02/16/2010 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HJR35 | |
| HB168 | |
| Presentation: | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HJR 35 | TELECONFERENCED | |
| += | HB 168 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 16, 2010
3:09 p.m.
MEMBERS PRESENT
Representative Bob Herron, Co-Chair
Representative Wes Keller, Co-Chair
Representative Tammie Wilson, Vice Chair
Representative Bob Lynn
Representative Paul Seaton
Representative Sharon Cissna
MEMBERS ABSENT
Representative Lindsey Holmes
COMMITTEE CALENDAR
HOUSE JOINT RESOLUTION NO. 35
Proposing amendments to the Constitution of the State of Alaska
prohibiting passage of laws that interfere with direct payments
for health care services and the right to purchase health care
insurance from a privately owned company, and that compel a
person to participate in a health care system.
- MOVED HJR 35 OUT OF COMMITTEE
HOUSE BILL NO. 168
"An Act relating to state certification and designation of
trauma centers; creating the uncompensated trauma care fund to
offset uncompensated trauma care provided at certified and
designated trauma centers; and providing for an effective date."
- MOVED CSHB 168(HSS) OUT OF COMMITTEE
PRESENTATION: FOSTER CARE IN ALASKA
- HEARD
PREVIOUS COMMITTEE ACTION
BILL: HJR 35
SHORT TITLE: CONST AM: HEALTH CARE
SPONSOR(s): REPRESENTATIVE(s) KELLY, KELLER, P.WILSON, GATTO
01/08/10 (H) PREFILE RELEASED 1/8/10
01/19/10 (H) READ THE FIRST TIME - REFERRALS
01/19/10 (H) HSS, JUD, FIN
02/09/10 (H) HSS AT 3:00 PM CAPITOL 106
02/09/10 (H) Heard & Held
02/09/10 (H) MINUTE(HSS)
02/16/10 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 168
SHORT TITLE: TRAUMA CARE CENTERS/FUND
SPONSOR(s): REPRESENTATIVE(s) COGHILL
03/09/09 (H) READ THE FIRST TIME - REFERRALS
03/09/09 (H) HSS, FIN
04/09/09 (H) HSS AT 3:00 PM CAPITOL 106
04/09/09 (H) Heard & Held
04/09/09 (H) MINUTE(HSS)
02/09/10 (H) HSS AT 3:00 PM CAPITOL 106
02/09/10 (H) Heard & Held
02/09/10 (H) MINUTE(HSS)
02/16/10 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
DEREK MILLER, Staff
to Representative Mike Kelly
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HJR 35 for the prime sponsor,
Representative Mike Kelly.
CHRISTIE HERRERA, Director
Health and Human Services Task Force
American Legislative Exchange Council (ALEC)
Washington, DC
POSITION STATEMENT: Testified in support of HJR 35.
SENATOR JOHN COGHILL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 168 as the prime sponsor of
the bill.
WARD HURLBURT, Chief Medical Officer;
Director
Division of Public Health
Office of the Commissioner
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 168.
REGINA CHENNAULT, Chair
American College of Surgeons Committee on Trauma
Alaska Trauma System Review Committee
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 168.
AMANDA METIVIER, Statewide Coordinator
Facing Foster Care in Alaska (FFCA)
Anchorage, Alaska
POSITION STATEMENT: Presented speakers and a video about Foster
Care in Alaska.
FHERRON HINES
FFCA Advocate
Anchorage, Alaska
POSITION STATEMENT: Testified during the presentation on Foster
Care in Alaska.
CANDICE TUCKER
FFCA Advocate
Anchorage, Alaska
POSITION STATEMENT: Testified during the presentation on Foster
Care in Alaska.
ANTHONY BARRIL
FFCA Advocate
Juneau, Alaska
POSITION STATEMENT: Testified during the presentation on Foster
Care in Alaska.
REPRESENTATIVE LES GARA
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified during the presentation on Foster
Care in Alaska.
ACTION NARRATIVE
3:09:25 PM
CO-CHAIR BOB HERRON called the House Health and Social Services
Standing Committee meeting to order at 3:09 p.m.
Representatives Herron, Keller, T. Wilson, and Lynn were present
at the call to order. Representatives Seaton and Cissna arrived
as the meeting was in progress.
HJR 35-CONST AM: HEALTH CARE
3:09:43 PM
CO-CHAIR HERRON announced that the first order of business would
be HOUSE JOINT RESOLUTION NO. 35, Proposing amendments to the
Constitution of the State of Alaska prohibiting passage of laws
that interfere with direct payments for health care services and
the right to purchase health care insurance from a privately
owned company, and that compel a person to participate in a
health care system.
3:11:17 PM
DEREK MILLER, Staff to Representative Mike Kelly, Alaska State
Legislature, explained that HJR 35 "gave Alaskans the
opportunity to vote on a constitutional amendment prohibiting
the passage of laws that would force any person or employer to
participate in a particular health care system." He added that
similar resolutions had been introduced in 36 other states. He
reported that HJR 35 would protect a person's right to
participate or not in any health care system, and would prohibit
the government from imposing a fine for that decision. It would
also protect both a person's right to purchase, and a doctor's
right to provide, lawful medical services without government
fines or penalties. He explained that this would be placed on
the ballot of the next general election for inclusion to the
Constitution of the State of Alaska. He directed attention to
the Memorandum [Included in committee packets.] which answered
questions which arose during a prior committee hearing.
MR. MILLER paraphrased the Memorandum. Referring to question
one, he said that HJR 35 did not prevent Alaska from initiating
a new retirement tier, as long as health insurance was not
mandatory, and individuals were not fined for choosing not to
participate in the health care system. Discussing question two,
he explained that this resolution did not preclude the federal
government from making changes to health care programs, it
simply protected the right not to participate. Addressing the
third question, he said that HJR 35 prevented a universal
coverage system, but added that Alaska legislators would work on
a targeted set of policy solutions for the uninsured. With
regard to question four, he relayed that any federal government
program that mandated individuals to purchase insurance would
not be adopted by the Alaska legislature. Responding to
question five, he stated that HJR 35 prevented the state from
implementing a plan that penalized employee and employers for
not purchasing health insurance.
3:15:35 PM
CO-CHAIR HERRON, noting a possible increase to the fiscal note,
asked for a clarification.
MR. MILLER responded that this was the same fiscal note as other
constitutional amendments.
CO-CHAIR HERRON asked for this to be answered in the House
Finance Committee.
MR. MILLER replied that he did not expect the increase to be
necessary.
3:16:45 PM
CO-CHAIR KELLER relayed that the Goldwater Institute had offered
to defend the constitutionality for this amendment at no cost to
the state.
3:17:16 PM
CHRISTIE HERRERA, Director, Health and Human Services Task
Force, American Legislative Exchange Council (ALEC), testified
that ALEC supported HJR 35 and that she was available to answer
any questions.
3:17:56 PM
CO-CHAIR HERRON opened public testimony.
Seeing no one, Co-Chair Herron closed public testimony.
3:18:17 PM
CO-CHAIR KELLER moved to report HJR 35 out of committee with
individual recommendations and the accompanying fiscal notes.
There being no objection, HJR 35 was reported from the House
Health and Social Services Standing Committee.
3:19:06 PM
The committee took a brief at-ease.
3:19:41 PM
CO-CHAIR HERRON brought the committee back to order.
HB 168-TRAUMA CARE CENTERS/FUND
3:19:56 PM
CO-CHAIR HERRON announced that the next order of business would
be HOUSE BILL NO. 168, "An Act relating to state certification
and designation of trauma centers; creating the uncompensated
trauma care fund to offset uncompensated trauma care provided at
certified and designated trauma centers; and providing for an
effective date."
3:20:10 PM
SENATOR JOHN COGHILL, Alaska State Legislature, explained that
HB 168 would create an account for payment of uncompensated care
to hospitals that "ratchet up their level of trauma delivery
systems," defined to be a Level II or Level III. He explained
that the request for a $5M appropriation was based on a study of
uncompensated trauma related care.
CO-CHAIR HERRON reminded the committee that an earlier proposed
amendment had not been introduced. He asked if there were any
suggested changes to that amendment.
SENATOR COGHILL suggested that the "tobacco money" would draw
away from the tobacco education issues, and he reminded that the
original focus of the tobacco suit and settlement had been to
reduce smoking. He opined that alcohol was more interconnected
with this bill, and he suggested using the alcohol tax as a
funding source. Noting that boating, skiing, and 4-wheeling
often resulted in trauma care, he suggested that these
activities could also be sources for funding.
CO-CHAIR HERRON reported that alcohol abuse was often a
contributing factor to trauma.
3:23:41 PM
SENATOR COGHILL agreed that both alcohol and drugs often were
significant contributors.
[CO-CHAIR HERRON opened public testimony.]
3:24:24 PM
WARD HURLBURT, Chief Medical Officer; Director, Division of
Public Health, Office of the Commissioner, Department of Health
and Social Services (DHSS), asked if there were any questions
from his prior testimony on February 9. Noting his personal
background as a surgeon, he agreed that alcohol was a common
factor in trauma.
3:26:57 PM
REGINA CHENNAULT, Chair, American College of Surgeons Committee
on Trauma, Alaska Trauma System Review Committee, shared that 80
percent of violent crimes involved alcohol or drugs.
3:27:37 PM
CO-CHAIR HERRON closed public testimony.
3:27:50 PM
CO-CHAIR KELLER read the proposed Amendment 1, labeled Version
26-LS0437\R.3, Bullock, 2/16/10:
Page 1, line 3, following "centers":
Insert "and including a portion of the tax levy
on alcohol as a source of money that may be
appropriated to the trauma care fund"
Page 2, following line 12:
Insert a new bill section to read:
"* Sec. 3. AS 43.60 is amended by adding a new
section to read:
Sec. 43.60.055. Disposition of proceeds;
availability for appropriation to the uncompensated
trauma care fund. The portion of the tax collected
under AS 43.60.010 that is not separately accounted
for under AS 43.60.050(a) may be appropriated to the
uncompensated trauma care fund (AS 18.08.085). Nothing
in this section creates a dedicated fund."
Renumber the following bill section accordingly.
CO-CHAIR KELLER moved to adopt Version 26-LS0437\R.3, Bullock,
2/16/10 as Amendment 1. There being no objection, Amendment 1
was adopted.
3:31:03 PM
SENATOR COGHILL said that there were consultations with the air
force and the army trauma doctors for assistance in local
hospitals. He lauded the efforts of first responders and noted
the necessity of having trauma centers for continued successful
care.
3:32:54 PM
CO-CHAIR KELLER moved to report CSHB 168(HSS) out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, CSHB 168(HSS) was reported
from the House Health and Social Services Standing Committee.
3:33:41 PM
The committee took an at-ease from 3:33 p.m. to 3:36 p.m.
3:35:59 PM
CO-CHAIR HERRON brought the committee back to order.
^Presentation:
Presentation: Foster Care in Alaska
3:37:12 PM
CO-CHAIR HERRON announced that the final order of business would
be a Presentation on Foster Care in Alaska.
3:37:18 PM
AMANDA METIVIER, Statewide Coordinator, Facing Foster Care in
Alaska (FFCA), explained that Facing Foster Care in Alaska
(FFCA) was a statewide advocacy group, comprised of almost 300
current and former foster care youth and young adults, who
shared their personal experiences in advocacy for improvement to
the foster care and child welfare system. She explained that
the video program was focused on education, permanency, and
culture as related to foster care. She introduced three FFCA
members who had accompanied her.
3:39:38 PM
FHERRON HINES, FFCA Advocate, stated that she was in twelve
placements over five years.
3:39:55 PM
CANDICE TUCKER, FFCA Advocate, shared that she was in eight
placements over three years, beginning in Homer, but that she
was moved to Anchorage because of a "lack of resources."
3:40:18 PM
ANTHONY BARRIL, FFCA Advocate, said that he was in eight
placements over seven years.
3:40:41 PM
MS. METIVIER observed that there were a lot of placements over a
lot of years, which often resulted in a youth aging out of the
foster care system without any permanence.
3:41:19 PM
MS. METIVIER showed a video of Courtney Morrison, currently
homeless in Anchorage, who talked about education. In the
video, Courtney said that she was 21 years old, and had been in
foster care for three years, during which time she was separated
from three of her brothers. She stated that she was in more
than 20 placements and was in the residential behavioral
treatment at North Star Behavioral Health for more than a year.
She voiced her hatred for school, as it depressed her because
she was made fun of for being in foster care. She said that the
schools just passed her on through during middle school and her
first two years of high school, and then she dropped out. She
shared that she was now working on her GED.
3:43:35 PM
MS. METIVIER discussed that the next video focused on culture,
with Marie Greist, who had bounced between Kotzebue and
Anchorage placements, until she aged out of the foster care
program. Marie was now homeless. During the video, Marie said
she had been in child protective services since she was a year
old, due to her mother's alcoholism. She said that staying in
child care in Kotzebue was good, as there was only one school,
so she did not have to change schools. She recounted that she
was not allowed to eat Native Alaskan food, as it was not
approved by the FDA. She shared her feeling of loss as food was
a major part of her culture.
3:46:27 PM
MS. METIVIER pointed to the video of Angel Adams, who was placed
more than 50 times in Anchorage and Fairbanks. She noted that
Angel had finally settled in a permanent home when she was 16
years old, and Angel spoke about this feeling of permanence.
Angel related that her mother was an alcoholic, who had
occasionally been so intoxicated that she had tried to kill
Angel. She stated that she was told that "I would never amount
to anything and would only be good for lying on my back." She
revealed that, upon her birth mother's death, she was separated
from her siblings. After another short stay with her aunt and a
30 day emergency care, she was moved in with the Adams' family.
She disclosed her expectation of being moved again, but she said
that the Adams' family treated her just like family, and not
like a foster child. She recounted a family trip to meet other
relatives, where she was introduced as "my daughter" and "my
sister." She shared her doubts that lingered until the moment
that her adoption was completed, announcing that this "was the
happiest I had ever been... the greatest day of my life."
3:49:32 PM
MS. METIVIER directed attention to the video of Becca Shier,
which spotlighted permanence and education. Becca expressed
that she was a ward of the state, and that she grew up with
little help from anyone else. She relayed that she was
separated from her brother when she entered foster care after
junior high school, and she had to endure more than 23
placements. She alluded to the stereotypes, assumptions, and
reasons. She said that her current living situation in
Anchorage, more than two years, had an enormous impact on her.
She described her role as the FFCA Statewide Representative, a
sophomore in college, and a full time photographer. She shared
that permanence had bettered her outcomes and life chances. She
emphasized that every youth in foster care should have the
opportunity.
3:53:22 PM
MS. METIVIER presented the video of Shane Nukwak, who lived in a
rural community outside of Dillingham, and his view of culture.
Shane recounted that alcohol had always been a part of his
family, "the ruler of the house." He shared his fear of
watching the violence and the depression that escalated from
alcohol. He spoke of being abused by his father. He alluded to
the "storm" of life and the need to balance the darkness and the
need for shelter. He shared the need to always know the
"forecast."
3:56:56 PM
MS. METIVIER asked that these videos serve as a reminder of the
changes and the improvements that needed to be made.
3:57:55 PM
CO-CHAIR HERRON asked her about the common theme throughout the
video presentations.
3:58:25 PM
MS. METIVIER replied that each video examined the high number of
placement changes and the resulting instability, as well as the
problems of substance abuse among the parents.
3:59:18 PM
CO-CHAIR HERRON asked Ms. Metivier what she would prioritize to
be the top two objectives.
MS. METIVIER responded that prevention was always very
important, but that the high number of placements and the
problem of youth "aging out" were paramount. She noted that the
outcome was not good for transition age youth, who especially
needed housing and education. She pointed out that education
was necessary to break the cycle.
4:01:05 PM
MS. METIVIER, in response to Co-Chair Keller, said that the
national average of homelessness for youth after they aged out
of the system was 25 percent, whereas the Alaska average had
been 38 percent in 2005, and she opined that it could now be
even higher. She noted that, anecdotally, they "leave custody,
and fall off a cliff."
4:01:57 PM
REPRESENTATIVE CISSNA reflected that she came to the Legislature
12 years prior, after working in the foster care system and as a
foster parent. She judged there to be a moral charge for doing
nothing. She cited the lack of change in the system, and noted
that there were now even more kids. She discerned the need to
hold the system accountable and raise the awareness that the
problem was growing. She touted the need to change the system.
4:04:47 PM
CO-CHAIR KELLER commended the Office of Children's Services
(OCS) for its development of community partnerships and team
decision meetings. He cited the importance of having people who
care.
4:06:47 PM
MS. METIVIER agreed that these partnerships acted as a problem
solving mechanism, and that it slowed down the process of moving
kids too much.
4:07:14 PM
REPRESENTATIVE SEATON offered his belief that the majority of
foster families were trying to do the right thing. He pointed
to the lack of permanence, and asked for any solutions.
4:08:52 PM
MS. METIVIER replied that teenage behavior can be difficult for
foster families. She detailed the placement process which
consisted of many temporary residencies.
4:10:11 PM
REPRESENTATIVE SEATON responded that he would welcome
suggestions, as he was at a loss for solutions. He asked for an
outline of the placement process that created non-permanence, in
order to work with OCS to look for solutions.
4:11:33 PM
MS. METIVIER agreed to respond.
4:11:52 PM
CO-CHAIR HERRON asked if there was any socio, economic, or
ethnic group that was not affected by foster care.
MS. METIVIER replied that there was not. She expanded to say
that it was rarer for wealthy families, and that almost 60
percent of youth in foster care were Native Alaskan.
CO-CHAIR HERRON agreed that it was a challenge to find foster
families, and he also asked for her suggestions for improvement.
4:13:33 PM
MS. METIVIER stated that "happy foster families recruit happy
foster families." She offered her support to the commercial
advertisements looking for Native Alaskan foster families.
4:14:16 PM
REPRESENTATIVE LES GARA, Alaska State Legislature, in response
to Co-Chair Herron, said that the hardest solution was for the
"bouncing between homes." He pointed to the shortage of foster
families, and applauded the recruitment advertisements as "a
great first step." He reported that this shortage made it
difficult to match a youth with a family. Directing attention
to the shortage of case workers, he stressed that this resulted
in crisis management instead of case management. He suggested
that transportation cost coverage to keep youth in the same
school would have tangible outcomes. He shared that the
turnover rate for social workers was about 30 percent annually,
and that the social workers only lasted about 1.5 years,
creating an obvious problem for the youth and for the foster
families.
4:19:33 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:19 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HJR35pkt.PDF |
HHSS 2/16/2010 3:00:00 PM |
|
| hb168r10.PDF |
HHSS 2/16/2010 3:00:00 PM |
HB 168 |