HB 197-INTENSIVE FAMILY PRESERVATION SERVICES Number 2324 CHAIR WILSON announced that the final order of business would be HOUSE BILL NO. 197, "An Act relating to intensive family preservation services and intensive family reunification services; and providing for an effective date." REPRESENTATIVE SHARON CISSNA, Alaska State Legislature, testified before the committee as sponsor of HB 197. TAPE 04-14, SIDE B  Number 2394 CHAIR WILSON said that an individual is on-line that must leave at 4 p.m. and would like to give that person an opportunity to speak. Number 2323 REPRESENTATIVE CISSNA told the members that this legislation introduces a model which is described in the language of the bill. Section 9 [page 9, lines 23 through 25] inserts language that reads: The department or agency shall also consider the  eligibility of the child and family for intensive  family preservation services or intensive family  reunification services, or both, under AS 47.10.550. REPRESENTATIVE CISSNA explained that Section 10 lists the requirements and steps that workers will use in identifying clients, collecting data, and accessing the tools necessary to submit a report to the governor by November 30, 2004. The report will describe the study, conclusions, and recommendations. Representative Cissna summarized that the study will determine if intensive family preservation [and reunification] services are needed and if needed, look for funding to implement it. REPRESENTATIVE CISSNA commented that Dr. Shelley Leavitt is at the meeting today to share what other states have done. She noted that there are some identifiable sources of funding for a pilot model to make sure this plan will work for Alaska. REPRESENTATIVE CISSNA shared her personal experiences. In 1963 she worked in the social services field with some of the population that is being discussed today. She said that "up stream" is where the work needs to be done. Representative Cissna emphasized that she believes prevention should be the first priority. Having been a foster parent of more than 14 kids in the late 1980s, she said she found that the Division of Youth and Family Services had more than 1,000 kids in foster care at that time. In a decade that number has doubled, she stated. During that next decade she shared that she worked as a therapist in a program that worked with that same population of kids. This is a toxic problem that has a huge cost. One of those costs is not just financial; there are faces that go with this program, and that is why she said she has such intense feelings about it. Representative Cissna explained that this program steps in at the juncture of where the child is about to be removed from the family. It is not the big fix, she added, it is a little fix that is relatively inexpensive if looking at the big picture. These services have been extraordinarily successful in the places that it has been implemented. Number 2146 MARCI SCHMIDT, volunteer, Family First Partnership, testified in support of HB 197. She told the members that she believes the pendulum has moved to the point that [children are removed from the home] and nothing is done to get families back together. Ms. Schmidt said that she knows of some instances where families could have been put back together if services had been provided. Number 2090 SHELLEY LEAVITT, Ph.D., Associate Director, Institute of Family Development; Board Member, National Family Preservation Network, testified in support of HB 197 and answered questions from the members. She told the members that the bill provides for intensive family preservation services and intensive reunification services, which are short-term in-home crisis intervention; skill-building services, which are designed to keep children safe, strengthen families, keep families together, and reduce the reliance and over-reliance on out of home placement. Intensive family reunification services have been widely used and replicated in 20 to 30 states and nine other countries for close to 30 years, she stated. There has been a great deal of research done on the services in tracking the effectiveness of keeping children safe, improving family functioning so that children can thrive and survive, and for potential cost savings for states. DR. LEAVITT told the members that many states, including Washington, have chosen to spend money to offer services to prevent [out of home] placement so families can be strengthened, instead of spending it on child welfare, mental health, juvenile justice, and out of home placement. Strong families are critical to the healthy development of children and teenagers, she said. Number 2011 DR. LEAVITT commented that it was interesting listening to the discussion on the earlier bill [HB 393] because many of the issues that are effecting the elder population are also effecting families. Intensive family preservation or reunification services is not the total fix; however, it is a critical piece of a system to keep children safe and strengthen families, she said. These services would enhance informal support within the family including relatives, neighborhoods, faith-based organizations, and churches, she added. Once the intensive services are completed, it is important to have someone there to provide support. It may be an elderly person helping to watch the children and in turn receive some kind of reciprocal help, she added. DR. LEAVITT told the members that the latest most dramatic research available is out of the state of Michigan. This study was done on a controlled group through the courts, who received short-term service of four to eight weeks. After one year, over 90 percent of the families remained together safely. Before being included in this study less than half, close to 40 percent, of the control group had their children removed from their homes and in some cases many times. DR. LEAVITT commented that one impetus across states in implementing this program is the cost savings. In state after state, when collecting data it is found that out of home placement costs much more than preserving the family. She emphasized that this does not mean that every family will remain together or that there is not a need for out of home placement; however, she said the need can be reduced. In Washington State the cost of these services is about $2,700 per child, compared to basic foster care which is about $12,000, $30,000 or more for therapeutic care, and $100,000 or more for residential treatment, Dr. Leavitt stated. The state of North Carolina, which implemented intensive family preservation and reunification services statewide for many years, has demonstrated that for every dollar that is spent on preservation services, the state saved $2 to $3 in placement costs. In the state of Alabama, which has been under a consent decree in the child welfare system for nearly 10 years has also demonstrated an enormous cost savings in their state's placement costs. Number 1865 CHAIR WILSON asked why this isn't already being done [in Alaska]. It appears to be a "no-brainer." This kind of program seems to be a common sense [approach to what needs to be] done. She asked if states other than Alaska are not doing this? DR. LEAVITT responded that these services have been very common in states for at least a decade. The pendulum swings, she said. There may be an interest in strengthening families, and then there may be situation which changes [that trend]. For example, there may be a death [of a child] that is publicized and is one death out of hundreds of thousands; however, the pendulum swings to removing children [from their families] and relying on these more expensive alternatives, she said. Number 1817 REPRESENTATIVE COGHILL pointed out that the wrong effective date is in this bill and suggested it be changed before the bill leaves committee. One struggle that he has with this bill is that a program is created that treats some people more special than others. That is hard to deal with, he said. It is difficult to provide special treatment to some people, but not to others. He said he believes this service will end up costing the state more. Representative Coghill said that he would prefer to have a policy set forth that says the family is to be preserved, [and intervention should take place] at the point where [a problem] is discovered. DR. LEAVITT told the members that federal law under the Adoption and Safe Families Act of 1997 and an earlier law has emphasized preservation and reasonable efforts for families. The act also emphasizes permanency for children because it is known that permanent and stable homes are related to good outcomes for kids. The federal law also pushes states to have shorter timeframes for making decisions about children and reunifying families. Dr. Leavitt summarized that the focus and heart of the federal law is in trying to strengthen and preserve families. Number 1714 REPRESENTATIVE COGHILL responded that is where his heart is in this issue as well. He said he agrees with the concept and would push for laws that would protect the family at a higher level, because the children are being protected. Representative Coghill said the struggle he has is how to mandate it. Every social worker has a different set of eyes, he said. He questioned whether these services would provide social workers with enough tools to [preserve the family]. Number 1668 DR. LEAVITT said one service is not a quick fix or the only fix, and when changing child welfare practice in the field, there needs to be a much more involved process. She told the members that what underpins the family preservation movement are the values and perspective that puts safety as the highest priority and focuses on empowering the family to ensure safety [of the children]. REPRESENTATIVE CISSNA acknowledged that there are parts of the continuum of services that are needed in prevention, which would prevent the family from requiring services to begin with or the first time a family needs services. These services, however, are only used when the courts are ready to remove the children from the home, she said. This is the last effort to keep the children with the family, Representative Cissna emphasized. REPRESENTATIVE COGHILL said he understands what Representative Cissna is saying. He pointed out that with this bill the state is creating a hurdle for that group only. He stated that he is not sure that this is the way to address [the problem]. DR. LEAVITT commented that many states have tried to revamp their child welfare system by putting a lid on this huge bleeding of money into the foster care system. She said most kids that go into foster care, eventually go home with attachment problems and many other problems. As a great example, she said, the state of Alabama started with the intensive family preservation services to prevent placement [outside of the home] and have moved those same services and philosophy much earlier onto family support. Dr. Leavitt said that her goal has always been to work herself out of a job. There needs to be a stop in the flow of children [being removed from their home]. CHAIR WILSON suggested that Representative Cissna get the effective date changed and the bill can come back before the committee at another time. She said she would like to hear from the department on this bill. Number 1419 MARCIE KENNAI, Deputy Commissioner, Office of Children's Services, Department of Health and Social Services, testified on HB 197 and answered questions from the members. She told the members that the department is taking a neutral position on this bill because it believes that the division is already moving in this direction. She said that while this is a good [idea], it does not need to be legislated. There are an array of family preservation services available to clients. Intensive family services is not available yet, but there is movement in that direction, she added. Ms. Kennai reminded the members of the discussions before the committee last week and told of the Family-to-Family initiative that is being brought to the state. She said she believes that out of this initiative the state would eventually get the intensive family services. MS. KENNAI told the members that another study would be difficult for the department to begin. The child welfare evaluation project is going on through the University of Alaska. It is currently evaluating all of the family preservation programs and will make some recommendations on how those can be refueled. She said that she is aware of the fact that the division is not doing all that it should be doing with that source of money. Ms. Kennai stated that she's pleased this legislation is being introduced, but explained that the difficult part of intensive family preservation services is that it requires a very small caseload, such as four to six cases. Even with the 20 new positions that the division will get [this year], there will never be only four to six caseloads [per worker]. It is possible to look for contract money to fund a pilot program for this. She said this would work best in urban areas. Ms. Kennai offered that it would be feasible to do this in Anchorage late this year or early next year through the Family-to-Family initiative. MS. KENNAI told the members that the Teen Decision-making Initiative will begin within the next two months. She explained that the division will need to refer to a family preservation provider for many of those families. The families will be asked to go to a model that is similar, but one that will work best for Alaska. She noted that in most states workers have to be available 24-hours per day and at this point the division does not have that capacity in Alaska, particularly in rural communities. This model would have to be used in an urban site, she reiterated. It would take a while to adopt it in the rural villages. Number 1243 MS. KENNAI summarized her comments by saying that she believes in intensive family preservation services, time limited reunification services, and intensive reunification services. She assured the members that the division is on its way and is reviewing the contracts now [in place] because they are not accomplishing what needs to be done. Having said that, she said she sees no reason to legislate this program. CHAIR WILSON asked about the contracts she mention [with respect to intensive family preservation]. MS. KENNAI explained that the division gets money from two sources. One is from the general fund and the other is federal funding from the Family Support and Preservation Act. She told the members that she has been in her job just six months and the division is working toward revamping all the contracts. Ms. Kennai said that prevention is her focus, the division is moving in this direction, but the intensive family prevention model is expensive. MS. KENNAI pointed out that if the members were to look at what has happened in other states, it would be found to show that there are actually very few families that will fit the criteria to benefit from a six to eight week model of intensive family preservation services. The division knows that many families have alcohol and drug addiction problems and six or eight weeks is not enough [time] for those families, she said. Ms. Kennai emphasized that there is a population that this works for and would like to see it implemented. Number 1152 MS. KENNAI told that members that she is also working with Bill Hogan, [Director, Division of Behavioral Health, Department of Health and Social Services]. She said that she and Bill feel that the Child and Youth Needs Assessment may be out within the next month. It identifies intensive family services as one of the pieces of the service array. Ms. Kennai commented that it might be funded through the Medicaid state plan. She added that this is a program that not only works for children who are at risk of coming into custody because of abuse or neglect, but also works very well with children who have mental health issues. For example, when a parent calls and says that he/she can no longer handle his/her child. She summarized that she does not disagree with anything in the bill, but that she is not sure it needs to be legislated because the division is already moving in that direction. CHAIR WILSON noted that Ms. Kennai did not plan on speaking today, and appreciates her willingness to comment on this bill. MS. KENNAI thanked Representative Cissna for caring so much for [Alaska's families]. Number 1077 REPRESENTATIVE WILSON asked that a committee substitute be done and brought back before the committee for action. The bill was held in committee.