Legislature(2011 - 2012)SENATE FINANCE 532

02/24/2011 08:00 AM Senate HEALTH & SOCIAL SERVICES


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08:01:32 AM Start
08:07:39 AM Presentation: Key Coalition of Alaska - Key Campaign
08:49:43 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
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+ Presentation: TELECONFERENCED
Key Coalition of Alaska - Key Campaign
(A grassroots advocacy group for people
with disabilities) (All legislators invited)
                    ALASKA STATE LEGISLATURE                                                                                  
                         JOINT MEETING                                                                                        
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                       February 24, 2011                                                                                        
                           8:01 a.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                            
                                                                                                                                
 Senator Bettye Davis, Chair                                                                                                    
 Senator Dennis Egan                                                                                                            
 Senator Johnny Ellis                                                                                                           
 Senator Fred Dyson                                                                                                             
                                                                                                                                
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                             
                                                                                                                                
 Representative Charisse Millett                                                                                                
 Representative Sharon Cissna                                                                                                   
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                            
                                                                                                                                
 Senator Kevin Meyer                                                                                                            
                                                                                                                                
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                             
                                                                                                                                
 Representative Wes Keller, Chair                                                                                               
 Representative Alan Dick, Vice Chair                                                                                           
 Representative Bob Herron                                                                                                      
 Representative Paul Seaton                                                                                                     
 Representative Bob Miller                                                                                                      
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                              
Representative Mia Costello                                                                                                     
                                                                                                                              
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
PRESENTATION: KEY COALITION OF ALASKA - KEY CAMPAIGN                                                                            
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
No previous action to record                                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
EMILY ENNIS, Key Coalition of Alaska                                                                                            
Fairbanks, AK                                                                                                                   
POSITION STATEMENT: Presented report on behalf of Key Coalition.                                                              
                                                                                                                                
STEVE WILLIAMS, Program Officer                                                                                                 
Alaska Mental Health Trust                                                                                                      
Department of Revenue                                                                                                           
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Presented information about the HUB                                                                       
component of the Alaska Complex Behaviors Collaborative.                                                                        
                                                                                                                                
JOANNE MASON, Parent                                                                                                            
Juneau, AK                                                                                                                      
POSITION STATEMENT: Related personal stories regarding Key                                                                    
Coalition issues.                                                                                                               
                                                                                                                                
MICHAEL BAILEY, Fiscal Controller                                                                                               
Hope Community Resources                                                                                                        
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified for Hope Community Resources.                                                                   
                                                                                                                                
WENDY CLOYD, parent                                                                                                             
Fairbanks, AK                                                                                                                   
POSITION STATEMENT: Related personal stories regarding Key                                                                    
Coalition issues.                                                                                                               
                                                                                                                                
LORIE KING, parent                                                                                                              
Juneau, AK                                                                                                                      
POSITION STATEMENT: Related personal stories regarding Key                                                                    
Coalition issues.                                                                                                               
                                                                                                                                
DANA GRAHAM, parent                                                                                                             
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Related personal stories regarding Key                                                                    
Coalition issues.                                                                                                               
                                                                                                                                
BARBARA GORMAN, retired school librarian and parent                                                                             
Fairbanks, AK                                                                                                                   
POSITION STATEMENT: Related personal stories regarding Key                                                                    
Coalition Issues.                                                                                                               
                                                                                                                                
STEVE LESKO, Key Coalition Member                                                                                               
Anchorage, AK                                                                                                                   
POSITION  STATEMENT:   Related  personal  stories   regarding  Key                                                            
Coalition issues.                                                                                                               
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
8:01:32 AM                                                                                                                    
CHAIR  BETTYE DAVIS  called the  joint meeting  of the Senate  and                                                            
House Health and  Social Services Standing Committees  to order at                                                              
8:01 a.m. Present  at the call to order were  Senators Egan, Ellis                                                              
and Chair Davis and Representative Millet.                                                                                      
                                                                                                                                
^Presentation: Key Coalition of Alaska - Key Campaign                                                                           
      Presentation: Key Coalition of Alaska - Key Campaign                                                                  
                                                                                                                              
EMILY ENNIS,  Key Coalition of Alaska,  said for over  two decades                                                              
the Key Campaign  has come to  Juneau to speak for  themselves, as                                                              
well as  for others  who cannot  speak for  themselves. In  Alaska                                                              
over 13,000  children and adults  have a developmental  disability                                                              
(DD).  The Key  Campaign  believes that  a  disability should  not                                                              
prevent  a  child  or  an  adult   from  having  a  full  life.  A                                                              
developmental  disability is  one that  occurs before  the age  of                                                              
22,  and  perhaps  is  noted  at  birth  or  early  childhood,  or                                                              
acquired  from   an  illness  or   accident.  Such   a  disability                                                              
generally causes  substantial limitations  and impairments  and is                                                              
expected to  be life-long.  Some form of  support or  service will                                                              
be needed, usually  life-long. In Alaska over 13,000  children and                                                              
adults have  a developmental  disability.  Over one-third  of them                                                              
are  receiving  DD  services in  their  home  communities,  funded                                                              
through the Medicaid  waiver or Alaska state grant  funds. At last                                                              
count, around  840 remain  on the DD  registry, the  lowest number                                                              
on the DD waitlist  in many, many years. The Key  Campaign's dream                                                              
is  that eventually  they  will  end the  DD  waitlist, and  their                                                              
dream is  coming closer to a  reality thanks to  the legislature's                                                              
commitment.                                                                                                                     
                                                                                                                                
MS.  ENNIS said  she  would speak  about  four  priorities of  the                                                              
Alaska 24th Annual  Key Campaign. The first is  the Alaska complex                                                              
behavior  collaborative   [Hub]  component.  This   establishes  a                                                              
critically  needed  expertise  to  make  sure  that  children  and                                                              
adults with  behavior challenges do  not have the leave  the state                                                              
and  their  homes and  their  families  to receive  the  necessary                                                              
treatment and services.                                                                                                         
                                                                                                                                
The second priority  is the autism insurance reform,  to make sure                                                              
that  over 1,500  children in  Alaska  today with  autism are  not                                                              
excluded from medical coverage because of their autism                                                                          
diagnosis.                                                                                                                      
                                                                                                                                
The third priority is a periodic rate review, to assure that DD                                                                 
community services can continue to meet the needs of Alaskans                                                                   
with disabilities.                                                                                                              
                                                                                                                                
The fourth priority is to maintain Alaska's commitment to                                                                       
eradicate the DD wait-list in the state.                                                                                        
                                                                                                                                
8:07:39 AM                                                                                                                    
MS. ENNIS gave an example of the benefits of support from the                                                                   
state of Alaska, as follows:                                                                                                    
                                                                                                                                
     Twenty-four  years  ago  an   infant  boy  was  born  in                                                                   
     Alaska.  At  birth  it  was   noted  that  he  had  many                                                                   
     significant  disabilities. His  parents were  devastated                                                                   
     by  the loss  of  the child  that  they  dreamed of  and                                                                   
     looked forward  to, yet they  loved him deeply  and then                                                                   
     began  to build  the  hope  that he  could  have a  good                                                                   
     life.  Right away  they received  in  home supports  and                                                                   
     respite  care from  a community  service provider.  That                                                                   
     helped  ease their stress  and their  fatigue, and  also                                                                   
     helped  them   navigate  the  complex   medical  service                                                                   
     system. In a  short time their infant son  was receiving                                                                   
     early   intervention  services,   speech  therapy,   and                                                                   
     physical therapy.  And although he still had  delays, it                                                                   
     was  amazing  to see  how  well  he  did when  he  began                                                                   
     elementary  school.  His  parents   still  continued  to                                                                   
     receive  respite care  a few  hours a  week, which  they                                                                   
     called their  lifeline. It  assured that their  marriage                                                                   
     stayed strong  and that they  had time with  their other                                                                   
     children.  Over the  years they had  a care  coordinator                                                                   
     who  continued  to help  them  identify and  locate  the                                                                   
     needed  resources and  other services  for their  child.                                                                   
     By the  time their son was  21 years old he was  part of                                                                   
     a supported  employment program and he had  a job coach.                                                                   
     Before long  he had his first  real job. He  was feeling                                                                   
     his independence,  and his parents recognized  that they                                                                   
     were growing  older. Before his 23rd birthday  their son                                                                   
     moved  into  a supported  living  residence  with  other                                                                   
     young  adults who were  learning to  live on their  own.                                                                   
     Today he volunteers  in the community, he  works, and he                                                                   
     has a  great social  life with  friends. An agency  that                                                                   
     he  and his  parents selected  is now  there to  support                                                                   
     him, and  will continue  to do so  as his needs  change.                                                                   
     His parents feel comfort knowing that he will be fine                                                                      
     after they are gone.                                                                                                       
                                                                                                                                
MS.  ENNIS thanked  the  legislature for  the  services that  made                                                              
this story  possible. Yet, for many  other families who  wait, she                                                              
said this story is only a shared dream.                                                                                         
                                                                                                                                
8:10:04 AM                                                                                                                    
STEVE  WILLIAMS,  Program  Officer, Alaska  Mental  Health  Trust,                                                              
Department  of Revenue, Anchorage,  said he  would discuss  one of                                                              
their HUB components,  the Alaska complex behavior  collaborative.                                                              
This  collaborative   took  root   two  years  ago.   Adults  with                                                              
disabilities  were  being  sent   out  of  state  to  institutions                                                              
because their  behaviors were becoming  too challenging  for their                                                              
caregivers to  deal with. Two years  ago the Department  of Health                                                              
and   Social  Services   (DHSS)   contracted   with  the   Western                                                              
Interstate  Commission  for Higher  Education  (WICHE)  to take  a                                                              
look at  the depth of  the issue and  the complexities  around it,                                                              
and  to come  up with  a set  of recommendations  to address  this                                                              
issue.                                                                                                                          
                                                                                                                                
The  Hub component  pulls  together experts  to  work on  multiple                                                              
diagnoses  and associated  behaviors, so  that early  intervention                                                              
can  be  provided  either  in the  group  home  or  the  community                                                              
placement setting  or with  the family.  The target population  is                                                              
not  just  adults   with  developmental  disabilities,   but  also                                                              
seniors with challenging  behaviors. There are  multiple divisions                                                              
within the  Department of Health  and Social Services that  aid in                                                              
this.  The  trustees are  recommending  $500,000  of GFMH  to  the                                                              
governor for  the Hub. The  trustees have also committed  $150,000                                                              
of the trust fund for this effort.                                                                                              
                                                                                                                                
8:16:04 AM                                                                                                                    
JOANNE  MASON  said  she  was the  parent  of  a  twenty-year  old                                                              
severely  developmentally delayed  son  who has  lived outside  of                                                              
Alaska for  the last four years.  Because of the lack  of services                                                              
in their  community,  the family  was forced  to send their  child                                                              
across  the country  to help  with  his severe  autism. They  took                                                              
this drastic  step because they were  no longer able to  cope with                                                              
the  difficult behaviors  of their  son's  disability. During  the                                                              
last year,  he has learned  to cope with  his behaviors and  to be                                                              
successful in  a group  environment. It was  their long  term wish                                                              
to  bring  their  son  home.  Today   he  still  has  episodes  of                                                              
challenging behavior,  but has grown  into a wonderful  young man.                                                              
Their son  recently returned home  on Alaska Medivac.  She thanked                                                              
the governor  for helping bring their  son home and said  they are                                                              
now caring  for their son. They  need help to care for  their son,                                                              
but they  currently have no  support. She  said it is  a blessing,                                                              
though, to have him home.                                                                                                       
                                                                                                                                
8:19:15 AM                                                                                                                    
SENATOR DYSON joined the meeting.                                                                                               
                                                                                                                                
8:19:25 AM                                                                                                                    
MICHAEL  BAILEY,  Fiscal  Controller,  Hope  Community  Resources,                                                              
Anchorage,   said    two   questions   come   to    mind:   fiscal                                                              
sustainability   and   parity.    Having   the   cost   rates   of                                                              
reimbursement  adjusted   every  few  years  is   very  important.                                                              
However,  regulations  change  frequently  and  sustainability  is                                                              
still in  question. He asked that  the legislature put  in place a                                                              
statute  that  has a  cost  based  methodology. The  current  DSHS                                                              
regulations are a  good attempt towards that end,  but regulations                                                              
change  often, and  if  they change  again  the sustainability  is                                                              
still in  question. This is why  a regular review of  rates, using                                                              
cost based  analysis, needs to be  put in statute.  Most providers                                                              
of these  services are  nonprofit organizations  and they  have no                                                              
way to absorb  losses. The service providers are  also looking for                                                              
parity  in the  methodology used  by the  hospitals and  long-term                                                              
care institutions to establish rates.                                                                                           
                                                                                                                                
8:22:47 AM                                                                                                                    
WENDY  CLOYD, parent,  said she  was told  14 years  ago to  avoid                                                              
using the  word "autism"  in any  insurance related paperwork  for                                                              
her  child. When  early intervention  therapies were  recommended,                                                              
she was unable to  afford them. She said that she  did not realize                                                              
what  she  was  missing  until   her  child  attended  a  one-week                                                              
behavioral  therapy  session  sponsored by  the  school  district.                                                              
This makes  her wonder what  more they could  have done if  he had                                                              
access to  services at  an earlier age.  She asked that  insurance                                                              
companies treat  autism as any other  medical need and  include it                                                              
in coverage.                                                                                                                    
                                                                                                                                
8:24:55 AM                                                                                                                    
LORIE KING,  parent, said she  has a daughter,  20 years  old, who                                                              
experiences  autism. She  said that their  family's journey  along                                                              
the  autism  spectrum began  at  birth.  By fifteen  months  their                                                              
daughter  was  still  not  walking, and  seemed  to  prefer  being                                                              
alone. By  age three she was  throwing earth-shaking  tantrums and                                                              
attacking her  older sister  for no  apparent reason.  The results                                                              
of  her  daughter's  evaluation   took  a  long  time,  while  her                                                              
daughter's  behavior became  worse  and worse.  She  could not  be                                                              
left alone  with her older sister  out of fear for  their physical                                                              
safety. The  family started  with a diagnosis  of ADD,  then added                                                              
OCD and  ODD. Their  insurance appeared  to be  more of  a barrier                                                              
than a help.  No matter how she  worked to help her  daughter, she                                                              
would run  into another  wall. On  top of all  of this,  her older                                                              
daughter was not receiving the attention that she needed.                                                                       
                                                                                                                                
8:31:24 AM                                                                                                                    
MS.  KING said  her daughter  was not  effectively diagnosed  with                                                              
autism until  she was  eight years  old. She  said that  they have                                                              
struggled to  keep their  daughter in their  home over  the years.                                                              
She shared  an article with the  committee from the  University of                                                              
Wisconsin  in Madison:  research  found that  mothers of  children                                                              
with autism have  the same stress level of individuals  in combat.                                                              
She  urged  the  committee  to   support  any  bill  about  autism                                                              
insurance reform.                                                                                                               
                                                                                                                                
8:34:17 AM                                                                                                                    
DANA GRAHAM,  parent, said  that she had  a daughter who  was born                                                              
with  multiple disabilities  that  were not  diagnosed before  she                                                              
was born. She said  her daughter passed away only  20 months after                                                              
she was born. She  said imagine being told that you  were going to                                                              
have a baby, and  that child could not see or hear  you, and could                                                              
not feed  without your help. She  said this was her  daughter, who                                                              
was the  16th child diagnosed  with Bohring-Opitz Syndrome  in the                                                              
world. The  family was  directed to HOPE  in Anchorage  after many                                                              
months of  extreme stress  in trying to  care for their  daughter.                                                              
At  first, she  explained,  she was  apprehensive  about the  home                                                              
visits.  Once she  allowed HOPE  into  their home,  they became  a                                                              
huge emotional  and physical help for  her. She said she  does not                                                              
know  what  it  takes  to fund  a  service  like  HOPE,  but  this                                                              
community  service helped  them exponentially.  She explained  how                                                              
important it  was to keep their  daughter in their home.  She said                                                              
that her  family no longer needs  their assistance, but  every day                                                              
there is a  child that is born  or injured and those  services are                                                              
needed now and in the future.                                                                                                   
                                                                                                                                
8:42:48 AM                                                                                                                    
BARBARA  GORMAN, retired  school  librarian and  parent, said  she                                                              
was there  to represent  the other  end of  the spectrum,  and the                                                              
end  of one's  life. She  has three  children, and  her family  is                                                              
geographically   dispersed,  but   they  love   each  other.   She                                                              
explained  that when their  son was  born they  did not  know that                                                              
they  would  have  expense issues,  because  they  had  insurance.                                                              
However, the  insurance didn't  kick in until  he was 30  days old                                                              
and by that  time the family was  $50,000 in debt. Because  of her                                                              
age (85) she  is thinking about  what will happen to her  son when                                                              
she  is  no  longer  around. When  their  son  was  in  elementary                                                              
school, the  local school  was not  able to deal  with him  so the                                                              
family sent  him to a school  in Edmonton, Alberta,  Canada, where                                                              
he spent ten years. She asked the committee to erase the DD                                                                     
waitlist so that people with developmental disabilities can stay                                                                
at home in Alaska.                                                                                                              
                                                                                                                                
8:48:37 AM                                                                                                                    
CHAIR DAVIS said the committee had run out of time, but she                                                                     
would like to have the final testimony in writing.                                                                              
                                                                                                                                
8:48:54 AM                                                                                                                    
STEVE LESKO, Key Coalition Member, presented the committee                                                                      
members with butterfly pins, and emphasized that everyone can                                                                   
make a difference.                                                                                                              
                                                                                                                                
8:49:43 AM                                                                                                                    
There being no further business to come before the committee,                                                                   
Chair Davis adjourned the meeting at 8:49 a.m.                                                                                  

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