Legislature(2011 - 2012)BUTROVICH 205
02/16/2011 01:30 PM Senate HEALTH & SOCIAL SERVICES
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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
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 16, 2011
1:31 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Dennis Egan
Senator Johnny Ellis
Senator Kevin Meyer
Senator Fred Dyson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
PRESENTATION BY ALASKA CHILDREN'S ALLIANCE
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
PAM KARALUNAS, Chapter Coordinator
Alaska Children's Alliance
Anchorage, AK
POSITION STATEMENT: Presented report for Alaska Children's
Alliance.
CORY BRYANT, Program Manager
Alaska CARES
Anchorage, AK
POSITION STATEMENT: Presented report for Alaska Children's
Alliance.
ELENA ALUSKAK, Program Manager
The Children's Center
Bethel, AK
POSITION STATEMENT: Presented report for Alaska Children's
Alliance.
ACTION NARRATIVE
1:31:28 PM
CHAIR BETTYE DAVIS called the Senate Health and Social Services
Standing Committee meeting to order at 1:31 p.m. Present at the
call to order were Senators Egan, Ellis, and Chair Davis.
^Alaska Children's Alliance
CHAIR DAVIS announced the first order of business would be a
report by the Alaska Children's Alliance.
PAM KARALUNAS, Chapter Coordinator, Alaska Children's Alliance
(ACA), explained they would give an update on Child Advocacy
Centers (CACs) in Alaska. She introduced the other presenters
and explained that the Alaska Children's Alliance is a state
chapter of the national organization, and its job is to provide
information, training, and support to child advocacy centers
around the state, and to communities wanting to develop child
advocacy centers. She said they are part of a national
organization that sets standards and does accreditation. There
are currently three accredited centers in Alaska.
MS. KARALUNAS explained her job is to provide technical
assistance and support, state representation on a regional level
with the western region, as well as on a national level. She
said they also receive some very limited funds through the ACA
which they distribute to the CACs.
She stated they provide funding and support for a number of
statewide projects, including the TeleCam Medical Peer Review
and Consultation, which is based at CARES; a biennial state-wide
child maltreatment conference; forensic photography equipment
and medical treatment for each CAC; and coordination of medical
equipment and data collection. They are working on developing
some Alaska-specific projects, which include a pilot project in
the Copper River Basin, specialized support and training for
natural support people in the surrounding villages and
communities, and training for tribal entities on how to use
CACs; and training on developing satellite CACs.
CHAIR DAVIS asked how many centers total exist throughout the
state.
MS. KARALUNAS responded there are nine, and one being developed
in Kodiak.
1:38:27 PM
SENATOR DYSON joined the meeting.
SENATOR DYSON asked if the presenters had explained the mission
of the child advocacy centers.
MS. KARALUNAS answered that they save the good stuff for last.
CORY BRYANT, Program Manager, Alaska CARES, Anchorage, explained
that the Anchorage center serves the Anchorage area and any
other areas that lack access to a CAC. For instance, some
villages outside of Dillingham have to fly to Anchorage before
they can go to Dillingham, so they are seen at Alaska CARES.
They see on average 850-900 children per year. Their facility is
co-located with their team partners, such as the Crimes Against
Children unit of the Anchorage Police Department and the Office
of Children's Services. They also have an Alaska Native unit
housed in their building. This makes it easier for families to
come to one place. CARES is a program of the Children's Hospital
at Providence, and is located on the Alaska Native Medical
Center campus.
ELENA ALUSKAK, Program Manager, The Children's Center, Bethel,
said the center, also known by the Yupik name of "Irniamta
Ikayurviat" is under the Tundra Women's Coalition. This CAC has
recently moved into a brand new facility. The average number of
children served per year is 140 -145, and 80 percent are Yupik
speakers. All of their staff is bilingual, English and Yupik
speaking.
SENATOR DYSON asked, of the 145 clients served per year, how
many cases result in indictments.
MS. ALUSKAK responded maybe ten.
MR. KARALUNAS said the newest CAC is in the Copper River Basin,
and they provide forensic interviews on site.
MS. ALUSKAK said the CAC in Dillingham, also known as "Nitaput"
(We hear them), serves 32 communities, and has served about 222
children since they opened in 2003.
MS. BRYANT explained the Fairbanks CAC was started by Ms.
Karalunas. It is co-located with the State Troopers, and serves
about 83 communities. They have served about 1,000 children
since 2003.
MS. ALUSKAK said the Juneau CAC is a program of Catholic
Community Services, is accredited by the National Children's
Alliance, and serves 19 communities in southeast Alaska.
MS. BRYSON explained the Kenai Peninsula CAC is in the process
of developing satellite CACs in Kenai, Homer, and Seward. They
have been open since 2008 and have served over 200 children
since then.
1:42:00 PM
MS. ALUSKAK said that Kodiak has a developing CAC, and the
summer of 2011 is the projected opening time.
CHAIR DAVIS asked how much funding the Kodiak CAC is receiving.
MS. KARALUNAS said the governor's budget for next year includes
about $250,000 for start-up costs.
MS. BRYANT said the Mat-Su Valley CAC was established in 1999,
and has recently expanded so that the troopers' AVI unit is in
their facility as well.
MS. ALUSKAK explained that the Nome CAC is a program of Kawerak
Native Association. Annaktuq is their shelter name, and they
have served since 319 children since opening.
MS. KARALUNAS emphasized that CACs provide a child and family
friendly environment for coordination of the investigative
process in child abuse cases, specifically child sexual abuse.
MS. BRYSON said the first concern is to have a child and family
friendly environment. They try to make children as comfortable
as they can which sometimes involves feeding and clothing them;
they do whatever it takes to meet the needs of the child and
family.
MS. ALUSKAK explained that each CAC has a person who is trained
in doing forensic interviews with child victims, who is focused
on making the child feel comfortable. The caregiver is also
aware of everything the interviewer is doing.
MS. KARALUNAS explained that in the past, when an allegation of
child sexual abuse was received, OCS would take the child out of
class, interview the child, and take the child out of school to
be interviewed at the police station, then to the emergency
room. This process takes away all that. There is one interview,
which is video recorded, and can be used in court. All the
adults come together in one place, instead of making the child
come to them. The multidisciplinary response and investigation
reduces duplicative interviews.
1:48:38 PM
MS. ALUSKAK said that specialized, non-traumatic medical exams
can be done at the CACs. If law enforcement knows there will be
a medical exam, a medical person will be involved in the
interview.
CHAIR DAVIS asked which centers have medical exam rooms.
MS. KARALUNAS said most of the centers have exam rooms on-site,
but might not have their own staff. Providers will come to the
center if there is not staff on-site. Most of them have on-site
exam capability. This is not a traumatic exam. It is non-
invasive and kids often say that it was their favorite part of
the process, because a medical exam can be reassuring. It is not
done if the child refuses, unless there is some immediate
medical reason.
MS. BRYANT said that because most children don't tell about
abuse right away, there is usually not physical evidence present
on the child.
MS. ALUSKAK said CACs also provide on-going family support.
There are family advocates on staff to be with the family during
the initial interview, and they will continue providing support
for a year. The advocate also makes referrals to others as
needed. She explained that in Bethel many families are Yupik,
and having a Yupik speaking advocate helps them.
MS. BRYANT emphasized that cultural competency is a standard the
CACs have to meet.
MS. ALUSKAK said the CACs also provide consultation with mental
health services. Clients prefer a relationship where trust has
already been built. Many clients will prefer natural support
people instead of mental health professionals. There is training
available for these natural support people.
MS. BRYANT said the Anchorage CAC has two part-time therapists
on staff to provide trauma-specific training for children and
families, specifically for those families that have no
insurance. She noted there are very few resources for children
who don't have insurance.
MS. BRYANT also explained the case review process is different
at every CAC. In Anchorage, they do case review once a month and
they have specific criteria for disclosure or evidence of abuse.
Multi-disciplinary team review is the heart of CAC.
MS. ALUSKAK explained that all CACs use the NCATrak case
tracking system. This is a national system where basic
information is entered, and it is useful for evaluation. The
system helps pull out numbers, case information and
investigation outcomes. Villages seeing these numbers can
realize that abuse is everywhere, not just in their village.
1:57:23 PM
MS. KARALUNAS added that it is difficult to track numbers in
Alaska; OCS tracks their cases, but those are only cases where
the abuser is within the family or the family is not protective.
The State Troopers track other types of cases. The CACs get
referrals from both entities, so they can track all cases.
MS. BRYANT said that CACs in each community provide education,
outreach, presentations, and do whatever they can to get the
word out.
1:58:20 PM
MS. KARALUNAS explained that child sexual abuse is clearly
linked with increased risks for many problems, including
alcoholism, suicide, violent behavior, depression, drug abuse,
fetal death, and even heart disease and diabetes. The annual
cost of child abuse in Alaska is averaged at over $500 million
per year. The CAC model also has a cost benefit, because cases
move more quickly.
1:59:38 PM
SENATOR MEYER joined the meeting.
SENATOR DYSON noted he has friends who work with the prostitutes
at Hiland Mountain. Virtually all of them have been abused as
children. Most perpetrators were also abused. Breaking that
cycle is hugely important. It used to be that about one-third of
those molested were males.
MS. BRYANT said that about 35 percent of the children they see
are males.
MS. ALUSKAK said the percentage is a little bit lower in Bethel,
probably because it is harder for males to disclose.
MS. BRYANT added that the CAC model exists to stop the cycle, by
providing caring intervention and treatment.
MS. KARALUNAS noted there are more reasons for the CAC model.
When kids are seen at CACs there is faster resolution, faster
charging decisions, and more cases prosecuted.
2:03:08 PM
She also said the research suggests that one in four girls and
one in seven boys will be the victim of some type of sexual
abuse or assault before age 18. Most shocking to many people is
the age of the children; 41 percent of those children are one to
six years of age, and 36 percent are between the ages of seven
and twelve.
MS. KARALUNAS then explained a chart of the numbers of children
served at CACs in Alaska, as well as the number of communities
served. She said that no CACs rely solely on state funding for
their existence, but that state funding is essential for
sustainability and to leverage other funding. The need is
increasing, as the number of CACs and children and families
served increases. There is no increase in their budget, but the
need is increasing. Caseloads are going up; they need satellite
centers; Nome needs a nurse examiner; Copper River needs an
additional full time staff position; Anchorage needs partial
funding for a part time medical director; Fairbanks needs an
increase in contract medical services; Kenai needs support for a
satellite CAC in Seward.
2:06:53 PM
MS. KARALUNAS also stressed that all staff are on call seven
days a week, which results in the need for additional funding.
2:07:38 PM
CHAIR DAVIS asked what the total amount of their budget for the
coming year is, and what the funding sources are.
MS. KARALUNAS said funding was originally through a federal
earmark, and the state started funding the program in FY 10. The
amount in the budget has been $3.2 million. She thought it was
the same amount in the governor's proposed budget this year.
CHAIR DAVIS asked if the funding was done under OCS.
MS. KARALUNAS responded that it was.
SENATOR DYSON asked how many probable crimes occurred out of 100
reported.
MS. KARALUNAS said about half of those children will disclose
some type of abuse, and about 25 percent of those cases will
have some type of prosecution.
SENATOR DYSON said, "So out of 100 kids, only 50 percent
disclose."
MS. BRYANT said that the other 50 percent either can't talk
about the abuse or nothing has happened.
SENATOR DYSON asked if about half result in some type of
prosecution.
MS. BRYANT said most children's cases don't go to trial;
prosecutors don't want to put children in the position of having
to testify, so they plead down.
SENATOR DYSON asked if the testimony produced at the CACs is
sufficient.
MS. BRYANT responded that the law requires the child to be
available to testify before the DVD can be used in court. If
they don't remember, you can play the video, but they have to be
available.
SENATOR DYSON asked if it is true that once the probability of a
crime is established, children don't have to press charges.
MS. BRYANT said the state will press charges but the victim and
family have to cooperate.
SENATOR DYSON asked if anything can be done to raise the rate of
convictions.
MS. BRYANT said one problem is not enough prosecutors. Also, the
court system is backed up with cases. Adult cases are more apt
to go to trial.
2:13:33 PM
MS. KARALUNAS said that more training is needed for prosecutors
who handle these types of cases. Child sexual abuse cases are
unique, and require specialized training. Also, prosecutors are
overwhelmed, and they don't have time to deal with these cases.
MS. ALUSKAK said that misunderstanding of traditional cultural
language and lifestyle makes it difficult for prosecutions to
happen, or even investigations.
MS. BRYANT said even judges need education in this area. There
is a lot of misperception. Recently a judge said there was no
relationship between people who view child pornography and
whether they will harm a child. Research shows there is such a
relationship.
SENATOR DYSON noted that many abused children are not forced,
they are seduced. The perpetrator has used child pornography as
an inducement. He then asked how much support there is from the
community leadership in Bethel.
MS. ALUSKAK said it is a difficult question, but they do get
some support.
SENATOR DYSON said many molesters present themselves as healthy
and successful people, so allegations of child abuse can be
surprising; people assume they must be false accusations.
SENATOR EGAN asked if the CAC is running any cases through the
therapeutic courts in Anchorage.
MS. KARALUNAS responded the therapeutic courts are not set up to
handle child sexual abuse cases.
2:18:01 PM
CHAIR DAVIS thanked the presenters. She said she knows the need
for CACs is real. She said the CACs are successful even if cases
are not prosecuted. Children can still be saved and made whole.
2:19:21 PM
There being no further business to come before the committee,
Chair Davis adjourned the meeting at 2:40 p.m.
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