Legislature(1999 - 2000)
02/11/1999 03:32 PM Senate HES
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE
February 11, 1999
3:32 p.m.
MEMBERS PRESENT
Senator Mike Miller, Chairman
Senator Pete Kelly, Vice-Chairman
Senator Gary Wilken
Senator Drue Pearce
Senator Kim Elton
MEMBERS ABSENT
All Members Present
COMMITTEE CALENDAR
SENATE BILL NO. 31
"An Act making appropriations for the operating and capital
expenses of the state's integrated comprehensive mental health
program; and providing for an effective date."
-MOVED SB 31 OUT OF COMMITTEE
PREVIOUS SENATE COMMITTEE ACTION
SB 31 - No previous action to report
WITNESS REGISTER
Ms. Annalee McConnell, Director
Office of Management & Budget
PO Box 110020
Juneau, AK 99811-0020
Mr. Jeff Jesse, Executive Director
Mental Health Trust Authority
550 W. 7th Avenue, Suite 1820
Anchorage, AK 99501
ACTION NARRATIVE
TAPE 99-04, SIDE A
Number 001
CHAIRMAN MILLER called the Senate Health, Education and Social
Services (HESS) Committee to order at 3:32 p.m. and announced that
the committee would take up SB 31. He said that Annalee McConnell
would begin with opening remarks, followed by Jeff Jesse. Six
agency representatives are also present to answer questions.
CHAIRMAN MILLER stated his intent to hear the bill today and move
it out to the next committee of referral, Finance, which will take
a closer look at it.
SB 31 - MENTAL HEALTH APPROPRIATIONS
MS. ANNALEE MCCONNELL, Director of the Office of Management &
Budget (OMB), expressed appreciation for the cooperative and
productive partnership between the Mental Health Trust Authority
(MHTA), OMB, and several of the state agencies. She stated the
MHTA recognized the need to look at the most effective expenditure
of dollars, and came up with creative ways to address the key
issues for the trust beneficiaries while recognizing these are
difficult financial times.
Number 043
MR. JEFF JESSE, Executive Director, Alaska Mental Health Trust
Authority, introduced Caren Robinson, a Board Trustee present at
the hearing. He stated he hoped to accomplish three results today:
to explain why there is a separate appropriations bill; to provide
an understanding of how the MHTA operates and its role in state
government; and to inspire each committee member to come up with
one issue for HESS to take up and implement in partnership with
MHTA. Next week he will detail the FY 00 initiatives for the
committee.
(Mr. Jesse's briefing followed the format of the report titled
"Alaska Mental Health Trust Authority: SB 31 presentation to the
Senate HESS Committee, February 11, 1999")
MR. JESSE explained the history of the trust, including the
territorial mental health program and the original land grant. He
discussed the history of litigation; and he explained the Breach of
Trust and the Supreme Court Decision.
Within the settlement framework, he described the creation of the
independent board of trustees, the reconstituted land base, and the
cash settlement.
Number 232
MR. JESSE described the need to integrate services by putting the
trust's four beneficiary groups under one umbrella to be managed as
a unit under program budgeting.
MR. JESSE delineated the basic trust responsibilities: to manage
the land and cash assets, to provide leadership and advocacy for
the beneficiaries, and to recommend the separate appropriation
bill.
Number 269
MR. JESSE discussed the management of the trust's assets, including
land management by the Department of Natural Resources land office;
cash management by the Permanent Fund; the payout system of a
percentage of principle of the Permanent Fund (currently 3.5%); and
the principle reserve that belongs to the beneficiaries in
perpetuity. A prudent principal reserve, he said, is 400% or four
times the annual payout.
The net income account available to the trustees in any year comes
from two sources: the payout and the income generated from the
trust land office. The trust begins each fiscal year with money
that is already in the bank, not money that it anticipates earning.
MR. JESSE talked about where the fund income goes.
Number 377
He explained the trustee philosophy that focuses on results; on
changing the culture through training, consistency and
accountability; and on a comprehensive, integrated service system.
Number 455
He discussed transitioning problems from an institution into the
community. He said that getting a person to stop drinking is not
enough if he has no job or housing, no health care or
transportation; he will start drinking again.
Number 492
MR. JESSE brought up Harborview Developmental Center, and the
partnership with AHFC; and housing initiatives to break the cycle
of homelessness and people moving in and out of institutions.
MR. JESSE discussed the criminalization of mental illness in this
state. The trust had funded a $600.0 plan for the Department of
Corrections and agreed to pay for it in FY 98, two-thirds of it in
FY 99, and one-third of it in FY 00, allowing the legislature to
bring the program on gradually.
MR. JESSE discussed the Healthy Families program, Seniors and
dementia growth.
Number 590
CHAIRMAN MILLER asked why Mr. Jesse's original budget
recommendation of roughly $780.0 for Assisted Living was removed by
the Governor, what was the rationale for that, because that ties in
directly with dementia and Alzheimers. CHAIRMAN MILLER stated he's
curious...(his following remarks were lost while the tape
automatically reversed to Side B)
TAPE 99-04,SIDE B
Number 578
CHAIRMAN MILLER repeated that he was curious about the
Administration's rationale of taking that out of the (budget).
MR. JESSE responded that he wouldn't speak for the Administration.
CHAIRMAN MILLER asked Mr. Jesse what rationale the Administration
gave him.
MR. JESSE replied, "basically lack of ability in the state budget
to fund the match; it was a matching program, it was part of our
money matching part of their money, and they didn't feel they could
come up with their part of the match."
CHAIRMAN MILLER responded by asking Mr. Jesse "if the Legislature
decided we could come up with our part of the match...I'm just
thinking of the mechanics to reach back and pick up your part of
the match."
MR. JESSE replied, "there's no mechanics; if it's in the bill when
it's passed by the Legislature and signed by the Governor, our
match will be there."
SENATOR WILKEN asked where it's located. CHAIRMAN MILLER responded
it's on the spreadsheet, and he pointed out the line to Senator
Wilken.
MR. JESSE brought up API, which he will discuss further next week.
The facility needs replacement. The trust is purchasing a smaller
facility and creating an emergency psychiatric system for Anchorage
and South central Alaska. The community-based system of care
includes designated evaluation and treatment beds, crisis respite,
and detox services. A designated evaluation and treatment bill
will come through the HESS committee this year.
Number 562
SENATOR ELTON questioned why the Governor did not recommend the
$2.0 million that MHTA put in for the API-related community
services.
MR. JESSE replied the state's plan to replace API has never
included demolition. The hospital sits on trust land, and once it
is no longer used, it will become a toxic waste storage facility
for asbestos. Senator Stevens could not get funding for the
demolition, but he secured $5 million in SAMSA (Substance Abuse and
Mental Health Services Administration) funds in the current fiscal
year and $4 million in HUD funds, and the promise of similar
funding in the next federal fiscal year.
The trust planned to use the $2.0 million originally shown as
operating dollars, to "jump-start" community services when people
came out of API. Obtaining the SAMSA funding changed their
strategy; SAMSA will be used for those operating expenses, allowing
the trust money to be changed to capital to be used directly for
construction, demolition or purchase. SENATOR ELTON asked if MR.
JESSE agrees with the change and he replied, yes.
Number 520
MR. JESSE discussed Mental Health Quality Assurance and Medicaid
expenses escalating at non-sustainable levels. Multiple reviews
will change to one set of surveys. The trustees feel the wisest use
of funds is strategic improvements in the system. Shared funding
between the trust and agencies assures objectivity and accurate
information.
Number 460
He discussed economic security, and strategies in helping
beneficiaries get a job, employment initiatives that continue
people's health coverage, and the better use of existing resources,
including coordinating transportation.
Number 416
MR. JESSE discussed FY 00 budget recommendations. About $200.0 a
year in trust funds do not go through a legislative appropriation,
and are given out in small projects or grants under $10.0 to
consumer-driven activities.
Next week he will cover the issues of parity, API, designated
evaluation and treatment, recommendations on guardianship,
Assisted Living, legislation stemming from the Long -Term Care Task
Force, and mental health needs of the elderly.
Number 385
SENATOR KELLY asked about results-based accounting, and if the
trust requires that type of information whenever it gives out a
grant.
MR. JESSE replied yes, and agencies are required to deliver status
reports during the year. He said the requirement is a little
contentious and needs improvement. SENATOR KELLY stated he hopes
the trust can develop those measures and hold people more
accountable, leading to more results-oriented projects.
SENATOR WILKEN thanked Mr. Jesse for the briefing, and asked him to
consider adding a line item on long-term care in next year's
budget.
SENATOR ELTON requested a follow-up on Department of Corrections
issues such as FAS, at some future time. MR. JESSE responded that
those issues will be presented to the committee next week.
Number 336
CHAIRMAN MILLER clarified that the follow-up will take place next
Wednesday, February 17 at 1:30 p.m. He asked Mr. Jesse how many
acres were sold of the million acres that were reconstituted.
MR. JESSE responded it was relatively small, mostly scattered
subdivision lots, totaling between 200 and one thousand acres.
CHAIRMAN MILLER asked the wish of the committee regarding SB 31.
SENATOR KELLY moved SB 31 from committee with individual
recommendations. Without objection, it was so ordered. The
committee adjourned at 4:45 p.m.
| Document Name | Date/Time | Subjects |
|---|