HOUSE BILL NO. 39 "An Act making appropriations for the operating and loan program expenses of state government and for certain programs; capitalizing funds; amending appropriations; making reappropriations; making supplemental appropriations; making appropriations under art. IX, sec. 17(c), Constitution of the State of Alaska, from the constitutional budget reserve fund; and providing for an effective date." HOUSE BILL NO. 41 "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." 3:07:35 PM Co-Chair Johnson reviewed the public testimony protocol. ^PUBLIC TESTIMONY: OFF NETS 3:08:22 PM ANNA GRACE JEFFRIES, PRIMARY PREVENTION COORDINATOR, ADVOCATES FOR VICTIMS OF VIOLENCE, VALDEZ (via teleconference), thanked the committee for including increased funding for prevention work. She stated there were strategies to prevent violence. The organization had introduced evidence-based curriculum such as the Girls on the Run program and hoped to have the Let Me Run program for boys in the coming summer. She shared that the previous month, the organization invited the Alaska Network on Domestic Violence and Sexual Assault to assist in a presentation at the Valdez High School on Bree's Law and Erin's Law. She discussed the benefits of the presentation. The organization helped provide direction and strategies for the community to come together and to prevent crime and change community norms so that violence against women, men, and children would no longer be tolerated. 3:10:26 PM MOIRA GALLAGHER, SELF, ANCHORAGE (via teleconference), called in support of adding $15 million to the childcare grant program to increase wages for childcare providers. She is a mother of two young children. Her younger son had been on 10 daycare waiting lists for longer than his life due to a lack of daycare in Anchorage. She elaborated that her son could not get into a daycare due to a lack of facilities and caregivers at open facilities. She relayed that many daycares had closed due to a lack of staff. She emphasized that caregivers needed to keep up with inflation and be competitive because it was necessary to keep talented workers in the childcare field. She shared that she and her husband were now spending more than $5,000 on a nanny. She shared it was almost her husband's entire net monthly income after taxes. She underscored that the workforce shortage was real, and people were leaving their jobs because they could not find childcare. She shared that her family was privileged to have the ability to afford a nanny, but just barely. She urged the committee to add the funds. She spoke about the benefits of the additional funding. 3:12:50 PM TIFFANY MILLS, EXECUTIVE DIRECTOR, HELPING OURSELVES PREVENT EMERGENCIES (HOPE), PRINCE OF WALES (via teleconference), spoke in support of funding for domestic violence prevention and services. She shared information about the advocacy work HOPE provided to victims of sexual assault and domestic violence. She was supportive of the Council on Domestic Violence and Sexual Assault (CDVSA) victim services budget. She thanked Representative Ortiz for his support of victims' services on Prince of Wales. She relayed that the organization had not closed during the COVID-19 pandemic and the numbers of individuals seeking help increased each year. She detailed that in 2022, the organization provided services for around 130 adults, which was double the number assisted in 2018. Additionally, the organization had fewer staff in 2022. She relayed that without the one-time increment funding of $6.5 million in the CDVSA budget, there would be a shortage from the 2022 funding. The organization was appreciative that the budget allowed victim services providers to receive consistent funding as in previous years; however, the costs facing rural Alaska were higher and were continuing to increase. She cited examples of the cost of goods in rural Alaska. The agency was also facing staffing shortages because it had just begun offering health insurance to full-time employees to compete with other employers on the island and it was being very conservative about its hiring practices. She shared that when the organization got insurance in 2022, it cost $4,000 per month. She stated that HOPE did not want to be priced out of the market and have to cut the benefit for employees; however, premiums had increased $400 per month in the current year. She hoped the committee could find more available funding to support victims' services. 3:15:07 PM JENA CRAFTON, SELF, EAGLE RIVER (via teleconference), shared that she had been out of work for six years. She spoke in support of reducing the waitlist for people to get services for improved quality of life. Her dad was helping her to try to get a job by driving her. She shared that she was learning how to drive. 3:17:32 PM CARRI CRATER, SELF, ANCHORAGE (via teleconference), supported the addition of $15 million to the childcare budget. She shared that her childcare expenses increased 40 percent since COVID. She shared that her family had spent over $40,000 on childcare the past year. She highlighted the difficulty of finding quality childcare. She thought the situation was a real problem for the workforce. She noted that childcare providers were shutting down. She spoke to the importance of increasing funding for childcare providers to enable increased staff wages and accessibility. 3:19:19 PM MARIA LEGEND, SELF, ANCHORAGE (via teleconference), shared that her son was diagnosed with schizophrenia in 2015. She elaborated that her son had been in and out of psychiatric hospitals and jail. She provided details. She believed that if she and her son had enough help, guidance, and educational resources they would not have been faced with many unnecessary issues. Her son wanted to get his GED, but he was still in need of continuous care, IDD, housing healthcare directives, and guardianship papers. She shared that she was a recovering alcoholic and had dealt with grief and depression in the past. She advocated on behalf of Alaska Native people who were struggling with resources and education to overcome the burdens of mental and behavioral health issues. She asked for increased funding for the Division of Behavioral Health crisis now continuum of care grants, peer support, homelessness assistance, behavioral health treatment recovery grants, IDD waitlist reduction, and disability services grants. 3:22:28 PM TOM CRAFTON, SELF, EAGLE RIVER (via teleconference), shared that he was representing his daughter Jenna Crafton and 700 others who were currently on the developmental disability waitlist for receiving a Medicaid waiver to enable them to have meaningful lives. He had been helping his daughter for 25 years and seeing she had a meaningful life. He stated that he would not be here forever, and he did not know how she would survive later in life without support. He was a highly trained behavioral clinician, but he could not work in his field and help others while his daughter suffered without the services she was entitled to receive. He highlighted the workforce shortage. He stated his daughter was quite able to work (she had called in to testify previously) and wanted to provide for herself. He asked how many other people were home taking care of their loved ones. His mom was now living in his home. He noted that more people were taken out of the workforce with the senior population as well. He stated it was time to eradicate the waitlist. His daughter wanted transportation to and from a good job. He appreciated all of the hard work legislators were doing. 3:24:46 PM AMANDA FAULKNER, ALASKA ASSOCIATION ON DEVELOPMENTAL DISABILITIES, KENAI (via teleconference), advocated for an additional Medicaid increment of $15 million UGF to stabilize home and community-based services while the state worked to address flaws in the rebasing system. The funding would be matched by an additional $15 million in federal funding (a 10 percent increase in Medicaid rates). The increment would provide bridge funding to prevent system collapse during the process of addressing flaws in the rate methodology system. She clarified the request was separate from the $647,000 increment as requested to fund the infrastructure needed to start implementation of the waitlist elimination plan. She elaborated that rates were implemented in 2011 and should have been reestablished at least every four years using provider data collection. She reported that rates had not been reestablished in 2014 and 2018 despite regulatory requirements. She stated that the significant lack in responding to increased cost had been exacerbated by the pandemic and reduced services and workforce shortage. She detailed that some providers had gone out of business and other organizations had calculated a path to closure within one to three years. She elaborated that system capacity did not currently exist with smaller providers; therefore, the delivery of care would default to larger institutional settings at a much higher cost to the state, including out of state placements. She remarked that the state's plan would fail if the provider system was weak to the point of not being able to support people with a wide variety of disabilities. 3:27:25 PM JON ERICKSON, CITY MANAGER, YAKUTAT (via teleconference), thanked the legislature for the community assistance recapitalization and an increase in the Base Student Allocation (BSA). He stated the community did not have a ferry for the summer because of the Kennicott [the Alaska Marine Highway System (AMHS) announced it did not have sufficient crew to run the Kennicott ferry in the summer of 2023]. Additionally, the community was always short on childcare. He reiterated his thanks to the committee. 3:28:41 PM KATHLEEN FITZGERALD, SELF, SOLDOTNA (via teleconference), shared that her 40-year-old daughter was autistic, nonverbal, and required full personal care support and close supervision. Her daughter had a loving and caring heart and a beautiful smile. She shared things her daughter loved to do including hiking, being in the woods, going for drives with her dad, and going to Home Depot. She and her husband were in their 70s and had had worked hard to prepare for when they pass; however, many of the developmental disability agencies were facing challenges attracting staff to care for disabled individuals. She urged the committee to include an additional $15 million to stabilize agencies. She highlighted the anxiety she and her husband had over their daughter's future. She referenced hard work related to the Harborview Developmental Center in order to provide community support for children, which allowed for family and community input at a much more reasonable cost. She thanked the committee. 3:31:05 PM JOHN SOLOMON, CEO, ALASKA BEHAVIORAL HEALTH ASSOCIATION, KOTZEBUE (via teleconference), supported funding the recommendations made by the Alaska Mental Health Trust Authority (AMHTA). He provided details about the work performed by the Alaska Behavioral Health Association. He shared that he had started as a therapist flying into remote villages and saw how difficult it could be to deliver care, but he had also seen how much care changed a community and saved money by treating people when they needed it before it was too late. He stressed that something needed to be done. He supported taking care of the most vulnerable Alaskans by funding a behavioral health system. He spoke in support of funding the behavioral health system, which would avoid throwing good money after bad. He stressed when cuts were made, the state paid more. Additionally, when flat funding was provided, the state paid more. He thanked the committee. Representative Josephson remarked that the organization represented groups that did not necessarily qualify for 1115 waivers. He noted there had been some backfilling with COVID funding of behavioral health grants. He asked how Mr. Solomon viewed the governor's budget in terms of grants outside the 1115 waiver and continuing need. Mr. Solomon replied that grants allowed for the building of capacity to stand up services. He stated that when there was no ability to start services, the state kept losing providers and care. There was an opportunity to provide startup funds to get providers going. He noted that COVID funding had provided some of the opportunity, but the funds had not been sufficient to stand up the 1115 services. 3:35:14 PM AT EASE 3:36:06 PM RECONVENED TOM MORPHET, SELF, HAINES (via teleconference), testified in support of increased funding for Alaskans with disabilities and families struggling with childcare. He shared that he ran for legislative office in 2018 and all young families wanted to talk about was childcare. He was also concerned about people dying in state prisons, the lack of funding for the Alaska Marine Highway System (AMHS), and inadequate funding for public schools. He wanted to be taxed. He stressed that the state had $80 billion in the bank and "we are acting like paupers." He found it very frustrating. He asked for the implementation of an income tax. He underscored the need to act like Alaskans and have courage to do what was right. 3:38:27 PM DAWN WALDAL-ANDERSON, MAYOR, WHALE PASS, PRINCE OF WALES (via teleconference), testified in support of the recapitalization of the community assistance program funding. She shared that Whale Pass was Alaska's newest city and it had incorporated just over five years ago. The funding from the community assistance fund accounted for almost 75 percent of the community's budget. The community's city clerk was its only employee. The community was working hard to build up its infrastructure to become a self-supporting and independent city. She reported that if community assistance funding was not recapitalized, it would put the community in a very uncomfortable situation. She thanked the committee. 3:39:58 PM JOHN SONIN, CIVILIZED HUMANITY, DOUGLAS (via teleconference), thought it sounded like the other departments could use the pay increase that had just been given to the legislature and executive branch. He could not believe what the basics cost. He stated the funding designated for a pay raise would be better used on education. He asked if the state could not spend $600 to $1000 more on students but it could spend a substantial sum on the executive branch. He thought that there needed to be some sense in the budgeting process. He thanked the committee. 3:42:13 PM EMILY CARROLL, SELF, ANCHORAGE (via teleconference), shared that she is a pastor. She loved her work but thought about quitting because of the difficulty finding childcare. She elaborated that the provider she had found was closing because other opportunities provided more money. She had called every place in town and could not find childcare because so many childcare workers did not get paid enough. The state was lacking workers and many moms or dads were having to stay home with their kids because they could not find affordable childcare. She encouraged the committee to add $15 million for childcare grant wages. 3:44:03 PM SUE LIBENSON, SELF, HAINES (via teleconference), supported funding for AMHS. She stressed that the situation was critical. She shared that teachers were leaving and people were quitting because people could not come and go from the community. She received calls from people expressing incredulity that they were unable to make a reservation. She highlighted the once-in-a-generation federal funding that required a state match. She remarked that the state needed to step up and provide a full match in order to qualify for over $100 million in federal funds. She stated the situation impacted the military deployed up north, school teams, a lack of medical services. She emphasized that Haines was losing valued members of the community due to lack of ferry service. 3:46:27 PM ERIC GURLEY, EXECUTIVE DIRECTOR, ACCESS ALASKA INC., ANCHORAGE (via teleconference), supported funding for independent living centers. He shared that Access Alaska was one of the state's four centers for independent living in Fairbanks, Anchorage, Fairbanks, Mat-Su, Southwest Alaska, and other locations. The organization's efforts assisted individuals and families to improve their independence and enabled Alaskans with disabilities to remain in their own homes and communities. He noted that one of the largest programs provided consumer directed personal care services to qualifying Alaskans. The workforce shortage created significant challenges with filling the need. He elaborated that Alaska's service providers continued to struggle with filling vacancies. He thanked the committee for its support for senior and disability services community based grants. He requested the addition of an increment to support participant directed care. The model placed employment and budget authority in the hands of those who need and receive services. He stated that the ability to hire a friend or family member to provide needed support was the next step of meeting the needs of Alaskans. He asked the committee to support an increment to initiate a program for Alaska to begin the effort. He thanked the committee. Representative Cronk thanked Mr. Gurley for calling in. Co-Chair Johnson relayed there were no additional testifiers currently in the room or online. She recessed the meeting until 4:10 p.m. 3:48:57 PM RECESSED 4:14:09 PM RECONVENED Co-Chair Johnson noted there were no additional testifiers online. She recessed the meeting until 4:30 p.m. 4:14:09 PM RECESSED 4:30:53 PM RECONVENED RICK NELSON, SELF, ANCHORAGE (via teleconference), testified in support of funding for people with disabilities and their services. He referenced a lack in workforce due to the rate caretakers were paid. He testified in support of increased wages for caretakers. He shared that the rate for home and community-based services had not increased in the past 12 years. The 10 percent rate increase in the past year had not helped anyone. He stated an increase of at least 13 percent was needed for individuals to earn a living wage. He stated that without the increase, the agencies would die. He urged the committee to pass the budget with the increment. Representative Galvin thanked Mr. Nelson for calling in and for his leadership. She was grateful for his work. Co-Chair Johnson noted there were no additional testifiers. HB 39 was HEARD and HELD in committee for further consideration. HB 41 was HEARD and HELD in committee for further consideration. Co-Chair Johnson reviewed the schedule for the following meeting.