited in  their ability  to                                                               
respond  to  policy and  budgetary  decisions  that affect  young                                                               
children.     As  far  as   the  question  of  AECCC's   role  in                                                               
coordinating  early childhood,  she advised  the short  answer is                                                               
that it can't.                                                                                                                  
3:30:46 PM                                                                                                                    
MS. BEN-YOUSEF  stated that regarding  system-level coordination,                                                               
Alaska  gets bogged  down in  the program  level.   She explained                                                               
that  Alaska has  a coordinated  governing  structure that  spans                                                               
across departments but lacks the  strong governance or organizing                                                               
structure   that  can   provide  a   common  vision,   oversight,                                                               
management,  and accountability  of the  state's early  childhood                                                               
system and  funding streams, including  the ability to  report to                                                               
stakeholders  in  a  meaningful  way.   Many  of  the  previously                                                               
mentioned leadership  bodies have overlapping  priorities related                                                               
to early childhood.  For example,  while the AECCC is tasked with                                                               
providing  oversight  for five  federal  grants  it doesn't  have                                                               
oversight of  all early childhood  programs.  Some  programs fall                                                               
under the Governor's Council on  Disabilities, the State Board of                                                               
Education  and  Early  Development,  or  other  state  boards  or                                                               
commissions that have responsibility  for goals or plans relevant                                                               
to Alaskans  and children.   Also, the  AECCC is more  limited in                                                               
both resources  and authority, which  means that there is  a need                                                               
and  an  opportunity for  more  coordination  of early  childhood                                                               
coalitions,  tribal organizations,  and entities  like hospitals,                                                               
private funders,  and businesses  that fund or  support community                                                               
early childhood initiatives.                                                                                                    
3:32:17 PM                                                                                                                    
MS. BEN-YOUSEF, in response to  Representative Prax, stated there                                                               
are 94,000 children in Alaska.                                                                                                  
REPRESENTATIVE PRAX  offered his  understanding that  between the                                                               
federal government  and state government,  $154 million  is being                                                               
spent per year.                                                                                                                 
MS. BEN-YOUSEF  replied that  in 2018  the federal  investment in                                                               
Alaska for  early childhood specifically,  so it  doesn't include                                                               
Medicaid for  example, was  $138.4 million  with a  $26.4 million                                                               
state match.                                                                                                                    
REPRESENTATIVE PRAX calculated that that  is $14,000 per year per                                                               
child, plus Medicaid and others.   He concurred there is room for                                                               
3:33:55 PM                                                                                                                    
REPRESENTATIVE  MCCARTY asked  whether the  94,000 children  aged                                                               
zero to eight  is the number of children in  Alaska or the number                                                               
of children being served by these programs.                                                                                     
MS.  BEN-YOUSEF answered  that it  is the  number of  children in                                                               
Alaska in 2018 aged zero to eight.                                                                                              
REPRESENTATIVE  MCCARTY inquired  about  the  number of  children                                                               
being served.                                                                                                                   
MS. BEN-YOUSEF responded she will get  back with an answer as she                                                               
doesn't have the number off the top of her head.                                                                                
3:34:45 PM                                                                                                                    
IRIS  MATTHEWS, President,  The  Stellar Group,  stated that  the                                                               
number probably  could be [calculated] but  explained it wouldn't                                                               
necessarily  be  a  unique number  because  some  children  might                                                               
receive funding  through multiple  programs and some  of Alaska's                                                               
numbers are  based on eligibility,  not actual.   She said  it is                                                               
known how  many sites  receive CACFP [Child  and Adult  Care Food                                                               
Program] redemptions,  how many children they  serve roughly, but                                                               
that the  number can fluctuate  throughout a  month or a  week or                                                               
even a  day.   She said she  therefore wouldn't  feel comfortable                                                               
just  adding up  all the  numbers of  children served  across the                                                               
categories and giving that as a unique number.                                                                                  
REPRESENTATIVE  MCCARTY  said  he would  appreciate  getting  the                                                               
MS. MATTHEWS noted that the need  for data is one of the sections                                                               
of  the early  childhood system  that Ms.  Ben-Yousef hasn't  yet                                                               
talked about.  She specified that  one of the only ways to answer                                                               
a question like that is to  have an integrated data system, which                                                               
Alaska does not  currently have.  When data can  be linked across                                                               
programs  a  much  more  complete  picture  is  provided  of  how                                                               
different programs might be contributing  to particular or unique                                                               
children and allow a look for  outcomes later down the line.  For                                                               
example, a question  that could answered with  an integrated data                                                               
system is whether children who  receive a certain set of services                                                               
do better  in, say, their third  grade reading scores than  a set                                                               
of children  from the  same community who  maybe do  not [receive                                                               
that  set of  services].    Some states  have  invested in  those                                                               
systems  and  are able  to  answer  some  of those  more  complex                                                               
questions about how services are distributed across their state.                                                                
3:37:20 PM                                                                                                                    
REPRESENTATIVE  KURKA stated  he knows  many children,  including                                                               
his  own, who  don't  receive  services.   He  said he  therefore                                                               
questions the relevancy  of the 94,036 children  in this category                                                               
and would appreciate receiving the data.                                                                                        
MS. BEN-YOUSEF  answered she  would argue  that all  children are                                                               
involved in  this in one way  or another "because we're  not just                                                               
talking about  services or supports  for children in  need, we're                                                               
talking about workforce development,  so childcare, teachers, and                                                               
early education,  and we're  talking about  health care,  and ...                                                               
early intervention services,  developmental screening that occurs                                                               
within  a pediatrician's  office."   She  added  that she  "would                                                               
argue that  every child  in the  state is  accessing one  form of                                                               
service here  in early childhood  programs or another in  one way                                                               
or another."                                                                                                                    
MS. BEN-YOUSEF  resumed her presentation.   She brought attention                                                               
to the  regional profiles and  pointed out that the  northern and                                                               
southwestern  regions  of  Alaska are  consistently  underserved.                                                               
She explained that  poverty, which is the  single greatest threat                                                               
to  a child's  well-being, has  the highest  rates in  those same                                                               
areas.  For children ages zero  to seventeen, it is 27 percent in                                                               
the Northern  Region and  35 percent in  the South  Region versus                                                               
11-15 percent  in the Matanuska-Susitna ("Mat-Su")  and Southeast                                                               
Alaska regions.   The teen birth  rate is over 43  percent in the                                                               
Southwest Region and 56 percent  in the Northern Region versus 9-                                                               
19 percent  in other regions.   These profiles highlight  some of                                                               
those  areas where  there  could be  clear  benefit from  digging                                                               
deeper to understand what is behind these disparities.                                                                          
3:40:14 PM                                                                                                                    
MS.  BEN-YOUSEF stated  that rural  Alaska is  underutilizing the                                                               
childcare  assistance   program,  which  operates   under  Public                                                               
Assistance  at the  DHSS.    She related  that  for the  Northern                                                               
Region,  which  includes  the  Nome   Census  Area,  North  Slope                                                               
Borough,  and Northwest  Arctic  Borough,  children zero  through                                                               
eight  make up  16 percent  of the  regional population,  but the                                                               
average  monthly  caseload  for  Child  Care  Assistance  Program                                                               
(CCAP)  represents  less  than   1  percent  of  average  monthly                                                               
caseloads for the state, which  translates to just over $5,000 in                                                               
average monthly  benefits to that  region.  She compared  this to                                                               
the Gulf Coast Region where young  children make up 12 percent of                                                               
the population, roughly  9,490 children compared to  4,425 in the                                                               
Northern Region, and  the average monthly caseload  is 12 percent                                                               
of  monthly   caseloads  in  Alaska  and   translates  to  nearly                                                               
$164,000.  Children  zero through eight make up  about 16 percent                                                               
of the population in Southwest Alaska  and less than 1 percent of                                                               
the average  monthly caseloads are  utilized there,  amounting to                                                               
just $150.   In Anchorage  young children  make up 13  percent of                                                               
the population,  like the  Northern Region,  but in  Anchorage it                                                               
translates to about 36,856 kids,  approximately 8 times more kids                                                               
than the  Northern Region, and  the average monthly  caseload for                                                               
childcare  assistance  is  64  percent,  which  amounts  to  over                                                               
$740,000,  which  is  148  times 5,000  the  monthly  average  of                                                               
benefits utilized in the Northern Region.                                                                                       
MS. BEN-YOUSEF noted  that something to reflect  on while looking                                                               
at the above-mentioned numbers is  that based upon the Providence                                                               
Community  Health   Council's  2018  Anchorage   Community  Needs                                                               
Assessment,  Anchorage is  considered an  underserved area.   She                                                               
said  she recognizes  that this  isn't black  and white  and that                                                               
there  are  other  sources of  funding  distributed  directly  to                                                               
tribes that could be supplementing  some of these services.  But,                                                               
she continued, it  does raise some big questions  about how these                                                               
benefits  get distributed,  whether regions  are set  up to  even                                                               
utilize  these benefits,  or  how much  is  understood about  how                                                               
funding gets distributed across the state.                                                                                      
3:43:30 PM                                                                                                                    
MS. BEN-YOUSEF stated that there  are some logical answers behind                                                               
some of these  questions about how regions  utilize resources and                                                               
assistance programs, but they're  not widely known or understood,                                                               
and a better understanding can  provide opportunities for serving                                                               
families more  efficiently.  For  the Child Care  Program Office,                                                               
for  example,  it's  likely  a question  of  access  to  licensed                                                               
childcare.  There are only  five licensed childcare facilities in                                                               
the  Northern Region  compared to  56  in Southeast  which has  a                                                               
smaller   percentage,  11   percent  of   young  children,   than                                                               
Southwest.    Of  the five  licensed  childcare  facilities,  two                                                               
accept Child Care Assistance Program  vouchers, both of which are                                                               
in the Nome  Census Area.  The CCAP  childcare assistance program                                                               
vouchers can only  be used at licensed facilities  or with exempt                                                               
providers.  Head  Start and Early Head Start  and school district                                                               
pre-K  programs   provide  most  early   learning  opportunities,                                                               
although  not all  children are  served in  a classroom  setting.                                                               
Thread estimates that 40 percent of  children zero to five in the                                                               
Northern  Region were  in unlicensed  care,  which might  include                                                               
using family, friends, or neighbors to care for children.                                                                       
MS.  BEN-YOUSEF  advised  that   tribes  receive  federal  tribal                                                               
childcare  assistance  funds  which  are not  included  in  these                                                               
regional  profiles.   As  sovereign  governments, she  explained,                                                               
that  data is  not  reported to  and through  the  state, so  the                                                               
bigger picture  isn't had  that tells how  those funds  are being                                                               
spent by  each community.   There are  missing pieces  that could                                                               
explain  how  different  communities are  braiding  and  blending                                                               
their funds  to support families  outside these  state resources.                                                               
Understanding  those  pieces,  or  whether the  state  funds  are                                                               
considered  meaningful  and  effective  investments,  could  help                                                               
increase or strengthen the services  and supports provided by the                                                               
tribal assistance funds.  Knowing  this information would provide                                                               
the ability to  identify what supports communities  have or don't                                                               
have access  to and would  provide the ability to  strengthen and                                                               
elevate investments that lead to  positive outcomes.  State level                                                               
priorities and policies must also  consider the diversity between                                                               
Alaska's different regions and the  very different challenges and                                                               
strengths of each of them.                                                                                                      
MS.  BEN-YOUSEF pointed  out that  the  Mat-Su School  District's                                                               
school readiness and success rates  are higher than the statewide                                                               
average and  higher than Anchorage.   She  asked why that  is and                                                               
noted that there is anecdotal  information on private investments                                                               
and initiatives  that bring  community members  and organizations                                                               
together  in  collaboration  to  promote  family  resilience  and                                                               
reduced  child maltreatment.   However,  she continued,  it would                                                               
require a deeper level of  analysis of how Mat-Su invests private                                                               
funds  to make  any causal  correlation and  understand which  of                                                               
those investments are most effective.                                                                                           
3:46:52 PM                                                                                                                    
MS.  BEN-YOUSEF  moved to  the  status  report and  examined  the                                                               
section on health and development.   She noted that this baseline                                                               
report  on the  status  of  young children  and  moms would  look                                                               
different if it were compiled today.   She explained that many of                                                               
Alaska's  communities  were  already struggling  with  access  to                                                               
childcare pre-COVID-19,  and now  new data is  showing staggering                                                               
increases in  the rates of  maternal depression  during pregnancy                                                               
and in  the year  after pregnancy.   Research,  including studies                                                               
from Harvard  University Center for  the Developing  Child, shows                                                               
that   mothers  experiencing   depression   are   less  able   to                                                               
sufficiently  respond  to  their  baby's needs  during  the  most                                                               
critical  period  of the  baby's  development.   Mother's  stress                                                               
disrupts the  infant's brain development  which then  impacts the                                                               
ability  to learn  and  the child's  physical  and mental  health                                                               
later  in  life.   In  Alaska  pre-COVID-19, depressive  symptoms                                                               
among mothers are reported at the  same rate at four months post-                                                               
partum as at  three years post-partum.  New data  shows the rates                                                               
of maternal depression doubling and tripling due to COVID-19.                                                                   
MS. BEN-YOUSEF turned  to the topic of social workers.   She said                                                               
Alaska  has three  professional licenses  for social  workers but                                                               
only the highest level of  licensed clinical social worker (LCSW)                                                               
can  go Medicaid  for services,  such  as psychological  testing,                                                               
psychotherapy, and crisis intervention.   To be an LCSW, a person                                                               
must hold  a Master  or Doctor  of Social  Work from  an approved                                                               
college or  university, have two years  of post-master supervised                                                               
experience,  have passed  a  licensing exam,  and  met all  other                                                               
requirements.  The median salary  for social workers in Alaska is                                                               
just over  $47,000.  The  emotional stress  with that job  can be                                                               
high,  especially when  dealing  with kids  and  infants.   Other                                                               
barriers make it hard for Alaska  to retain and expand its mental                                                               
health workforce,  especially for  this population,  but Alaska's                                                               
Medicaid policies tend to  disincentivize providers from offering                                                               
their services  to the Medicaid  population, which often  are the                                                               
ones most in need.                                                                                                              
MS. BEN-YOUSEF returned to the  discussion of data and noted that                                                               
a  lot can  be done  with data    inform  policy, assess  program                                                               
effectiveness, ensure  the right investments are  being targeted,                                                               
and  develop quality  improvement  practices and  accountability.                                                               
She looked at  the sources and types of data  for early childhood                                                               
in Alaska.   She explained  that integrated data systems  are all                                                               
the  rage these  days and  rightfully so,  but while  there is  a                                                               
significant interest  in having  better data for  decision making                                                               
and for answering  questions like the committee  has asked today,                                                               
these  types   of  integrated   systems  require   a  significant                                                               
investment to build  and maintain.  Alaska had  an attempt during                                                               
the development of its Statewide  Longitudinal Data System (SLDS)                                                               
through   the    Alaska   Postsecondary   Commission    with   an                                                               
administrative order signed  by Governor Parnell.   But after the                                                               
initial funding ran out, the  SLDS, known as the Alaska Navigator                                                               
Statewide Workforce  and Education Related  Statistics (ANSWERS),                                                               
struggled to find sustainable  funding and decommissioned ANSWERS                                                               
in 2019.  While fully  integrated data systems probably still are                                                               
a faraway dream for Alaska, the  state has within DHSS the Alaska                                                               
Longitudinal  Child Abuse  and Neglect  Link (ALCANLink)  Project                                                               
developed  by  Dr.  Jared  Parrish.    That  program  is  already                                                               
providing extremely valuable data to programs and initiatives.                                                                  
3:51:54 PM                                                                                                                    
MS. BEN-YOUSEF related  that A2P2 has been involved  in leading a                                                               
group of stakeholders tasked  with developing recommendations for                                                               
a new  organizing structure for Alaska's  early childhood system,                                                               
and the  state now has an  Early Childhood Strategic Plan.   This                                                               
strategic plan  was created  in 2019  and the  Environmental Scan                                                               
report served  as one of the  key source documents for  the plan.                                                               
She  said 540  Alaskans provided  input for  this strategic  plan                                                               
through three  community gatherings, three joint  task force work                                                               
groups,  two statewide  video conferences  with 19  participants,                                                               
six joint  task force meetings, 63  early childhood professionals                                                               
in  11 sessions,  301 online  stakeholder survey  responders, and                                                               
over 50 joint task force leadership team meetings.                                                                              
MS. BEN-YOUSEF stated that this  strategic plan presents a north-                                                               
star 10-year vision that was  approved by federal funders and was                                                               
adopted  last week  by the  AECCC.   The governance  work is  the                                                               
result  of  goal three  of  this  plan.   Alaska's  children  and                                                               
families  are  supported  by  a  functional  comprehensive  mixed                                                               
delivery early  childhood system.   She urged that  while working                                                               
to allocate  the American Rescue Plan  dollars, legislators refer                                                               
to the  strategic plan as  a data driven  evidence-based resource                                                               
for how to infuse the funds  that can be spent on early childhood                                                               
services in Alaska.  The plan  was created and reviewed by people                                                               
with the closest and most  extensive experience in both utilizing                                                               
and providing  services to  families and  it is  one of  the most                                                               
collaboratively  created documents  in  Alaska today.   Ms.  Ben-                                                               
Yousef  encouraged  members to  read  the  16-page Policy  Impact                                                               
Summary  From Zero  to  Three  on the  benefits  for infants  and                                                               
toddlers in  the 2021 ARP Act.   She related that  many people in                                                               
this sector  are working  hard to  understand the  guidelines and                                                               
restrictions in this Act and  to identify opportunities to infuse                                                               
money  into  areas where  it  will  truly  make a  systems  level                                                               
impact.   Opportunities  are  in  there to  support  the type  of                                                               
governance  work being  done for  early childhood  systems.   She                                                               
encouraged  committee  members to  reach  out  to A2P2  with  any                                                               
questions when work is begun on those allocations.                                                                              
3:55:27 PM                                                                                                                    
CO-CHAIR  ZULKOSKY recalled  Ms. Ben-Yousef  mentioning that  she                                                               
wanted the data  in the report to speak for  itself and therefore                                                               
a  conscious  decision  was  made  not to  include  any  sort  of                                                               
specific  recommendations.     She   asked  how   Ms.  Ben-Yousef                                                               
envisions a document  like this being worthwhile in  terms of its                                                               
utilization by policy makers.                                                                                                   
MS. BEN-YOUSEF replied that it  takes understanding the system to                                                               
be  able to  make effective  decisions about  it.   The document,                                                               
through  the  visualizations  of  the  funding  map  and  through                                                               
looking at each of those components  that make up the system, can                                                               
provide a user-friendly way of getting  to know what makes up the                                                               
components of  the early childhood system.   It is a  resource to                                                               
refer to  and flip through while  working on policy.   The report                                                               
has served  already as  a supporting document  for SB  8, Senator                                                               
Begich's Reads  Act, and  she hopes  it continues  to serve  as a                                                               
resource for other policies moving forward.   It served as one of                                                               
the key resources for the strategic  plan and can be used to look                                                               
at  where  Alaska  has  some  big gaps  and  disparities  in  how                                                               
resources  are  distributed.    It   is  a  baseline  to  measure                                                               
effectiveness in  the future and  she encourages folks to  use it                                                               
in that way and to ask the questions:   "What is the data that we                                                               
want?   Can we answer the  questions that we have  with this data                                                               
and if  we don't  then how  can we  get that  data?"   The report                                                               
helps to bring everyone together in a more cohesive way.                                                                        
3:58:07 PM                                                                                                                    
REPRESENTATIVE  SPOHNHOLZ commented  that  compensation to  early                                                               
childcare providers  is under  $27,000 per year,  which is  not a                                                               
livable  wage, while  kindergarten  teachers make  an average  of                                                               
$62,000.    Early  childhood  providers   should  be  paid  in  a                                                               
commensurate fashion,  she opined,  because this is  a profession                                                               
and  children  are  the  most  important  national  asset.    She                                                               
recalled Ms. Ben-Yousef  stating that only a very  narrow pool of                                                               
social workers,  the licensed clinical  social workers,  can bill                                                               
Medicaid.   She asked what  the barrier  is to those  folks being                                                               
able to bill Medicaid.                                                                                                          
MS.  BEN-YOUSEF responded  it is  the way  Medicaid policies  are                                                               
written and who is eligible to bill.                                                                                            
REPRESENTATIVE SPOHNHOLZ further asked  whether there are special                                                               
hoops that  must be gone through  to be able to  bill Medicaid or                                                               
whether  it is  the  range  of services  that  can  be billed  to                                                               
Medicaid.    In other  words,  she  continued,  whether it  is  a                                                               
licensure issue or the categories  of services for which Medicaid                                                               
allows billing from social workers.                                                                                             
Ms. BEN-YOUSEF answered  it is the type of licensure  that is the                                                               
4:01:20 PM                                                                                                                    
REPRESENTATIVE   FIELDS   offered   his  appreciation   for   the                                                               
presentation.   He  related that  Alaska is  apparently going  to                                                               
receive  about $76  million  through the  Rescue  Plan for  CCDBG                                                               
grants.  He agreed with  Representative Spohnholz about underpaid                                                               
early education providers and a  lack of adequate supply of early                                                               
childhood education,  and thanked  Ms. Ben-Yousef for  the graphs                                                               
on pages  14 and 15 which  provide this information.   He offered                                                               
his  hope  that  the  committee   can  keep  looking  at  how  to                                                               
strengthen  the  system,  including making  early  childcare  and                                                               
learning a  living-wage profession  so there  can be  an adequate                                                               
supply [of professionals].                                                                                                      
^OVERVIEW: MyHouse Mat-Su Homeless Youth Center                                                                                 
         OVERVIEW: MyHouse Mat-Su Homeless Youth Center                                                                     
4:02:59 PM                                                                                                                    
CO-CHAIR  ZULKOSKY  announced that  the  next  order of  business                                                               
would be an overview regarding  the MyHouse Mat-Su Homeless Youth                                                               
4:03:10 PM                                                                                                                    
JUSTIN  PENDERGRASS, Suicide  Prevention  Advocate, Mat-Su  Youth                                                               
Housing,  MyHouse Mat-Su  Homeless Youth  Center, explained  that                                                               
MyHouse is a drop-in center  for homeless teens in the Matanuska-                                                               
Susitna (Mat-Su)  Valley.  He  said it serves the  demographic of                                                               
14-  to 24-year-olds  who are  at risk  of being  homeless, couch                                                               
surfing, or who are sleeping outside  in tents or vehicles.  Over                                                               
the  last 10  years a  job  training program  has been  developed                                                               
through  this  facility,  but  other   needs  are  also  directly                                                               
affecting  the youth  in  the  Mat-Su Valley.    A  big thing  is                                                               
suicide, so  he was brought  on to  help collect data  and combat                                                               
some of  the difficulties and  things that are struggled  with in                                                               
the Mat-Su Valley as far as suicide goes.                                                                                       
MR. PENDERGRASS  related that  during his time  in this  work, he                                                               
has noticed that  there is a lot of awareness  across Alaska, but                                                               
that  awareness does  not  provide  outcomes.   If  there are  no                                                               
measurable outcomes, he advised, it is  not prevention.  If it is                                                               
not intended  to be prevention  and offers no connections  and no                                                               
outcomes, then it  is awareness.  He said things  need to be done                                                               
in  a  different direction  to  lower  the  rates of  suicide  in                                                               
Alaska.   He pointed  out the ways  that this can  be done.   The                                                               
opposite  of   suicide  is  connection,   he  explained.     True                                                               
prevention requires  connection strategies for moving  out of the                                                               
depression and sadness and using  mentors and peer support models                                                               
for recovery.   Peer led support  has proven time and  time again                                                               
to  make large  impacts on  substance abuse  recovery across  the                                                               
state because of the connections it builds.                                                                                     
4:05:12 PM                                                                                                                    
MR.  PENDERGRASS stated  that if  true authentic  connections are                                                               
established between those  who are struggling and  those who have                                                               
struggled, a  true shift in suicide  will be seen in  Alaska.  He                                                               
advised that  this requires the  building of a  statewide network                                                               
of  peers who  understand  the difference  between awareness  and                                                               
prevention.  Placing a peer in  every school who is fully trained                                                               
with the standard of living  experience would help to connect the                                                               
counselors to  extra resources  to be able  to help  these youth.                                                               
Counselors are not  fully equipped for helping someone  who is in                                                               
a  crisis for  suicide.   Over  the last  six  years MyHouse  has                                                               
implemented the  strategies of true prevention  with peer mentors                                                               
and support  that builds  actual authentic  connections.   Of the                                                               
more  than 700  clients, 480  struggle with  suicide -  that's 67                                                               
percent of homeless  youth who struggle with suicide  in the Mat-                                                               
Su Valley  alone.  Since  implementing these  strategies, MyHouse                                                               
has not  had a  completed suicide within  its program  since 2015                                                               
and he has yet to see a  program that can show something that has                                                               
done better.                                                                                                                    
MR. PENDERGRASS shared that the  reason he is so passionate about                                                               
this is because  he struggles with suicide.  He  fell through the                                                               
cracks, he  related, he didn't  have school  to help him,  he was                                                               
homeless at 16, and he battled for  years.  He said he would like                                                               
to see for-real  change in his community because  the numbers are                                                               
increasing and the  awareness is increasing, but a  change is not                                                               
being seen  and the numbers  are not  going down.   The continued                                                               
funding of  programs that aren't  providing true  prevention will                                                               
result in  rates continuing to  increase and youth  continuing to                                                               
succeed  in ending  their lives.   This  [suicide] pandemic  will                                                               
continue  for  years to  come  and  affect  more and  more  youth                                                               
throughout the Mat-Su Valley and the rest of the state.                                                                         
MR. PENDERGRASS said  he wants to make clear  that counselors are                                                               
doing  a great  job in  providing clinical  support to  kids, but                                                               
they  are  not   doing  a  good  job  in   providing  real  human                                                               
connection.   Real  human connection  is  the difference  between                                                               
someone ending their life and someone  not ending their life.  He                                                               
found that  in mentorship  and peer  support, people  came around                                                               
him and loved him when he had no one who could.                                                                                 
4:08:25 PM                                                                                                                    
REPRESENTATIVE PRAX inquired whether  Mr. Pendergrass said he had                                                               
700 clients in the Mat-Su Valley.                                                                                               
MR. PENDERGRASS replied correct,  700 homeless youth, 700 clients                                                               
in  the  Mat-Su Valley.    Responding  further to  Representative                                                               
Prax, he clarified it is 700 clients with 1,300 being the cap.                                                                  
REPRESENTATIVE  PRAX recalled  Mr. Pendergrass  saying these  are                                                               
homeless  [youth]  who are  couch  surfing  or living  outside  a                                                               
building in a tent or car.                                                                                                      
MR. PENDERGRASS answered correct.                                                                                               
REPRESENTATIVE PRAX remarked, "Incredible."                                                                                     
4:09:58 PM                                                                                                                    
REPRESENTATIVE  MCCARTY  shared his  experience  in  Kodiak as  a                                                               
tennis  coach  and that  suicide  awareness  was one  of  several                                                               
themes.   Regarding connections and  that it takes a  village, he                                                               
asked what  Mr. Pendergrass would  suggest for how others  in the                                                               
village, especially youth, could be involved.                                                                                   
MR. PENDERGRASS  suggested that a  peer-to-peer network  be built                                                               
that includes  people like  himself who  have struggled  and come                                                               
out on the other  side.  He related that while  growing up in the                                                               
Mat-Su Valley  he lost  four friends in  high school  to suicide.                                                               
He said he  was homeless and didn't go to  school much because it                                                               
wasn't a priority to him; if he  went to school, it was for food.                                                               
It  is  building  a  connection  group  of  peers  who  know  the                                                               
difference between awareness and  prevention.  Prevention is real                                                               
authentic  connection,  having conversation,  listening,  meeting                                                               
with these people, it's going where  they are.  Real peer support                                                               
is someone who has gone through  the darkness and come out on the                                                               
other side and  has grown through it.   He said it is  the job of                                                               
every person in the state to prevent suicide.                                                                                   
^OVERVIEW: Child Welfare in Alaska                                                                                              
               OVERVIEW: Child Welfare in Alaska                                                                            
4:13:21 PM                                                                                                                    
CO-CHAIR  ZULKOSKY announced  that  the final  order of  business                                                               
would be an overview entitled, "Child Welfare in Alaska."                                                                       
4:13:34 PM                                                                                                                    
KIM  GUAY,   Director,  Office  of  Children's   Services  (OCS),                                                               
Department  of  Health and  Social  Services  (DHSS), provided  a                                                               
PowerPoint  presentation  entitled,  "Child Welfare  in  Alaska,"                                                               
dated 4/8/21.   She  displayed slide  1 and  stated she  would be                                                               
talking about  the day-to-day  work of  the Office  of Children's                                                               
Services and  how a case  or family flows  through the OCS.   She                                                               
moved  to  slide  2,  "Office   of  Children's  Services,"  which                                                               
outlined  the  mission,  vision,  guiding  principles,  and  core                                                               
values of  OCS.  She said  OCS strives toward its  vision to have                                                               
safe children  and strong families;  its guiding  principles; and                                                               
its core  values of hope,  integrity, respect, and empathy.   She                                                               
stated that these  are talked about with staff from  the day they                                                               
come in the door.                                                                                                               
MS.  GUAY turned  to  slide 3,  "Office  of Children's  Services:                                                               
Progression of a  Case."  She explained that things  begin with a                                                               
Report of Harm through community  and mandatory reporters who are                                                               
concerned about  children they are  working with, or  exposed to,                                                               
or related  to.  The report  is next screened by  Intake and then                                                               
progresses  to  Investigation  and Assessment,  where  OCS  folks                                                               
around the  state investigate child  maltreatment and  assess for                                                               
safety.   About  10 percent  of the  investigations end  up in  a                                                               
legal relationship with  OCS.  Those families  are called "family                                                               
services cases" or "family services  families," and this is where                                                               
OCS  is working  with the  families more  formally through  court                                                               
intervention.    With  family  services cases  there  is  then  a                                                               
conclusion that  OCS calls Permanency,  such as  reunification or                                                               
other forms of permanency for children.                                                                                         
4:16:39 PM                                                                                                                    
MS.  GUAY  addressed slide  4,  "Office  of Children's  Services:                                                               
Intake."   She related that  OCS has  an Intake hotline  and that                                                               
OCS receives  around 20,000 reports  a year via  walk-ins, faxes,                                                               
and phone  calls.  The  intake worker  talks to the  reporter and                                                               
tries  to  ascertain numerous  things,  such  as the  demographic                                                               
information, but primarily OCS needs  to know what the concern is                                                               
and how  immediate the concern is  so that OCS can  determine its                                                               
response  to that  call.   The  two decisions  that  come out  of                                                               
Intake are whether OCS is going  to "screen in" a call report and                                                               
investigate  it, or  whether OCS  is going  to "screen  out" that                                                               
report.   She  noted that  sometimes several  mandatory reporters                                                               
are exposed  to a  situation and  so OCS  gets multiple  calls on                                                               
that one incident,  in which case it will screen  in one call and                                                               
screen out the others.   Sometimes the information that is called                                                               
in  does   not  rise   to  the  level   of  a   maltreatment  and                                                               
investigation and assessment  by the state.   Sometimes OCS needs                                                               
to gather more  information and may end up calling  the school or                                                               
a doctor to help determine if this  needs to be a screen out or a                                                               
screen  in.   For  the  cases  that  are  screened in,  OCS  must                                                               
determine if  it's a priority 1,  or a priority 2,  or a priority                                                               
3,  which  means that  OCS  must  see the  children  face-to-face                                                               
within  24  hours,   or  72  hours,  or   7  days,  respectively.                                                               
Sometimes that's  easy, but Alaska's vastness  and the children's                                                               
location can make  it very difficult, especially if  OCS must fly                                                               
into a community  within a 24-hour period.  If  it is a situation                                                               
of needing  immediate safety  for a child,  OCS often  depends on                                                               
local law  enforcement or village public  safety officers (VPSOs)                                                               
or the  Indian Child  Welfare Act (ICWA)  workers who  are within                                                               
the communities.                                                                                                                
4:20:25 PM                                                                                                                    
MS. GUAY  discussed the data depicted  by the bar graph  on slide                                                               
5, "Office of  Children's Services: Intake."  She  stated that in                                                               
calendar  year 2020  [the start  of the  COVID-19 pandemic],  OCS                                                               
received  about  18,000  reports,  and of  those  18,000  reports                                                               
around 7,000 were  screened in.  A lot less  reports are screened                                                               
in  than are  screened out,  she noted,  and this  can be  due to                                                               
there being duplicate  reports, or reports go  to law enforcement                                                               
and so OCS  does not have jurisdiction.  Jurisdiction  for OCS is                                                               
defined by  parent or  caretaker abuse.   Something  that happens                                                               
outside  the home  is not  something that  OCS investigates;  OCS                                                               
investigates caretaker and parental abuse and neglect.                                                                          
REPRESENTATIVE MCCARTY  inquired whether  screened in  cases were                                                               
duplicated or individual cases.                                                                                                 
MS. GUAY replied that those are  new cases and are not duplicated                                                               
cases.   She said that  sometimes OCS will  get a report  about a                                                               
situation and then several days  later more information comes in.                                                               
If it  meets the  criteria to  be investigated,  it too  could be                                                               
screened in, and so numerous  investigations could be open on one                                                               
family at a time.                                                                                                               
MS. GUAY resumed her discussion of  slide 5.  She stated that OCS                                                               
investigates  and  assesses   neglect,  mental  injury,  physical                                                               
abuse, and  sexual abuse.   She  related that  75 percent  of the                                                               
reports are alleging neglect in  some fashion, which is substance                                                               
abuse,  abandonment,  lack of  food  or  clothing, or  children's                                                               
medical needs not being cared for.   Neglect is the primary issue                                                               
in Alaska  and the number  one issue is families  struggling with                                                               
alcohol  abuse and  what occurs  to children  in that  situation.                                                               
Thirty  percent are  mental injury,  which  is domestic  violence                                                               
with families in  front of the children; 25  percent are physical                                                               
abuse of children, and 10 percent are sexual abuse of children.                                                                 
4:22:06 PM                                                                                                                    
MS.  GUAY  displayed slide  6,  "Office  of Children's  Services:                                                               
Investigation and Assessment," and explained  that once a case is                                                               
screened in, it  goes to investigation and assessment.   She said                                                               
OCS  has a  practice model,  so it  has a  method, a  methodology                                                               
about  how  to approach,  investigate,  and  work with  families.                                                               
Once a case  is screened in for investigations  and assessment, a                                                               
protocol is followed.   One of the first things  OCS does is look                                                               
at  the  history of  the  family,  whether  the family  has  been                                                               
investigated  before.   A third  of  the reports  are first  time                                                               
reports  and about  66 percent  are  families that  OCS has  been                                                               
involved with or has had other  reports on.  So, OCS always looks                                                               
at what's happened  in the past and at criminal  history.  If the                                                               
family is Alaska Native and OCS  knows who the tribe is, OCS will                                                               
coordinate  with  the tribe  to  help  in the  investigation  and                                                               
assessment   and   tries   to  coordinate   the   response   when                                                               
interviewing the  children and talking  with the parents.   After                                                               
doing the paperwork  to gather information about  what's going on                                                               
with the family, OCS goes out  and talks with the children, which                                                               
is called assessing for present danger.   Is the child safe right                                                               
now?  Can  OCS leave here and feel comfortable  doing that?  Most                                                               
cases are  not present danger situations,  typically those happen                                                               
after  hours   and  many  times  law   enforcement  is  involved.                                                               
Sometimes it  is serious things  like skull fractures  and broken                                                               
bones, but  many times  it is  inebriated parents  where domestic                                                               
violence ensued,  the police  show up,  people are  arrested, and                                                               
somebody needs to care for the children.                                                                                        
4:24:18 PM                                                                                                                    
REPRESENTATIVE   KURKA  inquired   whether  the   categories  and                                                               
percentages on slide 5 are  based on the total protected services                                                               
reports (PSR) or on the screened in.                                                                                            
MS. GUAY replied that they are from the screened in reports.                                                                    
4:24:54 PM                                                                                                                    
MS. GUAY resumed  her review of slide  6.  She stated  that if it                                                               
is determined that  present danger is there,  OCS takes immediate                                                               
action.   A team decision making  meeting is held, and  OCs looks                                                               
to figure  out how  to put  a safety plan  in place  to determine                                                               
what's going on  with the family and make sure  the child is safe                                                               
and then find  out the circumstances that have led  to this child                                                               
to be unsafe.   If there is no present danger,  OCS then looks at                                                               
what is going on in the family and what are the needs.                                                                          
MS. GUAY  spoke to the  data shown on the  bar graph on  slide 7,                                                               
"Office  of Children's  Services: Investigation  and Assessment."                                                               
She  explained  that   Investigation  and  Assessment  determines                                                               
maltreatment  and determines  if the  child is  safe.   These are                                                               
independent decisions  that are  made, and the  data is  a little                                                               
bit different - about 40 percent  of the children are screened in                                                               
and 10  percent of the screened  in children end up  in a removal                                                               
type  situation, so  the rest  of those  cases end  up closed  in                                                               
investigations, which is different  than a substantiation.  There                                                               
may  be  a  family  where  OCS  substantiates  maltreatment,  but                                                               
removal  is  not  necessary,  so  that  is  why  the  number  for                                                               
maltreatment is higher than the  removal episodes.  Calendar year                                                               
2020 had 10 percent removal  and 19.3 percent in substantiations.                                                               
When OCS  goes to close  out a  case, after having  completed the                                                               
protocol  of  talking with  the  children  and talking  with  the                                                               
parents, if  there's a medical  concern on  a child OCS  wants to                                                               
talk  to  the doctor,  if  it's  an  educational concern  or  the                                                               
children  are not  showing up  at school,  they don't  have food,                                                               
they don't  appear well kept,  OCS wants  to talk to  the school.                                                               
So,  OCS tries  to talk  to the  people who  have the  collateral                                                               
information to help in making  determinations about what is going                                                               
on with  the family.   And  then OCS tries  to make  referrals as                                                               
needed.   If  it's  basic  needs OCS  tries  to  help with  food,                                                               
clothing, and shelter  within the communities and  it all depends                                                               
on the  communities in  which the family  resides and  how easily                                                               
that can happen.                                                                                                                
4:28:08 PM                                                                                                                    
REPRESENTATIVE KURKA  requested clarification of the  removal and                                                               
substantiation tables  found on the  right side  of slide 7.   He                                                               
offered his  understanding that these  tables are  the percentage                                                               
breakdowns of  the blue  bar (screened  in category)  depicted on                                                               
the graph.                                                                                                                      
MS. GUAY responded, "Correct."                                                                                                  
REPRESENTATIVE  KURKA surmised  the two  charts on  slide 7  were                                                               
comparing "apples to apples."                                                                                                   
MS. GUAY answered yes.  In  further response, she confirmed it is                                                               
quite a bit of difference [between removal and substantiation].                                                                 
REPRESENTATIVE  KURKA explained  he  is asking  because it  seems                                                               
that the  bar graph doesn't  depict as big a  difference [between                                                               
removals  and substantiation]  as is  stated in  the tables;  for                                                               
example, in  the tables for  calendar year 2016 the  removals are                                                               
at 9 percent and the substantiations are at 24.7 percent.                                                                       
MS.  GUAY  confirmed it  is  quite  a  bit  of difference.    She                                                               
explained how that  works by providing scenarios.   She said some                                                               
parents  can have  a  very  stressed moment  and  end up  leaving                                                               
bruises on  their child,  it's reported  to OCS,  they've already                                                               
engaged in  services, they  are remorseful  of what's  been done,                                                               
they don't want  this to happen again.  The  Office of Children's                                                               
Services may  substantiate maltreatment because  maltreatment did                                                               
occur  to  a child  but  there  is no  need  to  remove a  child.                                                               
Another  situation could  be  a child  was  sexually abused,  the                                                               
other parent had no idea that  was occurring and when that parent                                                               
found  out  they  took appropriate  action  such  as  immediately                                                               
getting  a  restraining order  or  leaving  the house,  and  they                                                               
protected their  child.  So,  yes, the maltreatment  occurred but                                                               
the other parent was protective.   That is why the discrepancy is                                                               
seen between a substantiation compared to a removal.                                                                            
4:30:22 PM                                                                                                                    
REPRESENTATIVE  MCCARTY referred  to slide  7 and  inquired about                                                               
the number of intakes for calendar year 2020.                                                                                   
MS. GUAY  replied that  OCS screened in  7,268 for  calendar year                                                               
REPRESENTATIVE  MCCARTY  asserted  that 17  percent  was  removed                                                               
rather than 10 percent.                                                                                                         
MS. GUAY responded  that this is where it gets  complicated.  She                                                               
explained  there  could  be  numerous   reports  that  have  been                                                               
screened in  on the family, but  one report led to  a removal and                                                               
that  is where  it  gets  harder to  understand  the  data.   She                                                               
reiterated that  typically the families  are familiar to  OCS and                                                               
the OCS system and that is where  it gets hard to track the data.                                                               
It takes a lot of research analysis to get the correct number.                                                                  
4:32:22 PM                                                                                                                    
REPRESENTATIVE PRAX  referred to slide  7 and asked  whether some                                                               
of the 1,270 removals for calendar year 2020 were repeats.                                                                      
MS. GUAY answered that 1,270 is  the number of children that were                                                               
REPRESENTATIVE PRAX  surmised that  that is  likely to  be unique                                                               
MS.  GUAY replied  yes, that  would be  1,270 children  that were                                                               
removed in  calendar year 2020,  which is a little  bit different                                                               
than the  number of PSRs  that were screened  in.  The  PSRs that                                                               
were screened in, which is closer to 18,000, are cases not kids.                                                                
4:33:39 PM                                                                                                                    
REPRESENTATIVE FIELDS recalled Mr.  Pendergrass talking about the                                                               
importance of  peer support  and said his  staff have  done great                                                               
work  looking at  how  to expand  peer  support.   Representative                                                               
Fields asked how much that expansion  in peer support is going to                                                               
be integrated with the school system and/or with OCS.                                                                           
MS. GUAY responded that OCS has  some grants for youth who are in                                                               
care  as  far  as  mentors  for  youth.    She  agreed  with  Mr.                                                               
Pendergrass as  far as  the social connections,  which is  one of                                                               
the things  that OCS strongly believes  in.  She said  there is a                                                               
lot of research  studying families that are strong  to figure out                                                               
what are their protective factors  and OCS works with families to                                                               
increase their  social connections,  their resilience,  and their                                                               
knowledge of parenting and skill  and resiliency.  In addition to                                                               
children, it is also a very  important aspect for parents and OCS                                                               
is working  on trying  to increase peer  support for  parents who                                                               
are  going through  the  child  welfare system  because  it is  a                                                               
difficult system to navigate, and it is complex.                                                                                
4:35:45 PM                                                                                                                    
MS.  GUAY continued  her presentation.   She  turned to  slide 8,                                                               
"Office of  Children's Services:  Court Process,"  and reiterated                                                               
that 10 percent of OCS cases end  up in a removal situation.  She                                                               
pointed out  that Alaska statutes  regulate how this works.   She                                                               
referred to  the twelve  subsections listed on  the slide  for AS                                                               
47.10.011 and explained  that when OCS files a  petition with the                                                               
court when  OCS removes a  child, OCS has  24 hours to  file that                                                               
petition with the court saying  that OCS has removed children and                                                               
is alleging it's due to whatever  the situation could be, such as                                                               
neglect, substance  abuse, physical harm.   She said OCS  files a                                                               
petition  and that  gets it  into the  court and  OCS will  be in                                                               
front  of a  judge within  48 hours  after filing  that petition.                                                               
She explained  that the flow chart  on the right side  of slide 7                                                               
is about  the child  in need  of aid court  process, it  is often                                                               
referred to as  the CHINA process.  That very  first hearing will                                                               
be a  temporary custody hearing  and there are  strict timelines:                                                               
120 days to  have an adjudication hearing;  a disposition hearing                                                               
is  done quickly  after that;  and a  permanency hearing  is done                                                               
every 12 months.                                                                                                                
4:37:25 PM                                                                                                                    
MS.  GUAY  spoke to  slide  9,  "Office of  Children's  Services:                                                               
Family  Services."   She  related that  when  children enter  the                                                               
custody of OCS, one  of the first things OCS does  is try to have                                                               
a meeting of  the parents, their social supports,  and talk about                                                               
relative  placements.   It is  very important  to make  sure that                                                               
children are placed  with their relatives when safely  able to do                                                               
so.   Statute  requires  OCS  to do  a  thorough relative  search                                                               
within 30 days.  In the  assessment process, OCS tries to include                                                               
the tribes very early on.   At this point OCS typically does know                                                               
the  tribes and  the tribes  are  active members  in these  CHINA                                                               
cases  and proceedings.   She  said  OCS meets  with parents  and                                                               
talks about  their protective factors  - how are they  doing with                                                               
their social connections, resiliency,  concrete supports in times                                                               
of need,  and OCS tries to  figure out where some  deficits could                                                               
be and how OCS could put  in activities and services to help some                                                               
of  those   deficits  to  increase  protective   factors.    Many                                                               
referrals are  made by OCS  to community  providers to try  to do                                                               
assessments to  figure out what  level of treatment is  needed if                                                               
it is substance  abuse or mental health needs.   Also, OCS always                                                               
is evaluating progress  of case plans.  A case  plan is developed                                                               
within 60 days  when a child has been removed  and OCS meets with                                                               
the  families and  the  children monthly.    During that  monthly                                                               
conversation there  is discussion  about how  they are  doing and                                                               
whether  behavioral changes  are  being  seen.   It  is not  just                                                               
attending a  parenting class; it's  about looking  for behavioral                                                               
change.  Also, OCS makes sure  that there are family contacts set                                                               
up with  the children.  That  is one area  that is a hard  one to                                                               
set up  and have enough  family contact  for families, but  it is                                                               
something OCS  strives to  increase as  things move  forward into                                                               
the system.                                                                                                                     
MS. GUAY  stated that  if a relative  placement cannot  be found,                                                               
OCS  has foster  homes  that it  places children  in.   When  the                                                               
process is first  started, almost always the  permanency plan for                                                               
children is  reunification.   Around 50  percent of  children who                                                               
are in out of home care are  reunified.  The other 50 percent end                                                               
up  in  adoptions,  guardianships,  or  tribes  sometimes  assume                                                               
jurisdiction.   A  small  number  of children  age  out of  their                                                               
planned living  arrangement.  The children  typically coming into                                                               
custody  are  younger  children,  under the  age  of  six;  these                                                               
children are  typically the  most vulnerable  but not  always, it                                                               
also depends  on the kind of  maltreatment.  The children  who do                                                               
age out are the ones often  that have had significant needs, have                                                               
been in mental health facilities,  numerous changes of placement,                                                               
and have  significant trauma.   Even when children are  placed in                                                               
foster homes,  OCS still  has an  obligation to  continue looking                                                               
for relatives throughout the child's experience within OCS.                                                                     
4:41:41 PM                                                                                                                    
CO-CHAIR  ZULKOSKY related  that she  recently participated  in a                                                               
child welfare  seminar where there  was discussion  about kinship                                                               
navigator,  which  sounds  similar  to  Alaska's  requirement  to                                                               
search for relatives for children  who are removed from the home.                                                               
She further  related that  in the seminar  it was  indicated that                                                               
there  is  an eligibility  for  federal  reimbursement for  those                                                               
types of services  from April 2020-2021.  She  asked whether DHSS                                                               
has sought reimbursement for its  staff time looking into placing                                                               
children with family members, regardless  of whether the children                                                               
are American Indian or Alaska Native.                                                                                           
MS. GUAY replied  that Alaska is one of the  number one states in                                                               
Title IVE  claiming for reimbursable activities  and she believes                                                               
DHSS is  pulling down  as many  dollars as  possible.   She noted                                                               
that  an  initial and  ongoing  relative  search  is one  of  the                                                               
activities  that  Alaska  tribes  do  through  the  Alaska  Child                                                               
Welfare Tribal Compact.   She said she doesn't  know the specific                                                               
amount for reimbursement and offered to get back with an answer.                                                                
CO-CHAIR  ZULKOSKY  stated she  is  interested  in any  follow-up                                                               
information the  department can provide  with respect  to drawing                                                               
down  federal  dollars  for all  Alaska  children  regardless  of                                                               
Native beneficiary status since that  is what it sounded like the                                                               
federal relief funds were being provided for.                                                                                   
4:43:37 PM                                                                                                                    
REPRESENTATIVE KURKA related he  has an internal conflict between                                                               
balancing the rights of the  accused and protecting the children,                                                               
particularly when immediate action is  needed, and a judgement is                                                               
being made.  He asked how DHSS  reaches that balance.  He said he                                                               
is also concerned about the  constitutional rights of the accused                                                               
to know who the accuser is.                                                                                                     
MS. GUAY responded that the  parents have the opportunity when in                                                               
front  of the  judge  to  be afforded  attorneys  if they  cannot                                                               
provide one for  themselves.  She said there are  many checks and                                                               
balances  within  [Alaska's]  child  welfare system.    It  isn't                                                               
common  for OCS  to remove  children, and  it is  very infrequent                                                               
that OCS goes into court and  has someone say the child shouldn't                                                               
have been removed.  Many  families are struggling with addiction,                                                               
historical trauma, or mental health  issues, and there is statute                                                               
and  regulation that  allows OCS  to investigate  and make  these                                                               
determinations but  then immediately  go into court  to determine                                                               
that OCS isn't abusing its power  or authority.  The parents then                                                               
have attorneys  appointed to them  or provide their  own attorney                                                               
to help  navigate the  system and to  advocate for  their rights.                                                               
There  is  statute that  protects  the  identity of  a  reporter,                                                               
although the judge  can choose to release that  information.  The                                                               
reason a  reporter's information is  protected is so  people will                                                               
reach out and protect children when they are in harm's way.                                                                     
4:47:33 PM                                                                                                                    
REPRESENTATIVE SPOHNHOLZ observed  on slide 7 that  of the number                                                               
of reports of harm made annually  only a very small number result                                                               
in  removal.   She  concurred there  is a  system  of checks  and                                                               
balances  so that  nobody's children  are  taken from  them on  a                                                               
permanent  basis   without  there  being  clear   and  convincing                                                               
evidence that a child is at  harm.  She inquired whether Ms. Guay                                                               
knows the average  number of reports of harm that  are filed in a                                                               
case before a child is removed.                                                                                                 
MS.  GUAY answered  she will  get  back with  specifics, but  she                                                               
knows  that 33  percent  are first  time reports  to  OCS and  40                                                               
percent have  three or more reports  that have come to  OCS.  She                                                               
said many  of these families have  significant history, including                                                               
having  been in  the foster  care system  before and  having been                                                               
returned and then  ending up in another removal  episode.  Alaska                                                               
has a poor statistic of repeat  maltreatment, she advised.  It is                                                               
one area  that Alaska doesn't do  well in.  Over  the last couple                                                               
years  OCS has  focused  on  looking at  children  who have  been                                                               
repeatedly maltreated  because these children end  up with trauma                                                               
and so it is  a concern for OCS.  Of  the 20,000 reports received                                                               
by OCS, 1,200  end up in some type of  legal intervention removal                                                               
from the home.   There is often  a thought that OCS  goes out and                                                               
removes all the children that it  gets reports on, but that isn't                                                               
true.   Ninety percent of OCS's  investigations end up in  a case                                                               
closure, so 10 percent end up into further involvement with OCS.                                                                
REPRESENTATIVE SPOHNHOLZ  expressed the importance  of prevention                                                               
to  keep children  from  entering the  child  welfare system  and                                                               
opined that this is the area  where Alaska could do a better job.                                                               
She recognized the work that OCS is trying to do in that regard.                                                                
4:52:27 PM                                                                                                                    
MS.  GUAY displayed  slide 10,  "Office  of Children's  Services:                                                               
Family  Services," which  outlines  how OCS  goes about  engaging                                                               
with families.   She  said OCS creates  case plans  and evaluates                                                               
case  plans, and  it's about  behavioral change  because that  is                                                               
what  OCS  is looking  for.    She  drew  attention to  the  five                                                               
protective factors listed on the  slide that are important in the                                                               
strengthening   of   families    [parental   resilience,   social                                                               
connections,  concrete supports  in times  of need,  knowledge of                                                               
parenting and  child development, social emotional  competence of                                                               
MS.  GUAY  reviewed slide  11,  "Office  of Children's  Services:                                                               
Child Experience."   She  reiterated that  the system  is complex                                                               
and  explained that  the slide  depicts  the child's  experience.                                                               
She  pointed   out  that  the   removal  creates   trauma,  being                                                               
maltreated, and repeatedly maltreated  creates trauma, and moving                                                               
foster homes  can create trauma.   There are checks  and balances                                                               
in  the child's  experience  with  OCS.   There  is OCS,  tribes,                                                               
foster  parents,  extended  family, courts,  guardian  ad  litem,                                                               
service providers, and public defenders.                                                                                        
MS. GUAY showed slide 12,  "Office of Children's Services: Parent                                                               
Experience," and said the parents'  experience is similar in that                                                               
there are  a lot  of people involved  in the  parents' experience                                                               
with child  welfare and the  CHINA process; there  are attorneys,                                                               
court hearings, service  providers.  There are  lots of different                                                               
struggles, with transportation often  an issue.  There definitely                                                               
are challenges  within the  system of child  welfare and  all the                                                               
providers that surround families.                                                                                               
4:54:00 PM                                                                                                                    
MS.  GUAY spoke  to  slide 13,  "Office  of Children's  Services:                                                               
Services Array."   She explained that this  slide depicts "behind                                                               
the scenes"  of OCS.  Typically  heard about is OCS  case workers                                                               
and supervisors and  their interaction with families.   There are                                                               
other  programs within  OCS,  such  as the  giving  of grants  to                                                               
children's  advocacy   centers.    There  are   the  foster  care                                                               
licensing programs, Title IVE.   Many staff are behind the scenes                                                               
that help  support all the work  done by OCS around  the state in                                                               
child welfare.                                                                                                                  
MS.  GUAY turned  to slide  14, "Office  of Children's  Services:                                                               
Oversight,"  and  pointed  out  that   OCS  has  many  levels  of                                                               
oversight.    For  example,  OCS   is  reviewed  by  the  federal                                                               
government on a  consistent basis; OCS is currently  on a program                                                               
improvement plan.  She said  OCS works closely with the ombudsman                                                               
and  that many  families  seek  out the  ombudsman  if they  have                                                               
issues.   She noted that  OCS has  audits and a  citizens' review                                                               
panel,  which  is a  legislative  requirement  that oversees  and                                                               
looks into  OCS's cases  and makes  recommendations that  come to                                                               
the legislature.   The OCS is  involved with courts all  the time                                                               
and OCS also has an  internal quality assurance unit that reviews                                                               
the cases and offers feedback and suggestions.                                                                                  
MS. GUAY  concluded her  presentation with  slide 15,  "Office of                                                               
Children's  Services:  Current  Priorities."    She  stated  that                                                               
current priorities include prevention,  as OCS is very interested                                                               
in getting upstream.  She said  OCS is being strategic about this                                                               
because  it knows  it is  still downstream  trying to  help those                                                               
families that  are currently in  the water.  Another  priority is                                                               
OCS's retention efforts  for its staff as OCS isn't  going to get                                                               
anywhere  unless it  can  get  better retention  of  staff.   Yet                                                               
another priority  is essential services,  which are  the services                                                               
that  OCS  gives  to  children  and  families,  such  as  monthly                                                               
meetings with the families, meeting  the children and making sure                                                               
they have case plans.  Also  a priority, are community and tribal                                                               
collaboration because OCS cannot do  this work alone and needs as                                                               
many people at  the table as possible trying to  help families be                                                               
successful, connect,  and have a  strong partnership so  they can                                                               
be successful in parenting their children safely.                                                                               
4:56:55 PM                                                                                                                    
REPRESENTATIVE  MCCARTY referred  to  slide 7  and observed  that                                                               
1,270 children  were returned home  [in calendar year 2020].   He                                                               
inquired about the average caseload of an OCS worker.                                                                           
MS. GUAY replied that it is a  hard number to give.  If averaging                                                               
every  worker who  is  filling  a PCN  and  looking  at how  long                                                               
they've  been here,  that number  would  be around  16 cases  per                                                               
worker, which  is not bad.   Realistically, she advised,  that is                                                               
not the truth.   When workers are  out on leave or  have quit the                                                               
agency but not yet walked out  the door, and those cases all must                                                               
be redistributed, she said her  best guess statewide is around 24                                                               
cases per worker, some higher, some  lower.  It also doesn't tell                                                               
that someone in a "roll office"  has enormous travel for going to                                                               
see some  of these families, so  their caseloads should be  a lot                                                               
lower when it takes two days to  travel to see a family, which is                                                               
much different than jumping into a car and driving across town.                                                                 
REPRESENTATIVE  MCCARTY offered  his understanding  that most  of                                                               
the  cases involve  substances.   He asked  whether there  is any                                                               
ability to do monitoring, such as a portable breathalyzer                                                                       
several times a day that records body chemistry.                                                                                
MS. GUAY responded  that OCS uses a variety  of methods depending                                                               
on the  location in Alaska, but  the most common is  a urinalysis                                                               
at  different  facilities  to determine  drug  and  alcohol  use.                                                               
Sometimes it  is hair  follicles.  She  said she  doesn't believe                                                               
OCS typically does any kind of ankle monitoring at home.                                                                        
5:00:01 PM                                                                                                                    
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 5:00 p.m.                                                                                                          

Document Name Date/Time Subjects
A2P2 - Alaska Early Childhood Environmental Scan.pdf HHSS 4/8/2021 3:00:00 PM
All Alaska Pediatric Partership
Prenatal-to-3 Policy Impact Center - ARP Benefits for Infants and Toddlers.pdf HHSS 4/8/2021 3:00:00 PM
Early Childhood Alaska - Strategic Direction - Planning Report and Appendices.pdf HHSS 4/8/2021 3:00:00 PM
Early Childhood Alaska - Strategic Direction Brochure.pdf HHSS 4/8/2021 3:00:00 PM
Early Childhood Alaska - Strategic Direction Slides.pdf HHSS 4/8/2021 3:00:00 PM
Early Childhood Alaska - Strategic Direction 2020-2025.pdf HHSS 4/8/2021 3:00:00 PM
OCS Case Flowcharts 6-8-17.pdf HHSS 4/8/2021 3:00:00 PM
OCS presentation final.pdf HHSS 4/8/2021 3:00:00 PM