Legislature(2011 - 2012)CAPITOL 106
02/07/2012 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Alaska Health Care Commission | |
| Presentation: Citizen Review Panel | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 7, 2012
3:06 p.m.
MEMBERS PRESENT
Representative Wes Keller, Chair
Representative Alan Dick, Vice Chair
Representative Bob Herron
Representative Paul Seaton
Representative Bob Miller
MEMBERS ABSENT
Representative Beth Kerttula
Representative Charisse Millett
COMMITTEE CALENDAR
PRESENTATION: ALASKA HEALTH CARE COMMISSION
- HEARD
PRESENTATION: CITIZEN REVIEW PANEL
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
WARD HURLBURT, M.D.
Chief Medical Officer
Director
Division of Public Health
Office of the Commissioner
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint, "Alaska's Approach
to Increasing Value in Health Care."
DEBORAH ERICKSON, Executive Director
Alaska Health Care Commission
Office of the Commissioner
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the PowerPoint
presentation.
SUSAN HEUER, Chair
Citizen Review Panel (CRP)
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint, "Alaska's Citizen
Review Panel."
PAT HEFLEY
Citizen Review Panel
Juneau, Alaska
POSITION STATEMENT: Answered questions during the CRP
PowerPoint presentation.
CHRISTY LAWTON, Director
Central Office
Office of Children's Services
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during the presentation
by the Citizen Review Panel.
ACTION NARRATIVE
3:06:06 PM
CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:06 p.m.
Representatives Keller, Dick, Miller, and Herron were present at
the call to order. Representative Seaton arrived as the meeting
was in progress.
^Presentation: Alaska Health Care Commission
Presentation: Alaska Health Care Commission
CHAIR KELLER announced that the first order of business would be
a presentation by the Alaska Health Care Commission.
3:08:04 PM
WARD HURLBURT, M.D., Chief Medical Officer, Director, Division
of Public Health, Office of the Commissioner, Department of
Health and Social Services, introduced himself as the Chair of
the Alaska Health Care Commission, and mentioned that Chair
Keller was also on the commission. He stated that one important
reason for the Alaska Health Care Commission was to better
understand the increasing cost of health care. He presented a
PowerPoint, "Alaska's Approach to Increasing Value in Health
Care:" and pointed to slide 2, "Presentation Overview." He
listed the PowerPoint topics to include the background, the
process and strategy, the findings to date, the recommendations
and the next steps to take.
3:10:09 PM
DR. HURLBURT, directing attention to slide 3, "Commission
Background," stated that the purpose of the commission was "to
provide recommendations for and foster the development of a
statewide plan to address the quality, accessibility and
availability of health care for all citizens of the state." He
pointed out that the commission was advisory, established in
2009 with 14 members appointed by the Governor, and represented
the needs of all Alaska.
3:12:13 PM
DR. HURLBURT moved on to slide 4, "International Comparison of
Spending on Health, 1980 - 2009," pointing to the graph on the
left, which depicted the average per capita spending on health
care. He affirmed that the U.S. had the highest average per
capita spending and the highest spending on health as a percent
of the national Gross Domestic Product (GDP) of any of the
industrialized countries. He pointed out that U.S. spending was
50 - 100 percent more than any of the other countries. He
surmised that, as the average life expectancy for an American
was lower and the infant mortality rate was higher than almost
all the other industrialized countries, the U.S. health care
expenses did not guarantee a better product. He noted that
almost 18 percent of the current U.S. gross domestic product was
spent on health care, and the Center for Medicare and Medicaid
Services was predicting this to reach 21 percent by the end of
the decade. He recognized the dilemma of where to fund.
3:16:22 PM
DR. HURLBURT furnished slide 5, "Cost of Health Care in Alaska,"
which projected the Institute of Social and Economic Research
(ISER) analysis for the cost of health care in Alaska. He
declared that costs will double in the next ten years, and the
cost of health care in Alaska will equal the value of the
extracted oil.
CHAIR KELLER declared his concern that current health care costs
were half of the cumulative wages of all Alaskans.
3:19:12 PM
DR. HURLBURT expressed his concerns that this business was too
important not to be dealt with, and that, as these costs
increased, they would need to be addressed by the medical
community or there would be "a slash and burn" response because
the costs would become unsustainable. He opined that this was a
mission of the Alaska Health Care Commission.
3:20:37 PM
DR. HURLBURT moved on to slide 6, "Affordability - Cost vs.
Inflation, Earnings," which viewed national workers' earnings
and costs from 1999 to the present. He reported that, during
this time period, inflation had increased 38 percent, worker
earnings had increased 50 percent, health insurance premiums had
increased 160 percent, and workers contribution to health care
premiums had increased 168 percent.
3:22:25 PM
DR. HURLBURT provided slide 7, "Affordability - U.S. Families,"
which stated that, although the median family income had
increased by $23,000 between 1999 and 2009, the out of pocket
costs for health care had increased by the same amount.
DR. HURLBURT addressed slide 8, "Affordability - Alaskan
Families," which reflected cost increases from 1982 to 2010. He
assessed that housing had increased about 76 percent, overall
costs had increased 96 percent, energy had increased,
specifically in the last six years, by 280 percent, and medical
care had increased by almost 420 percent.
3:25:59 PM
DR. HURLBURT presented slide 9, "Affordability - Alaskan
Employers," and stated that Alaskan employers, especially small
employers, were offering fewer health benefits. He observed
that commercial insurance premiums in Alaska were the highest in
the United States, 30 percent higher than comparable states,
with an average cost of almost $12,000 per employee. Employee
cost for family coverage had increased from 17 percent to 22
percent from 2003 to 2010. He reported that although Premera
[Blue Cross] had 60 percent of the health care business in
Alaska, its profit margin had been less than 1 percent over the
last ten years.
3:28:14 PM
REPRESENTATIVE MILLER asked for clarification to the profit that
Premera [Blue Cross] showed.
DR. HURLBURT offered his belief that the profit was reflected
after paying all expenses, including shareholders.
REPRESENTATIVE MILLER asked what costs were the drivers for
these increases.
DR. HURLBURT replied that he would address that.
3:29:49 PM
DR. HURLBURT summarizing slide 10, "Value in Alaska's Health
System," stated that Alaska had about 14 percent uninsured, and
that its per capita health care expenditures were second only to
Massachusetts, and its health care reform program. However, for
all this expenditure, Alaska only ranked 38th for health care
quality, and was only the 35th healthiest state.
3:31:09 PM
DR. HURLBURT indicated slide 11, "What System?" and asked how to
redesign the system to deliver the best possible health care at
the lowest possible cost. He clarified that this did not
include rationing or denying care, but that full value for the
expenditure was necessary. He declared that the goal was to
prudently and responsibly provide the best health care in the
world for Alaskans.
3:32:00 PM
DR. HURLBURT quoted slide 12, "The Conundrum," "If we don't cut
costs, we'll have to cut care."
DEBORAH ERICKSON, Executive Director, Alaska Health Care
Commission, Office of the Commissioner, Department of Health and
Social Services, referring to slide 13, "The Answer," stated
that the question seeking an answer was "How can we make health
care less expensive by making it better." She directed
attention to slide 14, "5 - Year Strategic Planning Process,"
which detailed that process for the Commission: develop a
vision for the ideal Alaska health care system, diagnose the
problems for achievement of the vision, and identify strategies
for movement toward the vision. She described this vision,
slide 15, "The Future," as a focus beyond delivery of health
care services, to create a healthy Alaska population. She
declared an important component of the vision was for it to be
sustainable for the long term, with high value, safe,
affordable, and accessible care. She declared the necessity for
both patients and providers to be satisfied with the system.
3:35:10 PM
MS. ERICKSON referred to slide 16, "Health Care Transformation
Strategy," which defined the building blocks for a strong health
care system in Alaska. These included building a foundation of
leadership and health information technology, while designing
policies to support healthy life styles with innovations in the
delivery of patient centered health care. She reviewed slide 17
and slide 18, "Diagnosing the Problem," and listed the
discussion of current challenges to include the fragmentation
and duplication in the system, and the unique logistical
challenges for health care delivery in Alaska. She relayed that
the focus for the past year had been on the cost of health care.
She referenced the ISER study for total health care spending now
and in the future, which identified the payers and in what
service categories the funds were spent. She spoke about the
Milliman, Inc. study which focused on health care pricing in
Alaska. She noted that, of the $7.5 billion spent in 2010 for
health care, about 60 percent was for hospital and physician
services, as detailed on slide 19, "What do Alaska's Health Care
Dollars Buy?"
3:38:54 PM
MS. ERICKSON, indicating slide 20, "Premiums" and slide 21,
"Cost Drivers: Utilization," noted that health insurance
premiums, compared to the national average, were about 30
percent higher per member in Alaska, even though Alaska had 29
percent fewer hospital admissions and 23 percent fewer inpatient
bed days, with 21 percent more outpatient visits.
3:40:44 PM
REPRESENTATIVE SEATON, indicating slide 21, asked if the fewer
admissions and inpatient bed days were an inverse cost driver
for the 30 percent higher health insurance premiums in Alaska.
3:41:42 PM
DR. HURLBURT, in response to Representative Seaton, said that
this information was not age adjusted. He reported that
although Alaska had the fastest growing senior population by
percentage, there was still half the percentage of seniors as in
most other states. He pointed out that hospital visits increase
after the age of 65. Directing attention to slide 22,
"Utilization - Milliman's Conclusion," he opined that Alaska's
utilization did not appear to be driving the high premiums.
3:43:17 PM
DR. HURLBURT, in response to Representative Seaton, clarified
that the rate of increase to seniors over 65 in Alaska was
higher than any other state, but the relative percent to the
absolute population of Alaska was still much lower.
3:43:57 PM
REPRESENTATIVE DICK gave an example of personal health costs
which he questioned.
3:45:02 PM
DR. HURLBURT moved on to slide 23, "Alaska prices* are
significantly higher than comparison states," and explained that
physician services were 69 percent higher for commercial payers
and 60 percent higher for all other payers, including Workers'
Compensation, Medicaid, Medicare, and Veterans Health Care. He
pointed out that this varied by specialty, noting that
pediatrics were 43 percent higher and cardiology was 83 percent
higher in Alaska. He reported that the hospital rates in Alaska
were 37 percent higher for commercial payers and 36 percent
higher for Medicare than in the comparison states. He declared
that there were very wide price disparities to each payer.
3:47:06 PM
DR. HURLBURT moved on to slides 24 - 25, "Sample comparisons:
Mean commercial allowed charges non-facility based professional
svcs," which compared procedural charges in Alaska to five other
states. He stated that Alaska charges were often twice those of
other states. Directing attention to slides 26 - 27, "Sample
Comparisons: within Alaska, by payer," he pointed out that
although the Medicare rates were the lowest, the Workers'
Compensation rates were the highest.
3:49:24 PM
DR. HURLBURT assessed slide 28, "Cost (Price) Drivers- Operating
Costs" and stated that medical salaries in Alaska were 2 - 10
percent higher in Alaska; the cost of living in Alaska was 15 -
20 percent higher; and that hospital operating costs were 38
percent higher than comparable states. He pointed out that
these higher hospital operating costs included the rural
hospital operating costs which were 86 percent higher on
average.
3:50:34 PM
REPRESENTATIVE DICK asked if this included the Alaska Native
medical centers.
3:50:54 PM
DR. HURLBURT, in response to Representative Dick, said that the
salary and wage statistics reflected the marketplace, but that
the comparisons for operating costs and profit margins excluded
tribal and federal hospitals.
3:51:29 PM
DR. HURLBURT discussed slide 29, "Cost (Price) Drivers -
Provider Discounts" which depicted the discount percentage to
bill charges that payers negotiated with providers. He stated
that, as bill charges were not fixed, the health payers did not
want to contract for billed charges; instead, payers negotiated
a case rate and a per diem rate. He offered that the only
reason for a payer to contract for billed charges was due to a
lack of competition and a need to have the provider. He
reported that this precluded the provider from balance billing
the difference to the patient.
3:53:20 PM
DR. HURLBURT introduced slide 30, "Private Hospital Sector
Average Operating Margins," which compared the operating margins
of comparison states and the nationwide average with those
margins in both urban and rural Alaska. He concluded that
Alaska's operating margins were more than twice as high as the
comparison states, and even higher when just comparing the urban
hospitals with those of other states. He analyzed slide 31,
"Milliman's Cost (Price) Driver Conclusions," clarifying that
these conclusions were just reflecting private hospitals. He
reported that the operating costs were driving higher prices in
rural Alaska, but that the operating margins were driving the
higher prices in urban Alaska hospitals. Pointing to physician
services, he stated that the high prices were driven by lack of
competition and by Alaska statute, which locked payers to pay at
least 80 percent of the billed charges. He shared that the low
Medicare rates also created upward pricing to other payers.
3:55:34 PM
REPRESENTATIVE SEATON, referring to the aforementioned Alaska
statute, asked for further definition to the 80 percent required
payment. He asked if the Department of Health and Social
Services (DHSS) supported this.
3:56:09 PM
DR. HURLBURT opined that DHSS had not taken a position, but that
the Alaska Health Care Commission had determined this to be a
driver for higher health care costs.
3:56:32 PM
REPRESENTATIVE SEATON asked if there was a purpose for the 80
percent reimbursement.
DR. HURLBURT postulated that historically the legislature was
concerned about enough health care for Alaskans, so incentives
were created to attract the medical community. He noted that
this had included legislation to limit malpractice rates in
Alaska.
3:58:11 PM
REPRESENTATIVE SEATON asked if the Certificate of Need program
compounded the problem of inadequate competition.
3:58:51 PM
DR. HURLBURT specified that the aforementioned legislation
applied only to physician charges, not hospital charges. He
reported that the cost disparity for hospital charges was not as
wide as for individual provider charges. He pointed out that,
as the Certificate of Need applied to institutions, it should
have no effect.
3:59:32 PM
DR. HURLBURT provided slide 33, "5% of the U.S. population
required 50% of health care spending in 2009," and reported that
"5 percent of the population consume about 50 percent of the
health care dollars," whereas, "50 percent of the population
consumes about 3 percent of the health care dollars." He
observed that, narrowing this down, about 1 percent of the
population consumed 25 - 30 percent of the health care dollars.
He declared that it was necessary to keep this in mind when
planning to control costs.
4:00:14 PM
REPRESENTATIVE HERRON, referring to slide 33, asked about
recommendations for change.
DR. HURLBURT replied that, philosophically, it was not worth the
time to intervene with the 50 percent healthy population. He
reflected on a prior management role he had, and cited that
targeting some groups to reduce their needs for hospital visits
could result in significant savings.
4:02:41 PM
DR. HURLBURT, in response to Representative Herron, suggested
that improving the health of the 5 percent would decrease the
health expenditure, as shown on slide 33.
4:03:46 PM
DR. HURLBURT, in response to Representative Herron, agreed that
it could either lower the actual cost or the percentage of
health care cost to GDP.
4:04:33 PM
DR. HURLBURT moved on to slide 34, "Focus on Health & Value,"
and suggested to focus on prevention for the healthy population
in order to keep them healthy. He opined that this generation
of kids may be the first that does not live as long as its
parents. For the mild to moderate illnesses and conditions, he
suggested high quality, evidence-based, efficient, effective
care to prevent conditions from worsening. With the most
complex conditions, the cost increased, and it becomes necessary
to provide care coordination and management.
4:05:37 PM
DR. HURLBURT presented slide 35, "Ensure the best available
evidence is used for making decisions," stating that evidence
based medicine was a difficult concept for both the public and
medical professionals. He touted the use of evidence to make
coverage and clinical decisions. He opined that a randomized,
blind study offered the highest grade of evidence, while
consensus conference, or expert opinion, elicited the lowest
grade of evidence. He opined that 30 to 40 percent of health
care was not supported by evidence, and he offered a number of
examples.
4:09:58 PM
DR. HURLBURT directed attention to slide 36, "The need for
application of high grade evidence," and offered as an example
Vioxx, a drug which was used without the high grade evidence.
4:10:37 PM
MS. ERICKSON presented slide 39, "Enhance quality and efficiency
of care on the front end," and slide 40, "Commission
Recommendations." She mentioned both patient centered primary
care and patient centered medical homes as ways which offered
relationships and good access with primary care providers to
better manage early conditions. She said the commission
researched state initiatives regarding successful models for
patient centered primary care, and then convened a panel to
review the challenges and opportunities these created for
Alaska. She noted that the successful programs had strong
medical leadership and management, a lot of flexibility for
individual participating physician practices, and a focus on
improving care for the complex case management of patients with
multiple chronic conditions. She emphasized that the
initiatives were grounded in the idea to make the patient care
better. She pointed to the attributes for success which
included upfront investment by the payer, shared learning
environments, and timely access to patient data.
4:15:10 PM
MS. ERICKSON continued on to slide 41, "Commission
Recommendations, Trauma Systems," and announced support for the
continued implementation of the recommendations by the 2008
American College of Surgeons.
MS. ERICKSON, noting slide 43, "Commission Recommendations,
Preliminary Steps Toward Transparency," said that for price and
quality transparency it was necessary to have full participation
in the Hospital Discharge Database, and to study the feasibility
of an All-Payers Claims Database.
4:16:18 PM
CHAIR KELLER opined that although other states had already
passed this legislation, the complexity of medical billing made
it very difficult for the consumer. He identified this as
possible legislation for the House Health and Social Services
Standing Committee to address.
4:17:43 PM
REPRESENTATIVE SEATON asked about the feasibility of an index
for the patient to find the cost and quality information.
4:19:17 PM
MS. ERICKSON replied that the consumer was one step removed from
price concern when there was insurance coverage. Referring to
slide 46, "All-Payer Claims Databases (APCDs)," she declared
that some state models for APCDs required state legislation
mandating that the payer data be available to consumers, which
could incentivize the consumer to shop before medical decision.
She relayed that the commission would work with a consultant on
a feasibility and needs assessment study. She opined that this
could be a more simple approach for transparency than for each
provider to supply prices.
4:22:38 PM
REPRESENTATIVE SEATON asked about a mechanism for decision
making about hospitals.
4:23:29 PM
DR. HURLBURT replied that the quality rating systems would be
adjusted to account for the types of service.
4:23:40 PM
REPRESENTATIVE DICK asked if the cost of non-paying patients
affected the cost of health service.
4:24:11 PM
DR. HURLBURT replied that the hospital profit margins were
determined after all expenses, including the non-pay patients.
He pointed out that profit margins were much lower in rural
areas.
4:24:52 PM
REPRESENTATIVE DICK asked to clarify the percentage of cost to
the system from non-paying patients.
DR. HURLBURT replied that he would research this.
CHAIR KELLER expressed his belief in the free market. He
offered his belief that health care shopping now included more
out of state spending.
4:26:23 PM
MS. ERICKSON moved on to slide 52, "'Continuum' of Payment
Reform," and declared that most medical care was fee for
service. She said that the commission was reviewing reform for
the payment of services to better drive value and not just
delivery of individual services. She directed attention to
slide 53, "Payment Reform System Requirements," which listed
various requirements necessary to payment reform. She stated
that both payers and providers needed data and actuarial
expertise if providers were going to assume more financial risk
for providing service. She indicated that payment for outcome
and value required a partnership between patients, providers,
and payers, to keep the healthy population healthy, and to
better manage the sick patients. She spoke of the movement to
better integrate services, as it was necessary to better align
payment policies.
4:29:49 PM
MS. ERICKSON reviewed slide 58, "Health Workforce," and referred
to recommendations from an earlier report to build a sustainable
work force and information infrastructure.
4:30:07 PM
MS. ERICKSON mentioned that obesity was the most significant
public health challenge, immunization programs needed adequate
funding, and behavioral health needed to be integrated with
primary care services, slides 61 - 63.
4:30:33 PM
MS. ERICKSON mentioned that the commission would review
challenges that the provider community had identified as
hampering innovation and driving increased costs, plans that the
business community had to improve employee health plans, patient
choices for end of life care decisions, and barriers to the use
of telemedicine, slide 65, "Commission's 2012 Agenda."
MS. ERICKSON mentioned that the appendix of the Commission's
2011 Annual Report included an update on implementation of
provisions in the Affordable Care Act.
4:32:07 PM
MS. ERICKSON, in response to Chair Keller, said that the Request
for Proposal (RFP) for a health plan consultant by the
Department of Administration (DOA) said that Commissioner
Hultberg (DOA) and Commissioner Streur (Department of Health and
Social Services) would work together on joint strategies, to
redesign the employee health benefit plan and develop an
employee wellness and health management program. She offered
her belief that this would address opportunities for an
alignment of strategies for Medicaid, Workers' Compensation, and
other state health care programs.
4:34:57 PM
The committee took a brief at-ease.
^Presentation: Citizen Review Panel
Presentation: Citizen Review Panel
4:35:46 PM
CHAIR KELLER announced that the final order of business would be
a presentation by the Alaska's Citizen Review Panel.
SUSAN HEUER, Chair, Citizen Review Panel (CRP), presenting a
PowerPoint, "Alaska's Citizen Review Panel," stated that the
mission was to provide oversight to the Office of Children's
Services (OCS) and gather public input on how well child
protection was being delivered statewide. She listed the places
CRP had recently visited including Bethel, Wasilla, and
Fairbanks. She noted that, nationally, this was the only CRP
funded by a state legislature.
MS. HEUER, directed attention to slide 7, "Benefits of CRP," and
explained that the eight volunteer members annually contributed
250 hours of active service, and had the unique function of
identifying and advocating for ancillary services and
improvements that OCS could not request.
4:38:48 PM
MS. HEUER shared slide 8, "Issues CRP is monitoring," and said
that CRP was focusing to resolve the struggles of the Wasilla
OCS office, and to find solutions for the Bethel OCS office to
ensure it was fully staffed and fully functional.
4:40:31 PM
CHAIR KELLER commented that the Department of Health and Social
Services and OCS had been very responsive to the issues in
Wasilla.
4:41:20 PM
REPRESENTATIVE HERRON reported that the Bethel OCS staff had
challenges for discussion, and anticipated a visit from the
Citizen Review Panel.
4:42:22 PM
MS. HEUER, directing attention back to slide 8, explained that
the third issue to monitor was in-home safety, an OCS strategy
to determine the safety of children remaining in the family home
after a report of crime. She reported that CRP was working with
OCS to acquire data to monitor the safety of the children in
this situation.
4:43:31 PM
MS. HEUER, referring to slide 9, "2012 CRP Recommendations to
OCS," presented input from statewide communities for OCS. The
first recommendation was for OCS to use the data they collect as
a management tool. She acknowledged that the often previously
maligned ORCA system now appeared to be improved and was a good
tool. She suggested that the ORCA data could offer reasons for
the high turnover rate in the Wasilla office.
4:45:54 PM
REPRESENTATIVE SEATON asked if exit interviews would better
address the reasons for low staff retention.
4:46:25 PM
MS. HEUER replied that there were no requests to improve ORCA.
She clarified that staff turnover was merely an example of a use
for the ORCA data.
4:47:07 PM
PAT HEFLEY, Citizen Review Panel, confirmed that there had been
issues with the ORCA database, and that it could be better used
as a management tool. He acknowledged a challenge to address
the key workforce issues, such as training needs, salaries, or
retention.
4:47:42 PM
REPRESENTATIVE SEATON asked if a requirement for an exit
interview could be included in staff contracts.
4:48:05 PM
MR. HEFLEY replied that the use and understanding of why people
leave was an issue throughout the state. He opined that an exit
interview could only be required through the union contract.
4:48:44 PM
MS. HEUER encouraged the statewide use of data as a management
tool. She moved on to slide 10, "2012 CRP Recommendations to
OCS," and stated that protective service reports, or reports of
harm, should ensure the safety of a child if they remain in a
family home. She declared the difficulty to obtain information
regarding a child's safety after a report of harm has been
screened in to an "in-home" situation. She declared that it was
difficult to establish when OCS staff initiated work with a
family in an "in-home" situation, when the referral for services
for the family was made, who was monitoring the child's safety,
and what happened at the end of the six month "in-home" period.
She suggested that this data could demonstrate the timeliness
and effectiveness of referral and services to families and
children. She declared it to be in a child's best interest if
family services could be received while a child remained in the
home.
4:53:42 PM
MR. HEFLEY confirmed that OCS was trying to do a balancing act
between keeping children safely at home and having them taken
out of homes.
4:54:45 PM
MS. HEUER reviewed slide 11, "2012 CRP Recommendations to OCS,"
and recommended that OCS address the licensing for those foster
homes where substantiated reports of problems were filed.
4:56:02 PM
MS. HEUER concluded with slide 12, "CRP Recommendations to the
Legislature," which listed housing for OCS rural workers as a
critical issue for staff retention. She offered some examples
for solutions. She declared a need for more support staff to
social workers, pending the results of the upcoming workload
study. She pointed out that the Palmer court had struggled with
the load from Wasilla OCS cases, and that there was also a need
for an additional Office of Public Advocacy (OPA) Child In Need
of Aid (CINA) attorney in the Palmer office.
4:58:55 PM
CHRISTY LAWTON, Director, Central Office, Office of Children's
Services, Department of Health and Social Services, in response
to the discussion of exit surveys, stated that OCS did request
this from employees, but that it was not required. She
acknowledged that this data was collected, and she reported that
an additional staff survey was conducted annually to ascertain
factors behind decisions to stay or leave the agency. She
acknowledged that some reasons for departure included a lack of
clerical support, as well as not having the time for one on one
work with family members.
5:02:39 PM
MS. LAWTON respectfully disagreed with the allegation that OCS
was not using the data they had collected. She declared that
the ORCA capacity had increased, which allowed for collection of
raw data, annual site reviews at each field office, and a
statewide analysis of workloads and available resources for
guidance in scheduling.
5:05:18 PM
CHAIR KELLER asked that Ms. Lawton return to the next committee
meeting, February 9, to finish the discussion.
5:05:54 PM
REPRESENTATIVE HERRON asked that Ms. Lawton, at her next
presentation, address the culture within OCS.
5:07:33 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:07 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| H HSS 02-07-12 Alaska Health Care Commission update.pdf |
HHSS 2/7/2012 3:00:00 PM |
Alaska Health Care Commission Presentation |
| PRINT Presentation 2012 HSS Committee Feb.pptx |
HHSS 2/7/2012 3:00:00 PM |
Citizen's Review Panel Presentation |