HCR 31-HEALTH INFORMATION & REFERRAL SYSTEM 3:57:44 PM CHAIR WILSON announced that the final order of business would be HOUSE CONCURRENT RESOLUTION NO. 31, Relating to an integrated statewide information and referral system. REPRESENTATIVE CISSNA moved to adopt HCR 31. There being no objection, HCR 31 was before the committee. 3:58:05 PM LORI CARINI, Staff to Representative Sharon Cissna, Alaska State Legislature, introduced HCR 31, on behalf of Representative Cissna, prime sponsor, paraphrasing from a statement which read as follows [original punctuation provided]: This resolution advocates for the development of a health-related, integrated information and referral system in Alaska. Before I describe how this information service might work, I would like to briefly explain those factors that exit in Alaska that point to a need for an information and referral system which would be available to anyone with a phone. Currently in Alaska 19% of the population is uninsured - ISER Study and Combine the issue of the uninsured with those who are actually underinsured, then numbers increase even more for those whose health care dollars are really stretched and health care options are restricted. 3:59:34 PM MS. CARINI continued: Besides access issues, this committee heard the Lewin Group report which stated the senior population is growing at an increased rate, and the HSS budget subcommittee overview indicated that on a per capita basis have the second fastest growing senior population in the nation. And this population is finding it more difficult to find doctors who will accept Medicare patients. One report by Commonwealth North placed Alaska as one of the top five states in terms of the cost of medical and surgical procedures This same report described the doctor shortage since ½ the doctors in Alaska are over 50 and getting closer to retirement age. This shortage will only increase in the future. *Rough estimate of bankruptcies 70% nationwide due to health-related debt - (One study indicated) So all these factors, access to affordable healthcare and the limited availability of resources, not to mention the remoteness of some of Alaska's communities, points to a need for a service that matches people with health and social service providers. An Information and Referral service, with a corresponding searchable website helps, people through the maze of health and human service agencies. This information line could: Provide various types of information and referral services, but all have a health care/social service referral emphasis and usually connect people with volunteer opportunities Provide links to appropriate agencies/services with one number, most states using a dedicated 2- 1-1 line. The concept behind HCR 31 does not advocate medical advice being provided or becoming a database for storing people's personal information Other states have already started this process: Included Connecticut and California Some of these examples from their websites show that this 2-1-1 system, which is easy to remember could actually be used to coordinate services and volunteers during natural/manmade disasters. Currently two bills (referred to as the "Calling for the 2-1-1 Act House and Senate) going through Congress that would dedicate Federal funds (150 mil) to support states in starting-up or expanding these services. 2-1-1 is found to be most effective when built on solid public/private partnerships with a diverse and sustainable funding base Alliance of Information and Referral Systems (AIR  standards and certification process)    Most states are participate in this certification process for training those manning the infolines and maintaining the database As of March 2006, 2-1-1 information and referral system served over 168 million Americans through 187 active 2-1-1 systems in 38 states, Washington DC and Puerto Rico. Usually funding is though public and private partnership and the United Way is the non-profit organization, in most instances, used to implement the program statewide. United Way America commissioned a study to assess the expected costs and benefits of a nationwide system. University of Texas at Austin found it would ultimately provide American taxpayers up to $1.1 billion in net value over the next 10 years (unitedway.org) One of the main points I would like to leave you with that instead of people using the emergency rooms as their primary form of medical care or waiting until an illness reaches the crisis level, a 2-1-1 system could help them find the appropriate assistance earlier. Basically provides options for "who" to call and ultimately saves communities/hospitals money. Really this resolution is highlighting a very basic economic principal that in order for consumers to maximize their purchasing power, especially where resources of goods and services are limited, then they need to have adequate and reliable information before making these purchasing decisions. 4:07:30 PM MICHELE BROWN, President, United Way of Anchorage, informed the committee that for many years United Way of Anchorage has operated "AK Info", which was a limited information and referral system. The AK Info system was designed jointly with the state in order to ensure that information regarding Denali KidCare and WIC [Special Supplemental Nutrition Program for Women, Infants and Children] locations are readily available. That limited system has been fielding about 500 calls per month for assistance. She highlighted the mobile population that exists between rural and urban Alaska, which results in individuals who arrive in the state's major communities not knowing where to obtain help. Therefore, the United Ways in the state wanted to expand the system such that it's a statewide information and referral system so that there would only be one number to know. U.S. Senator Ted Stevens provided a grant through the federal Department of Health and Social Services to begin an expanded statewide system that would match the 2-1-1 requirements. This system will begin in the urban areas where information and referral systems already exist and can be built upon. In other states the aforementioned has saved much money due to a centralized database. MS. BROWN pointed out that currently the databases are being created, expanded, and linked. This system will be both a telephone and web-based system. This system, she opined, has proven to be enormously responsive in other states. In fact, about 50 percent of the nation now has access to a 2-1-1 line. Although this system was very useful during Hurricane Katrina, it is also useful on a daily basis for connecting people to food banks, rent assistance, mental and physical health resources, et cetera. What has been discovered is that often the most difficult thing is for an individual to find the help needed because when people can be connected quickly, the amount of services necessary in each location can be determined. Ms. Brown related that she expected for a call center to be in place by next fall. 4:12:18 PM MS. BROWN, in response to Chair Wilson, clarified that this system won't be statewide this fall, but that is the ultimate goal. In further response to Chair Wilson, Ms. Brown specified that this call center will provide referrals for services related to the caller's needs. 4:13:13 PM TED ISRAELSON, Manager, Information Technology Services, Department of Health and Social Services (DHSS), turned to the indeterminate fiscal note. He explained that he looked at this creation of an integrated database from a technical perspective. With the information at hand and reviewing how a database such as this would become a statewide-integrated database, a higher level of research and analysis would be required in order to make any type of reasonable estimate as to the fiscal impact. 4:14:42 PM CHAIR WILSON asked if the department will work with the United Way on this. MR. ISRAELSON replied yes, and echoed Ms. Brown's testimony that this is a state/private partnership. 4:15:09 PM REPRESENTATIVE CISSNA related her understanding that one of the concepts is that the providers will pay a nominal amount. She also noted that there are other ways in which to bring in private sector funding. There is the notion that all of the aforementioned would benefit the state, and she asked if Mr. Israelson believed that to be true. MR. ISRAELSON answered that he agreed that the benefits will be there for the state to capitalize on this. Furthermore, the providers will want to participate, perhaps even with money, as this may offer a competitive advantage. REPRESENTATIVE CISSNA recalled the pandemic summit in Anchorage during which there was discussion brought forward with regard to the need for people to isolate themselves in their own home. She opined that this 2-1-1 system could possibly assist [in a pandemic situation]. MR. ISRAELSON agreed that this proposed system could partner to address a situation requiring coordination. The volunteer aspect of this service, he opined, is essential, especially given a situation like a pandemic. Any type of a disaster, he said, calls for a means of coordinating people who can provide medical assistance. 4:18:44 PM REPRESENTATIVE CISSNA mentioned that this proposal is a means for the state to help the private sector work more efficiently. She pointed out that obtaining basic health care information, which requires the use of long distance phone calls can be a burden on individuals. [HCR 31 was held over.]