Legislature(2007 - 2008)BUTROVICH 205
03/07/2007 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Brain Injury Awareness | |
| SB90 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 90 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 7, 2007
1:33 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Thomas, Vice Chair
Senator John Cowdery
MEMBERS ABSENT
Senator Kim Elton
Senator Fred Dyson
COMMITTEE CALENDAR
Presentation: Alaska Brain Injury Awareness Network
SENATE BILL NO. 90
"An Act relating to the senior care program; and providing for
an effective date."
MOVED SB 90 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 90
SHORT TITLE: SENIOR CARE
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/21/07 (S) READ THE FIRST TIME - REFERRALS
02/21/07 (S) HES, FIN
03/07/07 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
Martha Moore, Vice-chair
Alaska Brain Injury Network
Anchorage AK
POSITION STATEMENT: Participated in presentation
Jill Hodges, Executive Director
Alaska Brain Injury Network
Anchorage AK
POSITION STATEMENT: Participated in presentation
Carol Greenough, planner
Department of Health and Social Services
Juneau AK
POSITION STATEMENT: Participated in presentation
Tina Trudel, President
Lakeview Healthcare System
Anchorage AK
POSITION STATEMENT: Participated in presentation
JIM SHINE, Former Chairman
Alaska Brain Injury Network (ABIN)
Anchorage AK
POSITION STATEMENT: Participated in presentation
Naomi Maloney, Program Manager
Norton Sound Health Corporation
Nome AK
POSITION STATEMENT: Participated in presentation
DAVE EUBANK, representing himself
No address provided
POSITION STATEMENT: Testified that he had a TBI.
Karleen Jackson, Commissioner
Department of Health & Social Services
Juneau AK
POSITION STATEMENT: Presented SB 90
Janet Clark, Assistant Commissioner
Department of Health & Social Services
Juneau AK
POSITION STATEMENT: Available for questions on SB 90
Herb Simon, representing himself
No address provided
POSITION STATEMENT: In support of SB 90
Pat Luby, Advocacy Director
American Association of Retired Persons (AARP)
Anchorage AK
POSITION STATEMENT: In support of SB 90
ACTION NARRATIVE
CHAIR BETTYE DAVIS called the Senate Health, Education and
Social Services Standing Committee meeting to order at 1:33:34
PM. Present at the call to order were Senators Cowdery, Thomas,
and Chair Davis.
^PRESENTATION: BRAIN INJURY AWARENESS
CHAIR DAVIS announced that the committee would be hearing a
presentation from the Alaska Brain Injury Awareness Network
(ABIN).
1:36:42 PM
MARTHA MOORE, Vice-Chair of ABIN, said that 800 new traumatic
brain injuries (TBI) are registered every year in Alaska, 150 of
which are fatalities. There are between 10,000 and 12,000
Alaskans currently living with these injuries. However, some
people don't even realize that they have had a brain injury, and
so it remains unidentified; unfortunately, there are many gaps
in the system of care for brain injured people. The top three
causes of such injuries are motor vehicles, falls, and assault,
and the Alaska rate is higher than the national average. A nine
state study was done in 2003 that showed that Alaska has the
second highest TBI rate in the US, with males having two times
the number of injuries as females.
She said that TBI rates for Alaska Natives are three to four
times higher than national rates, and rural rates are also
higher than urban rates. Alaska has high risk industries and
activities, as well as high rates of alcohol and drug abuse that
lead to these heightened numbers. Prevention is the only cure
for such injuries: safety belts and helmets are important for
motorists and bikers.
She added that soldiers are also coming back from Iraq with
TBIs, up to 60 to 70 percent of those who are injured.
1:44:18 PM
SENATOR THOMAS asked how motorcyclists fit into the TBI
statistics.
MS. MOORE replied that they're included as motor vehicle users.
SENATOR THOMAS asked for the cause of the high differential
between TBI occurrence in northwest Alaska and the Aleutian
chain.
MS. MOORE replied that the exposure in certain areas of the
state is higher, and the Aleutians have a low population and low
vehicle use rates.
1:45:40 PM
JILL HODGES, Executive Director for the Alaska Brain Injury
Network, said that over a lifetime the cost of care for a person
with a TBI can be up to 1.9 million dollars, as well as lost
productivity; direct and indirect medical costs reach $60
billion yearly across the country. She related a personal story
about TBI rehabilitation, and said that every $1 in
rehabilitation saves $35 in later medical costs. Drug abuse,
mental health problems, and suicide are also more prevalent in
brain-injured people.
1:47:21 PM
CAROL GREENOUGH, planner with Department of Health and Social
Services (DHSS), said that frequently TBIs are not diagnosed and
the resulting side effects can affect lifestyle and work. Women
who suffer from domestic violence also have a high incidence of
TBIs which can be misdiagnosed as depression. TBI victims are
also often found in correctional facilities, and can be
misdiagnosed as having a mental illness.
MS. HODGES said that preventing a single brain injury can save
millions of dollars. Currently there is no grant money for TBI
services, and very little Medicaid funding. The Alaska Mental
Health Trust Authority (AMHTA) has been helpful in providing
funds for TBI services, but TBI funding in Alaska is very low
compared to other states' rates; many states are developing
trust funds for TBI research and victims, which are funded by
vehicle moving violation taxes. 21 states currently offer TBI
waivers, which cover home modifications, day programs,
equipment, and rehabilitation. The Alaska legislature could help
make changes to Medicaid plans and increase neurobehavioral
infrastructure in the state.
1:52:53 PM
CHAIR DAVIS requested that the program provide descriptive
material to every legislator.
SENATOR COWDERY asked for statistics on drug and alcohol abuse's
role in fetal brain injuries.
MS. HODGES replied that brain injuries can occur neo-natally or
from child abuse, and both reflect a need to treat families.
1:54:35 PM
TINA TRUDEL, President of Lakeview Healthcare System, said that
brain injuries are a leading cause of death and disability, and
there's a wide spectrum of injury. She then explained how the
brain can be injured in different ways. The disruptions
resulting from brain injuries can affect every area of life. She
referenced several slides to show how regions of the brain
affect different aspects of life: cognitive, physical, or
emotional.
She explained that most people are familiar with mild brain
injuries, where the post-traumatic amnesia lasts under 24 hours.
Unfortunately, later symptoms can persist. She then related a
story about a TBI. She explained that these individuals continue
to burden the psychiatric and justice systems although their
problems could have been treated earlier on; also, a longer-
living population means that there will be increasing problems
with brain injuries. She then explained how returning military
personnel have frequently occurring TBIs, and explained how the
injuries can happen in combat. She showed a slide that cited the
number of TBIs occurring in Walter Reed Medical Center's
patients, and commented that while the center has gotten some
bad press recently, it's important to note that more people than
ever are being saved on the battlefield and afterwards. She then
listed a number of services meant to help with TBI treatment.
She then showed a slide of photos of returned veterans receiving
treatment for TBIs, including vocational programs and civilian
resources. Multidisciplinary and community-integrated
rehabilitation gives the best outcome, and contributes to higher
rates of employment.
She mentioned that some states execute a full TBI treatment
continuum, which ranges from acute medical and psychiatric care
to long-term supported living and day programs. This continuum
is critical to support people from the hospital to their homes.
The benefits of such treatment is far broader than just brain
injury, but also helps with neuropsychological conditions, Fetal
Alcohol Syndrome, autism, and other issues.
2:13:45 PM
CHAIR DAVIS asked who paid for Ms. Trudell's trip to Alaska.
MS. TRUDEL replied that she came up on her own, but has
participated in teleconferences from Alaska Psychiatric
Institute in Anchorage to rural communities.
CHAIR DAVIS requested that the presenters keep in touch with the
HES committee, and asked for clarification on the idea of using
waivers.
2:15:13 PM
MS. HODGES said that the initiative is working closely with the
state Alcohol and Drug Abuse Advisory and Mental Health boards
to see how the current Medicaid system can be changed to help
with TBI services. A new waiver program isn't necessary, but a
rewrite of the current one would be useful.
2:17:15 PM
JIM SHINE, former chairman of the Alaska Brain Injury Network
(ABIN), said that Ms. Trudell, who participates in various
rehabilitation facilities around the country, is helping to
explore the possibility of beginning an instate treatment
program in Alaska. Last year the legislature gave the network a
planning grant to explore the feasibility of starting such a
program, and it will continue to report to the legislature on
its findings.
2:19:20 PM
NAOMI MALONEY, Program Manager for the Norton Sound Health
Corporation (NSHC) in Nome, said that currently the NHSC is
providing services to brain injured patients. One of the major
difficulties with providing these services is recruiting and
retaining providers; consistency of treatment is very important
for rehabilitation efficacy. Oftentimes larger agencies receive
funding but smaller programs have no guidance for searching out
and utilizing such funding.
2:21:57 PM
PAT CHAPMAN, representing herself, said that her daughter had a
TBI, and explained how the injury has affected her family. She
said that there aren't any facilities for dealing with such
injuries in Alaska, and that her daughter cannot attend school
or get on with her life without intensive help; the state waiver
is useful but insufficient. She asked the committee to look into
waivers that cover a wider variety of needs.
2:28:24 PM
DAVE EUBANK, representing himself, said that he had a traumatic
brain injury, and that the only person he can change is himself.
He continues fighting the effects of his injury and due to
proper care when he first had his injury he is productive today.
2:33:00 PM
SB 90-SENIOR CARE
2:34:24 PM
CHAIR DAVIS announced SB 90 to be up for consideration.
KARLEEN JACKSON, Commissioner for the Department of Health and
Social Services (DHSS), said that the bill concerns the
governor's proposal for the Alaska senior care program, which
currently provides $120 a month and a prescription drug benefit
for a number of Alaskan seniors. The governor's bill will update
the income eligibility for senior care and eliminate the drug
benefit. The program eligibility was previously frozen at 135
percent of the 2005 federal poverty level; the bill will change
it to the current rate with adjustments for each year
afterwards. The drug subsidy is underused and will be dropped
from the program to simplify its administration.
JANET CLARK, Assistant Commissioner for the Department of Health
and Social Services (DHSS), commented that the fiscal note does
need some work in the finance committee.
2:38:04 PM
CHAIR DAVIS said that she intended to pass the bill out of
committee that day and asked for any comments or concerns.
HERB SIMON, representing himself, said that he had no comment
and encouraged the committee to move the bill along.
PAT LUBY, Advocacy Director for the American Association of
Retired Persons, said that the organization is pleased with the
bill but takes issue with three items: many low income seniors
try to save for future health costs and their assets should not
be capped for qualification; the monthly stipends should be
raised to $150; and seniors between 100 and 135 percent of the
federal poverty level, who are not eligible for the stipend,
should eligible for the drug benefit. Even if few people are
using the drug benefit, they are living in the edge financially
and the state should consider allowing them the benefit.
2:41:36 PM
SENATOR COWDERY moved to report SB 90 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
CHAIR DAVIS, finding no further business to come before the
committee, adjourned the meeting at 2:42:24 PM.
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