03/21/2017 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Alaska Citizen Review Panel | |
| HCR2 | |
| HB151 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 151 | TELECONFERENCED | |
| *+ | HCR 2 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 21, 2017
3:03 p.m.
MEMBERS PRESENT
Representative Ivy Spohnholz, Chair
Representative Bryce Edgmon, Vice Chair
Representative Sam Kito
Representative Geran Tarr
Representative David Eastman
Representative Jennifer Johnston
Representative Colleen Sullivan-Leonard
MEMBERS ABSENT
Representative Matt Claman (alternate)
Representative Dan Saddler (alternate)
COMMITTEE CALENDAR
PRESENTATION: ALASKA CITIZEN REVIEW PANEL
- HEARD
HOUSE CONCURRENT RESOLUTION NO. 2
"Urging Governor Bill Walker to join with the Alaska State
Legislature to respond to the public and behavioral health
epidemic of adverse childhood experiences by establishing a
statewide policy and providing programs to address this
epidemic."
- HEARD & HELD
HOUSE BILL NO. 151
"An Act relating to the duties of the Department of Health and
Social Services; relating to training and workload standards for
employees of the Department of Health and Social Services;
relating to foster care licensing; relating to placement of a
child in need of aid; relating to the rights and
responsibilities of foster parents; relating to subsidies for
adoption or guardianship of a child in need of aid; requiring
the Department of Health and Social Services to provide
information to a child or person released from the department's
custody; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HCR 2
SHORT TITLE: RESPOND TO ADVERSE CHILDHOOD EXPERIENCES
SPONSOR(s): REPRESENTATIVE(s) TARR
01/23/17 (H) READ THE FIRST TIME - REFERRALS
01/23/17 (H) HSS, STA
03/14/17 (H) HSS AT 3:00 PM CAPITOL 106
03/14/17 (H) <Bill Hearing Canceled>
03/21/17 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 151
SHORT TITLE: DHSS;CINA; FOSTER CARE; CHILD PROTECTION
SPONSOR(s): REPRESENTATIVE(s) GARA
03/01/17 (H) READ THE FIRST TIME - REFERRALS
03/01/17 (H) HSS, FIN
03/16/17 (H) HSS AT 3:00 PM CAPITOL 106
03/16/17 (H) Heard & Held
03/16/17 (H) MINUTE(HSS)
03/21/17 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
DIWAKAR VADAPALLI, PhD
Chair
Citizen Review Panel (CRP)
ISER
University of Alaska, Anchorage
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint titled "Alaska
Citizen Review Panel."
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 Alaska Citizen Review Panel.
REPRESENTATIVE GERAN TARR
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HCR 2 as the sponsor of the
resolution.
LAURA CHARTIER, Staff
Representative Les Gara
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 151 on behalf of the bill
sponsor, Representative Gara.
REPRESENTATIVE LES GARA
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
151 as the sponsor of the bill.
BARBARA MALCHICK
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 151.
ROSALIE REIN
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HB 151.
TAMMI SANDOVAL, Director
UAA Child Welfare Academy
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 151.
ACTION NARRATIVE
3:03:54 PM
CHAIR IVY SPOHNHOLZ called the House Health and Social Services
Standing Committee meeting to order at 3:03 p.m.
Representatives Spohnholz, Johnston, Eastman, and Kito were
present at the call to order. Representatives Edgmon, Tarr, and
Sullivan-Leonard arrived as the meeting was in progress.
^Presentation: Alaska Citizen Review Panel
Presentation: Alaska Citizen Review Panel
3:04:34 PM
CHAIR SPOHNHOLZ announced that the first order of business would
be a presentation by the Alaska Citizen Review Panel.
3:05:26 PM
DIWAKAR VADAPALLI, PhD, Chair, Citizen Review Panel (CRP), ISER,
University of Alaska, Anchorage, said that he was also an
assistant professor of public policy at ISER (Institute of
Social and Economic Research) at the University of Alaska
Anchorage. He shared some background of the CRP and its
interaction with the House Health and Social Services Standing
Committee.
CHAIR SPOHNHOLZ asked if there was a list of CRP members in the
presentation packet.
DR. VADAPALLI said that the members were listed on the CRP
website and that he would forward the list. He directed
attention to slide 1, "Presentation Outline," and said that he
would discuss the CRP goals and recommendations for the previous
year and the upcoming year. He moved on to slide 2, "History,"
and offered a brief history from its inception by congressional
mandate in 1996, and its subsequent establishment in Alaska in
May 2002. He said that Congress had mandated the CRP through
amendments to the Federal Child Abuse Prevention and Treatment
Act in 1996. He reported that the panel had produced an annual
report and held town hall meetings since the passage of House
Bill 53 in 2005. He said that all the members of the panel were
volunteers and worked 1500 - 2000 hours each year with an
operating budget of $100,000. He noted that there was a maximum
of nine members on the panel. He shared slide 3, "Function -
Mandates," stating that the panel was a statutory body with a
very broad mandate, almost exactly mirroring the federal
statute. He emphasized that the central focus was for policies,
procedures, and practices of OCS, slide 4, "Primary Functions."
He listed the three specific functions: Review and evaluate,
outreach, and advocate. He reported on slide 5, "Central
Purpose," and stated that the central purpose of CRP was to help
child protection services agencies. He reported that public
participation and community engagement was seen as a necessary
reform in the mid-1990s, hence the creation of the CRPs. He
stated that this had made the OCS policies, procedures, and
practices more responsive to the needs of the citizens.
DR. VADAPALLI presented slide 6, "OCS - Mission." He declared
that OCS was a complex agency with a very difficult job, to work
in partnership with families and communities to support the
well-being of Alaska's children and youth. He declared that
there was a synergy between the congressional intent behind the
CRPs and the mission of the agency. He pointed out that OCS was
a service agency designed to serve families in difficult
circumstances and not a police agency. He introduced slide 7,
"OCS - Significance," and read from the Alaska Ombudsman 2012
investigative report, which stated: "it is difficult to imagine
a more fear-inspiring authority than the power to take away a
person's children." He declared that OCS was invested with an
awesome power and a huge responsibility, which was exercised by
the front-line case workers and the supervisors. He added that
a lot of good was done by OCS, although any mistakes could be
very expensive for children and families.
3:15:42 PM
DR. VADAPALLI shared slide 8, "Functions - What CRP does not
do." He said that it was easier to list what CRP did not do, as
it was "big and broad." He said that CRP did not comment on
proposed or pending legislation, and was set up as a systems
level review with no role in individual cases, contracts, or
situations. He said that CRP had the statutory authority to
review individual cases, but that it should not intervene to
revise decisions. He added that CRP did not micromanage OCS and
could not handle complaints against case workers or supervisors.
REPRESENTATIVE SULLIVAN-LEONARD, referencing an earlier comment
with regard to not micro-managing the OCS operations, asked if
the data for the ratio of children versus case workers reflected
a balance.
DR. VADAPALLI said that the data was reviewed to the extent to
which they had access to the data. He relayed that the statute
authorized access to anything CRP deemed necessary, although
there were barriers to access all this data. He stated that one
barrier was the capacity for CRP to handle sensitive data as,
even when OCS wanted to share this data, there was no clear
protocol in place to deal with the handling and sharing of
sensitive data. He noted that there were statutory guidelines
for sanctions against members breaching confidentiality.
REPRESENTATIVE SULLIVAN-LEONARD asked if CRP could comment on
any disparity for the average ratio of case workers to clients
in different regions.
DR. VADAPALLI explained that average caseload was a question to
staff during the CRP site visit reviews, which averaged five
visits every year. He relayed that, although OCS had shared the
case load by worker, CRP had not tracked those numbers in
previous years. He stated that all cases were not the same
amount of work, so it was necessary to discuss work load.
DR. VADAPALLI continued with slide 8, "Functions - What CRP does
not do," and stated that CRP did not conduct program evaluations
but instead it assessed the procedures and practices of OCS as
stated in its own policies. CRP does not lobby for or against
OCS. He shared slide 9, "CRP - A Statutory Institution," and
stated that CRP was an institution with a statutory role and
responsibility, and was a state organization, not a private,
non-profit, grass roots organization. He reported that CRP was
a congressionally mandated, statutory organization and that it
facilitated citizen participation.
3:21:52 PM
DR. VADAPALLI addressed slide 10, "OCS Offices," which mapped
the OCS offices throughout the state, and he noted some of the
changes to the statistics. He reported that CRP tried "to reach
out to all five regions every year." He spoke about slide 11,
"CRP's Annual Calendar," and stated that it was a typical CRP
calendar. He moved on to slide 12, "Work During 2015 - 2016,"
which listed the goals, the site visits, the public meetings,
and the presentations. He shared the four CRP goals, slide 13,
"Goals 2015 - 2016," which were included in the work plan, along
with a description of the background explaining its importance.
DR. VADAPALLI shared slide 14, "Recommendation 1," which
suggested consideration for assigning CRP a significant role for
implementation of priority areas in the OCS-Tribal relationship.
This could lead to another challenge, as CRP was not a
stakeholder. He suggested to identify an appropriate and
specific role for CRP to work in partnership with others.
DR. VADAPALLI discussed the second recommendation, slide 15,
which stated that child protection services needed additional
resources, as there were problems which everyone needed to
address. He explained that this recommendation acknowledged
that tribal partners could bring assets to the table.
REPRESENTATIVE EDGMON asked if the recommendation should instead
read "Alaska Native not for profit corporations."
DR. VADAPALLI explained that the recommendation read as was
intended, as OCS already had working relationship with non-
profits, but it needed the resources, relationships, and funding
from the for-profit corporations to tackle the many challenging
issues. He stated that every shareholder of a for-profit
corporation was also a tribal member.
REPRESENTATIVE EDGMON offered his belief that the recommendation
was "highly aspirational," and asked if there had been any
success for constructive dialogue.
DR. VADAPALLI expressed his agreement that it was ambitious and
aspirational. He relayed that CRP, as a body, can recommend and
broker the conversations, but that the parties had to commit and
enter in to see if it would work.
3:31:28 PM
DR. VADAPALLI explained slide 16, "Recommendation 3," and stated
that, as CRP had been an afterthought for many years, there was
no oversight or evaluation of its work. He reported that the
panel existed for 13 years without any by-laws or policies, and
had been in violation of state sunshine laws until January,
2015. He declared that CRP may or may not be doing its job, or
OCS may or may not be responding adequately, which had led to an
erosion of the accountability mechanism and a failure of the
legislative intent to help OCS be more responsive to community
needs. He said that the sequence of presentations was more
meaningful as it required enforcement of some accountability.
He pointed out that currently the only federally monitored
accountability was for production of the annual report and the
subsequent response from OCS, although the quality of either
document was not assessed. He acknowledged that, as the
recommendations were not legally binding, they could only result
in meaningful action through legislative oversight. He reported
that CRP had conducted an evaluation of its own structure and
relationship with OCS, resulting in many ideas for improvement.
He declared that it was necessary to have clarity for the role
of CRP in order to avoid any conflicts.
REPRESENTATIVE JOHNSTON asked if anything had been gleaned from
the aforementioned national CRP conference which was helpful for
the process and procedures.
DR. VADAPALLI, in response, said that many CRPs did things
differently, as some were private, non-profit, consulting firms,
and some were based at a university. He allowed that the
template was popular. He offered some examples for various
models, but admitted that it was unclear which were successful
as there was not any federal evaluation. In response to
Representative Johnston, he said that the non-profits did fit
into the federal mandates, although the mandate did not dictate
how to organize each CRP.
REPRESENTATIVE JOHNSTON asked if the Wyoming approach had been
effective.
DR. VADAPALLI said that effectiveness could only be determined
if there were standards to evaluate. He offered his belief that
effectiveness was determined by the actual changes that a CRP
initiated, which could not be quickly assessed due to the number
of factors.
REPRESENTATIVE JOHNSTON asked if Wyoming felt their system was
effective.
DR. VADAPALLI explained that the relationships seemed to be good
in Wyoming, although they raised their own funding and that CRP
work was only a small part of the agency.
CHAIR SPOHNHOLZ suggested that this was not an apples to apples
comparison, as there was no federally prescribed evaluation for
effectiveness process for CRPs.
DR. VADAPALLI said that CRP reports do not assess the actual
effectiveness.
3:40:20 PM
DR. VADAPALLI returned to slide 16, "Recommendation 3:" and
explained that this pointed to the need to assess the
effectiveness of collaboration with OCS. He introduced slide
17, "Recommendation 4:" which was the result of a CRP survey of
OCS front line case workers who, although they held their
immediate supervisors in very high regard, felt that the
community at large did not understand the purpose and work of
OCS. The recommendations included a review for a longer
training period, as it takes about two years for new front-line
workers in child protection to learn their job well. They
suggested that structured training opportunities should be
available during these first two years and beyond, and that OCS
should verify whether those on the job training opportunities
were "helping to the extent they should." He shared a result of
the survey that improvement was needed in the feedback channels
from the front line to the leadership. He stated that it was
not evident that any in-depth analysis was conducted to inform
policy or practice since resources were scarce. He said that
CRP would request the data and analyze it.
DR. VADAPALLI shared slide 18, "Recommendation 5:" and stated
that for the past four years he had focused on clarification of
the purpose of CRP, and that this had been his biggest challenge
as the chair. He added that the panel was a mechanism for
public participation and not just a watchdog group to raise
alarms at every perceived OCS mistake. He declared that it was
the responsibility of the panel to lead a constructive dialogue
among the stakeholders, but this required a structured
relationship with OCS. He stated that funding would not resolve
all the challenges.
DR. VADAPALLI pointed to the four goals listed on slide 19,
"Goals for 2016 - 2017," noting that two of the goals were
retained from the previous year, and pointing out that the panel
may not be able to accomplish these goals as planned.
DR. VADAPALLI shared slide 20, "Grand Jury Investigation," and
stated that Representative Tammie Wilson had called for a grand
jury investigation of OCS. The grand jury had concluded that
CRP was required by statute to conduct a review. He reported
that CRP had received all the material from the grand jury and
was also compiling the information from all the recent public
hearings held by Representative Wilson. He declared that this
review would be a major challenge for CRP, adding that the plan
for how to conduct the review would be available on June 30.
3:48:38 PM
DR. VADAPALLI discussed slide 21, "Anticipated Changes in CRP
operation," and explained that CRP needed more volunteers, a
better recruitment and retention strategy, and more
partnerships. The panel needed to gain visibility and trust
among the general population and it needed to be held
accountable for its work. He declared that it was necessary to
remove the misperception that CRP was a watchdog agency, and it
needed reorientation as a mechanism for public participation and
community engagement in child protection. He added that CRP
needed support from the legislature.
REPRESENTATIVE JOHNSTON asked if there were term limits for the
panel members.
DR. VADAPALLI replied that there were no term limits and no
restriction to the number of members. He opined that there
should be 15 to 25 members, distributed across the state, with 3
to 5 members in each OCS region.
REPRESENTATIVE JOHNSTON asked if there would be an executive
panel if there were such a large membership.
DR. VADAPALLI replied, "I would expect that, yes."
REPRESENTATIVE EASTMAN asked how many panel members had been
previous clients of OCS.
DR. VADAPALLI replied that no one had been as far as he knew,
but that would not be a disqualification. He cautioned any
prospective member that it was difficult to not have an opinion
on OCS. He declared that the panel was not a decision making
body, but was there to facilitate informed conversations. He
cautioned that strong opinions not derail the conversations.
REPRESENTATIVE EASTMAN asked if there was consideration for a
change of the name to Citizen Participation Panel.
DR. VADAPALLI replied that was an excellent point, and that
there were benefits for changing the name of the panel. He
offered background to the decision for the naming of the panel.
He suggested that a more contextual name which allowed people to
relate would be a good thing.
REPRESENTATIVE KITO asked how Alaska compared to the function of
its CRP for the federal requirements in other states.
DR. VADAPALLI said there was not an evaluation or comparison of
CRPs across states. He said that he had created a basic matrix
of the function of CRPs and which states were meeting the
various functions for a "very rough perception based analysis."
He said that various conversations with those serving on panels
across the country revealed that, structurally speaking, no
other CRPs had the same reach as with the Alaska State
Legislature. He maintained that there was still a lot of room
for improvement. He stated that citizen participation in policy
formulation and practice was a very good idea.
CHAIR SPOHNHOLZ reminded that there was not a standard for
performance of CRPs, which created a challenge to compare with
other CRPs. She opined that anecdotally Alaska was doing quite
well.
DR. VADAPALLI shared slide 22, and announced that the Alaska CRP
was hosting the next national conference in Anchorage.
3:59:04 PM
CHRISTY LAWTON, Director, Central Office, Office of Children's
Services, Department of Health and Social Services, said that
she concurred with much that Dr. Vadapalli had shared, and that
there was a lot of opportunity for further improvement. She
offered her belief that a lot of the challenges stemmed from the
vagaries of the Child Abuse Prevention and Treatment Act, and
that there was not much guidance given to the states. She said
there had been fluctuating levels of interest from the voluntary
panel. She expressed her agreement that it was long overdue to
put some regulations in place to offer some clarity and
structure.
REPRESENTATIVE JOHNSTON asked who was responsible for providing
regulations for CRP.
MS. LAWTON said that the statute specifically stated that the
Department of Health and Social Services had the primary
responsibility to create the regulations.
REPRESENTATIVE JOHNSTON asked if more in-depth policies and
procedures for CRP would resolve some of the disconnect.
MS. LAWTON replied that recently more things regarding
composition and structure had been put in writing, although
guidance for the budgeting and a clearer framework for role and
interface with department was also necessary.
REPRESENTATIVE JOHNSTON asked how to get there given the unique
relationship interface.
MS. LAWTON expressed her agreement that was a quagmire which was
indeed a challenge. She allowed that there was a question for
whether the oversight of CRP should reside in OCS, and that more
separation might relieve some of the role confusion.
REPRESENTATIVE JOHNSTON asked about discussions for having an
independent review of CRP.
MS. LAWTON replied that this could be potentially helpful,
although it would be difficult to determine effectiveness
without a foundation of regulations and policies.
REPRESENTATIVE JOHNSTON asked where the CRP should be located,
suggesting that it possibly be in the legislative branch.
MS. LAWTON replied that there was a potential for conflict of
interest when the agency being reviewed was also administering
the funding and contract, although that had been managed in the
past. She suggested the Office of the Ombudsman, or Boards and
Commissions, as possible locations for CRP.
4:06:34 PM
CHAIR SPOHNHOLZ reiterated that CRP was not a watchdog, but was
looking to review, evaluate, conduct public outreach, and
advocate. She expressed her concern that moving CRP to another
location could exacerbate the problem. She applauded the
current leadership of OCS and CRP for working around the
potential conflict. She asked about the 10 oversight groups to
which OCS was responsible, and how efficient was it to have this
many different groups. She asked if there was existing
coordination among them.
MS. LAWTON acknowledged that, although she was not sure how many
groups there were, there was a lot of oversight at all levels
which was not usually coordinated among the groups.
CHAIR SPOHNHOLZ asked about the public participation and how OCS
could engage with an expansion of this.
MS. LAWTON said that CRP offered an opportunity for public
access which did not currently exist. She stated a challenge
for how to ask things of the panel because of its voluntary
nature and what was within reason. She declared that the
development of a strategic plan for the transfer of child
welfare would offer lots of opportunities for suggestions.
CHAIR SPOHNHOLZ asked about the time frame for the strategic
planning process.
MS. LAWTON explained that the strategic plan for the
transformation of child welfare outcomes in Alaska was a five-
year plan which had stemmed from a national report regarding
violence on women and children. She said that one chapter of
this report had been dedicated to Alaska, and that one
recommendation had been for Alaska to form a task force to
review issues around child welfare, especially regarding
compliance with the Indian Child Welfare Act (ICWA). She noted
that a group of tribal leaders was convened with objectives for
six strategic priorities. She said there was exploration for
contracting tribal welfare services with tribes, as well as
enriching and growing culturally appropriate and locally driven
services for family case plans. She stated that this work would
be through 2020.
CHAIR SPOHNHOLZ asked if the strategic planning process to
transform child welfare was focused primarily on tribal
relationships, and not on an overall performance of the system.
MS. LAWTON explained that most of the work, although targeting
the work with Alaska Native families in Alaska Native
communities, would benefit all children in the state and the
improvements would be across the board.
HCR 2-RESPOND TO ADVERSE CHILDHOOD EXPERIENCES
4:16:53 PM
CHAIR SPOHNHOLZ announced that the next order of business would
be HOUSE CONCURRENT RESOLUTION NO. 2, Urging Governor Bill
Walker to join with the Alaska State Legislature to respond to
the public and behavioral health epidemic of adverse childhood
experiences by establishing a statewide policy and providing
programs to address this epidemic.
4:17:56 PM
REPRESENTATIVE GERAN TARR, Alaska State Legislature, paraphrased
from the sponsor statement, which read:
In 1998, more than 17,000 middle-class Americans were
administered a 10-question study to evaluate childhood
traumatic experiences concerning abuse, neglect, and
household dysfunction. The results of this study were
used to formulate an adverse childhood experiences or
"ACEs" score ranging from 0-10. The term "ACEs"
thereafter became synonymous with traumatic
experiences that occur during childhood and have a
lasting, negative effect on a child's developing brain
and body.
There have been two key findings as a result of ACEs
studies conducted in Alaska: childhood trauma is far
more common than previously realized; and the impact
of this trauma affects individuals over a lifetime,
and societies over multiple generations. Sixty-seven
percent of Alaskan children have an ACEs score, and
Alaska has some of the highest ACEs rates among the
five other states surveyed (Washington, Louisiana,
Tennessee, Arkansas, and New Mexico).
In Alaska, we are seeing that ACEs is synonymous with
asthma, depression, teen pregnancy, suicide, drug
abuse, employment difficulties, and intimate partner
violence. Health measures are linked to ACEs, and
these community challenges are also fiscal challenges
for our state. According to Dr. Hirschfield of the
University of Alaska and Alaska's Southcentral
Foundation, reducing Alaska's ACEs score by fifty
percent could save the state $90 million annually.
That means $90 million more dollars that could be
spent on preventative measures that add to our
children's wellbeing.
Alaska's state slogan "North to the Future" was
adopted to signify that our state is the land of
promise and that Alaskans are always advancing for the
benefit of the people and land that sustains us.
HCR 2 urges the Governor to establish policies and
programs that address the public and behavioral health
epidemics associated with ACEs so that we can uphold
the promise to our children that they may grow up in
safe households with the best opportunities before
them in order to become upstanding Alaskan citizens.
REPRESENTATIVE TARR lauded the Advisory Board on Alcoholism &
Drug Abuse and the Alaska Mental Health Board for public
outreach with research. She stated that prevention was a
necessary tool to mitigate the cost to families and communities
of these bad outcomes in adulthood.
4:24:58 PM
REPRESENTATIVE SULLIVAN-LEONARD asked how asthma was determined
as part of the ACEs (adverse childhood experiences) effect but
not diabetes or other medical conditions.
REPRESENTATIVE TARR acknowledged that other health conditions
could be included on the list. She reported on the cycle of
violence, with an increased likelihood of violence and abusive
behavior by someone who grew up in a home with violence. She
declared that the physiological impact on these physical health
conditions brought attention and created a paradigm shift from a
concern only with the social problems. She explained that the
bodily response to prolonged stress could be manifested in many
ways, including the physiological impact on the internal
systems. She offered an example of obesity and diabetes from
this stress.
CHAIR SPOHNHOLZ added that research indicated that both diabetes
and heart disease rates go up considerably for those people with
4 or more ACEs.
REPRESENTATIVE TARR said that it was difficult to separate
between causation and correlation in public health and
environmental research as there were often multiple influences.
She said that hundreds of millions of dollars were spent
annually, especially in Medicaid. She offered her belief that
this was an opportunity to review the need for more investments
into prevention for unwanted outcomes in adulthood. She spoke
about the costs associated with ACEs, offering an example of the
costs of smoking. She declared that it was necessary to develop
the policies that get us to savings from the outcomes, and that
an intent of the proposed resolution was to realize dollar
savings and have healthier communities. She explained that
trauma informed health care and trauma informed curriculum for
education were opportunities for prevention and to raise
awareness. She offered her belief that increased awareness and
understanding for the impact of ACEs would allow for better
engagement and cooperation within the communities. She directed
attention to the critical nature for early stages of
development. She relayed that a constant stressor at an early
age created connections in the brain familiar with the stress
response, and this negatively affected development.
REPRESENTATIVE TARR concluded by pointing to the relationship
between child abuse prevention and sexual assault awareness.
She pointed out that the rates of sexual abuse in Alaska were
six times the national average, and that the rates for
incarcerated family members were also higher. She reminded that
many of the issues in adults could be traced back to sexual
assault as a child.
4:40:07 PM
CHAIR SPOHNHOLZ shared a personal experience of one of her
foster children, reporting that she had an ACEs score of nine
before the age of nine. She directed attention to the health
alert [Included in members' packets] which was "startling then
as how it relates to actual health outcomes." She stated that
chronic, costly, challenging, expensive health problems were
tied to these early childhood experiences.
CHAIR SPOHNHOLZ said that HCR 2 would be held over.
HB 151-DHSS;CINA; FOSTER CARE; CHILD PROTECTION
4:42:17 PM
CHAIR SPOHNHOLZ announced that the final order of business would
be HOUSE BILL NO. 151, "An Act relating to the duties of the
Department of Health and Social Services; relating to training
and workload standards for employees of the Department of Health
and Social Services; relating to foster care licensing; relating
to placement of a child in need of aid; relating to the rights
and responsibilities of foster parents; relating to subsidies
for adoption or guardianship of a child in need of aid;
requiring the Department of Health and Social Services to
provide information to a child or person released from the
department's custody; and providing for an effective date."
[In front of the committee was Version R, which had not yet been
adopted as the working draft.]
4:43:11 PM
LAURA CHARTIER, Staff, Representative Les Gara, Alaska State
Legislature, directed attention to the Sectional Summary
[Included in members' packets] for the proposed committee
substitute, Version R, and she paraphrased these changes, which
read:
Section 1 provides that the short title of the bill is
the Children Deserve a Loving Home Act.
Section 2 provides that an adoption subsidy for a
hard-to-place child may be paid until the child turns
21; under current law, the subsidies are available
until the child turns 18.
Section 3 amends legislative findings related to
children to add a finding that the Department of
Health and Social Services (the department) should
enable a child's contact with previous out-of-home
caregivers if it is in the best interests of the
child.
Section 4 amends requirements relating to the transfer
of a child from one placement to another to require a
supervisor at the department to certify in writing
whether the department has conducted a search for an
appropriate placement with an adult family member or
family friend.
Section 5 provides that a foster parent has the right
and responsibility to use a reasonable and prudent
parent standard to make decisions relating to the
child in care, and requires the department to provide
foster parents with training relating to the
reasonable and prudent parent standard.
Section 6 requires the department to engage a child in
an out-of-home placement who is 14 years of age or
older in the development or revisions of a case plan
or permanency plan for the child and allows the child
to select up to two adults to participate in the
development of the plan.
Section 7 amends confidentiality provisions to require
a state or municipal agency or employee to disclose
appropriate confidential information regarding a case
to the sibling of a child who is the subject of the
case if it is in the best interests of the child to
maintain contact with the sibling.
Section 8 requires a supervisor at the department,
when the department takes emergency custody of a
child, to certify in writing whether the department
has conducted a search for an appropriate placement
with an adult family member or family friend.
Section 9 requires the department to pay the costs of
caring for a foster child with a physical or mental
disability, and for respite care, until the child
turns 21; under current law, the payments are
available until the child turns 18.
Section 10 requires the department to search for an
appropriate placement with an adult family member or
friend when the child is removed from the parent's
home. The section also requires a supervisor at the
department to certify in writing whether the
department has conducted the search.
Section 11 amends AS 14.14.1 OO(i) to provide that
when a child can remain safely at home with an adult
family member or guardian who lives with the child,
the child may not be placed with an out-of-home care
provider.
Section 12 requires the department to provide contact
information to siblings who are in separate placements
if it is in the best interests of the children to
maintain contact.
Section 13 requires the department to implement
workload standards and a training program for
department employees and to provide a report to the
legislature if the department is not able to meet
certain standards.
Section 14 adds a new subsection requiring the
department to assist an adult family member in
obtaining a foster care license, including any
necessary variances, if placing the child with the
adult family member is in the best interests of the
child.
Section 15 requires the department, for a person who
is 16 years of age or older, to provide the person, or
assist the person with obtaining, the person's birth
certificate, social security card, health insurance
information, medical records, driver's license or
identification card, and certificate of degree of
Indian or Alaska Native blood, if applicable, when the
person is released from state custody under AS 4 7
.10.
Section 16 requires the department, to the extent
feasible, to approve or deny a foster care home
license, including a request for a variance, not more
than 45 days after the date the department receives
the application for a foster care home license.
Section 17 provides that sections 2 and 9 of the Act,
which relate to payments for foster care,
guardianship, and adoption, apply to a person who is
eligible for a payment on or after the effective date
of sections 2 and 9, including a person who was
ineligible for a payment solely because the child
turned 18. All other sections of the Act apply to a
child in the custody or under the supervision of the
department under AS 4 7 .10 on or after the effective
dates of sections 3 - 8 and 10 - 16 of the Act.
Section 18 allows the department to adopt regulations
necessary to implement the changes made by the Act.
The regulations may not take effect until the
effective date of the section of the Act implemented
by the regulation.
Section 19 requires the department to (1) adopt
training regulations necessary to meet the standards
in AS 47.14.112(a)(3)(A) (sec. 13 of the Act), not
later than one year after the effective date of sec.
13 of the Act, (2) hire the staff necessary to meet
the workload standards in AS 47.12.112(a)(l), (2), and
(3)(B) (sec. 13 of the Act), not later than two years
after the effective date of sec. 13 of the Act, and
(3) implement the changes made by the remainder of the
Act not later than three years after the effective
date of secs. 1 - 12 and 14 - 16 of the Act.
Section 20 provides that sec. 18 of the Act take
effect immediately.
4:49:23 PM
REPRESENTATIVE KITO asked about the limitations on placements
and penalties and what were the consequences of limiting the
number of placements and not meeting that level.
REPRESENTATIVE LES GARA, Alaska State Legislature, said there
was not any limitation on placements or penalties for those
limitations in the proposed bill. He opined that the discussion
for limits was with trying to meet the federal standard of case
load limits for new case workers, as there was a 50 percent
turnover rate by new case workers in the first year. He said
that there was a 75 percent federal match for meeting the
federal standard of no more than six cases in the first three
months, and no more than twelve cases in the first six months,
in order to learn the job and train. He reiterated that there
were no penalties for the number of placements, even though "we
don't like a lot of placements."
REPRESENTATIVE KITO asked to clarify that the limitation was on
the number of cases per caseworker.
REPRESENTATIVE GARA expressed his agreement, and explained that
a major part of the proposed bill was to limit the number of
cases for a new caseworker, in order to decrease the 50 percent
caseworker turnover in the first year. He shared that each new
worker training cost about $50,000.
REPRESENTATIVE JOHNSTON pointed out that the CRP did not track
the cases per case worker as different cases resulted in
different time demands, and asked if this should instead reflect
the time element instead of the number of cases.
REPRESENTATIVE GARA explained that the only case load
limitations were for new case workers, as the training
necessitated a smaller case load. He reiterated that there was
a 75 percent federal match if this was implemented. After the
six-month period, the case load limit was determined by the
department in order to allow for each case to achieve permanency
in a loving home. He said that the standard was for good work
to "get youth out of the system as quickly as possible." He
shared that OCS wanted to achieve a case load limit of twelve
families per case worker, although this would differ per region
as some areas were more accessible. He pointed out that case
workers in the Matanuska-Susitna office had 43 cases each at one
point.
4:54:44 PM
CHAIR SPOHNHOLZ removed her earlier objection to the committee
substitute, Version R [objection carried from House Health and
Social Services Standing Committee meeting on March 16, 2017].
There being no further objection, the proposed committee
substitute (CS) for HB 151, labeled 30-LS0451\R, Glover, 3/7/17,
was before the committee as the working document.
4:56:15 PM
BARBARA MALCHICK stated that she was in support of HB 151. She
reported that she had served for 25 years as a guardian ad litum
in Anchorage and other urban and rural communities. She noted
that she was on the board of directors of Facing Foster Care in
Alaska and was also a part time, temporary employee of the court
system, working on a multi-disciplinary training curriculum for
the judges, lawyers, tribal representatives, and child
advocates. She stated that she was speaking on her own behalf
and that she had submitted a letter of support. She said that
she would focus on three topics. She addressed Section 13 of
the proposed bill regarding the extra training and the case load
standards for new OCS employees. She offered her belief that
hiring, training, and retention of good case workers would
alleviate the necessity for other areas of the proposed bill.
She stated that the lower-case load would allow for
establishment of the necessary relationships and the adequate
assessment of the situations, as well as the time to do
relative, family, and friend searches for appropriate adoptive
homes. She declared that the huge turnover at OCS was bad for
families, and it was her firm belief that children, families,
and the system as a whole would benefit if OCS was able to do
its job better. She moved on to discussion of the relationships
with siblings, which were often the most important, as when the
parents were not available for physical and emotional needs, the
children become care givers for each other. She relayed that
current law required that siblings be placed together if
possible, and, although OCS policy required that communication
should be arranged between separated siblings, this was "one of
those things that falls by the wayside when the case workers are
overworked," and it was not happening. She pointed out that the
proposed bill required OCS to provide contact information for
siblings, and it encouraged that care givers provide
opportunities for siblings to see each other. She suggested
that the proposed bill could be even stronger and include
legislative language recognizing the importance of sibling
relationships. She suggested that there should be provisions in
the adoption decree if siblings are separated for there to be
ongoing contact, if it was in the best interest of the children.
She added that confidentiality should allow for the contact
information to be shared in order to maintain the relationship.
She spoke about the guardianship and adoption subsidies. She
reported that current law allowed for subsidies until 18 years
of age, although it was proposed for an increase to age 21. She
offered her observations that, as many youth often don't
graduate from high school until after 18 years of age, the court
case stays open even though the subsidies end, and that an
increase of the age, to at least the completion of high school,
would allow for more adoptions and guardianships.
5:07:23 PM
ROSALIE REIN said that she had been a licensed front line social
worker with OCS for seven years, although she was not speaking
on behalf of OCS. She highlighted two components of the
proposed bill: improving relationships between workers and the
families, and training and caseload. She stated that case load
was directly tied to the worker being in contact with the
children and families on a regular basis. She shared that
parents and foster parents had to have communication and
concerns addressed by the case workers, yet, suffice it to say,
there were not enough hours in the day for the case workers to
keep up good communication with the invested parties, as well as
do high level social work, which included diligent searches for
extended relatives or tribal members who could provide the best
home for the children who could not return to their parents.
She declared that it was important for caseworkers to maintain
relationships between family members, the resource family, the
biological parents, and the child in care, which would lead to
an integrated sense of self for the child, with the best long-
term outcomes, but that they needed time and training to do
this. She relayed that actual social work was about educating
the parties for the importance of providing each child with the
network of support. Child welfare research suggested that
caseworkers with social work education, appropriate training,
specialized competencies, and greater experience were better
able to facilitate permanency. She stated that proposed HB 151
could ensure that case workers have the necessary training to
develop the skill set specific to child protection and to foster
resiliency. She stated that the proposed bill would help
address the steep learning curve issues for new workers.
5:11:50 PM
TAMMI SANDOVAL, Director, UAA Child Welfare Academy, stated that
she was in support of the proposed bill. She reported that she
had worked in child welfare work for 33 years, and that the
Child Welfare Academy provided the training to all the OCS
frontline workers, supervisors, and other staff. She declared
that Section 13 of the proposed bill would help the situation
for retention, meet federal outcomes, and offer best practice
for families and children. She pointed to earlier testimony for
the necessary time for staff to learn, and stated that the only
way to make a difference for the way we treat children and
families was with more training. She declared that it was
necessary to change "what we give to our front-line staff" and
that the proposed bill was "the right thing to do."
REPRESENTATIVE TARR asked that some of these individuals be
available for later testimony. She stated that she wanted the
opportunity for testimony from the Office of Public Advocacy and
to share the case worker side of things, as well as the
representation for families.
CHAIR SPOHNHOLZ said that the bill would be held over.
5:17:16 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:17 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HCR002 Sponsor Statement 2.22.17.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
|
| HCR002 Supporting Document- Article ABADA.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HCR 2 |
| HCR002 Supporting Document- Article ABADA-AMHB.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HCR 2 |
| HCR002 Supporting Document- Article CDC Injury Prevention & Control Division of Violence Prevention.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HCR 2 |
| HCR002 Supporting Document- Article Felitti.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HCR 2 |
| HCR002 Supporting Document- Article Yosef.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HCR 2 |
| HCR002 Supporting Document-Support Letters A 2.22.17.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HCR 2 |
| HCR002 Supporting Document-Support Letters B 2.22.17.pdf |
HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HCR 2 |
| House HSS Presentation_03202017 from CRP.pdf |
HHSS 3/21/2017 3:00:00 PM |
Citizen Review Panel |
| 2016 Annual Report.pdf |
HHSS 3/21/2017 3:00:00 PM |
Citizen Review Panel |
| 2016 OCS Response.pdf |
HHSS 3/21/2017 3:00:00 PM |
Citizen Review Panel |
| 2017 National CRP Conference Agenda_For public release_03092017.pdf |
HHSS 3/21/2017 3:00:00 PM |
Citizen Review Panel |
| Grand Jury Recommendations.pdf |
HHSS 3/21/2017 3:00:00 PM |
Citizen Review Panel |
| HB 151 Explanation of Changes ver R 3.15.2017.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Fiscal Note DHSS-CSM 03.10.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Fiscal Note DHSS-CST 03.10.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Draft Proposed Blank CS ver R 3.7.2017.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Fiscal Note DHSS-FCBR 03.10.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Fiscal Note DHSS-FLSW 03.10.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Fiscal Note DHSS-SAG 03.10.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Sectional Analysis ver R 3.15.2017.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document - Casey Family Programs Letter 3.15.2017.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 1. OCS Office by Office Caseloads 3.1.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 2. High Caseloads How Do They Impact Health and Human Services 3.1.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 3. Children Waiting to be Adopted 2014.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 4. Applying the Science of Child Development in Child Welfare Systems (Excerpt).pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 5. NJ DCF Workforce Report (Excerpt).pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 6. Why the Workforce Matters.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 7. Creating a Permanence Driven Organization - Anu (Excerpt).pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 8. DHSS Memo OOH Growth.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 9. DHSS Memo NJ Standard and Workforce.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 10. Relevant Statistics.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document 11. Supporting Article.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 Supporting Document-Letters of Support 3.15.2017.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM HHSS 3/23/2017 3:00:00 PM |
HB 151 |
| HB 151 vers. U Sponsor Statement 3.1.17.pdf |
HHSS 3/16/2017 3:00:00 PM HHSS 3/21/2017 3:00:00 PM |
HB 151 |