HB 329 - HARBORVIEW DEVELOPMENTAL CENTER Number 0326 CHAIR JAMES announced the next order of business is HB 329, "An Act amending the definition of correctional facility to include a therapeutic treatment center; providing for the conveyance of the Harborview Developmental Center and appurtenant land to the City of Valdez for the purpose of conversion and lease of a part of the center for a therapeutic treatment center for the Department of Corrections; providing that such a land conveyance counts toward the general grant land entitlement of the City of Valdez; and providing for an effective date." Number 0330 BETSY ROBSON, Assistant Director, Division of Institutions, Department of Corrections presented HB 329 for the Governor. She noted, also with her, to provide explanation on the bill, are Dugan Petty - Department of Administration, Larry Streuber - Department of Health and Social Services, and Joe Reeves - Department of Corrections. She said the Harborview project is a very important project for the state of Alaska and has far reaching implications for being able to reduce recidivism to make our state safer. MS. ROBSON said HB 329 gives the Department of Corrections the authority to establish a therapeutic community for the purpose of providing intensive drug treatment to incarcerated offenders. She referred to a brochure that was distributed and explained Harborview Developmental Center is in the process of being closed down and noted it is the facility that they are looking at having their therapeutic community at. Ms. Robson noted they have done preliminary studies with an architectural firm to look at programming and planning, and find that the therapeutic community would fit nicely into two wings of this building. Number 0348 MS. ROBSON further explained that it's part of the Department of Correction's plan for addressing our severe overcrowding issues, the facility will incarcerate 16 medium to minimum custody inmates. The inmates who are participating in this program are inmates who would not otherwise be eligible for furlough or parole situations but by participating in this program that will enhance their possibility for furlough and parole, thus freeing up the beds sooner. The program will also have a strong transition component into the community which means that those inmates that are releasing on probation, parole, or furlough will in fact be supervised in the community and will have treatments that will follow them into the community. Number 0356 MS. ROBSON pointed out this program will allow the department to address some of our seriously addicted inmates. She said they estimate approximately 80 percent of the people who come to them have had involvements with substance abuse. They're also aware that they have very seriously addicted offenders, and up until this point in time, they have not had the opportunity to address that serious addiction. Ms. Robinson said, "We do have substance abuse programs in our facilities, they include education, a pretreatment component, and then an outpatient model. With the addition of this therapeutic community we would be able to address those seriously addicted offenders in a 24-hour a day program." Number 0362 MS. ROBSON emphasized the significant impact on their success with this program is the fact that they are designing culturally relevant programming. Last year the Legislature appropriated $50,000 for them to look into their current treatment, and to look at their existing treatment as far as making it relevant to the population. With that funding they are putting together training that will be provided to the prison substance abuse councilors and probation officers so that they will be able to evaluate people that will be going to this program and will be able to address the cultural issues with our population. MS. ROBSON said she believes the most significant point of this program is that it has the potential to reduce recidivism. She called the members attention to the research summary of the pamphlet, April 1997, and noted they recently received it from the federal substance abuse folks. Ms. Robinson said the fifth program demonstrates the effectiveness of this type of treatment. Last week they meet with a national expert, Doctor Gary Field, who informed them that they tend to see anywhere from a 30 to 45 percent reduction in recidivism when this type of treatment is applied to offenders. Ms. Robinson indicated they expect to start out with a 25 percent decrease in recidivism by these offenders and anticipate that it will rise as the program gets underway. She noted that they are very excited about this program and are really urging that people give it due consideration. MS. ROBSON noted, "As part of the process of locating the therapeutic community, it is necessary for the State to convey a State facility, and that is the Harborview Hospital." She asked Dugan Petty, from Department of Administration to explain Section 2 of the bill which addresses the conveyance of the property. Number 0388 DUGAN PETTY, Director, Division of General Services, Department of Administration, came before the committee in support of HB 329. He said the Department of Administration has been working with the City of Valdez, the Departments of Health and Social Services, Corrections, Natural Resources and Transportation and Public Facilities in preparing an interim agreement to prepare for the conveyance of the property. He pointed out this building is approximately 89,000 square feet, with a replacement value that is estimated to be over $40 million. It's currently being used as the hospital in Valdez and, of course was used as the Harborview Development Center. MR. PETTY stated this is the first time they have decommissioned a (indisc.--coughing) building of this nature. He noted the Department of Administration has screened other state agencies and the only use within the system for this building, which has been expressed to them, is the one by the Department of Corrections. He reiterated they have been working with the City of Valdez to prepare an interim agreement based upon the indications that they received from the Legislature of last year in funding some funds to make available to explore this project. Mr. Petty said, "We have excessed the personal property from the building except for that will remain with the facility and are prepared to move forward with this project. We think it makes good sense and support the project." Number 0401 CHAIR JAMES asked if the current hospital is at one end of this. MR. PETTY replied yes. CHAIR JAMES asked who owns the hospital. MR. PETTY responded, "The hospital, it's been my understanding is owned by the..." [owned by the State of Alaska]. TAPE 98-33, SIDE B Number 0001 CHAIR JAMES said she understands that one of the reasons it was closed down and was not to be used as it was before was the high cost of operations. She asked what were the specific instances that caused it to be so expensive to operate in that building. MR. PETTY deferred to Larry Streuber, Department of Health and Social Services because he is more familiar with the operating costs of the facility. He said he knows that they have taken some efforts to put some energy conservation devices in there to both get a better read on the facility, to break them out, and also to reduce some of the operating cost. Number 0011 CHAIR JAMES expressed one of the concerns she has with these types of programs, of treating people who are subject to addictions, is that when they go back home sometimes they fall right back into it. She asked what kinds of provisions do they have for those kinds of conditions. MS. ROBSON explained they recognize that the return to the community is a very critical point for these individuals and in fact, as part of the staffing for this facility, they will have a transitional counselor and a counselor aid. They will begin working with that individual as soon as he enters the program to help design his release plan in terms of the type of employment he'll have, where he'll live, what kind of housing. Ms. Robinson explained that when they're ready to release the offender they will have made contact with the community to and make sure that support systems are in place because studies do show that there is a marked increase in success if you're able to have effective aftercare or transitional planning. CHAIR JAMES referred to the training program for the offenders. She asked "Are you going to be associated with some other ability for getting education such as the Prince William Community College or are you going to be doing all of the training for job opportunities throughout your program or is it associated in any other way with any kind of education for these people." MS. ROBSON replied they have been primarily focusing on the treatment aspect of it. She said they know they will have to have an education component and have had brief discussions with the community college in Valdez. That program has not been designed yet, but they understand that they need to have an educational program. CHAIR JAMES asked what is the time line. Number 0033 MS. ROBSON responded they are looking at the program opening in October of this year and indicated they do have some very real concerns in terms of the renovations that have to be made on the facility because the two wings that we will be occupying (indisc.-- coughing) will have to be renovated. She noted last year the Legislature approved a federal appropriation of $400,000 that came through grant funding which will be transferred to the City of Valdez to be used for (indisc.--coughing) process. The City of Valdez has also indicated a willingness to support, through funds, the renovation of the building. She added that they are concerned with the time line. Number 0046 VICE CHAIRMAN IVAN called the State Affairs Meeting at-ease due to a fire alarm at 11:46 a.m. CHAIR JAMES announced the meeting will be called back to order at 12:00 p.m. Number 0053 REPRESENTATIVE GENE KUBINA, Alaska State Legislature, came before the committees. He said, "...and as Health and Social Services shut it down, it would create great problems for us in our hospital in what we would do with it. You asked the question of why it was so expensive. Health and Social Services made a decision years ago that they would not put more people in Harborview. In the last six years or so, it's been housed at less than half its capacity. It was in my opinion housed in so that it was made to be expensive so they could close it. They philosophically did not want to house developmentally disabled people in a large institution. So it's just a philosophy, they've all gone out to community based so that's why it was so expensive. ... We did have a facility before the earthquake, in old town, and this facility was built pretty much on federal funds to house the hospital and Harborview Developmental Center after the quake mostly on federal dollars." Number 0065 REPRESENTATIVE KUBINA noted that this is the only real option that anybody's come up with of what to use the facility for. He said it's basically not to house people. Last year, in the budget, we did approve $400,000 of federal crime dollars. He read, "For a therapeutic treatment community program of up to 100 beds in Valdez where the cost per inmate-day exclusive of treatment costs would not exceed the statewide average per inmate day for correctional institutions." So they've put in a ceiling. They said, all right you can have this program, but you have to come in at this cost, and that's what we're approving. REPRESENTATIVE KUBINA mentioned they had a meeting in the fall with the Chairs of both Finance Committees and they gave a report. He pointed out members of the Finance Committee insisted they have a recording mechanism to ensure -- it says, according to backup the savings generated by treatment will be substantial. In other state programs a cost average of a seven-dollar return for every dollar invested. Future savings should be documented for each dollar invested in Harborview and that again was in the budget last year that we passed. He reiterated that the department knows that they cannot go over a certain price for this thing and they have to show, over a period of time, that it's cost-effective. Number 0080 REPRESENTATIVE KUBINA mentioned they weren't able to get Doctor Gary Field in front of the House State Affairs Committee. He noted Doctor Field runs a similar program in Oregon and reported, in the last seven years, they've been able to document huge savings that they now have added three other programs in Oregon - spread around the state. REPRESENTATIVE KUBINA mentioned HB 329 has three other referrals and there is a catch, in the budget of last year, of the price that is has to come in at. While it's not in the budget, it is included in the Governor's overall budget number that is there so it's not an add-on to his proposal. CHAIR JAMES reiterated her concern of the offenders returning to their community. She suggested the offenders work during the day and return to Harborview in the evening as a transition. Chair James mentioned she was also interested in the training they would be given because just getting them well isn't enough because most of the people, who have substance abuse problems, don't have any work skills either. She asked if there are halfway-houses anywhere else in the state where these people can go out to work and come back. She said she believes those suggestions may make it a more successful program in the long run. Number 0119 REPRESENTATIVE KUBINA responded Doctor Field said, statistically one of the big things about this program is that it is separated and away by itself during the program. Doctor Field said they have found that when the offenders are still in a prison setting, drug and alcohol programs don't work. He suggested isolating them from all other inmates, to keep them with people that are going through this same type of program - maybe staggered in there depending on how long they've been there, how far they've gone, etcetera. He also mentioned the program shouldn't be less than six months long and maybe, depending on the individual, maybe up to a year. Representative Kubina suggested, once they reach the point of being released, rather than just say go home, suggest a halfway-house. CHAIR JAMES said there are so many laws affecting this person, the length of their sentence, that whether or not you have enough time to do this, and if you don't you might as well not spend any time on it. Chair James noted, because we haven't had a system like this before, maybe the rest of our system needs to be amended or adjusted to be sure that this is an opportunity for these people. Number 0135 MS. ROBSON pointed out they did survey the population prior to beginning any planning on this project to determine if we had an inmate population that had the need that this type of treatment would provide. She said they have completed three different surveys and found that there is certainly a population that has the sentence length to be able to participate in this program. In fact, there are easily 60 individuals in our system right now that could benefit from that. Substance abuse councilors look at each individual offender to determine if they were individuals who would benefit from this program, if they had the kind of background that would make them good candidates for this program. MS. ROBSON explained this would allow them to address serious substance abuse problems so that these individuals could be considered for furlough, for parole and their chances for being granted those early release mechanisms would be greatly enhanced by having gone through the treatment. REPRESENTATIVE BERKOWITZ said he would assume that a lot of the folks that would come through this program would be felons, because of the duration of the program, which would mean that subsequent to participating in this they would get a halfway-house as a further transition and then be on some form of intensive parole. Number 0150 MS. ROBSON responded they could possibly be furloughed to a halfway-house situation. One of the things the experts tell us is that once an individual completes this very intensive treatment, you have to be very careful that you don't put them back into a more restrictive setting because what you can do is you can undo the work that you have done. Ms. Robson said, "But there are cases, in fact when we were talking with Doctor Field, where there maybe individuals who need that very structured environment, to go out to work, to have somebody to be accountable to when they come back. The individuals, once they've finished, if they were furloughed to a halfway-house, or go out to the community, they would be under supervision - either it would be mandatory parole, in some cases there maybe an instance of discretionary parole. So there would be some furlough status there. In almost all cases in Alaska felons do receive probation supervision, so there would be supervision of these individuals out in the community." REPRESENTATIVE BERKOWITZ asked Ms. Robson if she anticipates that there will be aftercare and that aftercare is going to be flexible enough so you can cater to the individual who's being treated. MS. ROBSON replied that's correct. She noted that is one of the reasons they have two transition counselors, is to begin working on that release planning the minute they come into that program. If the individual for instance wants to go back to his village they can start making contact and ask if they have that support system there, is community treatment available. If it's not, how can we address that issue. They're looking at trying to send people back into their communities safely. Number 0167 REPRESENTATIVE ELTON said he believes this makes economic sense. He stated, "One is we don't have enough beds in the system anyway, and so we're adding beds, ... and those beds will be no more expensive than the beds that you're already providing on a statewide average, and so you're kind of redirecting how the dollar is being spent on the prisoners. You're spending the same amount of dollars on each individual that's incarcerated but, as Pete Wilson notes, each dollar that you spend on treatment you're saving seven dollars down the road so it makes economic sense in future savings. You're nodding your head, so I'm understanding correctly about the economic benefits." MS. ROBSON replied yes it has been shown nationally that there are economic benefits to doing this type of treatment. When they've done the studies and look at what substance abuse costs when a person is in an addictive cycle in terms of hospital courts, criminal justice system. Number 0178 REPRESENTATIVE ELTON mentioned a dollar is not going to be an added-on dollar, that's a dollar you'd be spending on these people because they would be incarcerated elsewhere. So you're not adding dollars on because of the requirement that the cost of keeping that person in that bed, not exceed the cost of keeping that person in a bed - in any other part of the correctional system. MS. ROBSON responded that's correct. She said they've done an analysis and found that the cost of this program is comparable to the cost of their other facilities. REPRESENTATIVE ELTON asked is the flow of people into these beds going to be completely controlled by the correctional system. Or can the court, as part of the sentencing portion, can they say we sentence you to two years in Palmer and eight months at Harborview. MS. ROBSON explained this program would be similar to some of their other treatment programs and that is the courts frequently will make a recommendation for treatment, it may be sex offender treatment, substance abuse treatment, batterers program, and when the Department of Corrections receives those judgements, they will look carefully at those and try to honor the request if at all possible for treatment if the person has the length of time and custody level and all to fit into the programs. That would be the same with this program. Number 0192 MS. ROBSON further explained this program adds to their continual month care. She said they have substance abuse education, introduction to treatment and then an outpatient treatment model, but they don't have the end of that treatment continuum which is this therapeutic community. So, by adding this, they now have a full continuum of care so when the councilors in the jails see these individuals coming in they can say, "Okay this is an individual that needs therapeutic community introduction and education aren't going to do the bill, this guys been at this for 25 years and needs some serious intervention." So it adds that extra tool on so that we can actually meet the needs of the offenders. REPRESENTATIVE ELTON noted that is the department's tool and not the court's tool. The Department of Corrections would be in control of the flow of people. MS. ROBSON replied yes we would be in control of the flow. Number 0200 CHAIR JAMES asked if you have somebody who is really a victim of substance abuse and now they're incarcerated, and it's not available to them, how do you take care of those people, how do they survive. MS. ROBSON stated an institutional substance abuse treatment councilor will do an assessment on the individual and they will determine the level of treatment the individual needs. In the case of someone that needs intensive treatment, they don't have that currently available. She said they may decide to put them in the next lower level of treatment which is the outpatient model and have them treated there. They may also, when the individual comes up furlough or parole, they may say, "I think this person needs wait longer, we need to wait and see if we can get him in a treatment program in the community when they're close to the end of their sentence or at the end of their sentence." MS. ROBSON asked Chair James, "Treatment in the community." CHAIR JAMES replied any level of that treatment. She asked if that is part of the Department of Correction's budget, is there any reimbursement by the offender. MS. ROBSON explained the treatment that occurs in the institutions with the substance abuse councilor is part of the Department of Corrections budget. The treatment facility that individuals might be furloughed to are paid for by the Department of Health and Social Services who have a specific number of grant positions available to the department for that. She said she believes, in the case of the individual in the community, that some of that is paid for through alcohol and drug grants and then the individuals may pay some of that if they're in the community. Number 0216 CHAIR JAMES said, "Gene [Representative Kubina] indicated that with the budget that was authorized last year to review this opportunity - and that 400 beds - and also to keep the level exclusive of the health provider, exclusive of the medical part that the cost to keep them in this facility would be the same as the average statewide. So, if the cost of keeping them there is the average statewide, but then on top of that you have the medical coverage -- what we we're talking in the hallway when I said what do these people do all day, and you said their treatment is all day. But you did say they would be doing their laundry and they're working in the kitchen and doing the scrubbing and those kinds of things. And then I asked well do they get paid for that. It occurs to me that if there's additional expense, over and above the amount that it costs just to keep them at the average cost, and they're going to get medical treatment that's past that, which has a cost, that may be they could get credit for working to pay for that so that at least they have some responsibility for what they're getting." She asked if her suggestion makes sense. She said she doesn't know if our law allows that or not, but was thinking that might be a way to deal with that extra cost for the medical. MS. ROBSON replied yes it does. She said she believes that (indisc.--noise) cost of care per day that they do have, in fact the health care is built in here, including the amount for inmate gratuities and wages. She mentioned Joe Reeves could go over the cost of care per day. Number 0234 JOE REEVES, Deputy Director, Division of Administrative Services, Department of Corrections, Manager, Division of Administrative Services, Department of Corrections came before the committee. He said he has been on board with the Valdez therapeutic community transition from the Department of Health and Social Services to the Department of Corrections as a therapeutic community for the last couple of years and has helped Ms. Robson and other members of the agency's transition team develop costs that would be within the (indisc.) of the legislative intent that was given to them. MR. REEVES referred to page 4 of the handout, he said it shows the statewide average that they currently operate under in the institutions, and that captured all cost categories that were provided in the fiscal note they attached to this bill - institutional costs, inmate programs, inmate health care and the Division of Administrative Services in support cost for a total. He stated, "And you say that, apparently in 1998 the statewide average for the institutions is $100.07 a day. We took the proposed Harborview therapeutic community and derived the cost of that on the fiscal note and that made up $1,800,000 - 58.9 of which we broke out to be $84.88 a day. You add the inmate programs at $28.49 a day, you add inmate health care that was in the fiscal note of $10.68 a day, you add the admin. support cost which was basically the date of communication... It works out to be about thirty-one cents a day, and that makes out to a total -- statewide indirect is not included in the Valdez therapeutic community because statewide indirect in this calculation pertains to equipment of building depreciation and capital resources which we don't have any in this project. So the statewide total is $124.36 a day, and when you extrapolate that, the inmate treatment. It comes out to be $95.87 a day." Number 0255 CHAIR JAMES reiterated there is approximately $30 a day calculated in for the treatment. MR. REEVES replied treatment would now be $28.49 a day. CHAIR JAMES mentioned that has to be paid for by the state. She indicated Mr. Reeves said the statewide indirect, which refer to maintenance and so forth is zero. She asked who's going to maintain the facility. MR. REEVES responded that it will be maintained by the City of Valdez. CHAIR JAMES said she understands this building was under the Department of Health and Social Services and is currently being transferred to the City of Valdez, and then the city will contract with the Department of Corrections to do this. Number 0260 MR. REEVES stated the facility will be transitioned from the State of Alaska to the City of Valdez and we will lease the portion of the facility from the City of Valdez. CHAIR JAMES said, so you're going to lease it maintained. MR. REEVES replied yes. CHAIR JAMES asked who will these people be working for. MR. REEVES responded they will be working for the Department of Corrections. CHAIR JAMES indicated she would like to have them working for the City of Valdez. Number 0266 REPRESENTATIVE KUBINA pointed out, because some people have had a fear of what the cost will be to maintain the building, the city has taken on that responsibility and that liability. He said the Health and Social Services maintenance person is going to be transferred to the City of Valdez. So if the roof has a problem, the city's taken on that responsibility, it will not be a State one. CHAIR JAMES mentioned the Legislature has dealt with a lot of issues in the area of prevention with calculations of how much money you're going to save if you do this. They're really a hard- sell only because you really don't know until you've done it. Even though you use other people's experiences, it's really difficult for people to buy into that. She noted that's one of the things that she's ever found to sell are prevention programs of any kind no matter where it is. She asked Representative Elton if he had any other questions. Number 0279 REPRESENTATIVE ELTON said he was going to make a motion to move HB 329 out of committee. CHAIR JAMES stated we're not going to be able to move this out today. REPRESENTATIVE ELTON said he thought the packet of information that the people provided was pretty thorough and appreciated the comments and testimony and this does have some legislative history that goes before the drafting of the legislation. He said he agrees with Chair James comment that you don't know what's going to happen until you try it. He mentioned one of the things that has given him some comfort is the fact that somebody has tried this in another jurisdiction. Representative Elton said, "I think that the comments by Governor Pete Wilson, that are part of the supporting packet, where he talks about the value of the dollars that you invest in this, giving you a savings for every one dollar, giving a savings of seven dollars down the road, now that may or may not be accurate and that may or may not be what happens here. But, I think that I'm comfortable enough to give this a boost in the right direction and I think that it is something we ought to try." CHAIR JAMES said he could make a motion. Number 0292 REPRESENTATIVE ELTON withdrew his motion. CHAIR JAMES said she thinks we can move HB 329 out on Tuesday.