Legislature(2021 - 2022)SENATE FINANCE 532

02/24/2021 09:00 AM Senate FINANCE

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09:01:43 AM Start
09:02:08 AM Presentation: Alaska Mental Health Trust Authority – Update and Fy22 Proposed Budget
10:15:22 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Alaska Mental Health Trust Authority - Update TELECONFERENCED
and FY22 Proposed Budget
- Mike Abbott, Chief Executive Officer
+ Bills Previously Heard/Scheduled TELECONFERENCED
                 SENATE FINANCE COMMITTEE                                                                                       
                     February 24, 2021                                                                                          
                         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 Bert Stedman, Co-Chair                                                                                                  
Senator Lyman Hoffman                                                                                                           
Senator Donny Olson                                                                                                             
Senator Natasha von Imhof                                                                                                       
Senator Bill Wielechowski                                                                                                       
Senator David Wilson                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Click Bishop, Co-Chair                                                                                                  
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Chris  Cook,   Board  Chair,  Alaska  Mental   Health  Trust                                                                    
Authority;  Mike  Abbott,  Chief Executive  Officer,  Alaska                                                                    
Mental Health Trust Authority.                                                                                                  
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
^PRESENTATION:  ALASKA  MENTAL   HEALTH  TRUST  AUTHORITY                                                                     
UPDATE AND FY22 PROPOSED BUDGET                                                                                               
                                                                                                                                
9:02:08 AM                                                                                                                    
                                                                                                                                
Co-Chair  Stedman  relayed  that the  Alaska  Mental  Health                                                                    
Trust Authority  (AMHTA) would be discussing  the trust's FY                                                                    
22  budget as  well  as some  COVID-19  response issues  and                                                                    
trust reserves.                                                                                                                 
                                                                                                                                
9:02:54 AM                                                                                                                    
                                                                                                                                
CHRIS  COOK,   BOARD  CHAIR,  ALASKA  MENTAL   HEALTH  TRUST                                                                    
AUTHORITY  (via  teleconference), discussed  a  presentation                                                                    
entitled  "Senate Finance  Committee  -  February 24,  2021"                                                                    
(copy on file).                                                                                                                 
                                                                                                                                
Mr. Cook showed slide 2, "Trustees":                                                                                            
                                                                                                                                
     ?Chris Cooke, Chair                                                                                                        
     ?Anita Halterman, Vice Chair                                                                                               
     ?Rhonda Boyles, Secretary                                                                                                  
     ?Vern? Boerner                                                                                                             
     ?John Sturgeon                                                                                                             
     ?Annette Gwalthney-Jones                                                                                                   
     ?Brent Fisher                                                                                                              
                                                                                                                                
Mr. Cook relayed that AMHTA's  purpose was to administer the                                                                    
Alaska  Mental Health  Trust, which  was a  perpetual trust.                                                                    
The mission  of the trust  was to  improve the lives  of the                                                                    
trust beneficiaries  and to  operate in  a sustained  way in                                                                    
order   to   positively   impact   the   lives   of   future                                                                    
beneficiaries.                                                                                                                  
                                                                                                                                
Mr. Cook  noted that  the corpus of  the trust  consisted of                                                                    
both money  and land,  specifically the Mental  Health Trust                                                                    
Fund,  managed  by  the Alaska  Permanent  Fund  Corporation                                                                    
(APFC), and trust  land of nearly one  million acres managed                                                                    
by the  trust land  office under  the Department  of Revenue                                                                    
(DOR). The  trust drew annual  income from the  resources to                                                                    
provide  for the  needs of  the  beneficiaries, pursuant  to                                                                    
Alaska's comprehensive  mental health  program. In  the role                                                                    
of  funder  of programs  for  beneficiaries,  the trust  had                                                                    
granted  over   $21  million  the  previous   year  to  fund                                                                    
community-based projects. Funding  also included significant                                                                    
trust  income   directed  to   various  state   agencies  to                                                                    
accomplish statewide  system change efforts. He  mentioned a                                                                    
mini-grant  program   that  provided  funds   to  individual                                                                    
beneficiaries   to  improve   quality  of   life  and   gain                                                                    
independence.                                                                                                                   
                                                                                                                                
Mr. Cook explained that in  addition to providing funds to a                                                                    
variety of  entities, the trust  provided leadership  in the                                                                    
advocacy,   planning,    and   implementing    of   Alaska's                                                                    
comprehensive mental  health program for  its beneficiaries.                                                                    
The  trust   had  supported  many   systems-change  efforts,                                                                    
including  reforms   to  Medicaid,  behavioral   health  and                                                                    
addiction services,  and most  currently efforts  to provide                                                                    
services to Alaskans experiencing a psychiatric crisis.                                                                         
                                                                                                                                
9:07:39 AM                                                                                                                    
                                                                                                                                
Mr. Cook continued his remarks.  He noted that the board was                                                                    
comprised of  long-time Alaskans.  He expressed  that thanks                                                                    
to the  trust's competent  staff, the financial  position of                                                                    
the trust remained  in a healthy financial  position and was                                                                    
bolstered by  strong performance  of trust land  and natural                                                                    
resources. The  strong position  allowed for  advancement of                                                                    
beneficiary priorities  while balancing the needs  of future                                                                    
beneficiaries.                                                                                                                  
                                                                                                                                
Mr. Cook was  proud of the work of his  fellow board members                                                                    
and  trust  staff,  particularly   in  light  of  unexpected                                                                    
challenges form the COVID-19 pandemic.                                                                                          
                                                                                                                                
9:09:16 AM                                                                                                                    
                                                                                                                                
MIKE ABBOTT,  CHIEF EXECUTIVE OFFICER, ALASKA  MENTAL HEALTH                                                                    
TRUST  AUTHORITY (via  teleconference),  discussed slide  3,                                                                    
"Trust Beneficiaries":                                                                                                          
                                                                                                                                
     Beneficiaries include Alaskans who experience:                                                                             
          ?Mental illnesses                                                                                                     
          ?Intellectual and/or developmental disabilities                                                                       
          ?Alzheimer's disease and related dementia                                                                             
          ?Traumatic brain injuries                                                                                             
          ?Substance use disorders                                                                                              
                                                                                                                                
Mr. Abbott  relayed that the  trust did  not keep a  list or                                                                    
index of  individuals that  met the  criteria listed  on the                                                                    
slide.  He   relayed  that   based  on   population  density                                                                    
calculations in  Alaska and elsewhere in  the United States,                                                                    
the  trust estimated  that approximately  70,000 to  100,000                                                                    
Alaskans would qualify as trust beneficiaries.                                                                                  
                                                                                                                                
Mr.  Abbott reviewed  slide 4,  "Financial Position,"  which                                                                    
showed  a bar  graph entitled  'Trust Invested  Assets.' The                                                                    
bar  graph   was  a  high-level  overview   of  the  trust's                                                                    
financial position.  He pointed out that  the trust's assets                                                                    
had grown relatively steadily over  the years. The dips were                                                                    
primarily  associated with  investment  returns. He  pointed                                                                    
out  a substantial  decline  in asset  value  over the  time                                                                    
period  of  2008 to  2010.  He  explained that  assets  grew                                                                    
primarily  through two  mechanisms:  investment earnings  on                                                                    
assets, and revenues from land  management activity. Both of                                                                    
the revenue  streams contributed to spending  capability and                                                                    
the growth of invested assets.                                                                                                  
                                                                                                                                
Mr. Abbott referenced slide 5, "FY22 Available Funding":                                                                        
                                                                                                                                
     Trust's Estimated Available Funding FY22                                                                                   
                                                                                                                                
          Investment Portfolio Payout (4.25%) $25,200,000                                                                       
          Prior Year Funds Carried Forward $3,500,000                                                                           
          Land Office Spendable Income $4,600,000                                                                               
          Interest Earnings $700,000                                                                                            
          Total $34,000,000                                                                                                     
                                                                                                                                
     Prior Years' Available Funding                                                                                             
                                                                                                                                
          FY21 $33,243,200                                                                                                      
          FY20 $31,875,600                                                                                                      
          FY19 $29,437,000                                                                                                      
          FY18 $28,908,000                                                                                                      
          FY17 $28,234,000                                                                                                      
                                                                                                                                
Mr.  Abbott shared  that for  FY 22,  the trust  expected an                                                                    
estimated an  approximately 3 percent increase  in available                                                                    
revenue over FY 21. The primary  source of the revenue in FY                                                                    
22 would  be investment earnings.  The trust used  a percent                                                                    
of market value (POMV) process  and paid out 4.25 percent of                                                                    
the previous  four years of  asset value. He  emphasized the                                                                    
steadily  increasing  annual  spendable  revenue,  which  he                                                                    
expected would  continue at approximately the  same pace. He                                                                    
thought the  amount could  change based  on factors  such as                                                                    
market  returns.   He  explained  that  even   a  period  of                                                                    
significant  market decline  should not  affect the  trust's                                                                    
ability  to  spend  funds  in  the  annual  budget  for  the                                                                    
beneficiaries because of access to trust reserves.                                                                              
                                                                                                                                
9:13:46 AM                                                                                                                    
                                                                                                                                
Senator von Imhof asked if  an upcoming slide would show the                                                                    
percentage of  returns for the  trust's investments  for the                                                                    
previous four  or five years.  She noted that  the committee                                                                    
looked at many funds to consider returns.                                                                                       
                                                                                                                                
Mr. Abbott did  not have the information at  hand but agreed                                                                    
to send the information to the committee.                                                                                       
                                                                                                                                
Co-Chair  Stedman  asked  for  the  information  to  include                                                                    
details  regarding  the  trust's  consultants'  expectations                                                                    
regarding future  returns. He had seen  expectations lowered                                                                    
in other areas.                                                                                                                 
                                                                                                                                
Mr. Abbott agreed to provide the additional information.                                                                        
                                                                                                                                
Mr. Abbott advanced to slide 6, "FY 22 Spending":                                                                               
                                                                                                                                
     Authority Grants                                                                                                           
     $16,084.9                                                                                                                  
     Designated grants to community providers, nonprofits,                                                                      
     local governments and Tribal organizations                                                                                 
     ?Includes $1.7 M in mini grants                                                                                            
                                                                                                                                
     Administrative Budgets                                                                                                     
     Trust Authority: $4,179.9                                                                                                  
     Trust Land Office (TLO) $4,393.8                                                                                           
     Administrative budget is lower than FY21 levels                                                                            
                                                                                                                                
     MHTAA                                                                                                                      
     $8,110.0                                                                                                                   
     Designated grants to state agencies, requires receipt                                                                      
     authority                                                                                                                  
                                                                                                                                
Mr. Abbott  explained that the slide  showed expenditures as                                                                    
approved by  the board for  FY 22. He explained  that Mental                                                                    
Health  Trust Authority  Authorized Receipts  (MHTAAR) funds                                                                    
were funds  the trust  provided to fund  a variety  of state                                                                    
government programs. The  funds had been part  of the budget                                                                    
for  a number  of years,  and  he expected  it to  continue.                                                                    
Roughly  half the  spending in  FY  22 were  grants made  to                                                                    
funding partners such as  local governments, non-profits, or                                                                    
tribes   that   provided    or   facilitated   services   to                                                                    
beneficiaries. He quantified that  roughly three quarters of                                                                    
the funds were  going out the door to  agencies and partners                                                                    
to direct services to trust beneficiaries.                                                                                      
                                                                                                                                
9:17:36 AM                                                                                                                    
                                                                                                                                
Mr. Abbott spoke to slide  7, "FY 22 GF/MH Recommendations,"                                                                    
which  showed a  data table.  He  reminded that  one of  the                                                                    
trust's  statutory obligations  was to  make recommendations                                                                    
as to how  general funds could be allocated  for the benefit                                                                    
of trust  beneficiaries. He thought  the AMHTA was  the only                                                                    
state  entities with  the explicit  statutory obligation  to                                                                    
make  the  recommendations. He  pointed  out  that the  blue                                                                    
column showed  trust recommendations, and the  yellow column                                                                    
signified  what  ended  up in  the  governor's  budget.  The                                                                    
significant  and  obvious difference  was  that  all of  the                                                                    
general  fund recommendations  that  the trustee's  provided                                                                    
(with the  exception of one for  coordinated transportation)                                                                    
were zeroed out in  the administration's budget and replaced                                                                    
with   direct   appropriation   with  trust   reserves.   He                                                                    
highlighted that the situation  was a significant departure,                                                                    
although there  was no obligation for  the administration to                                                                    
accept the trusts recommendations.  He thought the committee                                                                    
was  aware that  most recommendations  were adjusted  or not                                                                    
funded  at all.  The  current proposal  was  the first  time                                                                    
there  was  a  proposal  to substitute  trust  reserves  for                                                                    
general funds without authorization from the trust.                                                                             
                                                                                                                                
Co-Chair  Stedman  looked  at   the  operating  budget  item                                                                    
"Support Client Services at API  (DHSS)" which was listed on                                                                    
the table in red. He asked Mr. Abbott to speak to the item.                                                                     
                                                                                                                                
Mr.  Abbott stated  that in  addition  to a  fund swap,  the                                                                    
administration  had  proposed  to   replace  $6  million  of                                                                    
funding  for the  Alaska  Psychiatric  Institute (API)  with                                                                    
trust reserves  in both  the FY  21 supplemental  budget and                                                                    
the  FY  22 operating  budget.  He  explained that  API  was                                                                    
expecting  a  shortfall  in  recovered   revenue  in  of  $6                                                                    
million.  The  administration  had  proposed  to  use  trust                                                                    
reserves.  He  thought  the proposed  use  of  reserves  was                                                                    
problematic for  the trust  for two  reasons. He  noted that                                                                    
the administration had not engaged  with the trust about the                                                                    
need  during  its budget  process  the  previous summer.  He                                                                    
explained  that  the  item was  something  not  historically                                                                    
funded by the trust. Typically  trust funds were deployed by                                                                    
the trust to enhance the  efficiency of programs that served                                                                    
the beneficiaries,  rather than to supplant  state funds. He                                                                    
thought  the  item  would  be   a  clear  deviation  of  the                                                                    
approach.                                                                                                                       
                                                                                                                                
9:21:53 AM                                                                                                                    
                                                                                                                                
Co-Chair  Stedman  asked  if   the  trust  was  too  heavily                                                                    
invested  in reserves.  He asked  Mr. Abbott  to comment  on                                                                    
reserve  balance status,  and on  any potential  commitments                                                                    
that were not reflected.                                                                                                        
                                                                                                                                
Mr. Abbott  offered to jump  ahead to slides  that addressed                                                                    
the reserves.                                                                                                                   
                                                                                                                                
Co-Chair  Stedman asked  Mr. Abbott  to address  the subject                                                                    
when the appropriate slide was reached.                                                                                         
                                                                                                                                
9:22:54 AM                                                                                                                    
                                                                                                                                
Senator  Hoffman   asked  about  the  Capital   Budget  Item                                                                    
"Special Needs  Housing Grant" (SNHG)  listed on  the table.                                                                    
He thought  there was  a large  difference between  what the                                                                    
board had proposed and what  the governor was presenting. He                                                                    
asked what potential hole was  left if the governor's budget                                                                    
was  implemented without  following  the recommendations  of                                                                    
the board.                                                                                                                      
                                                                                                                                
Mr. Abbott  stated that  there would  be a  substantial gap.                                                                    
The  SNHG program  supported housing  work around  the state                                                                    
and was  managed by the  Alaska Housing  Finance Corporation                                                                    
(AHFC).  The  grant funded  a  number  of programs,  and  in                                                                    
combination  with the  Housing Assistance  Program, improved                                                                    
housing and addressed homelessness  around the state. He was                                                                    
happy  to provide  the committee  with specific  examples of                                                                    
programmatic impacts of the reduction.                                                                                          
                                                                                                                                
Senator Hoffman wanted to see  information about the impacts                                                                    
in order to make a decision  on how the mental health budget                                                                    
was brought together by the committee.                                                                                          
                                                                                                                                
Co-Chair  Stedman  thought  Mr. Abbott  would  be  providing                                                                    
detailed information.                                                                                                           
                                                                                                                                
Senator Wilson asked  if AHFC was able to  supplement any of                                                                    
the funds  with the generous  amount of COVID-19  funding it                                                                    
had received in the previous two years.                                                                                         
                                                                                                                                
Mr. Abbott did not know.                                                                                                        
                                                                                                                                
Senator Wielechowski  asked if  Mr. Abbott could  comment on                                                                    
how  the trust  was set  up and  the court  cases that  were                                                                    
involved.                                                                                                                       
                                                                                                                                
Mr. Abbott relayed that the trust  was formed as a result of                                                                    
a   combination  of   statute  change   and  settlement   of                                                                    
litigation between the state and  beneficiaries in 1994. The                                                                    
litigation arose from a concern  from beneficiaries that the                                                                    
state    had   been    mismanaging    its   federal    trust                                                                    
responsibilities.  The settlement  of the  litigation caused                                                                    
the  creation  of the  trust  authority.  The authority  was                                                                    
established with  a substantial amount of  independence from                                                                    
typical state  financial decision making. The  authority for                                                                    
the  expenditure  of  trust funds  was  explicitly  provided                                                                    
solely to the  trustees. The trust had operated  in the same                                                                    
manner for almost 27 years.                                                                                                     
                                                                                                                                
Co-Chair  Stedman   was  curious   about  the   legality  of                                                                    
switching from general funds to  trust reserves. He asked if                                                                    
Mr. Abbott believed the proposed  use of funds met the trust                                                                    
settlement requirements.                                                                                                        
                                                                                                                                
Mr. Abbott  thought it  was doubtful that  the use  of funds                                                                    
met  the  trust  settlement requirements.  He  referenced  a                                                                    
letter to  the committee  from January  2021 in  response to                                                                    
the governor's  proposed budget that had  expressed concerns                                                                    
that  the  approach  as described  in  the  administration's                                                                    
budget  was  compliant  with  the   terms  of  the  original                                                                    
settlement. He added  that the letter was  based on guidance                                                                    
that  the  trust  had  received  from  its  counsel  in  the                                                                    
department of law.                                                                                                              
                                                                                                                                
9:27:36 AM                                                                                                                    
                                                                                                                                
Senator von Imhof considered slides 5,  6, and 7 and how the                                                                    
information went together.  She considered available funding                                                                    
as shown  on slide 5  as well as  the breakdown on  slide 6,                                                                    
and estimated  that there  was $24  million left  for grants                                                                    
and programming.                                                                                                                
                                                                                                                                
Mr. Abbott  stated that Senator von  Imhof's calculation was                                                                    
"pretty close."                                                                                                                 
                                                                                                                                
Senator  von  Imhof  looked at  trustee-approved  budget  in                                                                    
light blue on slide 7,  which totaled about $24 million. She                                                                    
asked if she was reading the slides correctly.                                                                                  
                                                                                                                                
Mr. Abbott  stated that the only  piece of slide 7  that was                                                                    
included  in the  previous  slide was  the  $3.8 million  of                                                                    
MHTAAR. He clarified  that the general funds  and AHFC funds                                                                    
would not  be included  because they  were not  trust funds.                                                                    
The $3.8 million  of MHTAAR funds was a subset  of the total                                                                    
and was  highlighted as matching or  co-funding the programs                                                                    
recommend by the trust for general fund contributions.                                                                          
                                                                                                                                
Senator von Imhof assumed that  the $16 million in authority                                                                    
grants were found on another page.                                                                                              
                                                                                                                                
Mr. Abbot affirmed that the  authority grants were typically                                                                    
made directly by  the trust and did  not require legislative                                                                    
authorization. The  only trust  funds that came  through the                                                                    
legislative  process  were  the  MHTAAR  and  administrative                                                                    
budgets, which  showed up as receipt  authority for specific                                                                    
mutually  agreed purposes.  The  bulk of  the trust's  funds                                                                    
went  directly from  the trust  to grantees  and did  not go                                                                    
through the legislative appropriations process.                                                                                 
                                                                                                                                
9:31:00 AM                                                                                                                    
                                                                                                                                
Senator von Imhof mentioned  Co-Chair Stedman's reference to                                                                    
API. She  thought the use  of trust reserves was  a separate                                                                    
issue.  She  thought  that  after  looking  at  the  trust's                                                                    
charter documents,  there was an appropriateness  to funding                                                                    
some of API.  She did not think it  was wholly inappropriate                                                                    
for the  governor to  suggest AMHTA  use funds  towards API.                                                                    
She noticed  that the administrative  budgets for  the trust                                                                    
authority and land office were  almost 25 percent, which she                                                                    
thought were  high compared to  other trusts.  She suggested                                                                    
Mr.  Abbott   could  provide  a  written   response  to  the                                                                    
committee  with  information  about why  the  administrative                                                                    
budget the size it was.                                                                                                         
                                                                                                                                
Co-Chair  Stedman  asked  Mr.  Abbott to  get  back  to  the                                                                    
committee with the information.                                                                                                 
                                                                                                                                
Mr. Abbott discussed slide 8, "Work of the Trust":                                                                              
                                                                                                                                
     Established Focus Areas                                                                                                    
     ?Disability Justice                                                                                                        
     ?Mental Health and Addiction Intervention                                                                                  
     ?Beneficiary Employment & Engagement                                                                                       
     ?Housing and Home & Community Based Services                                                                               
                                                                                                                                
     Additional Priorities                                                                                                      
     ?Workforce Development                                                                                                     
     ?Early Childhood Intervention and Prevention                                                                               
                                                                                                                                
Mr.  Abbott relayed  that the  slide described  the priority                                                                    
areas that had been the focus  of the trust's work in recent                                                                    
years and would continue in FY 22.                                                                                              
                                                                                                                                
Mr. Abbott addressed slide 9, "Trust Grant Impacts":                                                                            
                                                                                                                                
     ?Supported project increasing substance use disorder                                                                       
     treatment capacity                                                                                                         
          ?$300,000 to Akeela, Inc. to increase residential                                                                     
          treatment capacity                                                                                                    
          ?$125,000 to SeaView Community Services Recovery                                                                      
          Housing Program in Seward                                                                                             
          ?$300,000 to Set Free Alaska's residential                                                                            
          treatment facility in Homer                                                                                           
    ?Expanded services to prevent and end homelessness                                                                          
          ?$150,000 to the Bethel Winter House?$250,000 to                                                                      
          Covenant House Alaska                                                                                                 
          ?$200,000 for the new Glory Hall facility in                                                                          
          Juneau                                                                                                                
          ?$500,000 to United Way of Anchorage                                                                                  
     ?Supported ongoing implementation of the Medicaid                                                                          
     Behavioral Health Waiver                                                                                                   
                                                                                                                                
Mr. Abbott mentioned some high-impact  program work shown on                                                                    
the  slide,  including  recent  significant  investments  in                                                                    
substance  abuse treatment  capacity  increase. He  expected                                                                    
the  level   of  investment  in  the   identified  areas  to                                                                    
continue. He commented on the  success of the enhancement of                                                                    
Medicaid   services,  that   would  significantly   increase                                                                    
behavioral healthcare in the  state without increasing state                                                                    
contribution.                                                                                                                   
                                                                                                                                
Mr. Abbott reviewed slide 10, "COVID-19 Response Grants":                                                                       
                                                                                                                                
     ?Trustees approved $1.5M in spring of 2020                                                                                 
     ?Supported 70+ beneficiary serving organizations                                                                           
     across the state                                                                                                           
     ?Program in addition to regular Trust granting                                                                             
     activity                                                                                                                   
                                                                                                                                
Mr.  Abbott shared  that  in response  to  the pandemic  the                                                                    
previous spring, the trust had  reallocated funds within its                                                                    
FY 20  budget as  shown on  the slide. He  was happy  to say                                                                    
that the  trust had  been able to  typically turn  around an                                                                    
application  from   a  grantee   within  two   weeks.  Funds                                                                    
typically   went  towards   enhancing  technology   so  that                                                                    
providers could provide services  to trust beneficiaries. He                                                                    
mentioned purchase  of protective equipment and  coverage of                                                                    
temporary  or long-term  revenue losses  as examples  use of                                                                    
the funds.                                                                                                                      
                                                                                                                                
9:36:36 AM                                                                                                                    
                                                                                                                                
Senator Wilson  asked if there  had been  any double-funding                                                                    
of items that occurred with  grantees due to application for                                                                    
federal funds.                                                                                                                  
                                                                                                                                
Mr. Abbott  thought it was  highly likely that  the grantees                                                                    
were seeking other funds, either  through state or federally                                                                    
administered programs.  He added  that the trust  had worked                                                                    
to steer applicants to the other programs when possible.                                                                        
                                                                                                                                
Senator  Wilson  asked  if  any of  the  grantees  had  been                                                                    
seeking  double  reimbursement  for the  same  services.  He                                                                    
asked about audits of grantees.                                                                                                 
                                                                                                                                
Mr.  Abbott relayed  that AMHTA  had not  done any  auditing                                                                    
beyond simple  grant reporting that was  required. He shared                                                                    
that  the vast  majority of  trust  grants had  gone out  in                                                                    
increments of  less than  $25,000 per  grantee. The  goal of                                                                    
the trust had  been to get the funds to  grantees as quickly                                                                    
as possible  in order  to assist  providers in  staying open                                                                    
and continuing to provide services.                                                                                             
                                                                                                                                
Mr.   Abbott  considered   slide  11,   "Improving  Alaska's                                                                    
Psychiatric Crisis Care":                                                                                                       
                                                                                                                                
     ?Our  behavioral health  crisis system  of care  should                                                                    
     provide people experiencing  a behavioral health crisis                                                                    
     the right  care, in the  right setting, when  they need                                                                    
     it --just  like what  we expect  for a  physical health                                                                    
     crisis                                                                                                                     
      Currently   law   enforcement,   EMS,   and   hospital                                                                    
     emergency rooms serve people having a mental health                                                                        
     crisis.                                                                                                                    
                                                                                                                                
Mr. Abbott noted that when  Alaskans had a medical emergency                                                                    
such as  a heart attack  or broken  leg, a patient  could be                                                                    
generally confident in being  served by emergency responders                                                                    
that  were trained.  He  described a  lack  of training  and                                                                    
resources as a reason for  the need for improvement. Current                                                                    
primary psychiatric crisis care  resources in the state were                                                                    
paramedics, police  officers, and hospital  emergency rooms,                                                                    
and correctional  facilities, which  did not  serve patients                                                                    
very  well. There  were better  services available,  and the                                                                    
trust was committed to bringing  the services to Alaska. The                                                                    
trust  had been  working with  other states  and communities                                                                    
that had  developed better systems  and were in  the process                                                                    
of  brings Alaska-adapted  versions  of the  systems to  the                                                                    
state.                                                                                                                          
                                                                                                                                
Mr.  Abbot continued  to address  slide 11.  He expected  to                                                                    
deploy  more than  $10  million in  trust  funds toward  the                                                                    
effort  in  FY 21,  FY  22,  and  FY  23. He  expected  that                                                                    
Medicaid would be a significant  funder of the serves in the                                                                    
1115 waiver. The  trust expected to supplement  the funds as                                                                    
the  services came  up  to speed.  He  thought the  enhanced                                                                    
services  were good  for  trust beneficiaries,  communities,                                                                    
and other service providers.                                                                                                    
                                                                                                                                
9:41:43 AM                                                                                                                    
                                                                                                                                
Senator Wilson assumed that Mr.  Abbott was referring to the                                                                    
"Crisis Now"  model. He  mentioned the  Biden Administration                                                                    
putting a hold  on Medicaid waivers. He asked  if Mr. Abbott                                                                    
felt  that  additional  Medicaid  waivers  for  reimbursable                                                                    
services would slow down the implementation of the model.                                                                       
                                                                                                                                
Mr. Abbott  stated that  the trust  was currently  trying to                                                                    
build  out the  system  using the  current  1115 waiver.  He                                                                    
thought future waivers maybe warranted  and applied for, the                                                                    
trust had started  the process with the  assumption that the                                                                    
status quo would be in place for the next several years.                                                                        
                                                                                                                                
Senator Wilson  asked if the  trust was  providing authority                                                                    
grants  to provide  additional services  for individuals  in                                                                    
API.                                                                                                                            
                                                                                                                                
Mr. Abbott relayed that the  trust was providing funding for                                                                    
a number of  things that supported API. There  were a number                                                                    
of grants  for a  variety of  equipment and  improvements to                                                                    
the  facility.  The  trust  was also  funding  some  of  the                                                                    
services  that  the state  agreed  to  through a  settlement                                                                    
executed  the  previous  year.   There  was  no  current  or                                                                    
anticipated  funding in  the trust-approved  budget for  the                                                                    
base-level  services at  API. He  added that  the trust  had                                                                    
been active in  a variety of issues related to  API, and the                                                                    
trust  had contributed  the land  on which  the current  API                                                                    
campus sat.                                                                                                                     
                                                                                                                                
Senator  Wielechowski asked  if the  trust was  consulted or                                                                    
did  the  trust  support  the governor's  decision  to  give                                                                    
Wellpath the sole-source $1 million per month contract.                                                                         
                                                                                                                                
Mr. Abbott answered  "no." Since that time,  API had rebuilt                                                                    
a  governance board  that advised  on significant  decisions                                                                    
relating to  the operation  of the  hospital. He  added that                                                                    
the trust served  as an ex officio member of  the board. The                                                                    
board was not  formed when the contract was  issued, and the                                                                    
trust had not had other involvement in the decision.                                                                            
                                                                                                                                
9:45:52 AM                                                                                                                    
                                                                                                                                
Mr. Abbott showed slide 12, "Trust Land Office":                                                                                
                                                                                                                                
     ?USFS Land Exchange                                                                                                        
     ?Icy Cape Development                                                                                                      
     ?Fort Knox 2021 Expansion                                                                                                  
       ubport Sale Finalized                                                                                                    
                                                                                                                                
     FY21 Anticipated Trust Land Office Revenues                                                                                
     Coal $171,000                                                                                                              
     Oil and Gas $1,257,000                                                                                                     
     Minerals $1,078,000                                                                                                        
     Materials $280,000                                                                                                         
     Timber $2,581,000                                                                                                          
     Land $22,865,000                                                                                                           
     Real Estate $1,668,000                                                                                                     
     Total $29,900,000                                                                                                          
                                                                                                                                
Mr. Abbott explained that the  slide highlighted the success                                                                    
of the  land office,  and described the  revenue anticipated                                                                    
in  the current  fiscal  year. He  was relatively  confident                                                                    
that the trust land office  was going to have an exceptional                                                                    
year in  generating revenue.  He shared that  in FY  21, the                                                                    
trust would  receive payment for  the Juneau  Subport parcel                                                                    
that  had  been  purchased  by Norwegian  Cruise  Lines.  He                                                                    
detailed that the sale took place  a little more than a year                                                                    
previously,  but the  transaction did  not take  place until                                                                    
2021. Of the  $29.9 million shown on the  slide, $20 million                                                                    
was  from the  single transaction,  while the  remainder was                                                                    
from other asset types managed by the trust land office.                                                                        
                                                                                                                                
Mr. Abbott discussed slide 13, "Trust Reserves":                                                                                
                                                                                                                                
     ?Create buffer for years with low earnings, ensuring                                                                       
     Trust programming is not impacted                                                                                          
     ?Described in the Trust Asset Management Policy                                                                            
     Statement                                                                                                                  
     ?Some Reserves are managed by APFC, some by Dept. of                                                                       
     Revenue                                                                                                                    
     ?If the Trust only relied on prior year earnings for                                                                       
     spending, there would have been spending reductions in                                                                     
     9 of the past 24 years                                                                                                     
          ?In 5 years since 1994, the Trust's investments                                                                       
          had negative earnings                                                                                                 
                                                                                                                                
Mr.  Abbott explained  that  trust  asset management  policy                                                                    
statement  was reviewed  every few  years  and was  recently                                                                    
updated   in  the   summer   of  2019.   As   a  result   of                                                                    
recommendations provided by  Callan and Associates, reserves                                                                    
were  managed  in  two  different   portfolios  by  the  two                                                                    
entities listed on the slide.  He discussed the value of the                                                                    
trust's reserves. He thought that  the trust had managed its                                                                    
reserves  responsibly in  order  to allow  for a  consistent                                                                    
presence in programming for support of trust beneficiaries.                                                                     
                                                                                                                                
9:50:09 AM                                                                                                                    
                                                                                                                                
Senator  Wielechowski  asked if  the  entire  amount of  the                                                                    
trust  reserves   and  trust   corpus  were   available  for                                                                    
appropriation by the legislature.                                                                                               
                                                                                                                                
Mr. Abbott informed that the  corpus, or Mental Health Trust                                                                    
Fund, was  not available for  the trust or any  other entity                                                                    
to  use for  any purpose.  The fund  was to  be managed  for                                                                    
perpetual functionality based  on statutory requirements and                                                                    
as  determined in  the  settlement in  the  early 1990s.  He                                                                    
continued  that trust  reserves  were  available for  trust-                                                                    
authorized uses.                                                                                                                
                                                                                                                                
Co-Chair Stedman  asked Mr. Abbott  to compare  and contrast                                                                    
the funds  as compared to  the Alaska Permanent  Fund (APF).                                                                    
He mentioned  the Earnings Reserve Account  (ERA), which was                                                                    
subject  to   appropriation.  He   thought  the   trust  was                                                                    
structured differently.                                                                                                         
                                                                                                                                
Mr.  Abbott  relayed  that  the   trust  and  the  APF  were                                                                    
relatively similar, and more similar than most other state-                                                                     
invested  assets.  Like  the   APF,  the  trust  corpus  was                                                                    
segregated  and was  off limits.  He realized  that the  APF                                                                    
could be  accessed by  a vote  of the  people, which  was an                                                                    
option  not available  for accessing  the  trust. The  trust                                                                    
reserves functioned much like the  ERA, and all the earnings                                                                    
from the  assets invested by  the trust went  into reserves,                                                                    
similar  to  the  ERA.  The  corpus of  the  trust  did  not                                                                    
fluctuate based  on investment earnings.  The trust  was set                                                                    
up as an endowment, as in many other states.                                                                                    
                                                                                                                                
Mr.   Abbott  continued   to   address  Co-Chair   Stedman's                                                                    
questions. He explained that the  only way the corpus of the                                                                    
trust  would  grow was  through  deposits  made by  trustees                                                                    
through  a  particular type  of  land  revenue or  inflation                                                                    
proofing. He acknowledged  that he was not an  expert on the                                                                    
APF, but  he thought that  the way  the corpus of  the trust                                                                    
operated was  roughly analogous.  For inflation  proofing to                                                                    
take  place,   an  appropriation  by  the   legislature  was                                                                    
required.  Conversely in  an  endowment, inflation  proofing                                                                    
took  place  naturally  as  the  earnings  and  corpus  were                                                                    
melded.                                                                                                                         
                                                                                                                                
Senator  Wielechowski commented  that  if  the governor  was                                                                    
starting to use  the trust reserves when there  had not been                                                                    
inflation-proofed  in  15 years,  the  trust  might want  to                                                                    
consider putting some of the funds into the corpus.                                                                             
                                                                                                                                
Senator von  Imhof looked back  to slide 5. She  assumed the                                                                    
$34  million  reflected  4.25 percent  of  the  total  trust                                                                    
amount comprised of the trust reserves plus the corpus.                                                                         
                                                                                                                                
Mr. Abbott stated that Senator von Imhof was correct.                                                                           
                                                                                                                                
Senator  von Imhof  asked if  the  legislature began  taking                                                                    
more reserves or more than  4.25 percent, than the potential                                                                    
was that  the annual draw  began to decrease as  the overall                                                                    
portfolio decreased.                                                                                                            
                                                                                                                                
Mr. Abbott answered in the affirmative.                                                                                         
                                                                                                                                
Senator von Imhof  thought the situation was  similar to the                                                                    
APF. She  knew it was  possible for the legislature  to take                                                                    
from the  trust reserves,  but thought  it was  important to                                                                    
consider the consequences, which  could require General Fund                                                                    
matching or program elimination.                                                                                                
                                                                                                                                
9:56:39 AM                                                                                                                    
                                                                                                                                
Senator  Wilson  asked  if the  governor's  proposed  budget                                                                    
could work if  there was only a one or  two year draw rather                                                                    
than an annual draw.                                                                                                            
                                                                                                                                
Mr. Abbott  thought that Senator Wilson's  question pondered                                                                    
whether the amount  of reserves exceeded the  proposed FY 21                                                                    
and  FY 22  draws, and  answered affirmatively.  He asserted                                                                    
that  there would  be long  term impacts  from the  proposed                                                                    
budget.  He  thought  in  the   near  term,  trustees  would                                                                    
consider  reducing   other  areas   of  spending   to  avoid                                                                    
overdrawing from reserves.                                                                                                      
                                                                                                                                
Mr. Abbott  continued to address Senator  Wilson's question.                                                                    
Based on his  guidance from the trustees,  the proposed draw                                                                    
from invested  assets was closer  to 7 percent or  8 percent                                                                    
rather than  4.25 percent. If  the trust was faced  with the                                                                    
larger draw, it would have to make some hard choices.                                                                           
                                                                                                                                
Senator Wilson was looking for  a more simplistic answer. he                                                                    
asked if it  would be catastrophic if the  proposed draw was                                                                    
taken for only one year.                                                                                                        
                                                                                                                                
Mr.  Abbott  was  not  sure he  was  comfortable  giving  an                                                                    
answer. He  thought the  draw would  be a  radical deviation                                                                    
from the  manner in  which the trust  had operated,  both in                                                                    
process and in  substance. He did not want  to challenge the                                                                    
legal authority  of the  legislature and  encouraged members                                                                    
to seek advice  from the Department of Law  or other counsel                                                                    
on the legal impact of  what was proposed, beyond the fiscal                                                                    
impact.                                                                                                                         
                                                                                                                                
Co-Chair  Stedman mentioned  the existing  4.25 draw  on the                                                                    
trust  and  asked  what  the  draw  rate  would  be  if  the                                                                    
legislature executed the governor's proposed budget.                                                                            
                                                                                                                                
Mr.  Abbott  stated  that the  appropriation  would  signify                                                                    
pulling  an additional  $16 million  beyond the  anticipated                                                                    
$25 million from the trust  assets. The amount would signify                                                                    
an approximately 7 percent draw  rather than the traditional                                                                    
4.25 percent POMV draw.                                                                                                         
                                                                                                                                
10:00:52 AM                                                                                                                   
                                                                                                                                
Senator Wilson  asked if Mr.  Abbott had stated  there would                                                                    
be a $16 million additional draw.                                                                                               
                                                                                                                                
Mr. Abbott  affirmed that the proposed  budget would signify                                                                    
a  $16  million   additional  draw,  as  a   result  of  the                                                                    
combination  of the  FY  21 supplemental  budget  and FY  22                                                                    
operating budget proposals from the governor.                                                                                   
                                                                                                                                
Mr. Abbott reviewed slide 14, "Trust Reserves":                                                                                 
                                                                                                                                
     Reserves target set after consulting with Callan at                                                                        
     400% of the current year's payout                                                                                          
          ?Allows Trust to sustain program work during                                                                          
          prolonged market downturns                                                                                            
          ?Trust Reserves are volatile                                                                                          
                                                                                                                                
     Trust Reserves                                                                                                             
                                                                                                                                
     FY20 Year End Balance:                                                                                                     
          $160,555,000                                                                                                          
     FY21 Year End Balance:                                                                                                     
         (estimated) $175,000,000 to $225,000,000                                                                               
                                                                                                                                
Mr. Abbot addressed the graph  on slide, entitled 'Available                                                                    
Budget Reserves  Compared to annual Payout.'  He pointed out                                                                    
that the graph showed the  last 18 months of reserve levels,                                                                    
which  had  fluctuated  between  a  starting  point  of  500                                                                    
percent of reserves, with a  dip seven months later to below                                                                    
400   percent,  and   growth  within   the   last  year   to                                                                    
approximately 800 percent of the  annual payout in reserves.                                                                    
He  thought  the  graph  was   a  good  description  of  the                                                                    
volatility that the  trust faced. He added  that because the                                                                    
trust was not  run like an endowment, all  of the volatility                                                                    
that the  APF experienced  as it  managed the  trusts corpus                                                                    
showed up in the trust's  reserves, which was another reason                                                                    
to keep a conservative amount of reserves available.                                                                            
                                                                                                                                
Mr. Abbott  described that if  the APF and DOR  (the trust's                                                                    
two managers)  had annual  projections for  FY 21  that came                                                                    
true  before  the end  of  the  fiscal year,  trust  reserve                                                                    
levels  would  drop  by  $30  million  to  $40  million.  He                                                                    
reminded  that  the APFC  and  DOR  were both  significantly                                                                    
exceeding initial annual projections.                                                                                           
                                                                                                                                
Co-Chair   Stedman  asked   Mr.   Abbott   to  restate   the                                                                    
information about  timing. He asked  when the last  time the                                                                    
trust inflation proofed.                                                                                                        
                                                                                                                                
10:05:05 AM                                                                                                                   
                                                                                                                                
Mr.  Abbott thought  Co-Chair Stedman's  question introduced                                                                    
the topic  of slide  15. He relayed  that the  trust's asset                                                                    
management policy  statement and state statutes  obliged the                                                                    
trust  to evaluate  inflation proofing  when trust  reserves                                                                    
exceeded the  target rate. He  cited that the last  time the                                                                    
trust   made  a   significant  inflation-proofing   transfer                                                                    
between the reserves  and the corpus was 2005,  and that for                                                                    
a variety  of reasons,  the trust  had not  done substantial                                                                    
inflation-proofing  since.  He   mentioned  the  legislative                                                                    
audit in  2018. He thought earlier  graphs depicting reserve                                                                    
levels showed  that investment  performance in  2008 through                                                                    
2010  had   been  part   of  the   reason.  The   trust  had                                                                    
contemplated  inflation-proofing a  year previously,  and at                                                                    
the time  the trust assets  were below target  and inflation                                                                    
proofing  had not  been recommended  at the  time. He  added                                                                    
that because of investment  performance over the previous 12                                                                    
months  there would  be trustee  consideration of  inflation                                                                    
proofing.                                                                                                                       
                                                                                                                                
Mr. Abbot referenced slide 15, "Trust Reserves":                                                                                
                                                                                                                                
     When Reserves exceed the target:                                                                                           
                                                                                                                                
     ?Asset Management Policy Statement says the Trust will                                                                     
     consider inflation-proofing the corpus                                                                                     
     ?There has been no substantial inflation proofing                                                                          
     since 2005                                                                                                                 
     ?Our FY21 inflation-proofing liability is $120 million                                                                     
                                                                                                                                
Mr. Abbott  cited that the  trust's finance  committee would                                                                    
be meeting the  following week to consider the  topic and he                                                                    
expected   the   committee    would   evaluate   the   staff                                                                    
recommendation  that  upwards  of   $100  million  would  be                                                                    
transferred from  trust reserves to  the corpus to  begin to                                                                    
address  the  roughly  $120  million  outstanding  inflation                                                                    
proofing liability.                                                                                                             
                                                                                                                                
Senator von  Imhof thought it  was good news that  the trust                                                                    
was contemplating  inflation-proofing the fund.  She thought                                                                    
inflation-proofing should  be done on  an annual basis  in a                                                                    
disciplined  manner.  She  thought the  400  percent  target                                                                    
recommended  by Callan  was generous.  She  thought it  made                                                                    
sense to inflation  proof, and she thought  entities such as                                                                    
the governor  would look  to the fund  when there  were high                                                                    
corpus  balances. She  thought the  long-term health  of the                                                                    
fund would be best  served by disciplined inflation proofing                                                                    
on a regular  basis, and it would be  good for beneficiaries                                                                    
who would benefit from programs being in perpetuity.                                                                            
                                                                                                                                
Co-Chair Stedman  also supported  a disciplined  approach as                                                                    
suggested by Senator  von Imhof. He agreed that  it would be                                                                    
nice for  the trust  board to consider  the topic  of annual                                                                    
inflation proofing.                                                                                                             
                                                                                                                                
Mr. Abbott believed the board  would be addressing inflation                                                                    
proofing  in the  October/November time  frame on  an annual                                                                    
basis  using audit  financials from  the  previous year.  He                                                                    
agreed with the recommendation.                                                                                                 
                                                                                                                                
Senator Wilson asked if it  was the board's intention to try                                                                    
to  make  up  for  the  entire  $120  million  in  inflation                                                                    
proofing  deficit,  or rather  to  set  a new  policy  going                                                                    
forward for an annual appropriation.                                                                                            
                                                                                                                                
Mr. Abbott stated  the board had not decided  on the matter.                                                                    
The  following  week  the board's  finance  committee  would                                                                    
consider the  condition of the reserves  and the outstanding                                                                    
inflation   proofing  obligation.   He  was   confident  the                                                                    
trustees would  make an  excellent decision  as to  how much                                                                    
and when to affect any inflation proofing transfers.                                                                            
                                                                                                                                
10:10:24 AM                                                                                                                   
                                                                                                                                
Senator Hoffman  asked what  discretion the  legislature had                                                                    
in inflation-proofing the trust if the board did not.                                                                           
                                                                                                                                
Mr. Abbott  referenced guidance from the  Department of Law.                                                                    
He understood  that the deployment  of funds into  the trust                                                                    
fund (from reserves  or any other source)  was the exclusive                                                                    
responsibility of trustees.                                                                                                     
                                                                                                                                
Senator  Hoffman requested  clarification  as  to the  exact                                                                    
responsibility  of the  legislature, and  as to  whether the                                                                    
legislature had  the authority to  inflation proof  since it                                                                    
was the appropriating body.                                                                                                     
                                                                                                                                
Co-Chair  Stedman thought  the  members  were interested  in                                                                    
inflation  proofing  the  trust  to protect  the  funds  for                                                                    
future generations.                                                                                                             
                                                                                                                                
Mr. Abbott would work with  the Department of Law to provide                                                                    
information on Senator Hoffman's  question. He stated he and                                                                    
the  board  chair   understood  Co-Chair  Stedman's  message                                                                    
clearly.                                                                                                                        
                                                                                                                                
Senator  Olson  asked  about the  "shuffling"  of  funds  as                                                                    
proposed by  the administration.  He asked how  the proposed                                                                    
splitting of  the Department of  Health and  Social Services                                                                    
(DHSS) would affect the budget of the trust.                                                                                    
                                                                                                                                
Mr. Abbott  did not see  any direct  impact on the  trust or                                                                    
its programming  from the  implementation of  the governor's                                                                    
executive order regarding DHSS.                                                                                                 
                                                                                                                                
Senator Olson asked if the  trust supported the split of the                                                                    
department as proposed by the governor's executive order.                                                                       
                                                                                                                                
Mr. Abbott  relayed that  the trust had  not taken  a formal                                                                    
position on  the reorganization. The trust  had been assured                                                                    
by  the department  that  the  reorganization would  improve                                                                    
service delivery  to trust  beneficiaries among  others. The                                                                    
trust  was confident  that the  executive order  as proposed                                                                    
would not impact the trust  directly. The statutory re-write                                                                    
involved in the executive order was neutral with regard to                                                                      
the trust.                                                                                                                      
                                                                                                                                
Mr. Abbott thanked the committee on behalf of the trust.                                                                        
                                                                                                                                
Co-Chair  Stedman  looked forward  to  the  response to  the                                                                    
member's  question.  He  asked  Mr.  Abbott  to  inform  the                                                                    
committee when  the board  took action  or gave  a direction                                                                    
regarding the inflation proofing issue.                                                                                         
                                                                                                                                
Mr. Abbot agreed to provide the information.                                                                                    
                                                                                                                                
Co-Chair Stedman discussed the agenda for the following                                                                         
day.                                                                                                                            
                                                                                                                                
ADJOURNMENT                                                                                                                   
10:15:22 AM                                                                                                                   
                                                                                                                                
The meeting was adjourned at 10:15 a.m.                                                                                         
                                                                                                                                
                                                                                                                                

Document Name Date/Time Subjects
022421 AMHTA Final Trust 2021 S FIN PPT.pdf SFIN 2/24/2021 9:00:00 AM
AMHTA
022421 Trust Follow-up S FIN Hearing 3.1.21.pdf SFIN 2/24/2021 9:00:00 AM
AMHTA