Legislature(2021 - 2022)DAVIS 106

02/03/2022 11:30 AM House WAYS & MEANS

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Audio Topic
11:33:17 AM Start
11:33:43 AM Presentation(s): the Cost of Substance Misuse in Alaska
12:41:07 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Teleconference <Listen Only> --
-- Testimony <Invitation Only> --
+ Presentation: The Cost of Substance Misuse in TELECONFERENCED
Alaska by Donna Logan, Senior Consultant,
McKinley Research Group
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
           HOUSE SPECIAL COMMITTEE ON WAYS AND MEANS                                                                          
                        February 3, 2022                                                                                        
                           11:33 a.m.                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Adam Wool, Vice Chair                                                                                            
Representative Andy Josephson                                                                                                   
Representative Calvin Schrage                                                                                                   
Representative Andi Story                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Mike Prax                                                                                                        
Representative David Eastman                                                                                                    
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
PRESENTATION(S):  THE COST OF SUBSTANCE MISUSE IN ALASKA                                                                        
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
No previous action to record                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
DONNA LOGAN, Senior Consultant                                                                                                  
McKinley Research Group                                                                                                         
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Provided a PowerPoint presentation, titled                                                               
"Economic Costs of Substance Misuse in Alaska."                                                                                 
                                                                                                                                
MICHAEL BALDWIN, Senior Evaluation and Planning Officer                                                                         
Alaska Mental Health Trust Authority                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during the presentation on the                                                                 
cost of substance abuse in Alaska.                                                                                              
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
11:33:17 AM                                                                                                                   
                                                                                                                                
CHAIR IVY  SPOHNHOLZ called the  House Special Committee  on Ways                                                             
and  Means  meeting  to  order at  11:33  a.m.    Representatives                                                               
Josephson, Schrage,  and Spohnholz  were present  at the  call to                                                               
order.   Representatives Wool  and Story  arrived as  the meeting                                                               
was in progress.                                                                                                                
                                                                                                                                
^PRESENTATION(S):  The Cost of Substance Misuse in Alaska                                                                       
    PRESENTATION(S):  The Cost of Substance Misuse in Alaska                                                                
                                                                                                                              
11:33:43 AM                                                                                                                   
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the only order  of business would                                                               
be a presentation on the Cost of Substance Misuse in Alaska.                                                                    
                                                                                                                                
11:34:45 AM                                                                                                                   
                                                                                                                                
DONNA   LOGAN,  Senior   Consultant,  McKinley   Research  Group,                                                               
provided  a PowerPoint  presentation, titled  "Economic Costs  of                                                               
Alcohol  &  Drug  Misuse  Reports" [hard  copy  included  in  the                                                               
committee packet].   She began on slide 2,  which highlighted the                                                               
two studies    one  titled "Economic Costs  of Alcohol  Misuse in                                                               
Alaska" and the  other titled "The Economic Costs  of Drug Misuse                                                               
in Alaska."   She  noted that  the research  organization changed                                                               
names from  "McDowell Group"  to "McKinley  Group."   The studies                                                               
use data from  2018 and she noted the significance  of the COVID-                                                               
19  pandemic subsequent  increased  opioid use  in recent  years.                                                               
Substance   misuse   has   many   adverse   health   and   social                                                               
consequences.   Some consequences  are tangible  like healthcare,                                                               
productivity, et  cetera.  Some consequences  are intangible like                                                               
quality of life, pain, suffering, et cetera.                                                                                    
                                                                                                                                
11:41:14 AM                                                                                                                   
                                                                                                                                
MS. LOGAN  stated that $3.45  billion is the total  economic cost                                                               
of  substance  misuse.    This calculation  is  based  on  values                                                               
available but  does not  reflect the full  picture.   The highest                                                               
economic  costs substance  misuse is  associated with  are health                                                               
care, followed  by productivity.   In response  to Representative                                                               
Wool,  she  clarified  that  the  $266  million  that  represents                                                               
traffic collisions  on the  pie chart shown  on slide  5 accounts                                                               
for collisions specifically caused by alcohol or drug misuse.                                                                   
                                                                                                                                
11:43:20 AM                                                                                                                   
                                                                                                                                
MS.  LOGAN advanced  to slide  6, which  provided a  breakdown of                                                               
costs  associated with  both alcohol  and drug  misuse.   Alcohol                                                               
misuse  represents approximately  70  percent of  the total  cost                                                               
associated with substance  misuse at $2.39 billion.   Drug misuse                                                               
was associated  with a  cost of  $1.06 billion.   She  noted that                                                               
both  drugs  and alcohol  impacted  the  overall economy,  though                                                               
impacts differed.   She highlighted  high healthcare  costs which                                                               
are  associated with  alcohol misuse  versus the  proportionately                                                               
higher criminal  justice and protective  services costs  for drug                                                               
misuse.                                                                                                                         
                                                                                                                                
11:50:04 AM                                                                                                                   
                                                                                                                                
MS. LOGAN continued to slides  7 and 8 and addressed productivity                                                               
losses  in  detail.    She  discussed  the  cost  and  diminished                                                               
productivity associated  with premature  deaths.  In  response to                                                               
Representative  Wool, she  said  models were  used from  national                                                               
organizations   with  specific   variables  applied   to  Alaskan                                                               
datasets.   Additionally,  incarceration  or addiction  treatment                                                               
contributes to productivity losses.   Total costs associated with                                                               
productivity loss are about $1.1 billion.   In 2016, 8 percent of                                                               
all  collisions that  occurred  in state  were  due to  substance                                                               
misuse.  She  said that 726 Alaskans were  involved in collisions                                                               
due to  alcohol misuse  and 194  due to drug  misuse.   There are                                                               
many costs  involved with vehicle collisions.   Productivity lost                                                               
due to injury is significant.                                                                                                   
                                                                                                                                
11:55:37 AM                                                                                                                   
                                                                                                                                
MS.  LOGAN said  that  criminal justice  and protective  services                                                               
account for $659  million in costs.  About 65  percent of arrests                                                               
and  offenses that  occur in  the state  are directly  related to                                                               
substance  abuse.   Of  the  total crime  victims  in Alaska,  55                                                               
percent  were victims  of  crimes associated  with  or fueled  by                                                               
substances.    She said  there  are  direct costs  like  property                                                               
damage and indirect  costs, such as trauma,  pain, and suffering.                                                               
She  noted that  indirect  costs  are not  included  in the  cost                                                               
analysis because  of how difficult  it is to  put a price  tag on                                                               
quality  of  life.   It  is  estimated  that  31 percent  of  the                                                               
spending  associated  with  the  Office  of  Children's  Services                                                               
(OCS),  $50 million  dollars is  attributed to  alcohol and  drug                                                               
misuse.  She  noted that in Alaska, the state  is responsible for                                                               
more  criminal  justice  costs in  comparison  with  states  with                                                               
federal penitentiaries.                                                                                                         
                                                                                                                                
11:59:35 AM                                                                                                                   
                                                                                                                                
MS.  LOGAN  detailed that  $183  million  is spent  on  hospital-                                                               
related costs for  drug and alcohol misuse.  The  figure would be                                                               
much  higher,  at  $1.3  billion,  if  secondary  diagnoses  were                                                               
included.   She  stated that  additional health  costs associated                                                               
with   alcohol  and   drug  misuse   includes  $16   million  for                                                               
prescription  drugs  for  alcohol   treatment,  $41  million  for                                                               
hepatitis  C  treatment from  drug  misuse,  and $2  million  for                                                               
HIV/AIDS treatment from drug misuse.                                                                                            
                                                                                                                                
12:04:46 PM                                                                                                                   
                                                                                                                                
MS.  LOGAN  emphasized  that  the  data  associated  with  public                                                               
assistance  and social  services is  limited and  outdated.   The                                                               
numbers  referenced  may  represent  significant  underreporting.                                                               
There are  current estimates of  $57 million in costs  for social                                                               
welfare  programs   such  as  adult  public   assistance,  senior                                                               
benefit,  Supplemental   Nutrition  Assistance   Program  (SNAP),                                                               
Tribal assistance, work services, and Head Start.                                                                               
                                                                                                                                
12:12:10 PM                                                                                                                   
                                                                                                                                
MS. LOGAN shared her understanding  that OCS captures situational                                                               
data during investigations  and when children are  removed from a                                                               
home.   Case  files are  also considered.   She  acknowledged the                                                               
complications  associated  with the  data.    She reiterated  the                                                               
limitations with the data due to  its complexity.  She noted that                                                               
in the  alcohol report, there was  a chapter set aside  for fetal                                                               
alcohol spectrum  disorder (FASD)  costs, utilization  of medical                                                               
health services,  and lifetime  costs of  FASD individuals.   The                                                               
level  of access  to  Medicaid  data has  increased,  which is  a                                                               
credit  to  the  state  for  investing  in  the  availability  of                                                               
important data.                                                                                                                 
                                                                                                                                
12:19:21 PM                                                                                                                   
                                                                                                                                
MS.  LOGAN  showed  the  alcohol beverage  tax  retained  in  the                                                               
general fund (GF) per capita graph  on slide 15.  She stated that                                                               
50 percent of  the receipts of alcohol tax revenue  goes into the                                                               
alcohol and  other drug use  treatment and prevention fund.   The                                                               
other 50 percent  goes into the General Fund.   The GF portion is                                                               
approximately $20.5 million  or $30 per capita in  Alaska and has                                                               
remained relatively  flat over  time.  She  noted that  in fiscal                                                               
year 2021 (FY 21), $30  million was collected in marijuana taxes.                                                               
Of  marijuana taxes  $8 million  is excise  tax, $7  million goes                                                               
into the marijuana education and  treatment fund, and $15 million                                                               
goes into the recidivism reduction fund.                                                                                        
                                                                                                                                
12:23:47 PM                                                                                                                   
                                                                                                                                
MS.  LOGAN  detailed  the  GF  portion  of  spending  related  to                                                               
alcohol,  opioid and  other drug  misuse on  slide 17.   Medicaid                                                               
spends  $37 million  on alcohol  misuse, $18  million for  opioid                                                               
misuse, and $21  million for other drug misuse.   The Division of                                                               
Behavioral Health's  prevention grants  are supported by  the GF,                                                               
including  $10  million  allocated  for  alcohol  misuse  and  $4                                                               
million for drug  misuse.  Social welfare programs  funded by the                                                               
GF include $7 million for alcohol  misuse and $3 million for drug                                                               
misuse.   Criminal Justice and  Corrections depend on the  GF and                                                               
attribute  $31  million for  addressing  alcohol  misuse and  $37                                                               
million for drug misuse.                                                                                                        
                                                                                                                                
12:26:40 PM                                                                                                                   
                                                                                                                                
MS.  LOGAN concluded  that  the total  economic  cost of  alcohol                                                               
misuse is $2.39 billion.  The  total economic cost of drug misuse                                                               
is $1.06 billion.                                                                                                               
                                                                                                                                
12:27:46 PM                                                                                                                   
                                                                                                                                
MICHAEL BALDWIN,  Senior Evaluation and Planning  Officer, Alaska                                                               
Mental  Health  Trust  Authority, emphasized  that  current  data                                                               
limitations create  conservative estimates for  figures mentioned                                                               
by Ms. Logan.  Investing  in prevention and treatment and efforts                                                               
to support  the implementation of  the 1115  demonstration waiver                                                               
to improve  the behavioral health  system care is important.   He                                                               
noted  the Title  4 alcohol  review that  is currently  underway.                                                               
Access  to care  is an  ongoing battle,  and the  more access  to                                                               
treatment for Alaskans, the better.   The psychiatric crisis care                                                               
continuum is an important program  to provide care to Alaskans in                                                               
need.  He noted the "Crisis Now" model.                                                                                         
                                                                                                                                
12:36:42 PM                                                                                                                   
                                                                                                                                
MS. LOGAN concluded  that prevention is an  important factor that                                                               
is difficult  to measure  in terms of  dollars.   She highlighted                                                               
that prevention  is an  important part  of addressing  crises and                                                               
saving lives.                                                                                                                   
                                                                                                                                
CHAIR SPOHNHOLZ thanked both presenters  for their thoughtful and                                                               
methodical  presentation.   She  commented on  the economic  drag                                                               
caused by loss of productivity  and intergenerational trauma that                                                               
builds  over time.    She expressed  that  early intervention  is                                                               
important and shared a personal  anecdote about alcohol misuse in                                                               
her  family.   She emphasized  the importance  of helping  people                                                               
find recovery  the moment  they are ready.   A  wide availability                                                               
and  variety  of  options  for   people  in  need  are  important                                                               
investments to increase prevention and limit severe chronic                                                                     
substance misuse in Alaska.                                                                                                     
                                                                                                                                
12:41:07 PM                                                                                                                   
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Ways and Means committee meeting was adjourned at 12:41 p.m.                                                                    

Document Name Date/Time Subjects
AMHTA Drug and Alcohol Costs Presentation, 2.3.2022.pdf HW&M 2/3/2022 11:30:00 AM