Legislature(2003 - 2004)
11/05/2003 09:03 AM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
JOINT MEETING
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
November 5, 2003
9:03 a.m.
MEMBERS PRESENT
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES
Senator Fred Dyson, Chair
Senator Lyda Green, Vice Chair
Senator Bettye Davis
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
Representative Peggy Wilson, Chair
Representative John Coghill
Representative Paul Seaton
Representative Kelly Wolf
Representative Sharon Cissna
MEMBERS ABSENT
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES
Senator Gary Wilken
Senator Gretchen Guess
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
Representative Carl Gatto, Vice Chair
Representative Mary Kapsner
OTHER LEGISLATORS PRESENT
Representative David Guttenberg
Representative Jim Holm
Representative Mike Hawker
COMMITTEE CALENDAR
Public Testimony on the Department of Health and Social
Services
WITNESS REGISTER
Commissioner Joel Gilbertson
Department of Health &
Social Services
PO Box 110601
Juneau, AK 99801-0601
Marcie Kennai
Deputy Commissioner
Department of Health &
Social Services
PO Box 110601
Juneau, AK 99801-0601
Testifying from the Homer LIO:
Susan Drathman, Colleen Powers, Mako Haggerty, Alice Haggerty,
Hal Smith
Testifying from the Fairbanks LIO: Larry Cagnina, Chuck Rollins,
Betty Rollins, Taber Rehbaum, Andy Harrington Annie Hopper,
Susan Roatch, Annette Freiburger, Jeanette Grasto, Ed Meyers,
Scott Calder, Liz Greig, Jodi Olmstead
Testifying from the Anchorage LIO:
Joseph Pichler, Monica McLeod, Lynne Koral, Lyn Freeman, Carl
Evertsbusch, Ellen Krsnak, Sallye Werner, Don Mitchell, Paul
Richards, Kitty Kohli, Robert Young, John White, Candace Winkle,
Laura Waldon, Wanda Gardner, Mary Elizabeth Ryder, Bonnie and
Gareth Nelson, Daryl Nelson, Bonnie Nelson, Delisa Culpepper,
Janet Johnson, Lizette Stiehr, Stephanie Rhoades, Gwen Lee,
Nathan Knowles, Mary Dyer
Testifying from the Mat-Su LIO:
Bernadine Janzen, Eleanor Oakley
Testifying from the Kenai LIO:
Margaret Parsons-Williams, Anne Evans, Linda Flowers, Vern
Smith, Steve Horn
Testifying from the Kotzebue LIO:
Ruth Ferguson-Schaeffer, Cathy Jones
Testifying from the Seward LIO:
Arthur Walters - Governor's Council on Disabilities and Special
Education, Monica Luther, Christine Hopkins, Claudia Simpson
Testifying from the Nome LIO:
Pam Karalunas
Testifying from the Kodiak LIO:
Linda DeRoy
Testifying from the Juneau LIO:
Jill Sandleben, Jodi Rumph, Rosemary Hagevig - Catholic
Community Services, Sharon Lobaugh, Diana Runde
Testifying from the Bethel LIO:
Louise Charles, Dick Andrew, John Smith, Pamela Bumsted,
Testifying Offnet:
Kristen Nygren, Karen Thompson, Regina Taylor, Dolores Pratt,
Don Ford, Frita Rogers
ACTION NARRATIVE
TAPES 03-29, 03-30, 03-31, 03-32
TAPE 03-29, SIDE A [SENATE HES TAPE]
CHAIR FRED DYSON called the joint meeting of the Senate Health,
Education and Social Services Standing Committee and the House
Health, Education and Social Services Standing Committee to
order at 9:03 a.m. This meeting was a joint meeting with Senate
HESS, House HESS, and other individual legislators. Those
present, including via videoconference and teleconference, were
Senators Lyda Green and Bettye Davis, and Representatives John
Coghill, Peggy Wilson, Paul Seaton, Sharon Cissna, David
Guttenberg, Jim Holm, Kelly Wolf, and Mike Hawker.
Chair Dyson indicated that the hearing would begin with a report
from Joel Gilbertson, Commissioner of the Alaska Department of
Health and Social Services (DHSS) outlining issues in their
departmental restructuring as well as future direction and
service provision. Also, Marcie Kennai, Deputy Commissioner of
the Office of Children's Services (OCS), will also provide a
brief overview of the improvements made to the programs within
OCS.
COMMISSIONER JOEL GILBERTSON, Department of Health and Social
Services (DHSS), announced that the department has been focusing
on its mission over the past year: to protect and promote the
health and well being of all Alaskans. The department is
constrained by the state's budget shortfalls. Medicaid growth
has also contributed to challenges in the budget. The department
is committed, as cost-containment strategies are sought and
implemented, to preserving direct services to clients. The
recent restructuring was a minor financial factor in the
refinancing of the budget, but a major factor toward the future
of effective service delivery for DHSS. A more efficient manner
of providing services has been the focus of budget cuts, rather
than eliminating services. A new Office of Children's Services
has been formed and centralized and dedicated to providing
services to keep Alaskan children safe. The State's substance
abuse and mental health services have been shifted to an
integrated behavioral health model to accommodate the co-
occurrence of many disorders. A new Division of Senior and
Disabilities Services will help provide service to these
recipients. The former Division of Medical Assistance was
eliminated in the restructuring, allowing program management
personnel to provide fiscal responsibility. He said, "I will not
cut direct services until we have eliminated all indirect
services first."
COMMISSIONER GILBERTSON continued by re-stating the importance
of integrating service delivery for mental health and substance
abuse treatments. This fundamental reform allows the state to
save money by loading services on the "front end" of treatment.
The Division of Juvenile Justice is entering a system reform to
increase the use of outpatient care and preventative treatment.
Again, service loading on the front end will improve the outcome
for Alaskan kids. Underage tobacco use is at an unacceptable
level, and education was provided to retail providers of tobacco
products to decrease this problem. Commissioner Gilbertson
reviewed that upon being firm with retailers and gaining their
cooperation, the illegal sell rate of tobacco has declined over
the past five or so years from 30.5 percent to 10 percent.
The federal government has identified Alaska as a high
performance state with regards to our welfare system. Our
program will continue to aim to temporarily assist families to
become self-sufficient. The Medicaid program continues to grow
at a rate that endangers other functions within the department.
Soon, the Medicaid budget will be close to $1 billion, growing
by $100 million every year over the last five years. This has
forced the administration to initiate cost-containment
strategies that are uncomfortable but necessary. A preferred
drug list (PDL) will be implemented. Pharmaceutical and
Therapeutics committees have begun meeting to discuss which
drugs comprise the PDL. Doctors and pharmacists are also
participating in the establishment of a PDL. The Department has
responded to fears that the PDL will dangerously compromise
access to necessary treatment by allowing prescribing physicians
who direct treatment with non-approved prescriptions to simply
document medical necessity on the prescription so that patients
can easily acquire needed medication. With the PDL, the
Department plans to increase cost savings and to protect access
to needed treatment.
With respect to the state's growing developmental disability
wait list, waivers are available for treatment for those who do
not qualify for Medicaid. The Department is examining the
prospects for regionalizing this wait list and for collaborating
with Native health care systems, for maximizing our use of
federal funding, and for services. Pioneer homes will continue
to be reformed to serve their patients. The Department is
attempting to consolidate the administration of its grant
programs so that grant recipients encounter fewer administrative
obstacles to acquiring desired resources.
In conclusion, Commissioner Gilbertson restated that DHSS will
continue to face fiscal challenges in the future, overall state
revenue is declining, and the demands for services are
increasing, but the Department is responding to these factors
responsibly by attempting to refinance services and obtain
alternative revenues, streamlining program administration,
improving customer service, and by continuing to focus on
protecting direct services. Each division in the Department can
meet its mission.
REPRESENTATIVE SHARON CISSNA emphasized the importance of
maintaining a focus on quality of care as the State examines
refinancing and cost-containment strategies.
Representative Hawker voiced concern from the pharmaceutical
industry that the Department has initiated the process to create
a PDL without the necessary collaboration with the industry.
MS. MARCIE KENNAI, Deputy Commissioner, Office of Children's
Services (OCS), spoke to her new duties as the Deputy
Commissioner. In June 2002, a federal audit was begun that
ultimately, pointed out many deficiencies in Alaska's child
protection system. As a result, DHSS developed a program
improvement plan (PIP) to address these shortcomings. The PIP
will constitute only a portion of the modifications planned for
OCS in the future. Safety, permanency, and wellbeing are the
main goals of the program changes. Alaska did not score well
concerning repeat maltreatment, maltreatment of children in
foster homes, and timely investigations. The Alaskan system does
not reach required success in reunifying children with their
families, but for those who are reunited, the incidence of
reentry into the system is very low. To solve these problems,
OCS must continue to prioritize safety of its children, to
initiate effective systemic change, to develop measurable
outcomes, and to partner with other involved parties, including
tribal agencies.
To promote safety, OCS has established ongoing safety work
groups, to hold staff accountable, to improve training, to
involve national research groups, to begin to assign lower-
priority cases to community agencies, allowing state resources
to focus on the most urgent cases, to partner with other state
agencies, to implement a new structured family decision-making
process, to improve risk assessment tools, and to enhance the
screening/recruiting/training of foster care resources. Efforts
have begun to prevent child abuse, rather than simply to respond
to it. The Online Resources for the Children of Alaska (ORCA)
system is nearing implementation that will dramatically improve
data management for staff. The staff of OCS remains committed to
protecting the children of our state. Focus will be maintained
on program strengths and resources rather than failures and
budget constraints.
CHAIR DYSON pointed out high caseloads and staff turnover as
obstacles to an effective agency. As a result, Deputy
Commissioner Kennai identified the formation of a recruitment
and retention committee. Also, Commissioner Gilbertson added,
the Governor's future budget will include additional funding for
social workers. In addition, social workers will be required to
perform less administrative functions, be supplemented with
administrative support, and will benefit from information
technology improvements and the ORCA system.
CHAIR DYSON then allowed testimony from the public.
From the Homer Legislative Information Office (LIO), SUSAN
DRATHMAN stressed the importance of protecting the "safety nets"
that serve our most vulnerable citizens as the state attempts to
contain costs. She is concerned that citizens may need to
migrate to larger communities such as Anchorage to obtain needed
services that cannot be efficiently offered in more remote
locations. If mental health services are reduced, recipients may
instead commit crimes that result in imprisonment. Increasing
revenue, she concluded, is more desirable than budget cuts -
including state income taxes.
From the Homer LIO, COLLEEN POWERS asked that infant learning
programs be exempted from budget cuts. She stated that early
intervention will ultimately save state money by preventing
problems from happening, rather than responding to crises, which
is more costly. Further regionalization would be counter-
productive to their infant learning program.
From the Homer LIO, MAKO HAGGERTY expressed gratitude that
Alaska has treatment assistance for his son, Max, who has cystic
fibrosis. His son's treatment would not have been possible but
for state programs. He echoed earlier suggestions to raise
revenue rather than cutting the budget, including state income
taxes.
From the Fairbanks LIO, LARRY CAGNINA explained his role at the
Ralph Perdue Center in Fairbanks, which provides mental health
treatment. He supported the state's efforts to introduce an
integrated treatment model and a single point of entry for
services. He cautioned the state to continue to focus on quality
of care throughout cost-containment strategies. He reported
obstacles with state law in integrating service delivery. He
urged continued communication between DHSS and the community
service providers.
From the Fairbanks LIO, CHUCK ROLLINS addressed staff turnover.
He encouraged offering counseling to social workers and others
in high-stress positions. Also, he emphasized the possibility of
finding non-chemical solutions to help children deal with
disorders and traumatic events.
From the Fairbanks LIO, BETTY ROLLINS stressed the high degree
of trauma that children encounter when removed from their homes.
She communicated her frustration with the nation's creation of
"legal orphans" as parental rights are terminated. She reported
that 93% of children adopted are receiving a subsidy, which
creates a new welfare system. She also is frustrated that
elected representatives are not addressing the problems. She
believes that 60% of the Alaskan children removed from their
homes could be safely treated in their homes.
From the Fairbanks LIO, TABER REHBAUM emphasized prevention as
an effective intervention, and appreciates that prevention
strategies remained in the budget. These strategies prevent
costly spending for incarceration, institutionalization, public
assistance, children's services, and emergency care.
From the Fairbanks LIO, ANDY HARRINGTON cautioned DHSS "not to
expect too much out of the reorganization" because it is the
local non-profit agencies that are providing the direct
services. These non-profit agencies, he maintains, are operated
more efficiently than state agencies.
From the Anchorage LIO, JOSEPH PICHLER explained the damage that
state budget cuts have contributed to People First. He is
willing to pay taxes. He would like funding restored for the
People First program.
From the Anchorage LIO, MONICA MCLEOD discussed how the waiver
she receives helps her financially with her assisted-living home
program, care coordination, and counseling.
From the Anchorage LIO, LYNNE KORAL offered herself as a
resource to train legislators and DHSS staff concerning the
abuse of people with disabilities, who are twice as likely than
the general population to being abused. Covert abuse, including
manipulation, can be a problem with family members, service
providers, and employers.
From the Anchorage LIO, LYN FREEMAN offered the resources of the
National Resource Center for American Indians, Alaska Natives,
and Native Hawaiian Elders. This newly funded group aims to
address elder abuse, long-term care, treatment within rural
communities, and education to health care providers to ensure
that services are provided in a culturally appropriate manner.
From the Anchorage LIO, CARL EVERTSBUSCH, President of the Key
Coalition, warns that cost-cutting plans and strategies to
increase federal funding may endanger programs for people with
developmental disabilities. The elimination of prevention
services will be costly in the long run. Also, the integrity of
the developmental disabilities programs must be maintained, he
added. It is feared that the State is moving towards a "one size
fits all" treatment model, which would not provide adequate
services to Alaskans.
From the Mat-Su LIO, BERNADINE JANZEN promoted the
representation of service consumers within non-profit
organizations. She urged the State to define what a "consumer
organization" is, to avoid "dual roles," and to ensure that
service consumers fill 51% of the appropriate boards and
commissions. These administrative changes will improve services
because the consumers are the best resource of information
needed to enhance services.
From the Mat-Su LIO, ELEANOR OAKLEY spoke of her experience as a
foster parent with a girl with significant abuse and mental
health issues. She believes that the State did not provide
adequate support to address these mental health challenges. She
urged the State to support faith-based organizations that are
working with foster families.
From the Kenai LIO, MARGARET PARSONS-WILLIAMS stressed the
importance of preventative services; substance abuse is the
cause of fetal-alcohol disorders and other issues that are
destructive to families. An accurate diagnostic tool will help
align families with appropriate services. The media can also
help educate the community about the problem.
From the Kenai LIO, LINDA FLOWERS advocated for adult day-
programs, which offer seniors opportunities to socialize, to be
mentally stimulated and physically active. This program also
provides relief to these seniors' caregivers, who are
responsible for providing supervision 24 hours a day, 7 days a
week. Ms. Flowers urged the legislators to continue funding
grants to these programs, even through sales tax and income tax.
From the Kenai LIO, ANNE EVANS represented the Central Peninsula
Health Center. She stressed the importance of early dental care
as children develop. Denali KidCare and Medicaid programs
provide crucial medical treatment for many families in her
region and across the state.
From the Kenai LIO, VERN SMITH supported efficient government
and accountability within programs. Qualified personnel within
programs are crucial. Goals for children should not necessarily
point to adoption; instead, child protection services should aim
to reunify children with their natural families.
From the Kenai LIO, STEVE HORN represented the Alaska Community
on Mental Health Services. This Community has worked with the
state to integrate mental health treatment services and to
maximize federal funding. They continue to provide community-
based services. Departmental cost cutting has negatively
impacted morale; instead of spending reductions, the government
should look to revenue enhancements. He urged elected officials
to visit the sites of state agencies and to initiate a complete
continuum of community-based care.
From the Kotzebue LIO, RUTH FERGUSON-SCHAEFFER wishes to see
changes to jurisdictional problems within the Office of
Children's Services as children move from village to village. In
her experience, the state closes the cases of children who are
temporarily safe, but should instead continue to monitor safety
and further improve the child's circumstances.
From the Kotzebue LIO, CATHY JONES urged the state not to target
developmental disability programs for spending reductions.
Respite and emergency services are extremely valuable to the
families of people with developmental disabilities.
From the Seward LIO, ARTHUR WALTERS represented the Governor's
Council on Disabilities and Special Education. The Council has
five priorities: new-born hearing screening, funding for infant
learning programs, the developmental disability wait list,
safety net, and the reauthorization of the special education
service agency. He asked the committees, "Do we really have room
to cut anymore?"
From the Seward LIO, MONICA LUTHER represented SeaView Community
Services whose clients are relying that are being cut.
From the Seward LIO, CHRISTINE HOPKINS reported that her two
grandchildren have been significantly helped by SeaView
Community Services
From the Seward LIO, CLAUDIA SIMPSON has benefited from state
services over her life. The importance of state services for
people like her, she claims, is crucial. The destructive cycles
of alcohol abuse could not have been overcome without the help
of these services.
From the Nome LIO, PAM KARALUNAS commended DHSS regarding the
grant consolidation process, in which she participated. She
stressed the importance of connecting all stakeholders involved
within the system and families. She also encouraged the use of
administrative staff to more efficiently support social workers
who may devote approximately half of their workday to
administrative duties, rather than direct services with
families. Also, whistle-blower protection is needed to protect
those people who wish to initiate positive change and
accountability in state programs.
From the Kodiak LIO, LINDA DEROY testified about the Welfare
Reform Act of 1996. This act, according to her, lacks compassion
and is instead punitive. Work requirements for single, working
parents are unreasonable and prevent the success of families.
From the Juneau LIO, JILL SANDLEBEN encouraged the state to
continue efforts to more efficiently operate the chronic care
programs by strengthening home and community based services on
the front end of treatment. Programs that provide skilled nurses
in homes should be enhanced. Increased services at the front end
save money in the long run.
From the Juneau LIO, JODI RUMPH appreciated the grant
consolidation process. She testified in support of newborn
hearing screening, which identifies the most common problem at
birth. This service will save the state money and will provide
needed treatment to Alaskan children. In addition, the infant
learning program also is beneficial to our citizens.
From the Juneau LIO, ROSEMARY HAGEVIG reported that Catholic
Community Services provides many services to families to address
problems such as homelessness, children of incarcerated parents,
physical abuse, and sexual abuse. Prevention programs are very
cost-effective. She reiterated that nonprofit agencies are
partners with DHSS. The consolidation of grant application and
reporting processes has benefited service providers.
From the Juneau LIO, SHARON LOBAUGH stated the importance of
advocacy for people with mental health problems. These people
are currently under-represented. They are working towards self-
sufficiency.
From the Juneau LIO, DIANA RUNDE spoke of the debilitative
nature of mental illness. State programs for people with mental
health problems have benefited her family. She urged the
departmental reorganization to be used as a tool to improve
services.
From the Bethel LIO, LOUISE CHARLES, director of Senior Services
for the City of Bethel introduced several speakers.
From the Bethel LIO, DICK ANDREW testified in Yupik while Joe
Chief translated Mr. Andrew's testimony. Mr. Andrew is 97 years
old and a member of the Senior Advisory Board. He expressed
dissatisfaction with the elimination of the Longevity Bonus
Program.
[Indiscernible comment]
MS. CHARLES continued to speak of the unmet needs of seniors in
rural Alaska, especially with a higher cost of living. The
Longevity Bonus Program should be reinstated soon, in her
opinion, as well as an income tax. An assisted living home in
Bethel is needed desperately.
From the Bethel LIO, JOHN SMITH urged the department to consider
the higher cost of living in rural areas when examining cost of
programs.
From the Bethel LIO, PAMELA BUMSTED stressed the importance of
the input from local senior advisory boards to the Council on
Aging.
From the Fairbanks LIO, ANNIE HOPPER explained that she works
for the Fairbanks Native Associations' Family Focus Program,
which provides services for youths including an emergency
shelter. Ms. Hopper agreed that the State's top priority should
be keeping our children safe. Their organization serves
approximately 500 youths per year. She commented on the positive
outcomes available to children when they are given a chance.
From the Fairbanks LIO, SUSAN ROATCH described negative and
unsuccessful experiences with the State's child protection
system. She stressed the importance of fairness in the system
and the goal of family reunification rather than adoption.
From the Fairbanks LIO, ANNETTE FREIBURGER encouraged the
department's efforts to increasing administrative efficiency
while preserving direct services. Further streamlining is needed
in the integration of mental health and substance abuse
treatment services.
From the Fairbanks LIO, JEANETTE GRASTO appreciated the
department's commitment to involve all stakeholders when making
decisions and changes. She outlined several programs that are
helpful to people of the Fairbanks area. She also encouraged the
state to continue working to bring Alaskan children back to the
state and the development of treatment options here in Alaska.
From the Fairbanks LIO, ED MEYERS encouraged the State to
develop useful oversight and accountability functions within our
child protection system. He hypothesized that many good
suggestions for improvement of the child protection system could
be found by polling parents involved in that system.
From the Anchorage LIO, STEPHANIE RHOADES spoke of her operation
of a mental health court. After our country's de-
institutionalization of mental illness, the mental health
treatment population declined while jail/prison population
skyrocketed. According to research, she reports, 25% of inmates
in the U.S. are mentally ill, compared to 37% in Alaska. The
incarceration-rather than the treatment-of the mentally ill is
known as criminalization of the mentally ill. Symptoms of brain
dysfunction-rather than criminal intent-categorize the behavior
of this population. As a result, incarceration does not address
the underlying problems that these people face. The mental
health courts connect the criminal justice system with the
behavioral health system. This collaboration saves state
resources, and it effectively gets people what they need.
Further collaboration will continue to help our state, she
reports.
From the Anchorage LIO, GWEN LEE encouraged the department to
continue its commitment to service principles and outcomes.
Shifting funding from grants to waivers will ultimately cost
more money. The Arc of Anchorage currently provides integrated
services, she reports. Aging parents who care for children with
disabilities are becoming a large, costly population in
treatment programs. Ms. Lee supported permanency and
reunification goals for families.
From the Anchorage LIO, NATHAN KNOWLES reported that he is a
member of People First. He described his experience growing up
in Sitka with autism. Since, he has graduated high school and
moved to Anchorage. He has been trained to independently use the
public transit system and has received job training and finally
part-time employment. He will be taking college classes soon,
and plans to move into his own apartment, independently. He is
thankful for the state programs that have helped him achieve
these successes.
From the Anchorage LIO, MARY DYER reported the waiting periods
for Alaskans planning to enter substance abuse treatment. Within
the Alaska Women's Resource Center, the Stepping Stones program
treats women with children. She further described this
vocational program, which has high success and ultimately saves
the state spending for public assistance and foster care
services.
KRISTEN NYGREN called in support of the infant learning program
for (1) support and (2) connections. She is grateful for the
social service agencies and would be willing to pay taxes for
those services. In her opinion, the privatization of public
health nurses would negatively impact health care. Rural
communities, such as Dillingham, benefit greatly from services
such as the infant learning program.
From the Anchorage LIO, DARYL NELSON said that he appreciates
the social service programs, but he would like to see a health
care/Medicaid system for all Alaskans. Without taxes, helpful
programs will be eliminated. He would like the asset cap and
income cap eliminated from the program.
From the Anchorage LIO, BONNIE NELSON praised the Chugiak infant
learning program and how well prepared he was for preschool.
Denali KidCare is another helpful program. A health care system
for all citizens would be beneficial to our citizens. Another
health reform task force would help our state move the right
direction.
From the Anchorage LIO, DELISA CULPEPPER represented the Alaska
Mental Health Trust. The reorganization has positively impacted
their service recipients. She advised the integrated services
efforts to keep alcohol treatment prioritized. The Trust
continues to work on developing an alcohol evaluation.
From the Anchorage LIO, JANET JOHNSON reported how her daughter
and entire family have been well served by the infant learning
program.
From the Anchorage LIO, LIZETTE STIEHR represented Focus, Inc.
She said that these services must be continued, even by way of
taxation. Infant learning programs and other preventative
programs are crucial. Network support allows families in need to
access appropriate services. She also urged DHSS to involve all
stakeholders in the planning process if block granting will be
used for communities.
KAREN THOMPSON called in to testify and talked about a
psychiatry program for youths in Metlakatla that received a
grant. Also, she expects all tribes to be represented in tribal-
state collaboration.
REGINA TAYLOR called in to speak about her dissatisfaction with
the cutbacks in her mother's plan of care, for whom Ms. Taylor
is the primary caregiver. The administrative burdens placed on
caregivers, oftentimes the patient's family, restricts the level
of care provided to the patient.
DOLORES PRATT called in and spoke of trauma that her daughter
encountered in foster care. In the Fairbanks area, according to
Ms. Pratt, mental health consumers and their families have no
voice or outlet to effect change.
DON FORD called in and reported that many Alaskans in need of
services are not receiving treatment that they need and qualify
for. Leaders of the state have moral and ethical obligations to
ensure all Alaskans enjoy a standard quality of life. He
reinforced previous comments about the importance of
preventative treatment and community supports.
FRITA ROGERS called in spoke of her experience with foster
children who were placed back into an unsafe home with their
biological mother. She urged OCS to establish collaborative
relationships with the extended families of foster children.
Also, OCS must take responsibility for the well being of the
children of this state.
From the Fairbanks LIO, SCOTT CALDER spoke of his
dissatisfaction with the State's intervention into his family.
He stressed the need for an appropriate forum for the redress of
grievances of people involved in the system. In the situations
when citizens have legitimate complaints, the state has
obstructed the opportunity for justice. Mr. Calder spoke of
current Alaskan statutes that absolve the State from
responsibility in providing any standard of care in the child
protection system.
From the Fairbanks LIO, LIZ GREIG encouraged social workers to
use video cameras when children are removed from their homes.
According to Ms. Greig, the state removes children from their
families far too frequently and without sufficient grounds.
From the Fairbanks LIO, JODI OLMSTEAD also encouraged the use of
video cameras. She spoke of a recent court case involving social
workers that supposedly strengthens parental rights. She also
accused OCS of misrepresenting statistics so that their agency
gets more money.
From the Homer LIO, ALICE HAGGERTY expressed gratitude to the
State for funding cystic fibrosis treatment for their son. She
also urged funding not to be reduced to DHSS programs.
From the Homer LIO, HAL SMITH said that health and social
service programs should receive increased funding, rather than
cuts. Also, according to Mr. Smith, Alaska should instate taxes.
From the Anchorage LIO, ELLEN KRSNAK supported research that
outlined a national child protection system that was
"comprehensive, child-centered, family-focused, neighborhood-
based, and focused on the prevention and treatment of child
abuse and neglect." MS. KRSNAK highlighted the benefits of
private non-profit and faith-based agencies.
From the Anchorage LIO, SALLYE WERNER encouraged the
department's reorganization to center on child safety. Ms.
Werner expressed dissatisfaction of the 35% turnover rate for
social workers. Hiring clerical support will save the state
money and will allow social workers to more effectively perform
their duties. Moving children from foster care into adoption is
also a cost-saving action that will benefit children. The recent
Balloon Project was successful because it provided additional
staff for social workers, district attorneys, guardians ad
litem, public defenders, and courts. She invited each legislator
to spend a day shadowing a social worker.
From the Anchorage LIO, DON MITCHELL expressed sympathy for the
OCS and their formidable tasks. That agency is required to
implement their strategies in lawful manners. OCS is not
investigating reports of harm as is required by law.
Confidentiality must always be maintained except in the cases of
notifying state troopers in child abuse situations and if the
department decides to involve the health and social service
agency of a municipality. The previous administration amended
their policies and procedures manual to require social workers
to hand over reports of harm (to Alaska Native children) and
subsequent investigations to the child's tribe with no further
action until an unspecified amount of time transpires and the
tribe has not acted on the case. Mr. Mitchell stated that his
experience as a lawyer leads him to view this policy as illegal
and explained a real situation in which this policy nearly led
to disastrous consequences. He also reported that this
administrative change occurred only in the manual, not by
regulation.
From the Anchorage LIO, PAUL RICHARDS represented Pharmaceutical
Research and Manufacturers of America (PhRMA). He stated that
although the department promised public participation, there has
not been sufficient public process devoted to the discussion of
the development of a preferred drug list (PDL). According to
PhRMA, a PDL restricts access to medications that may be more
expensive, but may also be the most effective. Instead of saving
money, a PDL may lead to additional surgeries, emergency room
visits, and more nursing care. DHSS has not produced rules to
inform stakeholders how to participate in the process. Also, the
State's contract with First Health may violate state and federal
law. PhRMA fears that our Alaskan health care system will be
inappropriately directed by this organization in Virginia and by
other states on the east coast who have developed PDL's. He
requested that DHSS commit to lawful public process in the
development of a PDL.
From the Anchorage LIO, KITTY KOHLI spoke of her son's situation
and involvement in the child protection system. She reported
that her family has been treated unfairly and unlawfully in this
situation.
From the Anchorage LIO, ROBERT YOUNG spoke of substance abuse
treatment funding from the alcohol tax. He also commented on
Alaska's status of having the highest rate in the nation of
fetal alcohol spectrum disorders. He suggested that the public
awareness that led to the decrease in tobacco use should be
applied to alcohol use. He warned against prioritizing mental
health treatment over substance abuse. He suggests targeting
young kids for education, prevention, and living skills
programs.
From the Anchorage LIO, JOHN WHITE advocated for the
continuation of substance abuse treatments for incarcerated
patients. Such treatment reduces crime. He identified a recent
event in which a temporarily released prisoner with substance
abuse problems created a community disaster in which a state
trooper was killed. The treatment options he identified have
helped to prevent such crimes.
From the Anchorage LIO, CANDACE WINKLER advocated for quality,
affordable, and available childcare and early education. These
services provide an economic benefit for their community,
strengthens families, and positively affects health child
development during a critical period. She urged the legislators
to consider the well being of Alaskan children when making
decisions, because they are the most valuable natural resource.
From the Anchorage LIO, LAURA WALDON expressed concern that OCS
and the Alaska Temporary Assistance Program have made changes
that are harmful to Alaskans.
From the Anchorage LIO, WANDA GARDNER urged continued funding
for substance abuse treatment. She also stressed the importance
that the former Division of Family and Youth Services entering
into families should consider that severe consequences-good and
bad-might result. She is not receiving support necessary to
become self-sufficient. She urged the department to consider
individual circumstances.
From the Anchorage LIO, MARY ELIZABETH RYDER addressed potential
improvements to the infrastructure of non-profit agencies
including billing, regionalization, tribal collaboration, and
personnel development.
From the Anchorage LIO, BONNIE and GARETH NELSON spoke about
Gareth's attendance in school.
CHAIR DYSON asked representatives from DHSS to reply to these
issues through the HESS Committees. The meeting was then
adjourned.
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