Legislature(2003 - 2004)
12/13/2004 10:06 AM Senate HES
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
December 13, 2004
10:06 a.m.
TAPE(S) 04-32,33
SENATE MEMBERS PRESENT
Senator Fred Dyson, Chair
Senator Gretchen Guess
HOUSE MEMBERS PRESENT
Representative Peggy Wilson
Representative Reggie Joule
Representative Sharon Cissna
MEMBERS ABSENT
Senator Lyda Green, Vice Chair
Senator Gary Wilken
Senator Bettye Davis
Representative Dan Ogg
Representative Bruce Weyhrauch
Representative Jack Coghill
OTHER MEMBERS PRESENT
Senator Con Bunde
Senator Ralph Seekins
Representative Eric Croft
Representative Paul Seaton
Representative Carl Gatto
Representative Nancy Dahlstrom
Representative-elect Mark Neuman
COMMITTEE CALENDAR
Presentation by Office of Children's Services
Presentation of Project Citizen at Goldenview Middle School
WITNESS REGISTER
Joel Gilbertson, Commissioner
Department of Health & Social Services
PO Box 110601
Juneau, AK 99811-0601
Marcia Kennai, Deputy Commissioner
Office of Children's Services
PO Box 110630
Juneau, AK 99811-0630
Joanne Gibbens, Program Administrator
Office of Children's Services
PO Box 110630
Juneau, AK 99811-0630
Mike Lesmann, Program Coordinator
Office of Children's Services
PO Box 110630
Juneau, AK 99811-0630
Dianne Olsen, Department of Law
1031 W 4th Ave #200
Anchorage, AK 99501
James Steele, Children Services Manager
Office of Children's Services
268 E Fireweed Suite 5
Palmer, AK 99645-6665
Pamela Collins, Social Studies Teacher
Goldenview Middle School
15800 Goldenview Drive
Anchorage, AK 99516
Katelyn Duncan, Student-Goldenview Middle School
15800 Goldenview Drive
Anchorage, AK 99516
Brenna Egeland, Student
Goldenview Middle School
15800 Goldenview Drive
Anchorage, AK 99516
Rori Ann Redick, Student
Goldenview Middle School
15800 Goldenview Drive
Anchorage, AK 99516
River Ramuglia, Student
Goldenview Middle School
15800 Goldenview Drive
Anchorage, AK 99516
Shannon Bradley, Student
Goldenview Middle School
15800 Goldenview Drive
Anchorage, AK 99516
TAPE 04-32, SIDE A
ACTION NARRATIVE
CHAIR FRED DYSON called the joint Senate and House Health,
Education, and Social Services standing committees to order at
10:06 a.m. on Monday, December 13, 2004. At present at the call
to order were Senators Dyson and Guess and Representatives
Wilson, Gatto, Dahlstrom and Joule. Senators Bunde and Seekins
and Representatives Croft, Seaton, Gara, Neuman, and Cissna
arrived as the meeting was in progress.
He announced that Department of Health and Social Services'
staff would present an analysis of the child protection system.
This presentation will not focus on individual cases, but will
cover the agency as a whole. Then, legislators would be able to
ask questions of the department; public testimony will not be
taken. Third, an executive session will occur with legislators
and agency personnel to discuss confidential details of specific
cases. The confidentiality of an executive session is necessary
because of pending legal action and current state law. The
department is also planning to brief the committees on upcoming
changes to confidentiality restrictions. After that, students at
Goldenview Middle School will present a panel on the treatment
of Alzheimers disease.
CHAIR DYSON stated that this meeting was not meant to be a
witch-hunt. Instead, it was the beginning of a long process of
collaboration with the Office of Children's Services to decide
how to better protect Alaska's children.
JOEL GILBERTSON, Commissioner of the Department of Health and
Social Services introduced Marcia Kennai, Deputy Commissioner of
the Department, who oversees the Office of Children's Services.
Commissioner Gilbertson thanked the Chairs for convening this
meeting and looks forward to continued work with the
Legislature. At a recent press conference, the department
explained its legislative goals for the upcoming session. Some
of the issues discussed were funding for staffing, training, a
new information technology system, and a revision of the
confidentiality guidelines under which the agency must operate.
DEPUTY COMMISSIONER KENNAI explained that over the past years,
the department combined several programs and created the Office
of Children's Services. Programs include child protection and
permanency, infant learning, nutrition, and the Healthy Families
Alaska program. During 2004, 27,000 clients were served in the
family nutrition program, 1721 clients in the infant learning
program, and 373 families in the Healthy Families program. The
agency also completed 11,202 investigations of child abuse or
neglect. On average in 2002, approximately 2000 Alaskan children
were in the custody of the Office of Children's Services.
DEPUTY COMMISSIONER KENNAI continued to explain that in 2004,
the Office of Children's Services began to implement their
Program Improvement Plan (PIP), as required by the federal
government. The PIP was created after an extensive review of the
agency completed in 2002. After one year under the PIP, the
agency has completed 53% of its action steps and 64% of its
benchmarks. The safety goals have been achieved. Repeat
maltreatment is now at 17.3%, which betters the goal of 22%. For
children currently in the custody of the state, 1.2% have
experienced abuse and/or neglect in foster care or relative
care, which is also better than the goal of 1.7%. The national
standard is 0.05%.
COMMISSIONER GILBERTSON reminded the committees about the
history of the PIP. The federal audit focused on three areas:
safety, permanency, and well-being. The PIP included a
benchmarked action plan for improving these areas. The PIP is a
negotiated agreement between the state and federal child
protection agencies. After it is begun, the state has two years
to meet the agreed-upon goals. Then, the federal auditors will
return to study, if in fact the state has met the goals. Another
PIP will then probably be made. Each state has areas it must
improve, as pointed out in their respective federal audits,
within their child protective systems.
COMMISSIONER GILBERTSON pointed out that the audit uncovered
some startling information regarding safety issues, such as
repeat maltreatment and incidences of child abuse and neglect
while in foster care.
CHAIR DYSON pointed out that the area of permanency was one in
which the state has historically performed poorly. The previous
administration initiated a large effort to improve this area,
which the Legislature funded.
DEPUTY COMMISSIONER KENNAI responded that adoptions are
increasing, but the federal government's standard is 24 months
for a child to enter a permanent placement. Reunification
(within 12 months) is another area needing continued
improvement. An area that the state is performing well in is
placement stability.
CHAIR DYSON indicated concern about the time children are in
state custody, rather than in permanent placements. He pointed
out that the process to terminate parental rights is cumbersome,
time-consuming, and an area for the agency to continue to work
on.
REPRESENTATIVE GATTO asked for clarification about children in
foster care.
DEPUTY COMMISSIONER KENNAI responded that nearly 80% of our
adoptions occur through the foster care system. Until that
adoption is finalized, each of these children remains in legal
limbo. Foster parents can choose between guardianship and
adoption, and guardianship is considered a permanent placement
by the federal government.
JOANNE GIBBENS, OCS, confirmed this for the committees.
CHAIR DYSON pointed out that uncertain medical treatment is
another factor that foster parents wrestle with in their
considerations to adopt a child.
DEPUTY COMMISIONER KENNAI added that all children in foster have
"special needs" to some degree, because it is traumatic for a
child to be removed from their biological family.
DEPUTY COMMISSIONER KENNAI reported that the agency has devoted
four of its new positions (one for each region) to assist
children who will soon "age out" of the state system, helping
them to learn the skills needed for a successful transition to
independent living.
REPRESENTATIVE JOULE asked for clarification on the four
regions, and the geographic areas they cover.
DEPUTY COMMISSIONER KENNAI responded that each child has his or
her own caseworker, and the independent living specialists work
with the caseworkers to develop independent living plans.
REPRESENTATIVE JOULE pointed out that the Northern region is
spread out over a tremendous distance, and that he was concerned
that these specialists provided sufficient coverage to the
children in need.
COMMISSIONER GILBERTSON pointed out that geographic issues are a
large challenge to overcome as caseworkers attempt to contact
each child once per month.
CHAIR DYSON pointed out that success has been achieved in the
past when the agency "subcontracts" some services with local
resources, and he inquired if the agency has any similar
agreements in the Bush.
DEPUTY COMMISSIONER KENNAI affirmed that the agency does
practice such agreements, but clarified that these alternative
response systems help with services like family assessments when
the agency receives a low-level report of harm.
COMMISSIONER GILBERTSON added that the federal government does
not recognize these alternative systems of support as valid, and
he agreed with Chair Dyson that this area needs to be worked on,
especially in a state like Alaska.
REPRESENTATIVE JOULE indicated that the tribes may be a useful
resource in this regard.
DEPUTY COMMISSIONER KENNAI explained that she is planning to
contact the regional federal office in an effort to receive
permission to utilize these local resources. In the meantime,
the state will continue to utilize these services, though the
federal government does not acknowledge them as valid portions
of a service plan.
DEPUTY COMMISSIONER KENNAI explained some recent reform efforts.
The newly-funded staff positions have helped to reduce
caseloads, and the average caseload is 24 cases per worker,
which is closer to the national standards.
CHAIR DYSON clarified that there were in fact 26 new positions
and that there were administrative difficulties in filling these
positions.
DEPUTY COMMISSIONER KENNAI explained some of the difficulties in
filling these positions. She explained that the federal stipend
program may help to attract new social workers to the state. In
this program, the federal government reimburses the state for
student grants paid to students who pledge two years of service
in Alaska's child protection system.
An unidentified speaker spoke to the geographic cost
differences.
CHAIR DYSON inquired about the turnover.
DEPUTY COMMISSIONER KENNAI replied that the current turnover
rate was 13-14%
MIKE LESMANN, OCS, confirmed this for the committees.
DEPUTY COMMISSIONER KENNAI attempted to explain how this
statistic is calculated.
CHAIR DYSON pledged to work in the Legislature to fix problems,
if they exist, with the compensation package offered to social
workers.
MR. LESMANN added that the current vacancy rate is 7.53%.
COMMISSIONER GILBERTSON reported that most states, including
Alaska, are developing new information technology systems. The
new system is called ORCA, which stands for Online Resources for
the Children of Alaska, which will replace a paper-based system
with a real-time, web-based, electronic system. The Department
will request funding from the Legislature for 34 new positions,
some of which will be devoted to expertise with the information
technology aspects of the new ORCA system.
SENATOR GUESS requested the length of service for social workers
in addition to the turnover rate.
DEPUTY COMMISSIONER KENNAI added that exit interviews are also
being implemented.
SENATOR GUESS asked about transcription services.
DEPUTY COMMISSIONER KENNAI confirmed that the agency still
offers transcription services for social workers to use, to cut
down on administrative burdens to productivity.
REPRESENTATIVE GARA asked if 18 months is a valid estimation of
the average length of service for front-line social workers.
DEPUTY COMMISSIONER KENNAI confirmed that 18-24 months is the
typical length of service due to the extremely difficult nature
of these jobs.
TAPE 04-32, SIDE B
DEPUTY COMMISSIONER KENNAI plans to issue a Request For Proposal
in the coming year for a workload study.
SENATOR BUNDE asked if the 18-24 month figure was due to social
workers being recent college graduates. He also indicated
interest in some type of apprenticeship for social workers,
similar to student teaching programs.
DEPUTY COMMISSIONER KENNAI replied that social work studies must
complete work programs in order to receive their degree.
CHAIR DYSON indicated his plans to modify the agency's Missions
and Measures plan to include measures of job retention.
DEPUTY COMMISSIONER KENNAI continued to explain the agency's
efforts to train tribal transition specialists for kids who are
about to leave their foster homes. ORCA was brought online in
September. The agency has increased federal funding from 31% to
64%. She reaffirmed that front-line social workers are focused
on child welfare, not money. Responding to a question from
Representative Joule, she explained that the federal government
rewards or punishes state agencies by adjusting their funding
levels, especially in the areas of safety and monthly visitation
of children.
CHAIR DYSON asked about parents' option of challenging in court
the agency's decision to remove children from their home, and
asked if the agency still distributes a handbook to the parents
explaining their legal options and resources.
DIANNE OLSEN, DLAW, confirmed that most parents have legal
representation of some kind.
Responding to a question from Representative Wilson, JAMES
STEELE, OCS, explained that the handbook has helped parents
better understand the legal process, and these handbooks are
distributed in each case. He also confirmed that Public
Defenders help the parents.
SENATOR GUESS asked if these handbooks are developed using
languages other than English.
DEPUTY COMMISSIONER KENNAI and JAMES STEELE explained that some
other languages are used and interpreters are also utilized in
these cases.
REPRESENTATIVE GARA pointed out that the high caseload is a
factor that leads to high turnover. He advised consideration of
the Child Welfare League's standards regarding caseload.
DEPUTY COMMISSIONER KENNAI added that, in addition to reducing
caseloads, we also need to reduce staffing vacancies. Also, the
work is very difficult, and high turnover may remain an
inevitable issue with such difficult work. Instead, compensation
should include promotional opportunities, varied task
requirements, and flexible schedules such as 4-day work weeks.
COMMISSIONER GILBERTSON reminded the committees of the planned
workload study.
DEPUTY COMMISSIONER KENNAI continued to speak about the
caseload. Social workers are near the Child Welfare League
standards concerning permanency cases. For the investigation
cases, caseloads remain high.
CHAIR DYSON inquired about the process for pre-placement
investigations.
COMMISSIONER GILBERTSON pointed out that the agency conducts two
types of studies: one focusing on the physical facility, another
regarding the persons in the home. He informed the committees
that Deputy Commissioner Kennai would like the home study to
occur at the beginning of the home licensing process. Currently,
the home study does not occur until the adoption process is
initiated; foster homes are not being regularly subjected to
home studies. Home studies are in-depth family assessments that
examine the impact of additional children upon a household.
History has indicated that in the majority of cases, foster
homes lead to adoption more often than not. As a result, a home
study completed at the outset of the foster parenting process
will insure that children will receive safe placements.
CHAIR DYSON indicated his interest in the agency moving forward
with specific selection criteria for placement.
DEPUTY COMMISSIONER KENNAI mentioned 'disproportionality' as a
factor that the agency is concerned about. Approximately 60% of
the children in state custody are Alaska Natives.
[Indiscernible]
DEPUTY COMMISSIONER KENNAI also mentioned that some requirements
for placement can be waived in certain circumstances.
[Indiscernible]
DEPUTY COMMISSIONER KENNAI stated that agency decisions are
based on many criteria, and attempts are made to place siblings
together. Placements with relatives are also prioritized.
CHAIR DYSON then closed this portion of the hearing, so that the
students from Goldenview Middle School could make a presentation
and then return to class.
th
PAMELA COLLINS, 8 grade Social Studies teacher at Goldenview
Middle School, provided opening remarks. Project Citizen is an
international program that leads kids to look for problems in
their neighborhoods, study them and try to improve the
situations. Students formulate an action plan that they present
to legislators for possible implementation.
SENATOR BUNDE mentioned that this student group presented at a
recent convention of the National Conference of State
Legislatures.
MS. COLLINS reported that eight Goldenview students were chosen
as ambassadors to the national convention, and received top
honors for their work.
KATELYN DUNCAN reported that the students represented "Choose
the Choice: Alzheimer's Home and Community-Based Care." Alaska
is one of only two states in the country that does not have a
Medicaid waiver program for Alzheimer's treatment. Our state's
Choice Waiver program only applies to skilled care. Alaska must
address these issues. These students seek development of a
Complete Coverage Waiver for treatment of Alzheimer's and
dementia.
BRENNA EGELAND pointed out that nursing homes can be impersonal
institutions where workers do not know their patients. Nursing
homes are also very expensive. Advantages, however, include the
provision of constant and skilled care. The new waiver system
should include intermediate, not just skilled, care.
RORI ANN REDICK stated that nursing homes are, and will continue
to be, an important part of Alzheimer's treatment. An
alternative is home and community-based services, which pay for
adult daycare centers, respite workers, and medical bills and
prescriptions. A disadvantage is that eligibility for these
services are based on the same criteria as nursing homes. Also,
care is not provided around the clock. Advantages include: care
provided in the client's familiar home; and cost-savings that
allow the state to provide services to more clients.
RIVER RAMUGLIA stated that Alzheimer's is a growing problem in
Alaska, and patients are not receiving needed care. Our current
Choice waiver is not sufficiently serving these clients. Of the
viable options, an expansion of home and community-based
services will address these problems most effectively. An
amendment to Alaska's Choice waiver program will allow coverage
for patients who do not need intensive skilled care.
TAPE 04-33, SIDE A
SHANNON BRADLEY concluded that the Choice waiver modifications
are the state's most promising improvements. The steps this
student group have taken are: Hours of research into
Alzheimer's and Medicaid, letters to the state Legislature,
speakers from the Alzheimer's Resource Agency of Alaska (ARAA),
and interviews with families. According to the ARAA, nursing
home treatment for Alzheimer's costs $83,950 per client year
while community-based care would only cost $34,000 per year per
client.
CHAIR DYSON asked for a written report and a response from the
Department of Health and Social Services.
In response to a question from Senator Bunde, COMMISSIONER
GILBERTSON reported that his agency would need to work through
the federal Health and Human Service Agency in a state plan
amendment process or a waiver process. Our Pioneer Home system
currently serves a large portion of the state's Alzheimer's
patients.
CHAIR DYSON then announced that the committees would now hear
again from Commissioner Gilbertson and Deputy Commissioner
Kennai. Another area of reform is post-adoption services. The
upcoming budget will reflect a request for additional funding so
that these supports are available for families.
[Indiscernible]
DEPUTY COMMISSIONER KENNAI announced that another area that the
agency is looking at is the decision-making matrix for
responding to investigations. This tool helps the agency
prioritize reports of harm, and is based on questions asked
about the situation.
In response to a question from Senator Guess, DEPUTY
COMMISSIONER KENNAI answered that the agency responds to all
potential reports of harm.
[Indiscernible]
For the fiscal year 2004, the agency received 12,088 reports of
harm.
[Indiscernible]
DEPUTY COMMISSIONER KENNAI reported that family assessments are
often referred to local agencies, in cases of lower priority.
Discretion is used by trained intake workers to decide whether
or not the circumstance is a report of harm.
In response to a question from Chair Dyson, JOANNE GIBBENS
reported that law enforcement personnel are notified if the
residence they are responding to contains a child in state
custody.
CHAIR DYSON pointed out that some calls and reports are
intentionally false, perhaps made to influence a custody
decision.
COMMISSIONER GILBERTSON reiterated that discretion is needed and
used by workers, in determinations of state involvement within
families. He added that another area that the department is
looking at is critical events management. A quality-assurance
function of the entire department will allow all agencies to
identify, collaborate on, solve, and learn from critical events,
especially when a single family may be served by multiple state
agencies. An information technology tool will assist agency
personnel in sharing and learning information about critical
events. Commissioner Gilbertson also expressed desire to
continue with efforts to more effectively share information with
the Legislature and the media. A single information technology
system used by all agencies in the department will improve
information sharing and collaboration processes.
REPRESENTATIVE SEATON pointed out that the new computer system
may need adjustment, as he has heard of some glitches.
CHAIR DYSON then announced that the committees would enter into
executive session so that the department could discuss with
members details of specific cases that would otherwise be kept
confidential. The information is confidential because of state
law, but allows for its release to legislators in executive
session. The information is part of pending civil and criminal
investigations and litigation.
The public portion of the hearing was then adjourned at 12:24
p.m.
| Document Name | Date/Time | Subjects |
|---|