SB 174-PROGRAMS FOR PERSONS WITH DISABILITIES  1:59:08 PM CHAIR WILSON announced the consideration of SB 174. 1:59:23 PM SENATOR MICCICHE, Alaska State Legislature, sponsor of SB 174 said the bill is puts forth a philosophy about identity. It does not have a fiscal note. People used to say physically and mentally disabled Alaskans and the bill changes that to Alaskans with physical and mental disabilities. This bill is about their active participation in decisions related to their own care. There are efficiencies associated with that. There are improvements to their quality of life for these individuals. 2:00:29 PM KAITLYNN STANSBERRY, Intern, Senator Peter Micciche, Alaska State Legislature, presented SB 174 on behalf of sponsor. She said SB 174 is the product of input from over 200 people across Alaska, including the Alaska Mental Health Trust, the Governor's Council on Disabilities and Special Education, and the Key Coalition of Alaska. All persons deserve to be treated with respect and dignity. Persons with physical and mental disabilities actively participating in the programs they use enhances their quality of life and treatment. They thrive when participating in the social and economic environment of their homes, communities, and Alaska. SB 174 enables the Department of Health and Social Services (DHSS) to take a more flexible approach to the application of programs, allowing Alaskans with physical and mental disabilities to participate actively in the systems of their care. These systems of care are the programs they use daily. SB 174 provides a unifying vision to assure that available resources, whether great or small, are allocated and applied in a manner that maximizes the contributions of Alaskans experiencing disabilities in their communities. SENATOR BEGICH said he was very pleased to see the bill. He asked what the phrase flexibility means so that it could be put on the record and encourage employers to take advantage of it. SENATOR MICCICHE said he could say what it means to him, but it will be more meaningful coming from people who are going to testify. SENATOR BEGICH said he'd also like the testifiers to discuss the different ways this will increase economic opportunity for the state. 2:03:29 PM CHAIR WILSON opened public testimony. 2:03:50 PM LIZETTE STIEHR, Executive Director, Alaska Association on Developmental Disabilities (AADD), supported SB 174. She said the Alaska Association on Developmental Disabilities is a trade association, a professional association that represents 47 dues- paying organizations, all of whom provide home and community- based services for individuals who experience intellectual or developmental disabilities. The association has been an active and strong supporter of this shared vision, which brings a renewed energy and excitement to the work of the provider community. The shared vision reminds them of why they dedicated their professional lives to this field. She mentioned that it is a challenging time for legislators, who are dealing with fiscal constraints, which roll down into the field and the services offered in Alaska. The provider world is feeling many changes, including SB 74, Medicaid reform. It seems so many things are going away or being reduced. It has been a trying time, but the shared vision work has been a ray of sunshine and a place of excitement and enthusiasm. She loves the question of what does flexible mean. It means people have a right to direct services they would like to have, not just what has been traditionally offered or has been a system of support. The economic impact is that they work with what people would like to have in their lives, they want to be in the community. One way inclusion happens is through unpaid or natural supports that then economically helps the community through inclusion and the price of services. She thanked Senator Micciche for sponsoring the bill. She said those in the field are very excited about it. 2:07:50 PM MICHELE GIRAULT, Board Member, Key Coalition of Alaska, supported SB 174. She said she is a guardian of two individuals who experience disabilities. She appreciated Senator Micciche reaching out to create a value-driven bill that puts into statute their vision of what life should be like for those who experience disabilities. It is really people first. Regardless of fiscal impact, the idea is that Alaskans will support those among them who experience disabilities in a way that honors their desire and right to have meaningful lives. Flexibility means that in these dynamic times all the different departments of the state work together to support people, whether someone has intellectual, behavioral, or mental health challenges. People might need more of one kind of support and less of another. From a consumer's point of view, flexibility means a person may need a support in one moment and then can later let go of that support. The bill puts into statute a framework that allows departments and stakeholders to come together to assure individuals will have opportunities to create meaningful lives for themselves. This is one of the platform issues for Key Coalition in their planned visit next week. 2:10:40 PM JIMAEL JOHNSON, Program Officer, Alaska Mental Health Trust Authority, supported SB 174. She said the trust exists to advocate on behalf of trust beneficiaries and to prioritize policies, practices, and funding for strategies that help improve the lives of beneficiaries. The beneficiary population includes Alaskans with mental illness, addiction, Alzheimer's, dementia, traumatic brain injury, and individuals with intellectual or developmental disabilities. The trust advocates for crucial services for the most vulnerable population through community-based services. Community-based services, especially when person centered and directed, reduce the level of need for costlier institutional care. The goal of the trust is to be a catalyst for change and improvement in the state's continuum of care. SB 174 is a visionary framework to increase opportunity and improve the quality of life for individuals, their families, and full communities. It elevates the person experiencing disability to more actively participate and determine their own community-based care and thus more fully direct their lives and wellness. 2:13:06 PM MAGGIE WINSTON, Chair, Governor's Council on Disabilities and Special Education, supported SB 174. She said she works at a center for independent living and most importantly, she is a person who experiences a significant disability. A flexible system can literally mean the difference for her getting out of bed in the morning or being able to go to work. This vision enables person-directed care and culture. This is super important, especially for individuals who experience disabilities. It gives more control in living the life she directs and she chooses. They have in statute the verbiage that enables them to be flexible and live a normal, autonomous life. SENATOR MICCICHE noted that Ms. Winston who was before the committee two weeks ago was the inspiration for the bill. Some physical limitations may seem debilitating, but they are not an impediment to absolute success in one's life. They are not asking for more resources. They are asking for more self- directions so people like Maggie can continue to thrive and inspire the rest of Alaskans. 2:15:48 PM DAVE LEWIS, System Advocate, Independent Living Center, supported SB 174. He said they support the bill and what everyone else said previously. 2:16:27 PM MICHEAL BAILEY, Chief Financial Officer, Hope Community Resources, supported SB 174. He said the systems and service delivery are often siloed, specialized, and governed by their own regulations. This limits flexibility. This unified vision engages a collaborative system of paid and unpaid supports to enhance abilities, not just to address disabilities. This bill allows flexibility in being able to adjust without a regulation rewrite. As they do that they are better stewards of state funds. His daughter's team won the Anchorage School District middle school Battle of the Books competition. A member of the team has a physical disability and listens to audio books. She's a valuable member of the team and an inspiration to other people. Her team members were her natural supports. That is an example of what they want to promote. The approach in SB 174 moves away from some traditional medical models to more integrated, meaningful lives and upholds person-centered directives from the federal government that are necessary to access Medicaid funds. This bill benefits everyone, regardless of the level of financial support available, by promoting partnerships and new models of support guided by a value-driven philosophy. People have heard the saying it takes a village to raise a child. It takes a community to help Alaskans with disabilities lead meaningful lives. 2:19:08 PM PATRICK REINHART, Executive Director, Governor's Council on Disabilities and Special Education, supported SB 174. He said they view this as a culture change. A few years ago, they pushed through similar aspirational language in statute around employment first. They wanted people with disabilities and the people who support them to look at the opportunities to lead a meaningful life through employment. It takes a long to make a culture change and shift in a large system of services and supports like they have in Alaska. A few years later, they are starting to see a cultural shift occurring. When people are making plans of care for people with significant disabilities, the question "What do you want to do when you grow up" is asked more often. This also is a cultural shift--more and more they are looking to the individual about their hopes and dreams and desires, which also means allowing them to take some risks. People with developmental disabilities need the same opportunities to take risks. The bill puts it back on the individual's plate and that comes with responsibilities to direct their own care and lives. 2:21:29 PM CHAIR WILSON closed public testimony. SENATOR GIESSEL thanked Senator Micciche for moving the dial for Alaskans with disabilities. Patrick Reinhart talked about the challenge of self-determination and decision making, but also the gratification of being able to do that. It reminds her of the House bill a few years that let Alaskans with disabilities participate in the federal program of ABLE accounts. They can save their own money to use as they see fit. The bill is another step in that direction, so bravo to Senator Micciche. SENATOR MICCICHE said folks are thanking him, but he knows they will pile on as cosponsors in recognition of the capabilities of those who have challenges. 2:23:12 PM CHAIR WILSON asked if there were amendments. There being no amendments, he entertained a motion to move SB 174 out of committee. 2:23:21 PM SENATOR VON IMHOF moved to report SB 174, version 30-LS1258\D, from committee with individual recommendations and attached fiscal notes. 2:23:35 PM CHAIR WILSON announced that without objection, SB 174 moved from the Senate Health and Social Services Standing Committee with the understanding that Legislative Legal was authorized to make any necessary technical and/or conforming adjustments.