Legislature(2019 - 2020)SENATE FINANCE 532
01/30/2020 09:00 AM Senate FINANCE
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| Audio | Topic |
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| Start | |
| Presentation: Alaska Mental Health Trust Authority | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
SENATE FINANCE COMMITTEE
January 30, 2020
9:01 a.m.
9:01:53 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 Donny Olson
Senator Bill Wielechowski
MEMBERS ABSENT
Senator David Wilson
ALSO PRESENT
Mike Abbott, Chief Executive Officer, Alaska Mental Health
Trust Authority; Mary Jane Michael, Board Chair, Alaska
Mental Health Trust Authority; Senator Cathy Giessel.
SUMMARY
PRESENTATION: ALASKA MENTAL HEALTH TRUST AUTHORITY
Co-Chair Stedman informed that the committee would hear a
presentation from the Alaska Mental Health Trust Authority
(AMHTA); and would consider budget highlights, current
issues, and where the trust felt it was headed.
^PRESENTATION: ALASKA MENTAL HEALTH TRUST AUTHORITY
9:03:40 AM
MIKE ABBOTT, CHIEF EXECUTIVE OFFICER, ALASKA MENTAL HEALTH
TRUST AUTHORITY, introduced himself and the AMHTA Board
Chair. He relayed the board chair would start the
presentation; after which he would address finances, the
trust land office activity, and the trust's FY 21 budget
proposal.
Co-Chair Stedman asked about board members.
9:04:17 AM
MARY JANE MICHAEL, BOARD CHAIR, ALASKA MENTAL HEALTH TRUST
AUTHORITY, discussed the presentation, "Legislative
Presentation - Senate Finance Committee" (copy on file).
Ms. Michael looked at slide 2, "Trustees":
? Mary Jane Michael, Chair
? Chris Cook, Vice Chair
? Ken McCarty, Secretary
? Vern? Boerner, Program and Planning Committee Chair
Anita Halterman, Audit and Risk Committee Chair
? Laraine Derr, Finance Committee Chair
? John Sturgeon, Resource Management Committee Chair
Ms. Michael added that the governor's most recent appointee
was in the audience.
Ms. Michael spoke to slide 3, "Trust Beneficiaries":
Beneficiaries include Alaskans who experience:
Mental illnesses
? Developmental disabilities
? Alzheimer's disease and related dementias
? Traumatic brain injuries
? Substance use disorders
The Trust also works in prevention and early
intervention services for individuals at risk of
becoming beneficiaries.
Ms. Michael detailed that the trust had recently celebrated
the 25th anniversary of the landmark settlement that had
created the trust. Over the previous 25 years, the trust
had increased its assets and served thousands of
beneficiaries that experienced mental illness,
developmental disabilities, substance use disorders,
Alzheimer's/dementia, and traumatic brain injuries. The
trust was the only organization of its kind in the United
States and was a state corporation.
Ms. Michael continued to discuss the trust. The trust's
funds were self-generated and granted projects,
partnerships, and programs that promoted long-term
systematic change. She shared that the trust's primary
focus was on improving the psychiatric crisis continuum of
care. She thought the recent challenges at the Alaska
Psychiatric Institute (API) highlighted the gaps in
community-based crisis intervention, which could reduce the
need for in-patient treatment for many trust beneficiaries.
The trust was working with the Department of Health and
Social Services (DHSS) and other community partners to look
at models that could replicated in Alaska to reduce the
need for long term in-patient psychiatric care.
Ms. Michael continued that the land office continued to
make significant progress, and the trust was seeing results
from over ten years of work on the United States Forest
Service (USFS) federal land exchange. She noted that the
Icy Cape heavy mineral project continued exploration
activities, finishing a sixth field session in the summer.
The recently closed sale of the Juneau Subport property
would generate $20 million for the trust. Not only did
trust land generate new revenue to add to investment
earnings but had been a stimulus for local economies and
had created jobs. The trust had invested in its internal
organization, had responded the previous year's audit
findings, had increased staff and trustee trainings,
established committee charters and protocols, streamlined
operations to get more grant funds to organizations serving
beneficiaries. She asserted that the trust had a dedicated
and resourceful staff, a strong leader, and a board she was
proud to serve with.
9:07:58 AM
Senator Bishop was interested when Ms. Michael mentioned
national models for improving behavioral health. He was
focused on substance abuse disorders. He asked if the trust
was also considering what was being done internationally,
such as in Europe and other places.
Ms. Michael stated that the trust had looked at one
particular project, and there were subsequent slides that
would delve into the subject.
Co-Chair Stedman wanted more information about the
potential for the trust in Icy Cape.
Mr. Abbott stated that subsequent slides would address the
topic.
9:09:09 AM
Mr. Abbott referenced slide 4, "Financial Position," which
had a bar graph entitled "Trust Invested Assets." The slide
described the change in scale of the trust's invested
assets since just after it was formed. The trust was
granted $200 million of funds during the settlement process
in 1994; and since that time the invested assets were close
to $700 million, which did not include the proceeds from
the Juneau Subport sale. He commented that the sale had
radically exceeded expectations. He expected that the
invested assets would continue to grow over time through
investment earnings and proceeds from land management
activities such as timber, minerals, oil and gas, and land
sales and real estate.
Mr. Abbott turned to slide 5, "FY21 Earnings and Available
Funding," which showed three data tables depicting trust
assets, the trust's available FY 21 funding, and prior
years' available funding. At the end of FY 19 there was a
total of $650 million of investment assets, of which $450
million was in the corpus and could not be deployed while
being invested for the long term. There were $125 million
in reserves that were spendable and in a reserve status to
protect the trust as active programmatic funders in the
event of investment declines. He noted that the equity
position of the trust's commercial real estate investments
had grown and at the end of FY 19 was a little over $60
million. For current year funding, the investment earnings
would generate just under $25 million that would help fund
FY 21 spending. The investment earnings made up the vast
majority of the trust's spending, and the income from
investments was growing by $1 million to $2 million per
year.
9:12:45 AM
Mr. Abbott discussed the trust's spending capability. In
addition to almost $25 million of investment earnings, the
trust had a little over $3 million in prior-year carry-
forward. The trust land office generated a little less than
$5 million of spendable income the trust would use in FY
21. There were also interest earnings on cash accounts.
There was a net of $33 million, which the trust expected to
deploy in FY 21. He drew attention to the lower right-hand
corner of the slide, where FY 20 showed $33 million that
represented continued growth in spendable income and annual
budgets for the previous five years. He expected continued
growth of trust spending of $1 million to $2 million per
year based on reasonable expectations of investment
performance and land management activity.
Co-Chair Stedman asked about the real estate holdings of
the trust. He referenced past concerns about dealing with
holdings.
Mr. Abbott recalled a 5-year period starting in 2010, when
the trust acquired seven real-estate properties for
investment purposes. The funds that were used to acquire
the assets could have been deployed into the corpus account
and invested with the Alaska Permanent Fund. There had been
concerns reflected in the legislative audit completed in
2018. Since the concerns had been identified, no further
real estate investments had been made. The trust had
committed to no further use of investable funds that
without explicit statutory authority. Secondly, the initial
investment amount of roughly $40 million that the trust had
made in the properties had been transferred from the
reserves into the corpus of the fund to make it whole. The
corpus now sat at the same level as if the real estate had
not been acquired and the funds had been deposited into the
corpus.
9:16:18 AM
Mr. Abbott continued to address Co-Chair Stedman's
question. He relayed that the trust continued to hold the
real estate, which continued to perform well. The trust
expected $4.7 million of spendable income from land office
activities in FY 21. He detailed that $2 million of the
land office income was net income from the commercial
properties. A significant percentage of the land office
income and significant percentage of overall trust spending
was sourced in the real estate investments. He detailed
that one audit recommendation was to update the trust's
asset management policy statement (AMPS). The AMPS guided
all investment activity for the trust's different
investment classes. Callan and Associates had evaluated the
trust's AMPS and made recommendations for changes, which
were adopted unanimously in 2019.
Mr. Abbott detailed that one of the changes in the policy
statement was that if the trust owned commercial real
estate (and the AMPS allowed for it) the trust should
secure the services of a institutional real estate advisor
that worked to help evaluate the merits of different real
estate investment strategies. There had been a competitive
process through which the trust secured the services of
Harvest International, a reputable firm that advised on
several billion dollars in assets. The organization had
visited most of the trust's properties and would visit the
Alaska properties when there was better weather. The firm
would begin to make recommendations to the trustees
regarding the overall plans for the assets as part of the
trust's overall invested portfolio. He stated that the
first series of recommendations would be available at the
trust's finance committee meeting in April 2020, after
which the trust would report back to the committee and
share with stakeholders.
9:19:44 AM
Co-Chair Stedman asked if there was a real estate sale
pending.
Mr. Abbott informed that one of the trust's tenants at an
out of state property had sought an option to purchase the
property at the end of the lease period. The trust was
willing to sell the properties for appropriate terms. The
property might sell in a few years at the tenant's option.
Co-Chair Stedman stated he would contact the trust office
if he had any question regarding the newer audit work. He
was glad to have an update on the issue.
Mr. Abbott considered slide 6, "FY 21 Spending," which
showed a pie chart depicting the trustee's recommendation
of how funds would be deployed in FY 21. The orange and
yellow wedges were administrative budgets for the trust
authority and the trust land office. He pointed out that
the total administrative budget for FY 21 was less than
that of FY 20. The trust was working to drive down its
administrative spending and drive up its programmatic
spending. He thought over time total spending would grow,
and administrative spending would grow less quickly.
Mr. Abbott noted that the trust was working with the
finance subcommittees for the Department of Revenue and the
Department of Natural Resources on the administrative
budgets, which did require appropriations from the
legislature. He pointed out that the green wedge was Mental
Health Trust Authority Authorized Receipts (MHTAAR), which
were the funds which trustees deployed to spend inside
state agencies. The funds appeared inside of budgets as
authorized receipts. He explained that the trust needed the
legislature to grant receipt authority to use the funds.
Mr. Abbot identified that the authority grants, represented
in the blue wedge, were made to non-profits, tribes, local
governments and other non-state agencies and were not
required to go through the legislature and were authorized
by trustees. He informed that all of the authority grants
were done through public processes and there was more
detail if the committee had specific questions.
9:24:17 AM
Mr. Abbott displayed slide 7, "FY 21 GF/MH
Recommendations," which showed a table of spending
recommendations. He noted that one of the trust's
responsibilities as directed by the settlement was to make
recommendations for the deployment of general funds. Some
of the funds were capital items, some were in the mental
health budget, and some were in the operating budget. The
blue columns indicated the trustee's recommendation for
general funds (shown as GFMH). The list had several items
that the trust recommended that had not been included in
the governor's budget. The trust would be working with the
committee and subcommittees to discuss the items and
encourage the members to consider some or all of the
General Fund portion of the budget lines.
Senator Bishop asked about the total liability on deferred
maintenance as listed on the slide.
Mr. Abbott noted that the deferred maintenance program was
run by a state agency. The trust contributed and the agency
did a competitive process to identify grantees, and it was
not the state's deferred maintenance list. He qualified
that the trust had not captured the full potential of
deferred maintenance obligation. The funds would not be
used on trust facilities or operations, and the funds would
be granted. The 50/50 arrangement that the trust had
recommended had been in place for more than a decade.
Co-Chair Stedman asked if the trust dealt with Public
Facilities at the Department of Transportation and Public
Facilities.
Mr. Abbott stated that the grants were commonly for
facilities for non-profits or agencies had deferred
maintenance requirements. Typically, the grants were
relatively small and in the $10,000 to $30,000 range.
Senator Bishop thought it would be kind of nice to see what
the target might be.
9:27:46 AM
Mr. Abbott highlighted slide 8, "Trust Land Office":
? Subport Property Sale
? USFS Land Exchange
? Icy Cape Development
Mr. Abbott drew attention to the table on the right hand of
the slide and highlighted that the trust land office had
generated about $10.5 million. The funds were comprised of
investable and spendable funds. In the current year,
roughly half of the $10 million in revenue earned by the
trust land office was required to be invested. Earned funds
by the sale of property, oil and gas royalties, or a timber
sale were dedicated to being invested as the funds were
likely to be one-time earnings from a land asset. The
investment earnings would be spent from the contribution,
but not the contribution itself.
Mr. Abbott continued to address slide 8. The other portion
of revenue from the land office was "spendable" recurring
revenues from lands such as leases, permitting revenue,
funds for short-term easements, and interest from
financing. The trust land office had two different revenue
streams that added up to $10.6 million in FY 19. Some of
the amount was spendable, and some was invested in the
corpus.
9:30:13 AM
Mr. Abbott discussed the recent land sale of the Juneau
Subport. He detailed that Norwegian Cruise Lines had paid
the sale amount in $5 million increments on a quarterly
basis and the trust expected to receive the balance in
September 2020. The funds would be deposited into the
corpus of the trust fund. The trust used a percent of
market value (POMV) to generate investment earnings with a
payout rate of 4.25 percent. When the $20 million was
deposited, it would ultimately earn $850,000 per year in
perpetuity. In most years, the trust deposited $10 million
to $20 million from land office activity into the corpus.
Mr. Abbott mentioned the USFS land exchange, which was in
the final stages. He stated that there had been significant
progress, and the trust had already received lands on
Prince of Wales Island (originally part of the Tongass
National Forest) in exchange for trust lands above the City
of Ketchikan. The lands the trust acquired in the portion
of Prince of Wales known as Naukati were already under
contract for timber harvest and being harvested. The trust
had contracted for timber sale before it controlled the
acreage. There would be continued timber revenues for the
trust, and he thought timber revenues would be one of the
trust's largest revenue categories in the coming years. The
second phase of the land exchange was underway and would
allow the trust to transfer additional trust lands to the
Tongass National Forest. In exchange the trust would
receive additional lands, most of which were on Prince of
Wales Island. Most of the land would be used for timber
harvest in the coming years. He hoped that that the sale
was near completion the following year.
9:34:18 AM
Mr. Abbott mentioned the trusts development at Icy Cape, in
the northern part of the Gulf of Alaska near Yakutat. The
trust owned a lot of land in the area. There was a current
timber harvest, and there was a challenging timber market.
He was not sure that the trust would harvest all available
timber due to market conditions. He stated that the
Sealaska Corporation had been an excellent partner and had
been logging on the site for two years. There was also an
active mineral exploration underway at Icy Cape. He
detailed that on the beach and in the uplands there was a
significant gold deposit as well as an unusual
concentration of industrial abrasive materials such as
garnets and hard sands. There was a market for the
materials for industrial uses.
Mr. Abbott relayed that the trust had completed a fourth
year of field work on the site. He stated that the samples
were being evaluated and the trust was looking at a way to
develop the materials. He thought the development was
likely to be a significant revenue generator for the trust,
but it could be five years from fruition.
Co-Chair Stedman had mentioned Icy Cape because of the
potential for revenue generation.
Mr. Abbott agreed with Co-Chair Stedman. He stated that the
trust had a few mining exploration projects underway, and
Icy Cape was among the most promising.
Senator Hoffman asked how many employees were in the trust
land office and where they were located.
Mr. Abbott stated that the trust land office had 17
employees, all located in Anchorage save for one employee
in Ketchikan that ran the timber program. There was one
vacancy being actively recruited.
Mr. Abbott looked at slide 9, "25 Years of Supporting
Beneficiaries":
? Harborview closure
? Mental Health Court
? Bring the Kids Home
? Medicaid Reform/Expansion
Mr. Abbott commented that the slide showed examples of
things the trust had helped the state accomplish in the
previous 25 years.
9:38:39 AM
Mr. Abbott addressed slide 10, "Medicaid Reform/Expansion":
? $10M investment (SB 74)
? Capacity support to the department
? Administrative Services Organization
1115 Waiver development (Behavioral Health and
Substance Use Treatment)
Mr. Abbott recalled that the trust had made a $10 million
multi-year commitment to fund costs associated with
Medicaid reform and expansion. The trust had met its
obligation and the $10 million would be fully expended.
Most of the key elements of Medicaid reform, as it related
to trust beneficiaries, was online. He thought the
administrative services organization, which was essentially
was a managed care operation for behavioral health and
Medicaid was a big and important change.
Mr. Abbott discussed the 1115 Waiver, which would expand
the number and quality of behavioral health services
available in Alaska, specifically for substance abuse
treatment. In the past, Medicaid had been a limited funder
for behavioral health and substance abuse treatment, which
would be dramatically expanded. He DHSS for its work on the
waiver, which was a difficult bureaucratic process. The
trust was grateful to have been a funding partner and
advocate in the expansion.
9:40:51 AM
Mr. Abbott advanced to slide 11, "Medicaid Reform Success":
? Estimated $166M in GF savings and cost avoidance
? Flat state GF spending despite significant
enrollment growth
? An increased use of Home and Community Based Service
(HCBS) waivers
? 1115 Waiver will lead to continued savings
Mr. Abbott thought Medicaid reform and expansion had been a
great success. The information on the slide came from DHSS
and the most recent Medicaid reform update produced two
months previously. He directed attention to the graph on
the slide which showed a green bar that represented the
number of Alaskans that had been served by Medicaid, which
was up by 100,000 individuals from five or six years
previously. Medicaid total spending had gone up, but state
General Fund spending had stayed flat. He thought the
expansion was a success story. The trust was grateful for
the legislature pursing expansion and reform activity.
Mr. Abbott expected ongoing Medicaid reform activities
would continue to improve service and hopefully reduce
spending. The trust recognized that Medicaid reform had not
made every provider happy. He thought some providers would
prefer to work with state grants, specifically related to
substance abuse and behavioral health. He understood that
with the increase in Medicaid spending for like services,
grant funding would decrease. He thought that the increase
in Medicaid expenditures would be good for the state budget
because Medicaid expenditures would be primarily federally
funded, whereas the grant system was entirely state General
Funds. He expressed concern about the timing of Medicaid
funding not matching the timing in the reductions in grant
funding. He wanted people to understand that the trust was
capable of being part of the process and working to help
the state reduce the general fund contributions to the
services.
9:44:11 AM
Co-Chair von Imhof had seen the graph on slide 11 in
several iterations. She thought it was important to analyze
the many ways the graph could look in the future. She was
very interested in the 1115 waiver, particularly for
behavioral health. She thought the waiver was a complicated
mixed bag, with many categories with different levels of
reimbursement. She discussed the balance of state and
federal funding for services in different categories. She
thought it was not certain that further Medicaid reform
would lead to continued savings. She questioned what was
being done to manage the different levers so there was not
a bigger spike in expenses.
Mr. Abbott thought the green line representing enrollment
would go down as more people had access to health care. He
agreed entirely that Medicaid was a difficult enterprise to
manage. He acknowledged that different levels of federal
contribution came into play for different service types. He
explained that through the 1115 waiver was based on the
expectation that the new service types and reimbursement
types that would be allowable would be less expensive to
the Medicaid program generally than the previous system. He
discussed the concept of substance abuse treatment being
timely and preventing acute future care. He noted that
other states had demonstrated that the system could work.
He thought that Alaska's healthcare system did not have as
much in common with other states than was hoped for
purposes of comparison. The trust was committed to the 1115
wavier trial in working DHSS to increase access to services
and gaining expected savings. He acknowledged that it was
not a guarantee.
9:48:26 AM
Senator Olson congratulated the trust for providing
expanded care to individuals. He looked at flat state
general fund spending as shown on the graph and asked if
all the funding was undesignated.
Mr. Abbott did not know and reiterated that the information
on the slide was from DHSS.
Co-Chair Stedman commented on the increase in Medicaid
population. The legislature had tried to reduce it the
previous year. He expected that there would be a
supplemental budget proposed in the following days. He
acknowledged that there were challenges in the Medicaid
component of the budget. He hoped that the work of the
committee would not be evaporated in six months. He thought
it was alarming that 35 percent of the state population was
on public assistance. He thought it was one of the larger
percentages of all the states.
Senator Hoffman thought the way to control the DHSS budget
was to consider the services that were being provided,
which had been increasing over the previous ten to twenty
years. He opined that there had been no look at trying to
reduce services.
Co-Chair Stedman agreed with Senator Hoffman's comments,
and stated that he would be on the issue to change some of
the requirements if it was politically possible.
9:52:35 AM
Mr. Abbott looked at slide 12, "Psychiatric Crisis
Continuum of Care":
? Absence of full continuum including community based
services
? Reduction in API capacity
? Psychiatric boarding - Emergency
Departments/Department of Corrections
? Police/Fire resources misused
Mr. Abbott thought another opportunity for the trust was to
mitigate the crisis of the failure of the ability to serve
Alaskans with psychiatric crisis. There were many types and
causes of the problem, and it was known that the need was
not being properly addressed. First responders, hospitals,
correctional facilities, API and others were all being
over-burdened because there were no systems in place for
dealing with the problem productively. He gave kudos to the
state and the department for sharing in the recognition.
The trust had identified a model it believed would be able
to help the state with the situation.
9:54:44 AM
Mr. Abbott spoke to slide 13, "Crisis Now Model":
Model includes four elements:
Regional or statewide crisis call centers
coordinating in real time
? Centrally deployed, 24/7 mobile crisis teams
? Short-term, "sub-acute" residential stabilization
programs
? Essential crisis care principles and practices
Mr. Abbott shared that Senator Wilson had travelled to
Maricopa County and learned about the model. Other
stakeholders such as legislators, trust staff, department
staff, and police leadership. Subsequently the trust had
funded a field trip of 25 department staff and key
stakeholders. The model was able to radically improve the
success of the folks experiencing crisis and reduce the
impact on the rest of the community; within a system that
paid for itself with Medicaid and other funding. The model
had been successful by standing up a system of crisis care
that included call centers with available support. He noted
that the vast majority of calls resulted in the crisis
being alleviated without further support.
Mr. Abbott discussed mobile crisis teams, which were
comprised of a master clinician and a peer-support staffer
who typically had lived experience that was relevant. The
two-person teams went to the location of a crisis in 20
minutes or less and typically a first responder was already
present. The first action of the team was to release the
first responder, which often helped to de-escalate the
situation.
9:59:09 AM
Mr. Abbott discussed the third level of response as listed
on the slide. The facilities were sometimes walk-in centers
that provided 23-hour non-residential services or short-
term residential services. The facilities were typically
operated by non-profit entities and provided services for
individuals that needed to be in a different place. He
described the environment of a sub-acute stabilization
facility, which was staffed by clinicians and helped people
to stabilize. He noted that the state did not have any of
the three systems in place. He thought the City of Phoenix
had learned that it needed all three pieces in place to
complement each other.
Mr. Abbott discussed the differences in Phoenix and Alaska.
He thought the state could apply some or all of the
services listed on slide 13 throughout the state. He
acknowledged that each service could not be in every
community, but a portion could. The trust had hired the
entity that had built the system in Maricopa County, which
had visited the state and generated a report. The trust was
committed to testing the viability of the model in Alaska.
He emphasized that the trust was not asking for general
funds. He noted that later in the day the trust would
consider a multi-million-dollar multi-year funding
commitment for the planning for and startup of some or all
of the service types on the slide. He hoped that some of
the model could begin within a year.
10:03:37 AM
Mr. Abbott noted that Medicaid would ultimately pay for
many of the services that were part of the model on slide
13. He was optimistic that the trust would commit itself to
working on the change. He noted that other legislators had
expressed interest in the model.
Co-Chair Stedman asked to receive an update in a year.
Mr. Abbott hoped to be sharing information sooner than one
year.
Senator Bishop asked about results from the model and if
there was demonstrated savings for first responders and
emergency room visits.
Mr. Abbott relayed that there was tremendous data to
support the success of the model. He discussed the amount
of police officer savings in time associated with the
model.
Co-Chair Stedman suggested that Mr. Abbott get back to the
committee with more information.
Mr. Abbott noted that the system in Phoenix paid for itself
and had no supplemental state funding.
Co-Chair Stedman asked Mr. Abbott to get back to the
committee on more detail regarding Senator Bishop's
question.
10:07:36 AM
Senator Olson considered the growing homeless population in
the state and asked if the trust saw the model as a
mitigating solution for the homeless problem in Alaska.
Mr. Abbott expected the model to make a significant
improvement to the quality of care of those experiencing
homelessness in Alaska. He pointed out that a large part of
those experiencing homelessness were challenged by a lack
of substance abuse treatment, behavioral health care, and
other services. He noted that a significant percentage of
first responder calls and emergency room visits associated
with psychiatric crisis were experienced by Alaskans with
homelessness. He emphasized that the model would radically
improve the quality of care available to people
experiencing homelessness. He pointed out that one barrier
to housing was the ability to address mental health issues.
He thought people would seek housing when they had
addressed substance abuse or mental health challenges.
Senator Olson asked about the possibility of Medicaid
paying for the services being described in the model.
Mr. Abbott did not know about reimbursement rates for the
services. He stated that the 1115 waiver process
contemplated several of the service types. He thought the
department could speak to reimbursement rates. He knew that
Medicaid was a key payer in Arizona and other jurisdictions
that were using some or all of the service types and was
ultimately reducing overall Medicaid expense through
reduction in hospital visits.
10:10:55 AM
Mr. Abbott referenced slide 14, "Crisis Now in Alaska":
Crisis Now Consultation Report
? System accountability and performance metrics
? Policy considerations
? Funding options including Medicaid
? Implementation of key Crisis Now model elements
? Workforce needs
Mr. Abbott turned to slide 15, "Improving Alaska's Crisis
Continuum of Care":
Next Steps for the Trust
? Support alignment statewide
Statute and policy needs
? Facilitation/support of local planning and
implementation
Capital, equipment, and start-up needs
? Urban and rural Alaska
Mr. Abbott stated that the trustees would be looking at
additions to the FY 21 trust budget that would fund areas
necessary to advance the planning for the new model.
Mr. Abbott showed slide 16, "THANK YOU - Questions?":
In the past 25 years, Trustees have approved more than
$355,000,000 to fund more than 3,200 beneficiary
serving projects and more than 8,600 mini grants to
beneficiaries across Alaska
Co-Chair Stedman discussed the agenda for the following
day.
ADJOURNMENT
10:13:35 AM
The meeting was adjourned at 10:13 a.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 013020 Trust 2020 S FIN Final.pdf |
SFIN 1/30/2020 9:00:00 AM |
SB 153 |
| Senate FIN Follow Up_Alaska Mental Health Trust Authority_2.5.20.pdf |
SFIN 1/30/2020 9:00:00 AM |
SB 153 |