CS FOR HOUSE BILL NO. 313(FIN) am "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." Co-Chair Torgerson noted that during consideration of the FY 01 operating budget, SB 312, the Committee had previously adopted a committee substitute 1-LS1305\G to SB 313 as a workdraft. He explained the committee substitute had removed all reference to capital projects from the legislation. He said the intent of this meeting was to consider the capital projects receiving funding from the Mental Health Trust Authority (MHTA). JEFF JESSE, Executive Director, Alaska Mental Health Trust Authority, Department of Revenue, gave detail on the items listed on the Mental Health Capital Projects, HB 313 spreadsheet. [Copy on file.] Senior Services Data Integration Project - Department of Administration Mr. Jesse stated that MHTA funds would be used to help fund this new project. He explained the project was to assist the Division of Senior Services to increase efficiency of the division's operations. Telepsychiatry Video Communication System Equipment - Department of Corrections Mr. Jesse told the Committee this project was a continuation of a $75,000 FY 00 project that the trustees are involved in. He said the requested funds would assist the department in upgrading their system. He remarked that the Department of Corrections was a leader in utilizing video conferencing technology to increase their ability to provide psychiatry counseling and supervision to inmates in all the correctional facilities from the central mental health office in Anchorage. He spoke about how this project has been showcased at national conferences as a model program. He added that the program reduces professional and travel costs for the state. He congratulated the department for instituting this program using equipment that has a low "band width" and noted this upgrade would increase the band width to further increase the program's effectiveness. Alaska Psychiatric Institute 2000: Replacement of Existing Facility - Department of Health and Social Services Mr. Jesse stated this was a continuation of the Trustees' process of setting aside MHTA funds to further assist the state in making the transition from the current Alaska Psychiatric Institute (API) into the new facility, which he hoped the negotiations with the charter would be concluded shortly. He stated that the MHTA was working in tandem with the federal funds secured through the assistance of US Senator Ted Stevens. Alaska Psychiatric Institute Stop-Gap Repairs - Department of Health and Social Services Mr. Jesse bemoaned, "unfortunately this is not a new project at all." He continued that the stopgap repairs have been an on-going concern although the MHTA has been able to secure a matching program to utilize Alaska Housing Finance Corporation (AHFC) receipts. He explained the intent of this project is to keep the facilities operating as long as possible or until the new facility was available for occupancy. Coordination and Resource Sharing Among Mental Health Services Providers - Department of Health and Social Services Mr. Jesse shared that this was an exciting new project for the MHTA. He explained that through the auspices of the Governor's Council on Disabilities and Special Education the proposal was to review how the state operates with all the beneficiary nonprofit groups and providers. He said the project hopes to identify whether efficiencies could be gained and how the programs could become more results based. Another intent, he added was to identify whether any services can be integrated and the savings of which could be reinvested into further services for the beneficiaries. He summarized that this project was to improve the infrastructure of the mental health grant system. Senator Leman thought this item seemed more like an operating item than a capital project and asked what specifically would be provided with the $100,000. Mr. Jesse replied that the governor's council proposed convening a "think tank" of representatives of the four boards involved with the MHTA to develop a list of areas within the grant structure and the service provision system to submit to an independent contractor. This contractor, he continued would evaluate and make a series of recommendations as to how the MHTA could improve the efficiency and effectiveness of that system. Mr. Jesse suggested the reason this project was classified as a capital project was because it was unclear whether the work could be completed in one fiscal year. He said the MHTA thought that listing this as a capital project would give the greatest flexibility. Senator Green asked if it would be possible under the governing federal mandate to streamline and merge some of these services into one group rather than break them down by the four distinct constituency groups. Mr. Jesse said that was one of the goals of the project, to identify what areas have such flexibility. He cautioned that some programs have strict specific membership requirements and missions from the federal government. Fairbanks - Reopen Fahrenkamp Residential Facility - Department of Health and Social Services Mr. Jesse explained the goal of this project was to use the center for its original purpose, as a residential diagnostic treatment center for adolescents. He relayed that for many years, the facility has been used as office space and adolescent outpatient care by the Fairbanks Mental Health Center. However, he stressed there is a desperate need for residential services for this population. He noted this is a matching funds program between the trust and the state using AHFC receipts in order to make the physical modifications to the portion of the center that will house the adolescents and to but necessary equipment. Fairbanks Community Mental Health Center Relocation - Department of Health and Social Services Mr. Jesse pointed out that this project exclusively utilizes MHTA funds to assist the center, which is currently located in the Fahrenkamp facility and has been paying only one dollar per year as rent. Because of the plan to reconvert the Fahrenkamp to a residential facility, he explained that these funds are to relocate the mental health center and to pay additional rental costs for the first year. He stated that the hope in the next year was to include the increased operating costs due to space rental into their operating budget. Otherwise, he added the center would need to reduce its service capacity. Housing Modifications for Mental Health Trust Beneficiaries - Department of Health and Social Services Mr. Jesse talked about how this continuing project continues the relationship that the trust has developed with the AHFC to identify ways to deliver housing modifications for beneficiaries. He described some of the people served, such as Alzheimer patients needing their house modified so they could remain in their home. He stressed that this has been a successful project in handing out relatively small grants. Mental Health Grants - Essential Program Equipment - Department of Health and Social Services Mr. Jesse told the Committee that the trust had originally proposed this on-going project as a 50-50 matching program with the state. However, he said that the Governor's Office was only able to identify $50,000 of general funds to make available. He stressed that the trust deemed these grants particularly to smaller mental health centers, are essential to maintaining their capacity to operate. He listed computers and software as some of the items purchased using these grant funds. Mental Health Grants - Facilities Renovation and Deferred Maintenance - Department of Health and Social Services Mr. Jesse continued that this project is similar to the previous in that it is an on-going program also proposed to have a 50-50 general fund match, but that this does not have the adequate general fund money to meet the match. He explained the grants are used by non-profit organizations for facility renovation and deferred maintenance. He asserted these projects are a good investment in maintaining the infrastructure of the mental health program. Spirit Camp Facility Development - Department of Health and Social Services Mr. Jesse explained this new project to assist what has already been proven to be an effective culturally appropriate way to allow local Native communities to take responsibility for their own programs. He stated this project helps communities develop programs that build upon the cultural values and strengths of those communities rather than simply imposing a more Anglo approach. He told of efforts made on a smaller scale, saying that this is the largest culturally relevant treatment project undertaken by the trust. Transitional Housing for Recovering Substance Abusers - Department of Health and Social Services Mr. Jesse stated that the purpose of this project is to assist substance abusers who have completed treatment but still need some supervision during a transition period into their independent living situations. Mental Health Trust Land Development and Value Enhancement - Department of Natural Resources Mr. Jesse stated that this is a continuing project and a permanent part of the MHTA land office, to hire contractors for subdivision sales, timber sales. He said the contracting-out of these services is done in lieu of hiring additional staff. AHFC Beneficiary and Special Needs Housing - Department of Revenue Mr. Jesse explained this is also a continuing project, but at a smaller amount this year. He stressed that this is a critical part of the mental health program. He spoke of "tremendous strides" the trust has made in the ability to deliver treatment. However, he qualified the treatment system often does not give full consideration to all the facets of a person's life that are necessary to be independent and become productive members of society. He identified the need for developing safe, affordable housing as one of the most critical items for successful recovery. Senator Green asked if this was temporary housing. Mr. Jesse replied that a variety of mechanisms have been used to provide housing. He referred to a "Structured Production Model" of developing supported housing. He explained that in the past, the operational side of the mental health program had operational money but didn't know how to develop a housing project. On the other hand, he pointed out, AHFC knew about housing but not how to deliver necessary support. This project is to blend the two groups together to supply adequate housing facilities and also deliver services, according to Mr. Jesse. He added that this project includes a plan to assist beneficiaries into a home ownership situation. He stated that research shows that an investment in home ownership is a powerful mental health tool. Senator Green suggested attaining additional support from the residents. She asked if the housing provided included monitoring to ensure the participants were safe and getting necessary treatment. Mr. Jesse affirmed. AHFC Homeless Assistance Program Mr. Jesse stated this is also a continuing project and is instrumental in getting services to the most difficult to serve populations in the state. He told of how many of these people are not only unconnected with the normal mental health services systems, but that they "often don't want to be a member of the club." He detailed the difficulties this segment of the population has in getting employment and meeting other aspects of self-sufficiency. Senator Phillips asked how many people are served in this program. Mr. Jesse began his response. AT EASE 9:26 AM / 9:28 AM Mr. Jesse did not have the exact data with him but noted the performance measures for this project rely heavily on how many people are served by the program. He said he would supply the data to the Committee. Senator Phillips asked for a breakdown showing the different regions of the state. Co-Chair Torgerson asked if this funding request would supply the same level of support as the previous year. Mr. Jesse replied that the $250,000 AHFC funding amount was the same as the previous year and that the $200,000 of MHTAAR receipts is new. Coordinated Transportation and Vehicles - Department of Transportation and Public Facilities Mr. Jesse then told of this successful partnership project that also utilizes federal transportation funds. He described different non-profit groups each having a van to serve only those in their mental health program. He said this was because of the difficulties involved in determining who would own, maintain and operate these vehicles. The intent of this program, he explained, was to combine the use of these vehicles to serve more than one non-profit entity. He said that this project provides up- front money to allow communities to establish a local coordinated transportation system. He added that the funding would also be used to purchase new vehicles where necessary. Planning for Juneau Senior Daycare Center $100,000 Mr. Jesse explained this item does not appear on the spreadsheet because the governor had determined there was not an adequate general fund match for the construction costs. Mr. Jesse stated that the trustees want to utilize MHTAAR funds for the planning process in anticipation that once the community is able to develop a plan and identify more accurate costs, there may be a variety of fund mechanisms available to build the facility. Co-Chair Torgerson asked if the witness was working with a Committee member to propose such an amendment to the budget. Mr. Jesse believed so. Co-Chair Torgerson announced a committee substitute would be prepared to reflect the items on the spreadsheet and he explained the amendment procedure. Co-Chair Torgerson ordered the bill HELD in Committee.