HCR 19-SUPPORTING EFFORTS OF RECOVER ALASKA  8:57:03 AM CHAIR HIGGINS announced that the final order of business would be HOUSE CONCURRENT RESOLUTION NO. 19, Supporting Recover Alaska in its efforts to reduce the effects of excessive alcohol consumption. 8:57:18 AM REPRESENTATIVE BOB HERRON, Alaska State Legislature, paraphrased from the sponsor statement, which read: Alaska is "The Great Land"-and we know our great land takes first place on a number of lists. Year after year, Alaska tops national state-by-state rankings for domestic violence, sexual assault, certain serious illness, and suicide rates. More than just shocking numbers on paper, these "firsts" are loaded with real- life stories of hardship and pain. A major factor in the struggle? Excessive alcohol consumption. Recover Alaska is a public-private partnership initiative formed by a dynamic group of concerned Alaska business, government, and independent leaders. Together, members share expertise in the criminal justice and health care systems, community development, and other fields touching on the causes and consequences of excessive alcohol consumption. Working with diverse stakeholders, Recover Alaska pursues a variety of strategies to effect long-term change. Strategies include (but are by no means limited to): Implementation of a comprehensive statewide communication and advocacy plan to educate the public about the negative impacts of excessive alcohol consumption on individuals, families, communities, and the state as a whole; Development of a one-stop-shop for Alaskans to access accurate information, as well as prevention and treatment referral services; and A sincere review of laws governing the sale and distribution of alcohol in the state. Recover Alaska is not anti-alcohol, anti-self determination, or anti-business. Rather, in the course of seeking to reduce the occurrence and the aftermath of excessive consumption, Recover Alaska supports healthier communities and brighter futures for all Alaskans. 9:02:08 AM CHAIR HIGGINS asked how this resolution would be distributed. REPRESENTATIVE HERRON explained that the goal of the proposed resolution was for recognition by the Alaska State Legislature that there was excessive alcohol consumption in Alaska, and that the legislature would strive, in conjunction with Department of Health and Social Services (DHSS), to address the problem. 9:03:32 AM CHAIR HIGGINS asked if this proposed resolution would go to the governor, as it was important for the governor to understand this request for help with this problem. REPRESENTATIVE HERRON expressed his agreement, and deferred to Commissioner Streur. REPRESENTATIVE NAGEAK expressed his agreement that it was a big problem and that it was necessary to continue working with organizations to encourage young people. REPRESENTATIVE HERRON said that the resolution recognized the people working with Recover Alaska that want a change for excessive consumption. REPRESENTATIVE TARR expressed her appreciation for the resolution. 9:08:09 AM [A short video was presented] 9:11:29 AM DIANE KAPLAN, President and CEO, Rasmuson Foundation, commented on a letter previously received from Governor Parnell, explaining his veto that half of the alcohol tax be used for alcohol programs. He had stated that he would reconsider this decision if he was persuaded that there were impactful programs in place, and he had urged that Recover Alaska look at innovative ways to address the issue. She relayed that Rasmuson Foundation had convened a broad based, high level group of policy makers about four years earlier to discuss the issue of excessive alcohol use. She listed some of the programs with alcohol related problems that Rasmuson Foundation had supported, and she pointed out the necessity for Rasmuson Foundation to work toward the core of the problem. She shared that this was a joint initiative including participation by Rasmuson Foundation, the Alaska Mental Health Trust Authority, Department of Health and Social Services, and the Mat-Su Health Foundation, as well as members of the judiciary, health providers, and other non- profits. 9:13:28 AM ELIZABETH RIPLEY, Executive Director, Mat-Su Health Foundation, reported that surveys completed during the last year throughout Alaska had revealed that alcohol and substance abuse was the "top issue listed by Alaskans as detrimental to their health." She acknowledged that its impact had drained resources and that, although many organizations were addressing the issue, the effect had plateaued and many providers, funders, families, and individuals were frustrated. She emphasized that, as this hurt the schools, the communities, the employers, and the State of Alaska, it affected all Alaskans. She declared that it was such a complex issue that many organizations stayed away for fear of not making any impact. She remarked that discussion regarding the economic impacts of alcohol often focused on the hospitality industry, although alcohol was not an ordinary commodity and it had "a terrible social cost" which needed to be acknowledged and addressed. She stated that the monetary impact to the Alaska economy was almost $1.2 billion annually. She explained that the group would focus on the systems and the leadership to better align efforts and partners. She noted that the Mat-Su community had also ranked alcohol and substance abuse as the number one issue, and that the top five health issues in the community were all related to behavioral health. She said that the board of directors of the Mat-Su Health Foundation had selected behavioral health and child trauma as the areas to focus its funding. She said that $5 million was annually allocated to raise the health status of people in the Borough. She pointed out that alignment throughout Alaska by Recover Alaska to the behavioral health investment efforts for time, expertise, and money would "really make a bigger dent in this issue." 9:17:37 AM JEFF JESSEE, Chief Executive Officer, Alaska Mental Health Trust Authority, Department of Revenue, expressed his agreement for the alignment of efforts across a variety of partners, as this was critical for advancement of solutions to these problems. He declared that this was the best opportunity he had seen, in his 34 years working in this field, to actually make some progress. He pointed out that Rasmuson Foundation was leading Recover Alaska, the Alaska Mental Health Trust Authority had identified alcohol and substance abuse as one its new focus areas, and Senator Pete Kelly had coordinated a group with the goal to end fetal alcohol spectrum disorder (FASD) in Alaska. He noted that the Mat-Su Health Foundation was also leading a local effort to deal with this issue, and other wellness coalitions and tribal partners had dedicated their efforts to change some social norms and reduce the negative impacts of excessive consumption. 9:19:30 AM MS. KAPLAN reported that none of the partners were willing to simply meet and "contribute to a report that's gonna sit on someone's shelf for the next 20 years." She emphasized that there was a lot of drinking in Alaska, with very few consequences, so it was necessary to change the social norms. She pointed to the tobacco cessation program in the early 1990s as an example. She shared that change in alcohol consumption had already started, noting that not there were not too many three martini lunches anymore. She stated that people now routinely used seat belts, which was another major social change in the community. She expressed her belief that this change could also be accomplished with excessive alcohol consumption. She pointed out that it was very uncommon to see noticeably pregnant women drinking in public, as this behavior was subject to social pressure. She stressed the necessity to have public and private partners working together, which was the basis for Recover Alaska. This would be a long term project, noting that the tobacco cessation effort had taken 20 years, with the first impacts noticed after 3 years, and acknowledging that the alcohol program would also take this long. She stated that private entities made good partners, as they had patient capital. She reported that Rasmuson Foundation had taken the lead for the organization of the Recover Alaska efforts. She said that Rasmuson was actively involved in a review of Title 4, the state alcohol rules, and this review was chaired by an officer of the Cabaret, Hotel, Restaurant, & Retailers Association (CHARR). She reported that these 60 active members were looking at every aspect of the alcohol laws, with a goal for proposed legislation by 2015 to reduce the amount of excessive drinking in Alaska. She stated that there would be a social norms campaign focused on youth, sharing that kids like to be normal and commenting that cool kids don't drink, so other kids will want to be like them. She noted that most kids think every other kid was drinking. She discussed partnerships to review adverse childhood experiences, including neglect caused by alcohol. The outcomes in later life of this neglect were an increased prevalence of obesity, suicide, and other health conditions, and happiness would be impacted. She stated the need of a resource in Alaska for people who need help, and declared that Rasmuson would pilot a one-stop-shop for guided help to find the available resources. CHAIR HIGGINS asked about the United Way 211 system. MS. KAPLAN replied that this system offered no better resources, as no one kept a list of the available programs, available beds, assessments, in-patient care, and what insurance was accepted. She reported that Rasmuson Foundation would pilot this program in two communities. 9:25:54 AM REPRESENTATIVE REINBOLD commented on the wide spread use of alcohol on college campuses, and asked how the program would be implemented. 9:26:54 AM MS. KAPLAN replied that they were currently working to define the impact messaging, and she offered an example of the tobacco alliance messages to teenagers. She said that the Mat-Su partnership was working with professional media companies to try out different messages on focus groups of teenagers. She emphasized that kids would be defining the messages. 9:28:00 AM REPRESENTATIVE REINBOLD suggested reaching out to the youth leaders. 9:28:23 AM REPRESENTATIVE KELLER stated that he had "very little faith in legislation making the level of changes by itself." He expressed his support for the partnership described by Mr. Jessee, as there were "some really tough questions that have to be brought forward," and he offered FASD as an example. 9:29:39 AM MR. JESSEE, referencing the aforementioned legislation, said that the Alcohol Beverage Control (ABC) Board was reviewing the Title IV alcohol beverage control statutory framework, which he declared to be a "hodge-podge of additions over time." He stated that enforcement was inconsistent, and the ABC board had convened a number of committees to review topics which included local options, underage drinking, and licensing. He shared that he was the chair of the licensing committee, that 70 percent of his committee members were from the [alcohol] industry, and that the goal was to find common areas of agreement for a public health oriented approach to alcohol regulation without negatively impacting the legitimate business interests. He spoke about the committee review of underage drinking and the subsequent criminal records for offenders. He explained that the onerous consequences discouraged police officers from writing citations. He suggested lowering the criminality of the offense to be more consistent with law enforcement. He suggested that legislation for a follow-up to the registration of kegs found at underage drinking parties could be part of the solution. CHAIR HIGGINS offered his belief that a problem which groups fall into was to think "their mousetrap is better than everybody else's mousetrap." He declared that there was not any coordination among the many good groups. He opined that any group receiving state funding or grants should be required to have a conference for coordination of efforts. He suggested to team up with United Way 211 to make that site "the best it could possibly be, 'cause they're already doin' it." He stated a need for coordinated efforts. REPRESENTATIVE REINBOLD suggested that youth community service should be an aspect of sentencing for underage drinking. MS. KAPLAN, in response to Chair Higgins, said that the plan for the one-stop-shop was for the United Way 211 to be the entryway into services. This would be supported by a person acting as a guide to actual services, as currently there was just a list without any support or follow up help. She noted that United Way was also a key member of Recover Alaska. REPRESENTATIVE TARR asked if this effort was regional or statewide, and how it would identify those who need help to best meet their needs. MR. JESSEE acknowledged that the group was stealing this idea from the Tobacco quit line. He declared that the important part of the one-stop-shop was for someone to help decide what would be the most effective treatment program, and then check back with the individual for any follow up support. He declared that this was a fundamental difference from the 211 referral. He opined that more information for improvement would be forthcoming as the system and the services were being utilized. 9:37:43 AM MS. KAPLAN directed attention to the partnership strategy with media to raise public awareness. She mentioned the series on FASD in the Anchorage Daily News (ADN), and reported that Rasmuson Foundation was funding a full time reporter and part time photographer at ADN for 18 months to report on alcohol issues. Referring to the FASD series in ADN, she stated that 50 percent of pregnancies in Alaska were unplanned. She noted that most women were not thinking about ceasing alcohol consumption until pregnancy was a reality, and not just a possibility. She stated that the cost of an FASD child to the family, to the state, and to the child itself, was enormous. 9:39:42 AM CHAIR HIGGINS requested project directors: "please do not be politically correct." He suggested telling the truth. REPRESENTATIVE KELLER said that he was excited about the program and the quality of the organizations aligning to address the problem. He pointed to the "depth of the political ramification and the visceral reactions that are tied to this issue that you have to deal with." REPRESENTATIVE REINBOLD mentioned that both Mark Hamilton and Senator (Pete) Kelly were passionately working on eradication of FASD. She referred to a recently formed Medicaid taskforce. She offered her belief that this was an important opportunity to address the issue and reduce the DHSS budget. She suggested that the Friday night church programs, Recovery Alaska, were amazing and impressive. MS. RIPLEY, in response to Representative Reinbold, listed the medical sector, the education sector, and the business sector as all identifying alcohol and substance abuse as the number one issue. REPRESENTATIVE TARR, pointing to the earlier discussion for social norms surrounding alcohol abuse, suggested that there be more empathy and less judgment toward alcohol abuse. REPRESENTATIVE NAGEAK stated that it was our job to share the messaging with those who were struggling. REPRESENTATIVE PRUITT acknowledged that this was a monumental task and he suggested that adults had to be targeted in the message, as well as kids. He declared that the public norm had to also be viewed, and he offered an anecdote regarding alcohol consumption at public functions. He asked that the program message be expanded beyond kids, declaring that we all had to keep ourselves, our colleagues, and our friends from excessive alcohol consumption. MR. JESSEE offered several anecdotes regarding the atmosphere of social norms that needed to change. CHAIR HIGGINS shared an anecdote. 9:49:37 AM WILLIAM STREUR, Commissioner, Office of the Commissioner, Department of Health and Social Services (DHSS), stated "this is a good thing. What we're doing with this is something that is, I think, going to get us off of dead center." He shared that there had been these same challenges for 40 years, and that it was financially evident that this could not continue in the same way. He pointed to the negative effects of alcohol and the amount of money spent on alcohol problems among the divisions in Department of Health and Social Services. He declared that a common theme among many departments in the state were the results from mis-use of alcohol and drugs. He declared the need for a partnership with "our tribes, with our municipalities, with our villages, and with our private partners." He expressed his support for the Recover Alaska group. 9:52:35 AM REPRESENTATIVE HERRON offered two insights he had gained after this presentation, one insight was that this was not a project, as it had no end date, and the second insight was that all 60 legislators had to be involved and supportive. He expressed his appreciation for Senator Kelly "carrying that banner" for FASD; however, FASD and not drinking when you were pregnant had been in the statutes for 25 years. He declared that the proposed resolution not only recognized Recover Alaska, but it declared the need for help from everyone. 9:54:48 AM CHAIR HIGGINS opined that there would be substantial savings through Recover Alaska, if its efforts could be coordinated with other groups. He declared that it was a necessity for all the stakeholders to communicate. He emphasized that jobs were necessary as it gave value to people's lives. 9:56:05 AM REPRESENTATIVE KELLER suggested that the final paragraph of the sponsor statement be phrased more positively to state that Recover Alaska was willing to take on issues. CHAIR HIGGINS asked about an earlier reference for a change to the wording order in the title of the resolution. REPRESENTATIVE HERRON explained his request for a minor, though significant, change in the title to now read: "Supporting Recover Alaska in its efforts to reduce excessive alcohol consumption and the effects." 9:58:04 AM REPRESENTATIVE PRUITT suggested a conceptual amendment for the title to read: "Supporting Recover Alaska in its efforts to reduce excessive alcohol consumption and its effects." There being no objection, Conceptual Amendment 1 was adopted. 9:58:36 AM REPRESENTATIVE KELLER moved to report HCR 19, Version 28- LS1475\A, as amended, out of committee with individual recommendations and the accompanying zero fiscal notes. There being no objection, CSHCR 19(HSS) was reported from the House Health and Social Services Standing Committee.