Legislature(2019 - 2020)SENATE FINANCE 532
02/07/2019 09:00 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| Presentation: Fiscal Impacts of Opioids | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
SENATE FINANCE COMMITTEE
February 7, 2019
9:01 a.m.
9:01:43 AM
CALL TO ORDER
Co-Chair Stedman called the Senate Finance Committee
meeting to order at 9:01 a.m.
MEMBERS PRESENT
Senator Natasha von Imhof, Co-Chair
Senator Bert Stedman, Co-Chair
Senator Click Bishop
Senator Lyman Hoffman
Senator Peter Micciche
Senator Donny Olson
Senator Bill Wielechowski
Senator David Wilson
MEMBERS ABSENT
Senator Mike Shower
ALSO PRESENT
Andy Jones, Director, Office of Substance Misuse and
Addiction Prevention, Department of Health and Social
Services; Michael Duxbury, Deputy Commissioner, Department
of Public Safety; Laura Brooks, Deputy Director, Health and
Rehabilitation Services, Department of Corrections;
Gennifer Moreau-Johnson, Acting Director, Division of
Behavioral Health, Department of Health and Social
Services.
SUMMARY
PRESENATION: FISCAL IMPACTS OF OPIOIDS
DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DEPARTMENT OF CORRECTIONS
DEPARTMENT OF PUBLIC SAFETY
^PRESENTATION: FISCAL IMPACTS OF OPIOIDS
DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DEPARTMENT OF CORRECTIONS
DEPARTMENT OF HEALTH AND SOCIAL SERVICES
9:03:44 AM
Co-Chair von Imhof thanked the testifiers for being in
committee. She referenced discussions with Co-Chair Stedman
regarding how to run the committee, which had touched on
having overarching multi-departmental discussions of
programs. She had suggested the topic matter because it was
such a big multi-faceted problem in the state.
Co-Chair von Imhof continued her remarks. She had personal
experience with the issue of opioid addiction. She
referenced a McDowell Group study that estimated that drug
abuse cost the state $1.2 billion per year. Direct spending
for opioid treatment in 2018 was $70 million. She discussed
the spending in different departments related to the issue.
She believed collaboration and cooperation was the best
approach to tackling big issues.
9:06:13 AM
ANDY JONES, DIRECTOR, OFFICE OF SUBSTANCE MISUSE AND
ADDICTION PREVENTION, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, introduced himself and relayed that he was the
deputy commander for the opioid epidemic response. He
stated that a comprehensive approach was needed to address
the issue of the subject matter.
Mr. Jones referenced the report "State of Alaska:
Addressing Alaska's Poly-Substance Epidemic Comprehensive
Report" (copy on file).
MICHAEL DUXBURY, DEPUTY COMMISSIONER, DEPARTMENT OF PUBLIC
SAFETY, introduced himself. He relayed that he had
recognized that collaboration was identified as the key
piece for working on the issue of substance abuse and
addiction. He relayed that the departments had been
collaborating and sharing resources for the previous three
years. He thought a multi-angle approach was needed, and
that Alaska could not "arrest itself out of the problem."
9:08:00 AM
LAURA BROOKS, DEPUTY DIRECTOR, HEALTH AND REHABILITATION
SERVICES, DEPARTMENT OF CORRECTIONS, introduced herself and
thanked the committee for the opportunity to share
information.
Mr. Jones discussed the presentation "Addressing Alaska's
Poly-Substance Epidemic - Comprehensive Presentation,
Department of Public Safety, Department of Corrections,
Department of Health and Social Services, Department of
Law" (copy on file). He stated that since 2017 when a state
disaster was declared, stakeholders were identified
including state departments, local unions, and workforce
development. He had served for 15 years in disaster
response and had not seen as complex an issue as the poly-
substance epidemic.
Mr. Jones continued his opening remarks. He stated that the
presentation would overview the epidemic; and discuss the
response structure, cost association, resources,
partnerships, outcomes, results, and next steps.
Mr. Jones showed slide 2, "Alaska Opioid Epidemic Response
- Background Information."
Mr. Jones reviewed slide 3, "Overview":
?Drug overdoses now the leading cause of accidental
death in the US, exceeding deaths from automobile
accidents
?More than six out of 10 drug overdose deaths in 2015
involved opioids, including opioid pain relievers and
heroin ... that is almost 91 deaths a day
?In 2016, drug overdoses likely killed more Americans
(65,000) than the entire wars in Vietnam and Iraq, In
comparison, more than 58,200 US troops died in the
Vietnam War between 1955 and 1975, and more than
4,500have died so far in the Iraq War since 2003
which adds up to more than 62,700.
Mr. Jones thought it was sobering that drug overdoses were
the leading cause of accidental death in the country and
exceeded deaths from automobile accidents. He highlighted
the third bullet, which showed that drug overdoses in one
year's time exceeded the deaths than wars in Vietnam and
Iraq. He had seen a skyrocketing number of deaths
associated with drugs like fentanyl and other synthetic
opioids. He noted that the problem was not getting better.
Mr. Jones showed slide 4, "How Did This Happen?":
Medical fallacies driving the increased prescribing of
opioids:
?Pain can be objectively measured
?Tolerance is just under-dosing
?Pseudoaddiction: persons who display drug-seeking
behavior are simply in pain and need more opioid
?"If your medicine makes you feel better, then your
diagnosis must be whatever the medicine was meant to
treat" Ann Lembke, MD, in Drug Dealer, MD
?When used in treatment of pain, very little risk of
subsequent misuse or addiction
Mr. Jones recounted the need for pain management during the
Civil War, after which a pharmaceutical company had
produced heroin as a pain management tool. The trend had
continued. He mentioned the drug U4770, which was so
addictive that it was pulled off the market.
Mr. Jones continued to address slide 4 and mentioned
Oxycontin and other pain medications that were being
abused. He lamented the short duration of pain management
education in medical school. He referenced lawsuits
involving pharmaceutical companies because of mis-
advertising. He reported that the United States consumed
more opioids than anywhere else in the world.
9:12:45 AM
Mr. Jones reviewed slide 5, "From Prescription Opioids to
Heroin":
?Approximately 3 out of 4 new heroin users report
having misused prescription opioids in the past
?In some places, easier access to heroin than
prescription opioids
?Heroin does not require a prescription
?Street price for heroin may be more affordable than
prescription opioids
?Higher risk of overdose from heroin use due to
potency
Morphine > Heroin 50x > Fentanyl 100x
Mr. Duxbury relayed that law enforcement in the state dealt
with individuals from the Sinaloa cartels because Alaska
was a profitable environment. Illicit organizations
marketed heroin as a money-making scheme.
Mr. Jones displayed slide 6, "Poly-Substance Misuse":
Heroine use is part of a larger substance abuse
problem.
Most used at least 3 other drugs.
Heroin is a highly addictive opioid drug with a high
risk of overdose and death for users.
People who are addicted to
Alcohol are 2x
Marijuana are 3x
Cocaine are 15x
Rx opioid painkillers are 40x
more likely to be addicted to heroin.
Mr. Jones thought the state needed more of a poly-substance
response to the problem. He noted that cocaine was gaining
popularity.
Mr. Duxbury noted that fentanyl (a more powerful additive
or adulterant) was now being used in heroine products,
cocaine, and methamphetamine.
9:16:13 AM
Mr. Jones showed slide 7, "Alaska Opioid Epidemic Response
- Response Structure."
Mr. Jones turned to slide 8, "Alaska's Opioid Epidemic
Response":
?State Disaster Declaration
?February 14, 2017
?Administrative Order 287
?Multi-agency approach
?Local, Tribal, State, Federal, and Non-
Governmental Agencies
?Multi-Agency Coordination (MAC) Group
?Incident Command System
?Alaska Criminal Information and Analysis Center
?Joint Information System
Mr. Jones spoke to the flow chart on the slide, which
showed an "Incident Command System" chart. The system was a
time intensive but effective way to meet the initial
response priorities. He likened the epidemic to a fire,
flood, or flu outbreak. He noted that Dr. Jay Butler had
served as the Incident Commander.
Mr. Jones showed slide 9, "Cross-Sectoral Collaboration is
Key." The slide showed the importance of collaboration. He
explained that Department of Administration administered
state health insurance, through which it was possible to
track data.
Mr. Jones turned to slide 10, "Alaska's Response
Framework":
?Alaska Opioid Policy Task Force 2016-2017
?AOPTF Recommendations Document
?Opioid Initial Response Framework (Prevention Model)
2017
?Statewide Opioid Action Plan 2018
Mr. Jones identified that the Alaska Opioid Policy Task
Force (AOPTF) did not start out with a strategic plan, but
rather with Dr. Butler's prevention framework. He spoke
about the high-level document created by the task force
listed on the slide. He stated that a prevention model was
built. The Statewide Opioid Action Plan was built from the
ground up and had involved community recommendations.
Mr. Duxbury stated he had been a member of AOPTF and
stressed that front-loading prevention and harm reduction
on the front end of a law enforcement program seemed to be
the best way to spread the message and save lives. He
discussed community outreach and thought police officers
had saved up to 30 lives. He emphasized the need for a
multi-faceted approach.
9:20:38 AM
Co-Chair Stedman noted that commissioners from the
Department of Corrections and the Department of Public
Safety were in attendance.
Co-Chair Stedman commented that people were using village
areas for drug distribution because of the low
concentration of law enforcement.
Mr. Duxbury noted that the opioid enterprise was driven by
profiteering and was sucking money out of Alaskan
communities.
Co-Chair von Imhof referenced Mr. Duxbury's comment about
Alaska being more lucrative than other areas in the drug
business.
Mr. Duxbury opined that the demand and less enforcement
contributed to making Alaska a lucrative place to sell
drugs. It was understood that the collaborative efforts had
started to make an impact on the ability of drug dealers to
profit.
Mr. Jones discussed the logistical movement of goods and
the expense. He thought there was not a big competing
market in Alaska as with other places in the United States.
Ms. Brooks emphasized that the Department of Corrections
(DOC) had a captive audience and had a comprehensive plan
for substance abuse issues. She recognized the increase in
the opiate effect over the last several years and stated
that the department had tailored its efforts in response.
Co-Chair Stedman asked the testifiers to identify
themselves when speaking.
9:24:12 AM
Senator Wilson mentioned DOC and substance abuse treatment.
He asked if the department had looked into other
methodologies for treatment.
Ms. Brooks stated that DOC had made a concerted effort to
focus on medication-assisted treatment. There was a control
program in which individuals leaving facilities were given
injections before re-entering the community. Methadone
bridging was also used. There were community providers that
participated. The department was also exploring adding
additional medication-assisted treatment options.
Mr. Jones showed slide 11, "Alaska Opioid Epidemic Response
- Costs Association to the State of Alaska." He highlighted
that there were hardly any other states that attempted to
put a cost association together with a plan. He noted that
the task force was required to submit a report to the
legislature, and it would include ongoing cost information.
9:26:22 AM
Mr. Jones reviewed slide 12, "Costs Association to the
State of Alaska: Data Elements":
?Data will be pulled for years 2017 and 2018 to
calculate the cost association to address the opioid
epidemic. This timeframe represent when the State of
Alaska began the response to the epidemic.
?To calculate the cost association to the State of
Alaska addressing the opioid epidemic the following
data sources were utilized;
?Department of Health and Social Services
Medicaid Drug Treatment Reimbursement Claims
?Department of Health and Social Services
Medicaid Opioid Related Diagnosis Reimbursement
Claims
?Department of Health and Social Services,
Division of Behavioral Health Substance Use
Disorder, Treatment/Recovery, Prevention, and
Associated Grants
?Department of Health and Social Services,
Division of Public Health Hospital Discharge Data
?Department of Corrections, Substance Use
Disorder funding
?Department of Law, Therapeutic Court funding
?Department of Public Safety, Drug
incidents/costs
?Figures represented in this document reflect
estimates based on certain existing and evolving data,
and do not reflect the costs that the State of Alaska
might seek to recover in litigation based on fuller
evaluation of the damages and other remedies available
to the State.
Mr. Jones referenced slide 13, "Medicaid Opioid Treatment
Drug Reimbursement FY17/18," which showed two pie charts
and a data table. The pie charts showed the FY 17 and FY 18
opioid treatment drug reimbursements in relation to
Medicaid. In 2017, there was 1,400 recipients that received
the medications and in 2018 there were 2,300 recipients.
There was an increase in $1.7 million increase in 2018 in
the suboxone category, which was one of the most popular
treatment methods.
Mr. Jones showed slide 14, "Medicaid Opioid Related
Diagnoses Reimbursement FY17," which showed a pie chart and
data table. The data table was broken down into categories
of in-patient treatment, out-patient treatment,
professional behavioral health services, and professional
general services. The chart showed that 4,000 Medicaid
recipients received treatment for opioid related diagnoses
in 2017.
Senator Hoffman thought the slide gave a good analysis of
what was happening throughout the state. He asked how the
information was disseminated by region of the state. He
asked about the differences in how extensive the problem
was in various areas of the state.
Mr. Jones stated that the numbers on the slide were from
Medicaid. He offered to provide the regional information at
a later time.
Senator Micciche asked what the state was doing to guard
against abuse of the actual treatment drugs, particularly
in DOC. He wondered if there was a way to quantify the cost
of internal abuse.
Ms. Brooks informed that when an individual came into the
correctional system on methadone, the drug was brought in
and administered in the department. None of the medication
was kept on site, which was one way the department
mitigated abuse within the system. Narcotic medication was
very rarely prescribed within the system; only for an acute
injury or something to address cancer and only administered
in the infirmary.
9:30:54 AM
Mr. Jones moved to slide 15, "Medicaid Opioid Related
Diagnoses Reimbursement FY18," which showed a data table
and pie chart. He noted that there had been an increase by
about $10 million, and there had been about 4,800 Medicaid
recipients treated with opioid-related diagnoses. The
increase could be related to Medicaid expansion or because
word had gotten out about increased choices for treatment.
Co-Chair Stedman noted that asked what was expected for the
substance abuse problem in the state in the future.
Mr. Jones thought that the drug problem was a moving cycle.
He offered to provide more information at a later time.
Mr. Jones showed slide 16, "Medicaid Opioid Related
Diagnoses Reimbursement FY17/18," which showed two pie
charts to demonstrate the increase in cost from FY 17 to FY
18.
Senator Wilson referenced federal funding shown on the
previous slide. He asked about utilization of federal funds
and asked if the state had returned any federal funds for
unspent needs.
Mr. Jones stated that in the last two years the group had
received $35 million in federal grant funds. The group
looked at all available grants and applied if the grant was
a good fit for the state's needs. He noted that some grants
had extremely short cycles and stated that the group had
been successful with receiving no-cost extensions to move
funding into the next year. The goal was to move the
funding out. Of the $35 million, the funds spanned between
enforcement, to DOC reentry programs, and to the Department
of Health and Social Services (DHSS) prevention and
treatment programs.
9:34:07 AM
Senator Wilson asked to hear from other departments with
regard to utilization and possible return of federal funds.
Mr. Duxbury stated that in his experience with
collaboration with DHSS and DOC, the departments had
utilized cross-funding facilities. He was not aware of any
returned funding that was intended for opioids.
Co-Chair Stedman asked Mr. Duxbury to get back to the
committee with more information.
Mr. Duxbury answered in the affirmative.
Ms. Brooks identified that DOC's primary federal funding
for substance abuse treatment was a grant for resident
treatment programs. The funding was through the Bureau of
Justice Assistance. She specified that the previous year
there was an added requirement to apply for additional fund
for opioid treatment. The department continued to look at
other grant opportunities. The department had received
quite a bit of state funding to enhance and grow substance
abuse treatment programs. For the previous two years the
department had been challenged with growing the treatment
programs and had not had the capacity to seek further
funding.
Mr. Jones showed slide 17, "Treatment/Recovery and
Prevention/Intervention Grant Funding FY17/18," which
showed two pie charts. The state and federal cost was
shown. He shared that the grants were primarily used to get
entities and organizations up and running, after which the
organizations transitioned to a fee-for-service model. He
discussed the sustainability of sending federal grants to a
local jurisdiction. He expressed concern about the over-
reliance on the federal funds at a local level.
Mr. Jones continued to address slide 17. He detailed that
the community grants supported 18,000 recipients, roughly
2,000 of which were treated for opioid disorders. He noted
that there were co-occurring disorders.
Senator Hoffman referenced Mr. Jones remark about the
sustainability of starting programs with federal funds that
were not sustainable. He thought the people of Alaska were
less concerned about the issue. He questioned the path
forward if there was truly an epidemic, which he thought
was far more salient than whether the programs were
sustainable. He thought the people of Alaska needed to know
how the problem was being addressed and how the public was
being made safe.
Mr. Jones stated that a subsequent slide would address
Senator Hoffman's question.
Senator Wielechowski asked if Mr. Jones had any statistics
on the effectiveness of treatments that were being
provided.
Mr. Jones stated that he would provide the information at a
later time.
9:39:49 AM
Senator Wilson followed up on Senator Hoffman's question
about sustainability of programs and program transition. He
recalled that a few years previously many behavioral
health/substance abuse centers had transitioned from grant
funding to fee-for-service when Medicaid expansion came
into effect. Many of the centers had difficulty with
billing, and he wondered if billing had offset the grant
match for some agencies. He thought many agencies had
closed up shop in Fairbanks, Kenai, and Mat-Su because the
organizations couldn't sustain with the diminished grant
funds. He asked if there was a plan to reverse the grant
funding trend so agencies could keep pace with the growing
demand for treatment and backlog.
Mr. Jones agreed to bring the information to the committee
at a later time so that he could work with the director for
the Division of Behavioral Health.
Senator Micciche discussed Medicaid treatment options,
funding for which had been increased by 50 percent between
FY 17 and FY 18 while grant funding was reduced. He asked
for an explanation of the relationship, and why there was
not a better federal response on grant funding options.
Mr. Jones thought the director of the Division of
Behavioral Health was better equipped to answer the
question.
GENNIFER MOREAU-JOHNSON, ACTING DIRECTOR, DIVISION OF
BEHAVIORAL HEALTH, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, stated that there had been an ongoing effort to
increase federal funding, and mentioned SB 74 [legislation
passed in 2016 that enacted comprehensive reform of
Alaska's Medicaid program]. She posted that the best way to
increase federal funding was to incrementally decrease
grant funding and support agencies to bill Medicaid for
substance misuse disorder. The department had been
providing technical assistance to agencies to become
Medicaid billers; as well as through a long process of
negotiating with the Centers for Medicare and Medicaid
Services (CMS) for a Section 1115 waiver for the
demonstration project to reboot and enhance the behavioral
health system.
9:43:28 AM
Senator Micciche stated he was a co-sponsor of SB 74. He
referenced a ten million increase, largely because of
Medicaid. He wondered if the bill had been the correct
approach, or if the state was "leaving money on the table."
Ms. Moreau stated that the negotiation with CMS was long
and arduous and took longer than expected. She detailed
that in November the state received approval from CMS for
the substance use disorder component of the Section 1115
demonstration project. The approval allowed for approval of
the implementation plan, which was due February 19, 2019;
after which time she hoped the state would start to gain
traction through Medicaid financing.
Mr. Jones showed slide 18, "FY 2017 Total DBH Grant Funding
by Service Area and Grant Type," which showed a map of the
state and a data table. He stated that the slide correlated
with the previous slide. The slide showed where the grant
funds went but did not represent all the services available
statewide.
Mr. Jones showed slide 19, "FY 2018 Total DBH Grant Funding
by Service Area and Grant Type," which was the same as the
previous slide but updated for FY 18.
9:45:28 AM
Co-Chair Stedman referenced slide 18. He noted that there
was a disparity in grant funding in different areas of the
state and did not think the funds correlated with the
population bases.
Senator Hoffman explained that the Bethel region comprised
an area greater than the State of Washington and included
56 communities that provided services. One of the largest
problems with delivery of services was transportation and
the delivery of information. He noted that the Yukon-
Kuskokwim Health Corporation was by far the largest
corporation in rural Alaska. He invited Co-Chair Stedman to
come travel in the region.
Co-Chair Stedman clarified that his question was not
slanted toward an over-weighting of appropriations into
Bethel; but rather about the correlation of funding amounts
to population size. He recognized that Bethel had a
regional area, that he considered was not much different
than Sitka with its regional villages. He asked about a
population breakdown.
Senator Hoffman stated that there were not adequate
expenditures to address the problem in the Bethel region,
and also in the entire state, hence the reason for the
epidemic.
Co-Chair Stedman did not disagree. He asked the testifiers
to provide the committee with some population information.
Senator Wilson thought that a base level of grant funding
was sometimes needed in order for organizations to be able
to bill Medicaid.
Senator Micciche thought the larger question was how the
funding was distributed. He wondered if the funding
distribution was related to population or the difficulty of
delivering services.
Co-Chair Stedman hoped that some areas of the state had
less need than others.
9:50:00 AM
Mr. Jones spoke to slide 20, "Therapeutic Court Funding
FY17/18/19," which showed three pie charts addressing
funding distributed for 2017, 2018, and 2019. He clarified
that the courts provided for drug courts, DUI courts,
mental health courts, and family courts. He had been told
that the courts were very costly but extremely effective.
He thought the courts were an extremely important aspect of
the state's response going forward.
Ms. Brooks looked at slide 21, "Department of Corrections
Treatment Cost FY17/18," which showed three pie charts. She
asserted that the department had put together a
comprehensive treatment program. The slide represented the
amount of money that went toward the area of opioid use
disorders, which comprised about one-third of the
treatment. She identified about $830,000 in General Funds
(GF) which went towards various treatment programs.
Ms. Brooks continued to speak to slide 21. She relayed that
in 2017, the department received funding through SB 91
(criminal justice reform legislation passed in 2016] to
enhance substance abuse services systemwide. A large part
of the funds went toward opioid treatment. She noted that
the department had expanded substance abuse services in all
areas, but a priority went to opioid treatment. She noted
that the treatment was broken into two areas: institutional
programming, and for individuals in halfway houses.
Senator Wilson asked about FY 17 and understood that DOC
did not have a contract provider to provide substance abuse
treatment for some time in its facilities. He asked for a
list of facilities to which funds were provided.
Ms. Brooks agreed to provide the information.
9:53:09 AM
Mr. Duxbury reviewed slide 22, "Department of Public Safety
Drug Incidents," which showed a line graph depicting that
the component of the opioid drug use was also a component
of the poly-drug use in the state. The slide showed that
methamphetamine and heroine opioids were one of the biggest
issues in the state. In almost every incidence of drug
trafficking, methamphetamine appeared almost five times
more frequently than heroine.
Co-Chair Stedman thought it looked like there had been a
decline in 2018.
Mr. Duxbury stated that what drugs were seized were not
always indicative as to what drugs were available to the
public. Interdictions were the mainstay of drug enforcement
work.
Co-Chair Stedman clarified that he observed a substantial
increase in drug activity in the Southeast area. He
expected that the substantial arrests would show up as an
increase in activity.
Mr. Duxbury reminded that the graph represented a state-
wide perspective. He stated he would get back to the
committee with more information. He informed that drug
cases were intensive long-term undertakings, and open cases
put constraints on the information.
Co-Chair Stedman thought that the Department of Public
Safety had been doing a good job in Southeast in dealing
with the issue.
9:56:12 AM
Mr. Duxbury reviewed slide 23, "Department of Public Safety
Opioid Incident Costs 2010 - 2018," which showed a data
table illustrating the average based on what it cost to do
an investigation up to the point of arrest. The information
was aided by a study done by the University of Alaska,
which had taken components from all stakeholders. He
qualified that the data did not show information such as a
traffic stop which resulted in the seizure of opioids, or
an investigation that involved multiple individuals and had
a higher cost.
Co-Chair Stedman asked if Mr. Duxbury could speak to the
Village Public Safety Officer (VPSO) Program. He noted that
some areas wanted to have the program and wondered how the
subject might be taken into account in the data.
Mr. Duxbury stated that the VPSO program was an oversight
program that the Alaska State Troopers, but the officers
were not state employees. When there was a case that
involved a felony amount, then the troopers had purview and
oversight. He could not address the specific question about
where there were VPSOs.
Senator Hoffman clarified that the VPSO Program provided
public safety on behalf of the state and was the
responsibility of the state. The state had contracted with
non-profits to provide public safety in certain areas. He
wanted it known that public safety in these areas, although
contracted, was the responsibility of the state.
Senator Bishop noted that the state spent over $50 million
addressing addiction, but thought it appeared that there
were 41 people in law enforcement dedicated to stopping the
problem. He wondered what could happen if $50 million could
be invested differently and stop the problem on the front
end.
Mr. Duxbury thought money could be thrown at the problem,
and it would not necessarily solve the issue. He thought it
was important to have compassionate towards addiction, and
thought money spent in the area of treatment was important.
He thought drug enforcement was still reactive to the issue
and was still dependent upon human nature. He emphasized
the importance of a collaborative approach to keep Alaskans
happy, healthy, and productive.
10:01:51 AM
Senator Bishop referenced the war on drugs and Pablo
Escobar, who had $50 billion in the bank when he was
arrested. He stated that the war on drugs had not worked.
He pondered the question of legalizing drugs.
Co-Chair Stedman thought the state would be adding more
police and drug enforcement to the budget.
Senator Wielechowski referenced Senator Bishop's comments.
He discussed pain management and culture. He questioned why
people in the state were dealing with pain in the manner of
drugs rather than in other ways. He wondered how to address
the root causes of the problem. He thought there must be
research on the subject. He thought education seemed like a
fundamental component of the issue.
Mr. Jones stated that upstream prevention was a big focus
of the task force. He opined that there were biological,
environmental, and social factors that were at work. He
noted that the task force was partnering with the
Department of Education and Early Development (DEED) and
working with programs that had a great return on
investment. He mentioned starting to address Adverse
Childhood Experiences (ACES). He mentioned that a group had
travelled to Iceland to study its model. With time,
commitment and funding; he thought results could be seen in
upstream prevention. He stated he would send some further
information on to the committee.
10:05:06 AM
Senator Wilson considered slide 23, as well as the
following slide. He asked about "Detachment B."
Mr. Duxbury specified that Detachment B signified the
Matanuska-Susitna Borough.
Senator Wilson asked about where the state was in an
ongoing lawsuit against pharmaceutical entities.
Mr. Duxbury stated that there was a person present that
could elaborate on the lawsuit.
Co-Chair Stedman asked to continue with the planned
presentation.
Mr. Duxbury addressed slide 24, "Department of Public
Safety Methamphetamine Incident Costs 2010 - 2018," which
showed a data table. He pointed that funds spent to address
the opioid issue were almost three times that was spent to
address methamphetamine incident costs.
Co-Chair Stedman asked about the detachments listed on the
slide.
Mr. Duxbury described the detachment areas: Detachment A
was the Southeast area, Detachment B was the Mat-Su and
beyond, Detachment C was most of Western Alaska, Detachment
D was the Fairbanks area and some of the outlying villages,
Detachment E was the peninsula (and the Soldotna/Kenai
area), Alaska Wildlife Troopers (AWT) Detachment North
covered the Northern part of the state, and AWT Detachment
South was for the Southern Section from Valdez and below.
Co-Chair Stedman asked for another copy of the slides with
more explanation as to the detachments.
Mr. Duxbury agreed to provide the information.
Senator Micciche asked for more information abouth the
Alaska Bureau of Investigation (ABI), and assumed there was
crossover with other agencies.
Mr. Duxbury explained that there had been a change from
2010 to 2018 in that ABI was currently a statewide agency
that provided investigative service throughout the state.
Previously ABI had not included the statewide drug
enforcement unit but it had changed to be under one
supervision.
Mr. Duxbury looked at slide 25, "National Drug Threat
Survey-Drug/Property Crime," which showed a pie chart
depicting the crossover between drug and property crime. He
noted that the pie chart (based on a 2016 National Drug
Threat Survey) showed that the property crime percentages
were 35 percent attributed to heroin, and 27 percent
attributed to methamphetamine. Previous slides had
demonstrated that the state had a significant issue with
both of the controlled illicit substances. He stated it
would not be correct to assume that investigative and
arrest costs demonstrated the cost for the state to take
care of and respond to the opioid crisis.
10:09:43 AM
Mr. Duxbury turned to slide 26, "National Drug Threat
Survey-Drug/Violent Crime," which showed a pie chart. He
discussed the substances which contributed to violent crime
in the state. He thought it was difficult to enumerate how
much it cost the state to engage in response to the opioid
crisis.
Mr. Jones reviewed slide 27, "Alaska Opioid Epidemic
Response Total Costs 2017," which showed a pie chart and
data table. He highlighted that the total response cost was
$101 million, of which $30 million was the federal share.
Mr. Jones turned to slide 28, "Alaska Opioid Epidemic
Response Total Costs 2018," which showed a pie chart and
data table. He observed that 2018 saw an increase of about
$8 million in the same categories as the previous slide.
Co-Chair von Imhof wondered which programs being discussed
had worked the best. She hoped there would be an evaluation
and prioritization of programs. She emphasized the
necessity of helping the greatest number of people with the
funds that were available.
Co-Chair Stedman noted that Co-Chair von Imhof was the
subcommittee chair for the DHSS budget. He noted that
departments were ranking many programs. He thought a ranked
list of the programs mentioned in the presentation would be
helpful to members.
Mr. Jones agreed to provide the list.
10:12:51 AM
Mr. Jones looked to slide 29, "Alaska Opioid Epidemic
Response Total Costs FY17/18," which showed the total cost
for response for the two previous fiscal years. He noted
that slide 14 listed the services that were provided.
Between 2017 and 2018, 26,000 recipients were treated for
opioid-related diagnoses; 3,700 recipients received opioid
treatment medications; and there were a related 1,700
opioid-related incidents with DPS.
Mr. Duxbury commented that it would be remiss to not
address another aspect of the cost to the state and
utilizing 2017 UCR reporting. The estimated cost to the
public for the issues related to crime and the opioid
crisis was $60,750,667.
Mr. Jones read slide 30, " Alaska Opioid Epidemic Response
-Resources."
Mr. Jones turned to slide 31, "Prevention":
? Partnerships for Success Coalitions
? Community Substance Misuse and Abuse Task Forces
? Division of Behavioral Health, Prevention and Early
Intervention Section
? Office of Substance Misuse and Addiction Prevention
Data Dashboards
? Opioids in Alaska website
Mr. Jones noted that the coalitions brought together
multiple different agencies and community members to focus
on certain topics. The current grant focused on the opioid
epidemic. In partnership with the Alaska Native Tribal
Health Consortium (ANTHC) the group was also focusing on
alcohol. He stated that there were powerful local task
forces. He referenced a book entitled "Dreamland," which
highlighted that isolation fueled addiction and that
community provided the cure. He noted that the graphic on
the slide showed a data dashboard that showed the public
what was happening. He added that there was a webpage
referenced elsewhere in the presentation that discussed
data and provided resources.
10:16:07 AM
Mr. Duxbury noted that DPS had realized prevention should
also be part of its collaboration. He discussed
biodegradable bags for drug takebacks. He thought 75 to 80
percent of individuals utilizing heroin or opioids came
from diverted medications. He discussed means of prevention
and the importance of a multi-faceted approach.
Mr. Jones reviewed slide 32, "Community Coalitions":
? Mat Su Opioid Task Force
? Anchorage Opioid Task Force
? Juneau Opioid Work Group
? Fairbanks Opioid Work Group
? Southern Kenai Peninsula
? Change 4 Kenai Coalition
Aleutian Pribilof Islands Opioid and Substance
Misuse Task Force
? Ketchikan Substance Abuse Task Force
? Bristol Bay Opioid Task Force
? THRIVE Mat Su
Mr. Jones highlighted the efficacy of having a local point
of contact in a community.
Mr. Jones addressed slide 33, "Prevention and Early
Intervention Grant Funding for FY 2018 by Service Area and
Program Type," which showed a map and data table. The slide
highlighted some grants and showed a broad look of
prevention and intervention. The slide only showed grants
that were delivered rather than all prevention/intervention
efforts.
Mr. Jones spoke to slide 34, "Treatment":
Detoxification/Withdrawal Management
? Assessment/Intake
? Medication Assisted Treatment
? Inpatient/Residential Services
? Transitional Housing
Outpatient Services
? Reentry Services
? Peer Recovery Support Services
Mr. Jones noted that the graphic on the bottom of the slide
depicted the continuum of care. He highlighted that there
were four locations in the state for detox/withdrawal
management. There were only 300 prescribers in the state
for medication assisted treatment. He estimated that half
of the 300 prescribers were actively prescribing. The state
had nearly 300 beds for in-patient residential treatment.
Capacity for more transitional housing was being
continuously built. He discussed organizations that had
offered transitional housing.
Mr. Jones continued discussing slide 34. He discussed
reentry services and peer recovery support services. He
described the importance of peer recovery support services
in guiding people through a complex system.
10:20:20 AM
Senator Bishop asked about the treatment success rate.
Mr. Jones did not have a figure but offered to provide the
information at a later time.
Senator Wilson thought that Medicaid assisted treatment and
peer recovery support services had been effective ways of
getting people through treatment. He noted that peer
recovery programs in the State of Louisiana had done a good
job working with past felons. He asked about associating
with past felons in peer recovery support.
Ms. Brooks stated that DOC had implemented several peer
support groups in the system. She was not sure what the
policy was with regard to associating with felons. There
had been a shift in focus to efforts for peer supports.
Mr. Jones continued to comment on slide 34. He stated that
the group had built capability in the two years it had been
working on the response.
Mr. Jones discussed slide 35, "Treatment and Recovery Grant
Funding for FY 2018 by Service Area and Program Type,"
which showed a data table, map, and list. The slide
highlighted where services were in the state, and only
showed grant funding.
Mr. Duxbury showed slide 36, "Alaska State Troopers
Statewide Drug Enforcement Unit":
? Statewide Drug Enforcement Unit (SDEU) is a State
statute-mandated enforcement unit within the Division
of Alaska State Troopers under the Alaska Department
of Public Safety (DPS). AS 18.65.085.(a)(b)(c)
Narcotic Drugs and Alcohol Enforcement.
? As an enforcement body among different bureaus,
detachments, and units within AST, SDEU's specific
assignment is to provide services designed to deter,
detect, and interdict traffickers and trafficked
illicit controlled substances and alcohol.
? SDEU cooperates and collaborates with a myriad of
the federal, state, local, and tribal law enforcement
partners as well as other stakeholders.
Mr. Duxbury discussed partnerships with other agencies.
Senator Hoffman asked about the number of cases over the
previous four to five years and asked about the success of
the unit.
Mr. Duxbury agreed to provide more information on closed
cases that had been adjudicated. He stated that the unit
had been working heavily in the area of interdiction and
noted that Alaska was not a production state.
Co-Chair Stedman asked for the information to be broken
down by the regions of the state.
Senator Hoffman asked for the information to be broken down
by alcohol and narcotics. He stated that in rural Alaska,
alcohol abuse was most likely more prevalent than
narcotics, but the situation was changing.
Mr. Duxbury agreed to provide the information.
10:25:08 AM
Mr. Duxbury addressed slide 37, "Alaska State Troopers
Statewide Drug Enforcement Units/Locations":
? Anchorage Airport Interdiction Team
? Mat-Su Narcotics Team
? Fairbanks Area-wide Narcotics Team
? Southcentral Area-wide Narcotics Team
? Southeast Alaska Cities Against Drugs
? Western Alaska Alcohol & Narcotics Team
? Task Force Officer assignments DEA & FBI
Co-Chair Stedman noted that there was front-line drug
activity in Ketchikan due to access to the South through
the ferry. He wondered how to tighten up access on the
Alaska Marine Highway and force individuals to drive
through Canada and go through customs or travel through an
airport.
Mr. Duxbury noted that the state had been designated at a
high-intensity drug trafficking area (HIDTA), which would
help by bringing additional resources to expand upon
efforts being made. Additionally, it helped to enjoin
smaller communities to work with the troopers. He mentioned
the Southeast Alaska Cities Against Drugs program.
Co-Chair Stedman thought many people would like to see
drug-sniffing dogs at the ferry terminal in Bellingham.
Mr. Duxbury thought Co-Chair Stedman had made an
interesting suggestion that was worth looking at. There had
been similar programs in the past.
10:27:25 AM
Co-Chair von Imhof stated that one reason for having the
three agencies present was to illustrate the flow of
activity. She was interested in seeing how the agencies
communicated and how programs were interacting. She thought
the presentation did a good job of listing programs, but
she did not see a connection between them.
Mr. Jones highlighted a scenario in the Division of Public
Health that worked with needle exchange sites. The spent
needles were sent to the public health lab. The information
from tested needles could be provided to DPS to inform as
to what drugs were being sold/consumed on the street. He
emphasized that it was a new concept for public health and
law enforcement to work together. He mentioned the
potential for an Overdose Review Committee to bring
together multiple agencies analyze program effectiveness.
He agreed to follow up with more information.
Co-Chair von Imhof emphasized the importance of
demonstrated cooperation between different departments. She
mentioned the exchange of data and resources and
prioritization of effective programs.
Mr. Duxbury continued to address Co-Chair von Imhof's
question. He asserted that DPS tried to be responsive to
when DHSS would share funds between treatment and
enforcement. He discussed training in technology to analyze
fentanyl. The agencies had shared training. He recognized
what Co-Chair von Imhof was looking for and would try and
provide some more examples.
10:32:30 AM
Mr. Duxbury looked to slide 38, "Anchorage Airport
Interdiction Team":
Primary focus Interdiction of controlled substances
coming into Alaska and drugs and alcohol being moved
into rural parts of Alaska through the Ted Stevens
Anchorage International Airport. This group is well
versed in transportation related interdiction work.
Agencies involved in the task force
? Alaska State Troopers (4/1)
? Anchorage Airport Police (1)
? Anchorage Police (1)
? Drug Enforcement Administration (1)
? Federal Bureau of Investigation (1)
? North Slope Borough Police (1 + K-9)
? Sand Point Police (1)
This team will be the center of the Southcentral HIDTA
Enforcement Initiative. Future plans include the
addition of two more agencies.
Mr. Duxbury stated that there had been low numbers in the
detachments and few people with which to form task forces.
The interdiction team would spend time at the airport and
was about to grow. He noted that interdiction teams had
been improved.
Co-Chair Stedman did not see a Southeast member of the
interdiction team.
Co-Chair Stedman rephrased that his constituents had
concerns about drugs shipped to areas without VPSOs. He
thought drug traffickers seemed to be targeting smaller,
more remote areas of the state. He was concerned about the
shipping by air.
Mr. Duxbury pointed out that the Anchorage airport
interdiction team was not solely concerned with passengers,
but also mail and baggage and the bulk shipment of money.
The team worked closely with all parties including the
United States Postal Service, the United States Drug
Enforcement Agency (DEA), and the Federal Bureau of
Investigation (FBI). He added that it was also possible to
learn about human trafficking through the airport
interdiction.
Senator Bishop asked about the role of United States
Customs.
Mr. Duxbury answered that customs was part of the airport,
but not necessarily part of the interdiction team.
10:36:29 AM
Mr. Duxbury discussed slide 39, "Mat-Su Narcotics Team":
Primary Focus Investigation of high-level drug
traffickers and drug dealers in the Matanuska-Susitna
Valley, Copper River Basin, Valdez and Cordova.
Agencies involved in the task force
Alaska State Troopers (4/1)
This group will be a team attached to the Southcentral
HIDTA Enforcement Initiative and future plans include
the addition of Federal and Local partners.
Mr. Duxbury discussed slide 40, "Southcentral Area-wide
Narcotics Team":
Primary Focus Investigation of high-level drug
traffickers and drug dealers on the Kenai Peninsula,
Whittier and Seldovia.
Agencies involved in the task force
Alaska State Troopers (2/0)
Kenai Police (1)
This group will be a team attached to the Southcentral
HIDTA Enforcement Initiative and future plans include
the addition of a Federal partner and the Soldotna
Police Dept.
Mr. Duxbury showed slide 41, "Fairbanks Area-wide Narcotics
Team":
Primary Focus Investigation of high-level drug
trafficking and drug dealing in Interior Alaska.
Agencies involved in the task force
Alaska State Troopers (3/1)
Fairbanks Police (1)
North Pole Police (1)
This group will be the center of the Interior Alaska
HIDTA Enforcement Initiative. Future plans include
adding Federal and additional local agencies to the
task force.
Mr. Duxbury detailed that the Fairbanks area team had been
collaborative with the DEA, the FBI, and the Bureau of
Alcohol, Tobacco, Firearms and Explosives at times.
Mr. Duxbury spoke to slide 42, "Southeast Alaska Cities
Against Drugs":
Primary Focus Investigation of high-level drug
trafficking and drug dealing in all communities of
Southeast Alaska. SEACAD is based on a cooperative
agreement by AST, all southeast communities and
federal partners to combat drugs throughout Southeast
Alaska.
Agencies involved in the task force
Alaska State Troopers (2/1), Juneau, Ketchikan
Juneau Police (2/1)
Petersburg Police (1)
Sitka Police (1)
Federal Bureau of Investigation (2)
Coast Guard Investigative Service (2)
The group in Juneau will be the center of the
Southeast Alaska HIDTA Enforcement Initiative but will
have the flexibility to travel to all southeast
communities. Future plans include adding two DEA
Agents and one US Postal Inspector to Juneau as well
as additional local agencies to the task force.
10:39:19 AM
Senator Micciche asked about drug houses that had been
operating for years in a neighborhood. He wondered how
communities could help. He asserted that the property crime
cost in such neighborhoods was disproportionately large.
Mr. Duxbury stated that there had been a lack of discretion
on how law enforcement could operate. He stated that there
had to be a great effort and energy into the quantity of
drugs that were entering the state. He addressed the
quality of life issues in the neighborhood of drug
activity. He thought a newly proposed crime bill would have
a major impact on the situation. He stated it was very
difficult to do surveillance on a drug house thought it
took participation by the public to mitigate the situation,
and law enforcement needed a great deal of information
before it could act.
10:42:21 AM
Mr. Duxbury reviewed slide 43, "Western Alaska Alcohol &
Narcotics Team":
Primary Focus Investigation of mid to high level
drug and alcohol trafficking and dealing in Western
Alaska and Kodiak.
Agencies involved in the task force
Alaska State Troopers (5/1)
? Nome, Kotzebue, Bethel, Kodiak
Bethel Police (1)
Kodiak Police (1)
Coast Guard Investigative Service (4/1)
? Kodiak
Although this group will not be directly attached to
any of the HIDTA Enforcement Initiatives, members will
be working on Alaska HIDTA Enforcement Initiatives
during a portion of their time.
Mr. Jones reviewed slide 44, "Judicial":
Alaska Therapeutic Courts
(http://www.courts.alaska.gov/therapeutic/index.htm#ab
out)
? Drug and DUI Courts
? Anchorage Wellness Courts (Felony Drug, Felony
DUI, Municipal Misdemeanor DUI), Bethel,
Fairbanks,
Juneau, Kenai, Palmer
? Mental Health Courts
? Anchorage, Juneau, Palmer
? Family Court
? Anchorage, Palmer
Mr. Jones noted that there was a lot of collaboration in
therapeutic courts. He mentioned peer recovery services. He
thought therapeutic courts were expensive but highly
effective.
Ms. Brooks reviewed slide 45, "Corrections":
? The Department of Corrections is the largest
provider of substance abuse treatment and
detox/withdrawal services in Alaska.
? Approximately 80% of offenders in custody struggle
with substance abuse.
? 30% of those who are assessed report abusing
opioids.
Ms. Brooks detailed that mental health services had
increased by more than 60 percent in the previous ten
years, much of which was attributable to the increase in
substance abuse. The system had seen greater acute medical
needs, more complicated medical conditions, and an increase
in heroin and prescription drug abuse in particular. The
department's booking process had needed to change to
enhance awareness for addiction. Officers were trained to
recognize use, withdrawal, and overdose symptoms. She
discussed long-term use over time and the effect on
offenders' health.
10:45:14 AM
Ms. Brooks spoke to slide 46, "Corrections":
? DOC has comprehensive substance abuse programming in
place throughout the system.
? On-site and telehealth substance abuse
assessments
? 64 in-patient substance abuse treatment beds
? Three intensive out-patient treatment programs
? Three dual diagnosis programs
Psychoeducation programs
? Peer-based mentoring
Ms. Brooks noted that remand and booking facilities had a
high turnover and it was difficult to place treatment
programs. She discussed peer-based mentoring programs. She
noted that the department had done a lot to reduce wait
lists by expanding programs. Priority was placed with those
in the highest risk and highest need, those close the end
of a sentence, and those who had treatment as a part of a
legal requirement.
Ms. Brooks turned to slide 47, "Corrections":
? Other focus areas for DOC substance abuse treatment.
? Dedicated community treatment beds and
outpatient slots
Medication Assisted Treatment (MAT)
? Evidence-based treatment curriculum
? CCTV substance abuse education for segregated
prisoners
? Substance abuse assessment and withdrawal
screening software
Ms. Brooks noted that DOC had expanded its treatment in
other areas, including halfway houses. There were
agreements with community providers throughout the state to
have dedicated out-patient slots for individuals in halfway
houses. She noted that DOC had shifted to evidence-based
treatment curriculums and had standardized programs across
facilities.
10:49:09 AM
Mr. Jones showed slide 48, "Alaska Opioid Epidemic Response
- Partnerships, Outcomes, Results." He noted that the
remaining slides would discuss partnerships, outcomes, and
results.
Mr. Jones spoke to slide 49, "Policy":
? Patients to execute a Voluntary Non-opioid Directive
Statewide medical standing orders
? Naloxone distribution
Control substance emergency scheduling
? Limits first-time opioid prescriptions to no more
than a 7-day supply with exceptions
? Strengthens reporting and education requirements for
pharmacists and healthcare providers
? Requires the controlled substance prescription
database to be updated daily starting July 1, 2018,
instead of weekly
Mr. Jones displayed slide 50, "Prevention":
Project HOPE Naloxone
? 92 Overdose Response Programs
? 18,000 overdose rescue kits distributed
? Over 250 lives saved
? Medication Deactivation Disposal Bags
? Distributed 46,000 bags since 2017
? Potential reduction over 2 million pills
Opioids and Opioids Epidemic 101 teaching module
? First responder training
? Fatal Overdose Review Committee
? Community Caf? Events
Mr. Jones highlighted that troopers had carried overdose
rescue kits that were mentioned on the slide. He discussed
the importance of the community and partners in prevention
work. He discussed the opioid teaching model developed in
partnership with DEED. He discussed compassion fatigue
training developed in partnership with other stakeholders.
Senator Micciche thought it was quantifiable that
pharmaceutical companies were more directly responsible for
opioid addiction than drug providers South of the border.
He mentioned changes to the Prescription Drug Database, and
asked how actively it was monitored.
Mr. Jones went back to slide 49. He stated that the
database was checked daily. He agreed to provide more
information at a later time.
10:53:27 AM
Mr. Jones discussed slide 51, "Treatment":
Nearly 300 residential treatment beds
? 300 Medication-Assisted Treatment (MAT) prescribers
? Substance Use Disorder Expansion
? Section 1115 Behavioral Health Medicaid
Demonstration Waiver
? Project ECHO
Expansion of treatment, and recovery support
services utilizing federal grant funding
? Open Beds platform
Mr. Jones discussed Project ECHO, which allowed for
providers to get together on a secure platform to discuss
issues relating to substance use disorder. He discussed
tools for providers to guide people through the continuum
of care.
Mr. Duxbury addressed slide 52, "Enforcement":
? High Intensity Drug Trafficking Area (HIDTA)
Designation
? Task force expansion to include local, tribal,
state, and federal enforcement agencies and entities
? Improving our technology
? More efficient ways to collect data (monitor trends)
? Increased training
? Develop private sector partnerships
Mr. Duxbury explained that DPS was looking at all aspects
of how to engage the public.
Ms. Brooks turned to slide 53, "Corrections":
? Detoxification and withdrawal management
? Intake screening
? Housing/observation
? Medical management
? Development of detox beds for women at HMCC
? Medication Assisted Treatment
? Vivitrol
? Methadone bridging
? Narcan
Ms. Brooks noted that DOC had changed its detox and
withdrawal management protocols and had reached out to
DHSS. She discussed research in medication assisted
treatment.
10:57:22 AM
Mr. Jones discussed slide 54, "Strategic Direction":
Alaska Opioid Policy Task Force 2016-2017
? AOPTF Recommendations Document
? Opioid Initial Response Framework
(Prevention Model) 2017
? Statewide Opioid Action Plan 2018
? Community Cafe Series approach
? 15 communities(Bethel, Nome, Ketchikan, Sitka,
Juneau, Fairbanks, Anchorage, Kodiak, Petersburg,
Mat-Su, Kenai, Barrow, Homer, Valdez/Cordova,
Dillingham)
? The SOA strategic planning includes local,
tribal, state, and federal agencies
Mr. Jones highlighted that the action plan was available on
the department website. He added that the agencies involved
gathered data and formed an over 100-person advisory group;
the plan was an Alaska-based plan built by the community
for the community.
Mr. Jones spoke to slide 55, "Preliminary Results," which
showed a map of the state, two pie charts, and a data
table. He reminded that the slide reflected preliminary
numbers. He noted that the trend from 2017 to 2018 was
declining in every category of drug overdose death. He
noted that opioid overdose deaths were down 42 percent, and
fentanyl overdose deaths (which were skyrocketing in the
country) were down by 75 percent.
Mr. Jones advanced to slide 57, "Next Steps":
? Next Steps 1: Transition from Incident Command
System (ICS)
? Implement sustainable long term recovery
operation/approach, Working with States, local
jurisdictions, ASTHO, NGA, NCSL
? Next Steps 2: Statewide Opioid Action Plan
? Build capability and capacity in enforcement,
prevention, treatment, and recovery services.
? Next Steps 3: Implementation of HIDTA regional
task forces
? Next Steps 4: Focus on economic impact of
programmatic investments
? UAA's Alaska Justice Information Center (AJiC)
could:
? Update Alaska's Adult Criminal Justice model
(published in Fall of 2017) with current program
costs for therapeutic court and DOC substance
abuse treatment programs
Expand the model to behavioral health areas
? Provide results to inform investment/selection
of programs that are effective and efficient.
Pew-MacArthur Results First Model
? Uses combined results from scientifically
rigorous program evaluations to estimate the
effectiveness of programs;
? Calculates the return on investment for program
investment based on jurisdiction specific costs
and baseline outcome measures;
? Includes modules for programs in multiple
policy areas, notably Adult Criminal Justice,
Substance Abuse and Mental Health.
Mr. Jones pointed out that some states had an office of
drug control policy or a drug policy coordinator, that
could look at state systems and identify the most effective
approaches.
11:00:13 AM
Co-Chair Stedman asked to return to slide 55. He was
surprised that the 45 to 64 age group comprised 55 percent
of the opioid overdose deaths.
Mr. Jones shared Co-Chair Stedman's concern, and noted that
the national trend was more of the 25 to 34 year age group.
He pondered if the difference was due to the fact that the
state's population was aging. He stated that there had been
focus on education on prescription medication.
Senator Micciche observed that prescription opioids were
still the cause of the vast majority of opioid fatalities.
He asked to see the information on slide 55 in graph form,
including the years 2013 to 2018.
Senator Hoffman asked for the information by region and
year. He asked about the next steps for cost implementation
of the steps listed on slide 57 broken down by year and
region.
Co-Chair Stedman noted that the information would be
helpful as the committee would soon be starting the budget
process.
ADJOURNMENT
11:02:45 AM
The meeting was adjourned at 11:02 a.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 020719 Addressing Alaska's Poly-Substance Epidemic_Comprehensive Report_Final (002).pdf |
SFIN 2/7/2019 9:00:00 AM |
Opioid Epidemic |
| 020719 Addressing Alaska's Poly-Substance Epidemic_Comprehensive Presentation_F.._.pdf |
SFIN 2/7/2019 9:00:00 AM |