HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE April 10, 1997 3:04 p.m. MEMBERS PRESENT Representative Con Bunde, Chairman Representative Joe Green, Vice Chairman Representative Brian Porter Representative Fred Dyson Representative J. Allen Kemplen Representative Tom Brice MEMBERS ABSENT Representative Al Vezey COMMITTEE CALENDAR HOUSE BILL NO. 127 "An Act relating to the citizen review board and panels for permanency planning for certain children in state custody; renaming the Citizens' Review Panel For Permanency Planning as the Citizens' Foster Care Review Board; extending the termination date of the Citizens' Foster Care Review Board; and providing for an effective date." - HEARD AND HELD HOUSE BILL NO. 153 "An Act relating to the eligibility of aliens for state public assistance and medical assistance programs affected by federal welfare reform legislation; and providing for an effective date." - MOVED HB 153 OUT OF COMMITTEE HOUSE JOINT RESOLUTION NO. 29 Supporting an increase in federal funding for prostate cancer research. - MOVED HJR 29 OUT OF COMMITTEE HOUSE BILL NO. 193 "An Act relating to financial assistance for students attending certain graduate education programs; and providing for an effective date." - BILL POSTPONED (* First public hearing) PREVIOUS ACTION BILL: HB 127 SHORT TITLE: FOSTER CARE REVIEW BOARD SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES JRN-DATE JRN-DATE ACTION 02/12/97 318 (H) READ THE FIRST TIME - REFERRAL(S) 02/12/97 318 (H) HES, FINANCE 03/27/97 (H) HES AT 3:00 PM CAPITOL 106 03/27/97 (H) MINUTE(HES) 04/10/97 (H) HES AT 3:00 PM CAPITOL 106 BILL: HB 153 SHORT TITLE: ALIENS AND ASSISTANCE PROGRAMS SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR JRN-DATE JRN-DATE ACTION 02/24/97 442 (H) READ THE FIRST TIME - REFERRAL(S) 02/24/97 442 (H) STATE AFFAIRS, HES, FINANCE 02/24/97 442 (H) 3 FISCAL NOTES (DHSS) 02/24/97 442 (H) 2 ZERO FISCAL NOTES (DHSS) 02/24/97 442 (H) GOVERNOR'S TRANSMITTAL LETTER 03/11/97 (H) STA AT 8:00 AM CAPITOL 102 03/11/97 (H) MINUTE(STA) 03/13/97 (H) STA AT 8:00 AM CAPITOL 102 03/13/97 (H) MINUTE(STA) 03/15/97 (H) STA AT 11:00 AM CAPITOL 102 03/15/97 (H) MINUTE(STA) 03/17/97 690 (H) STA RPT 4DP 2NR 03/17/97 690 (H) DP: JAMES, ELTON, BERKOWITZ, DYSON 03/17/97 690 (H) NR: HODGINS, VEZEY 03/17/97 690 (H) 3 FNS (DHSS) 2/24/97 03/17/97 690 (H) 2 ZERO FNS (DHSS) 2/24/97 03/25/97 (H) HES AT 3:00 PM CAPITOL 106 03/25/97 (H) MINUTE(HES) 04/01/97 (H) HES AT 3:00 PM CAPITOL 106 04/01/97 (H) MINUTE(HES) 04/10/97 (H) HES AT 3:00 PM CAPITOL 106 BILL: HJR 29 SHORT TITLE: FUNDING FOR PROSTATE CANCER RESEARCH SPONSOR(S): REPRESENTATIVE(S) ELTON,Hudson,Kemplen,Austerman,Kookesh Berkowitz,Nicholia,Ivan,Dyson,Kubina,Sanders,Davies JRN-DATE JRN-DATE ACTION 03/14/97 665 (H) READ THE FIRST TIME - REFERRAL(S) 03/14/97 665 (H) HES, STATE AFFAIRS 04/02/97 913 (H) COSPONSOR(S): KEMPLEN, AUSTERMAN 04/02/97 913 (H) KOOKESH 04/03/97 977 (H) COSPONSOR(S): BERKOWITZ, NICHOLIA, IVAN 04/03/97 977 (H) DYSON, KUBINA 04/04/97 998 (H) COSPONSOR(S): SANDERS 04/09/97 1047 (H) COSPONSOR(S): DAVIES 04/10/97 (H) HES AT 3:00 PM CAPITOL 106 BILL: HB 193 SHORT TITLE: REPAY GRADUATE EDUCATION AID SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES JRN-DATE JRN-DATE ACTION 03/14/97 665 (H) READ THE FIRST TIME - REFERRAL(S) 03/14/97 665 (H) HES, FINANCE 03/27/97 (H) HES AT 3:00 PM CAPITOL 106 03/27/97 (H) MINUTE(HES) 03/27/97 (H) MINUTE(HES) 04/10/97 (H) HES AT 3:00 PM CAPITOL 106 WITNESS REGISTER PATTI SWENSON, Legislative Assistant to Representative Bunde Alaska State Legislature Capitol Building, Room 104 Juneau, Alaska 99801 Telephone: (907) 465-4843 POSITION STATEMENT: Provided testimony on CSHB 127(HES) CONNIE J. SIPE, Director Division of Senior Services Department of Administration 3601 C Street,Suite 310 Anchorage, Alaska 99503-5984 Telephone: (907) 563-5654 POSITION STATEMENT: Testified on CSHB 127(HES) EDITH McKINNON, Member Foster Care Review Panel 2203 West 46th Avenue Anchorage, Alaska 99517 Telephone: (907) POSITION STATEMENT: Testified on CSHB 127(HES) MASTER BILL HITCHCOCK Alaska Children's Court 820 West Fourth Avenue Anchorage, Alaska 99501 Telephone: (907) 264-0643 POSITION STATEMENT: Testified on CSHB 127(HES) L. DIANE WORLEY, Director Division of Family and Youth Services Department of Health and Social Services P.O. Box 110630 Juneau, Alaska 99811-0630 Telephone: (907) 465-3191 POSITION STATEMENT: Testified on CSHB 127(HES) JAY LIVEY, Deputy Commissioner Office of the Commissioner Department of Health and Social Services P.O. Box 110601 Juneau, Alaska 99811-0601 Telephone: (907) 465-3030 POSITION STATEMENT: Testified on HB 153 REPRESENTATIVE KIM ELTON Alaska State Legislature Capitol Building, Room 400 Juneau, Alaska 99801 Telephone: (907) 465-4947 POSITION STATEMENT: Testified on HJR 29 ACTION NARRATIVE TAPE 97-28, SIDE A Number 0000 CHAIRMAN CON BUNDE called the House Health, Education and Social Services Standing Committee meeting to order at 3:04 p.m. Members present at the call to order were Representatives Bunde, Green, Porter and Dyson. Representative Brice arrived at 3:06 p.m. and Representative Kemplen arrived at 3:54 p.m. Representative Vezey was absent. This meeting was teleconferenced to Anchorage, Fairbanks, Ketchikan and offnet sites. HB 127 - FOSTER CARE REVIEW BOARD Number 0059 CHAIRMAN BUNDE announced the first item on the agenda was HB 127, "An Act relating to the citizen review board and panels for permanency planning for certain children in state custody; renaming the Citizens' Review Panel For Permanency Planning as the Citizens' Foster Care Review Board; extending the termination date of the Citizens' Foster Care Review Board; and providing for an effective date." He said a Citizens' Review Panel assists out-of-home placement of children who have had various challenges or problems. Number 0123 PATTI SWENSON, Legislative Assistant to Representative Bunde, referred to a committee substitute, version H. Number 0134 REPRESENTATIVE BRIAN PORTER made a motion to adopt the committee substitute, version H. Hearing no objection CSHB 127(HES) was before the committee. Number 0169 MS. SWENSON explained that CSHB 127(HES) is similar to the last version, but has been expanded based on recommendations by the Department of Health and Social Services (DHSS). The name of the Citizens' Review Panel for Permancy Planning has been changed to the Citizens' Foster Care Review Board. The local citizen out-of- home care review panels have been renamed local review panels. MS. SWENSON stated that Section 1 is identical to Section 1 in version F. It extends the sunset date for the foster care review board to June 30, 2000. Section 2 is also the same as the previous version, requiring DHSS to notify the Citizens Foster Care Review Board within 60 days after a child is placed in out-of-home care. Under CSHB 127(HES), the state review board will be the core support for the local panels. Once notified of a child's out-of- home placement, the board will advise the appropriate local panels. MS. SWENSON said there are no real changes from the last version of CSHB 127(HES). This section requires the court to inform the interested parties about the review panels within 60 days after the court orders the child committed to state custody. MS. SWENSON referred to Section 4, this change allows the Citizens' Foster Care Review Board or the local panel to obtain confidential information about a case. This section also allows disclosure, as necessary, to school officials to protect the safety of a minor who is the subject of the case. There was some discussion of removing this provision from the bill. The provision actually protects the safety of the minor, students and staff and exists currently in statute. The language of CSHB 127(HES) clarifies that the subject of the case is to be protected along with other students, this prevents the subject from being treated differently. To prevent the current statute from being misinterpreted the language in this statute should remain. Number 0345 MS. SWENSON said that Section 5 does not represent a change from the current statute except to reflect the new name of the Citizens' Foster Care Review Board. Section 6 amends the name, Citizens' Foster Care Review Board and requires DHSS to notify the Citizens' Foster Care Review Board rather than the local panels within 60 days after the removal of a minor from the home. Since there is only one local panel working, the current statute tells them to notify it instead of the review board. MS. SWENSON explained that Section 7 is part of the juvenile delinquent statute. Usually the Citizens' Foster Care Review Board does not hear cases regarding juvenile delinquents. However, because some of the cases are classified as both Child in Need of Aid (CINA) and juvenile delinquent it might result in a problem if the panel wants to hear such a case and they are excluded from any of the juvenile statutes. The Division of Family and Youth Services (DFYS) is addressing this problem of dual classification because it impacts their Title IV-E money. Until the problem is fully resolved, this language should remain in CSHB 127(HES). Number 0471 MS. SWENSON referred to Section 8, this section reestablishes and renames the Citizens' Foster Care Review Board. The board will now consist of nine members appointed by the Governor with one public member from each judicial district. The board also includes, as non-voting members, the commissioner from DHSS, the Director of the Office for Public Advocacy, a member of the Attorney General's Office and a member from the Public Defender's Office. The make-up of the board has been changed in this section. It used to be seven people, but since two people from the Administration were taken off the board, the amount of public members was raised to nine. MS. SWENSON said Section 9 adds new language to reflect the new make-up and the new name of the board. This section allows for reappointment of board members and was in the previous version of CSHB 127(HES). Section 10 sets quorum and voting requirements for the board. This new language sets up requirements consistent with the changes in the make-up of the board in Section 8. This change is a slight variation of what was in the last committee substitute, it creates consistency. MS. SWENSON explained that Section 11 reflects the name change of the board and restricts reimbursement of board members to per diem and travel expenses only, as the board is required to meet at least twice a year. Section 12 sets the meeting requirements for the board to at least twice a year, telephonic meetings are possible. Section 13 allows the state board to have an executive director who services the board. The executive director is granted the power to employ staff who will provide technical assistance to local review panels. This language is consistent with the last version of the bill. Number 0586 MS. SWENSON said that Section 14 talks about the powers and duties of the board. Language has been added from the last version of CSHB 127(HES), it required the state board to ensure that local review panels meet permancy planning review requirements which will allow them to comply with Title IV-E federal requirements allowing the state to receive federal money for eligible minors. This section also requires the board to set local review panel priorities for the hearings. Some guidelines are set out for a high priority cases; children who are likely to be in out-of-home care for longer than 90 days, children that have been in more than one placement or whose parents are likely to loose their parental rights. The state board is also required, in subsection (c) to establish procedures for an expedited review of the high priority cases. Subsection (d) establishes the minimum number, of local review panels members, who must review the case and it also provides for the appointment of a substitute local review panel member to participate in the review. This provision would allow someone to sit in the review in case of an emergency. Number 0693 MS. SWENSON referred the change in Section 15, where a new subsection was added to empower the state board to make regulations requiring DHSS to provide the state board or a local panels aggregate data about permancy planning systems and to provide data and information requested by the state board and local panels. MS. SWENSON explained that Section 16 sets composition requirements for local panels. This section adds new language not in the last version of this bill, it accepts substitute members. She interpreted this section that when panel members are appointed, the substitute members are not counted. The intention of this section is to have people readily available for a scheduled review, in case of an emergency. This section also sets out the length of a panel members terms, the qualifications of the panel members, the make-up of the panels and empowers the state board to appoint additional panel members when it is necessary. All public members serve at the pleasure of the board. Panel members are also required to affirm, in writing, that they will keep all review information confidential. Number 0777 MS. SWENSON said Section 17 states that local panels shall meet in the judicial district where they reside. This language was in Section 16 of the last version of this bill. Section 18 is also the same as the last version, but it was Section 17. The public members of local review panels are entitled to reimbursement if they are required to travel. Normally, local review panel members don't travel, but travel might be required if the judicial district is big and someone else is needed. MS. SWENSON stated that Section 19 allows local review panels in a judicial district to request a local panel from another judicial district hear a case. In order to keep something confidential in rural areas, the review panel might not want to hear the case in that village. This language would allow the case to be heard in another panel for review. Section 19 also changes the initial review from 180 days to 90 days and adds language to allow lower priority cases to be heard 180 days after the child has been placed in out-of-home care. Even though the bill changes the initial review from 180 days to 90 days, it still allows the panel to hear a case at 180 days in order to comply with the Title IV-E requirements. This section gives flexibility to the 30 day notice of hearing provision required in current statute. The remaining sub-sections are in statute. The changes reflect the renaming of local panels, the number of days required to submit a report of the panel's recommendations is changed from 30 days to 15 days. Number 0900 MS. SWENSON said that Section 20 requires other executive branch agencies to disclose confidential information to local panels to assist them in locating persons entitled to participate in case reviews. Section 21 requires the DHSS to cooperate and consult with the state board in the development information systems relating to children in out-of-home placements. The DHSS is required to develop information systems to ensure that aggregate data and individual case information, needed by the state board and the local panels, is available from all departments. In the past there have been some problems getting needed information for annual reports and locating people. Language in CSHB 127(HES) just ensures that the panel will get the information that they need. MS. SWENSON explained that Section 22, as in Section 20 of the previous bill, states that necessary records shall be available to the local panels, concerning a child and their family, for the purposes of a review. Section 23 allows the review panel's recommendations to be entered into the court records. The only say that a panel has is in those recommendations. The panel's recommendations have not been allowed in court, unless they were requested by a attorney. Allowing the recommendations in court will give some weight to the panel regarding the disposition of the case. MS. SWENSON said that Section 24 provides immunity to the board, panel and staff members. In the past version only the board was given immunity. Section 25 defines the state board and local panels and is the same language as the previous version. Section 26 is also the same as the past version, it repeals sections of law whose subject matter has been added to other sections of the bill. Section 27 allows a phased in implementation of the bill with full implementation in two years after the effective date. Section 28 regards the effective date. Number 1054 CHAIRMAN BUNDE asked why the review board was needed and what exactly do they do. Number 1064 MS. SWENSON said the local review boards provide an oversight which works in concert with DFYS. The board is an independent viewpoint on what DFYS are doing for children that have been in out-of-home placements. These boards will decrease the amount of time that children are in out-of-home placements and hopefully save the state money. Number 1085 CHAIRMAN BUNDE clarified that out-of-home placement means children that have been taken away from their parents of record, for their own good. They are taken out of their home because of such problems as abuse and neglect. Number 1109 REPRESENTATIVE JOE GREEN asked how review system was currently being done. Number 1114 MS. SWENSON answered that right now only one panel is in existence. Initially, when this legislation passed, funding was available but it was never given to the panels. A little bit of money was given to allow one pilot project. One full time clerk and two others hold hearings; get the information necessary, notify the interested parties, gather the panel members and set a date. People come in and talk about what is happening with the child and what is happening with the parents. If a case plan is in place, then that is also reviewed. The board wants to see that permancy goals have been met for a child. These goals include reuniting the child with the family or termination of parental rights. Number 1178 CHAIRMAN BUNDE explained that enabling legislation established the citizens' review oversight panels, but the money was only there for one of them. This panel is about to sunset, it sunsets every three years and this bill, CSHB 127(HES), would not only reauthorize the program, but expand it. Number 1204 REPRESENTATIVE GREEN said CSHB 127(HES) goes beyond the pilot program, it talks about a statewide expansion program. MS. SWENSON agreed that this legislation would reauthorize and expand the Anchorage panel, start a Fairbanks panel and implement the program statewide within two years. Number 1217 REPRESENTATIVE GREEN stated that, prior to this expansion, this function was done in Fairbanks by DFYS. MS. SWENSON answered that currently there are no other panels besides the Anchorage panel. The DFYS does Title IV-E reviews on cases in Fairbanks, but there are no independent review panels. Number 1222 CHAIRMAN BUNDE explained that a Title IV-E review is a federal requirement which reviews children who have been taken out of the home in order for the division to receive federal money. Number 1252 REPRESENTATIVE GREEN referred to the fiscal note, $600,000 a year from the general fund. Number 1270 MS. SWENSON said money is needed to start up the panels on a statewide basis, expand the Anchorage panel and start a Fairbanks panel. The fiscal note represents the initial cost for the state board to meet and receive training. The new position of executive director of the board should be able to write grants and offer contracts to organizations in other areas to staff the panels. Those organizations will gather the information, mail it out to the interested parties and contact volunteers to do the reviews. She reiterated that this money represents start up costs for this year, for the first phase of expansion and implementation of new panels and expansion of the state board. Number 1334 CONNIE J. SIPE, Director, Division of Senior Services, Department of Administration, testified next via teleconference from an offnet site. She did not have CSHB 127(HES) in front of her but, based on the fact that the department has been working with staff on these changes and having heard testimony from Ms. Swenson, she felt the changes were fairly in line with the changes being discussed based on what may be needed for the panel. The fiscal note was done in preparation for the amendments that are in front in the committee, but it was not done after those amendments. If the committee adopts those amendments, there is still a possibility of paring down the fiscal note. She could also explain why those costs are necessary as the bill moves forward to other committees. Number 1411 CHAIRMAN BUNDE referred to the executive director's role of producing some non-general funds to keep this program running. He asked if the fiscal note reflected this role. Number 1429 MS. SIPE answered that it does not. Her experience is that it is very difficult to find grants for ongoing operations. Very few aid foundations, very few agencies are willing to use their grant money for an ongoing business. Grants are usually available to fund a special experiment, a special pilot project, better training, a curriculum book to give to the volunteers. Rarely can grant money be found to fund your ongoing operation. If members of the committee compare the fiscal note on CSHB 127(HES) as compared to the fiscal note on the Governor's bill, HB 100, the significant difference is that HB 100 anticipated that DFYS staff would actually service the citizens' panels throughout the state. The DFYS staff would prepare the cases, the case summaries, schedule and convene witnesses and parties and finally draft a report for the citizens' panel. The panel would always have the final okay on the report. MS. SIPE explained that the panel and the sponsors of CSHB 127(HES) did not want to have DFYS serving that role, so the Department of Administration had to go back to an idea of using local non-profit agencies such as the Anchorage Center for Families. These non- profits might be interested in having staff assigned to do some of this work in support of local citizens' panels. A non-profit agency and a panel could work together, but this concept raises the cost. MS. SIPE said the Administration is supportive of the bill. They want to remind the committee that the initial funding for this program, when it passed back in Governor Cooper's Administration, was in excess of $750,000 a year. This program will have a lot of benefits for children. After a few years, the program will be able to demonstrate cost savings to the state by helping children get out of out-of-home placements faster. This program cannot be done for free and with existing resources. Number 1555 CHAIRMAN BUNDE asked if the original idea was to have DFYS staff do a good bit of the work, but under CSHB 127(HES) state employees are not doing the work, then why is the fiscal note increased. MS. SIPE answered that for each hearing the DFYS employee, who is involved in the case, is going to have to participate in the case. The employee is going to have to take some of their time to prepare for the case and to come to the review hearing. In most of the regions, DFYS has a Title IV-E coordinator staff appointed. This staff has to comply with many other parts of Title IV-E in order to keep federal money for foster care coming into the state. The hearings being discussed are a minor part of this federal requirement. You cannot have an independent review board perform this function and say that you don't have to provide a staff from DFYS. MS. SIPE explained that this method of having local grant agencies supply support, training and paperwork is less expensive and can possibly generate volunteerism. This method also allows it to be independent and makes the citizens' panel feel most competent that they see that DFYS, although cooperating, are at arms length. Number 1645 REPRESENTATIVE GREEN referred to the fiscal note. He asked if grants and claims seemed to be the issue that raised the cost from $200,000 to $600,000 a year over a six year period. Number 1667 MS. SIPE described what it would take to hear all the cases of children who stay 180 days in foster care within the Anchorage DFYS and explained that this does not include children who would fall into the category of high priority; it would require panel hearings to occur 18 to 20 working days a month, basically every working day of every month around the calendar. If there are three to five panel members consisting of citizens, working on each of those panels, they figure they will need between 60 and 90 trained, active panel members. These members will drop off the panel if; their life changes, they move out of state or they get sick. Training classes will have to be held several times a year. Each day cases will be heard consisting of two or three major cases which take several hours in addition to hearing several minor cases. These hearings will require a conference room somewhere that will be used every day, all the time in Anchorage to hear these review cases. Someone will have to go down to the DFYS files ahead of time, cull out information for the citizen panel. Currently the citizen review panel volunteers, spend an average of one day, nine months out of the year. Only about nine of them actually put in one day a month. Volunteers not only attend the meetings, but they spend a couple of days ahead of time reading through a summary and documents from the cases. Because of these factors, you cannot expect to keep using the same volunteers over and over. A large cadre of volunteers will need to be trained and assisted. MS. SIPE said the pilot project in Anchorage is only hearing about one-third of the cases. This bill anticipates tripling the Anchorage case load. This translates to more volunteers, more hearings, processing of paperwork in order to get those reports over to the courthouse in 15 days. Grants will be given to non- profit agencies or contracts will be given to other entities to provide clerical, scheduling and support. The current state employees would become the employees of the state panel, they would be running the training process. A contractor would probably still be needed to train that many people. A lot of work is need to train and use volunteers. Citizen volunteers are wonderful, but if they are going to be effective then they have to be well trained and supported. The exact term of the fiscal note can be negotiated, but the Administration wants to honestly show what resources they believe will be needed. The original fiscal note on this bill was $750,000 a year. Number 1839 CHAIRMAN BUNDE asked the committee to stay to the philosophy of whether or not there should be panels and let the Finance Committee justify the dollars. Number 1857 REPRESENTATIVE PORTER asked what the panel would do from a layman's point of view as compared to what is currently being done. He asked for the mission, the steps, et cetera. Number 1871 MS. SWENSON said the goal of the panel is to make sure that children in foster care don't linger out-of-home unnecessarily. When the panel meets and reviews cases, they come up with a list of recommendations. Often the panel members find that goals within the permancy placement plan, a case worker's initial plan, hasn't been met. The panel finds out why the goals haven't been met, asks questions and tries to recommend ways to shorten the placement time. If the goals aren't met and the interested parties in the case, the mother and the father, aren't putting any effort into the plan then the panel may recommend that their parental rights be terminated and the child be put up for adoption. She explained that creating these panels will decrease the amount of time that state dollars will be put into children placed in foster care. Number 1923 REPRESENTATIVE PORTER asked for a typical plan. Number 1945 EDITH McKINNON, Member, Foster Care Review Panel, said what typically happens is that a packet of information, regarding cases involving abused and neglected children in the Anchorage area, is received. These cases involve children who have been removed from their home, they're in state custody. Generally the cases involve children who have been neglected and abused, usually drugs and alcohol are involved prior to their birth and/or the children have special needs. The panel members get the packet, read the packet which might have been updated if the panel has heard the case before. The members sit around a conference table and discuss the case ahead of time. They figure out what questions they want to ask; why hasn't the child been getting the proper counseling, are the parents complying with the case plan, are the parents in drug and alcohol treatment, et cetera. There are also questions that will be asked of the foster parents such as whether or not visits have occurred between siblings. MS. McKINNON said social workers, foster parents, a DFYS staff performing the Title IV-E review, attorneys for the mother or the father might attend the meeting if the parent(s) are trying to get their children back. Certain people cannot be in the room while certain things are being discussed. The foster parents might be dismissed allowing the panel to ask questions to the attorney. Finally everyone leaves the room so that the panel members have time to deliberate and make recommendations about what should be done. MS. McKINNON stated that the system is overloaded and without an outside entity to ask certain questions of why these things haven't been done and why it needs to be done. The panel advocates for the children. She said the state will pay these costs in ten years if these issues are not dealt with now. These kids need a proper placement. If the parents aren't complying, they need to get their parental rights terminated. Number 1088 CHAIRMAN BUNDE asked if it would be fair to say that the panel acts as an informal judge on the whole process involving the parents, foster parents, DFYS and the children to ensure that everyone is pulling their fair share of the load. MS. McKINNON answered yes. Number 2115 REPRESENTATIVE TOM BRICE asked what the panel did to address situations where a child has gone through 30, 40 different placements. Number 2125 MS. McKINNON explained that six months might lag between reviews. The panel might learn that a child has been moved three times. This situation is one of the reasons why she wanted to see the reviews occur closer to the time the child is taken from the home in order to evaluate what the needs are and to make sure there is a recommendation of proper placement. Number 2160 MS. SWENSON explained that CSHB 127(HES) puts the panel's recommendations into the court record. If the court sees the recommendation, then people will start paying attention and the number of times a child moves will change. TAPE 97-28, SIDE B Number 0000 REPRESENTATIVE DYSON stated that his wife used to be on the Foster Care Review Board. He felt the panel was very useful. His wife commented that the support items received from DFYS were excellent and credible. He stated that she spent about four hours preparing for a review. The panel is valuable both for a check on DFYS and a significant way to help build credibility for DFYS. He supported the expansion of the program. Number 0094 REPRESENTATIVE GREEN asked if this panel was advisory or does the panel's power come through the DFYS staff. Number 0115 MS. McKINNON explained that a DFYS staff sits in the review to allow them to do their Title IV-E review. This staff person has nothing specifically to do with the workings of the panel. The panel recommendations are forwarded to DFYS, but there is no one else who sees those recommendations. Number 0143 MS. SWENSON stated that there is a provision in CSHB 127(HES) allowing the Title IV-E reviews done by DFYS to be switched over to the panel. The panel would be required to meet all the requirements of the Title IV-E, saving the DFYS person from coming in and sitting in on the reviews. Number 0172 REPRESENTATIVE GREEN asked if having more people involved comprised a better review, as compared to having one person do it. He felt this was a large amount of money if it can be done without having the panel. Number 0198 CHAIRMAN BUNDE said the panel represents a group who are outside DFYS. This panel does assessments, overviews and evaluations. He explained that even if there were enough resources in DFYS, children still fall through the cracks. This panel provides an arms length review of the process. Number 0296 MASTER BILL HITCHCOCK testified next via teleconference from an offnet site. He stated that he was testifying in his individual capacity, that his views do not represent any official position of the Alaska court system. He has had some substantial involvement with the development of the citizens' review board, both in the 1990 bill and also on the national level with the National Association of Foster Care Reviewers. He currently sits on the Board of Directors of that association. MASTER HITCHCOCK felt CSHB 127(HES) heads this program in the right direction; keeping the independence of the panel and allowing the program to move forward to eventually become statewide. The bill also strengthens the linkage with the formal court process by making it clear that the reports of the panels should come into the court at various stages. In the 1990 bill's development, he had an opportunity to speak with the previous commissioner from the Department of Administration as well as the commissioner from DHSS. He stated to them that he thought people needed to look at the fact that this panel system is not a duplication of effort, this is a needed, independent overview of the entire child protective system. MASTER HITCHCOCK stated that the child welfare system is a multi- disciplinary, it involves the actions and non-actions of a variety of different agencies, primarily DFYS as the state mandated child welfare agency. This system can be a benefit or a detriment to a child based upon the actions or non-actions of courts, of the Department of Law, the Office of Public Advocacy, the Public Defender Agency and some of the non-profits who provide services to these families. This system has become even more complex in the last 10 to 15 years, it is not simply a matter of riding herd on what DFYS does or does not do in their particular case plan. The panel presents a way to balancing the power in the system and put some checks and balances in place with an independent citizen based panel. The cost is certainly an issue, particularly in a state which is trying to control costs. If the long-term yield is evaluated, not only of bringing that accountability and oversight responsibility into play, but the involvement of citizens as volunteers in a very important government action, the welfare of children and families. MASTER HITCHCOCK felt citizen involvement would broaden the horizon for this entire system and begin to educate the community as a whole about what the system is dealing with in terms of child abuse, neglect and dependency. The long term yield will balance the short term costs. He has seen this scenario happen with a court appointed special advocate program which works with the guardian ad litem. This program trains dozens of citizens, year after year, to serve on these cases to broaden the lens with which we view these cases. The values of having fresh insights and perspectives into case planning, negotiation, settlement and permancy planning is invaluable. MASTER HITCHCOCK stated that only infrequently does he see the reports of the review panel. He has requested information from the last two review panels for the case he will hear today. He is blocked from receiving that information prior to disposition or review of the case. He supported the early review concept which would enable both the court and the department to move forward more rapidly on handling some of these out-of-home placements. MASTER HITCHCOCK asked the committee to look at the long view of this process. He also asked them to look at the system which has gotten a lot more complicated, affecting the lives of many children. The current system does not do a good job of moving the lives of these children to permancy. Number 0654 REPRESENTATIVE PORTER asked how many times the panel would meet and why the panel would need three different agency attorneys. Number 0677 MASTER HITCHCOCK explained that he did not have a great deal of experience with the operations of the state panel. He felt there was an important function to be served regarding quality control issue, the recruitment, training and oversight of that process of the volunteers. These volunteer programs depend on good screening and quality control. Another function served by the panel is the annual reporting or periodic reporting to the legislature and the Governor. He said there has not been an aggregation of data on systemic barriers to permancy. These are the things that an oversight panel has to play a heavy role in because they will draw together the results of many different panel reviews from around the state in order to make some determinations. This systems level review, as opposed to a case level review, is almost as important and in some cases more important. MASTER HITCHCOCK stated that the Anchorage project has only had a limited ability to carry this out as there has not been an ability to gather a lot of the data. The information they have delivered has been anecdotal, not aggregate data. Number 0758 L. DIANE WORLEY, Director, Division of Family and Youth Services, Department of Health and Social Services, stated that DFYS is supportive of CSHB 127(HES) and the Citizens' Review Panel concept. Back in 1990, when the bill was first passed, she was working in the non-profit world and was appointed to the first citizens' review board. She learned about the concept, what was trying to be done, looking at the experiences of other states as it was a growing concept at that time. They tried to develop an oversight for children who are in the state child protection system. She still believes in the citizen review panels, it is a positive step towards making the child protection system even stronger than it currently is. MS. WORLEY stated that DFYS reviews cases as required by law and, even if they were not required to do it, they would still perform these reviews as part of good case planning. Throughout the state, DFYS does approximately 1,200 six month reviews every year. These reviews are required under the Social Security Act, Federal IV-E. The whole point of the Title IV-E reviews is that when the Social Security Act first came about, the makers realized that children who ended up in state custody, particularly those children who were in a lower economic status without advocates or parents who had a strong voice, appeared to be getting lost in our system. The Title IV-E regulation set up a process to ensure that the state followed certain regulations and requirements. These regulations determined the set up of six month reviews; how to plan these cases to make sure that the right people were being contacted and everything was being done to make sure that this case was moving through the system in a logical, thoughtful planned and appropriate process with a positive outcome at the end. If this process happened, then some federal dollars would be attached to help DFYS go through the system. She reiterated that the Title IV-E was a way to establish a review process so that children did not get lost in the system, particularly low income children who seemed to have the least amount of advocacy. Number 0892 MS. WORLEY stated that DFYS is required by law to do reviews of every child who is placed in state custody, in out-of-home care, every six months. The reviews can be done in shorter periods of time, 90 days. Ultimately DFYS is required to do the review within six months and to continue them every six months if they remain in care. There are many cases in this 1,200 review amount that are terminated before six months, so they do not undergo an official Title IV-E review. MS. WORLEY said, currently, the Anchorage pilot project for the Citizens' Review Panel does about one-third of DFYS cases. The reviews done by the panel meet the Title IV-E requirement. A DFYS staff is there to make sure that all components of a Title IV-E are met to ensure that DFYS does not have to go back and do another review. In the other parts of the state and for the other two- thirds of the Anchorage cases, these reviews still occur with an in-house staff from DFYS and at least one outside citizens. She referred to a time, before her current non-Administration position, when she acted as the citizen participant for the Fairbanks reviews. There are also panels in Fairbanks for the Indian Child Welfare Act cases which include two representatives from the Native Villages. An in-house viewpoint in combination with at least one citizen providing oversight makes up the formation of these panels. MS. WORLEY stated that the difference between what DFYS is doing and the overall concept of the Citizens' Review Panel is the issue of accountability, having more time and having an outside perspective to look at the cases. Number 1121 CHAIRMAN BUNDE referred to the 1,200 reviews and asked how many reviews were done in 90 days, in 180 days. Number 1135 MS. WORLEY did not have that data. She stated that DFYS is changing their information system because they are not getting accurate data from their current system. She would estimate that a majority, of the cases being done, do not have a formal review until six months. However the supervisor sits down with all the staff on a regular basis and goes through cases. Number 1169 CHAIRMAN BUNDE mentioned that CSHB 127(HES) talks about phasing in the review panel over a two year period. Number 1178 MS. WORLEY mentioned the difficulty of managing volunteers. Implementing the program will be a busy process, it will take willing volunteers and is an ambitious timeline. She concluded that there are a lot of people in our communities who are willing to do this type of work. Number 1215 CHAIRMAN BUNDE asked how DFYS would recruit the volunteers to sit on the panel. Number 1225 MS. WORLEY did not know if a plan had been set up, but ultimately the state foster care review board would be doing the recruiting. On the DFYS panels there are only a few citizens who participate, and the citizen participants usually come from the service providing community. These citizens already have some knowledge of how the system works which eliminates some of the need for extensive training. Number 1243 REPRESENTATIVE GREEN clarified that the 1,200 reviews could be broken down into 600 cases. He looked at the fiscal note and estimated that this would break down into about $500 per child per review. He asked how long the reviews took. Number 1289 MS. WORLEY said the DFYS reviews can take anywhere from 15 minutes to one hour, depending upon the complexity of the case and how many people choose to attend the case. The division is required to notify certain people of the review. Sometimes no one will show up except the social worker and the foster parent, other times it is a whole array of people and those reviews often take longer. The circumstances of the review also change the time factor. An example might be a child in out-of-home placement, who is going home in two weeks. However, it could be a child who keeps leaving placements because of their behavior and this situation might require a lengthier discussion. Number 1357 MS. McKINNON explained that she gets the packets, reads through them and writes questions. This is the same process other members are doing, it adds five different viewpoints. She said some cases are shorter than others. One case that she attended yesterday was 15 minutes long. The panel tries to include positive things in their reports, when possible, such as a social worker who is doing an exceptional job. Another case heard yesterday involved six children and took the entire hour. This case probably could have continued for a longer time period, but another case was lined up. The panel tries to write their report after the case is heard. If time runs out, then the report is written at the end of the day. Number 1420 CHAIRMAN BUNDE stated that each hearing does not necessarily mean a single child. MS. McKINNON verified that it depends on the size of the family. Number 1430 REPRESENTATIVE GREEN clarified that even if the meetings took an hour, it still works out to about $500 an hour. He asked, if you have volunteers, why it took so much to come up with a recommendation. He asked if the fiscal note was inflated or if it anticipated more cases. Number 1459 MS. WORLEY explained that the fiscal note was prepared by the Department of Administration. She could say that a lot of paper work was involved. The case files are extremely large, some families have six children, some children have been in the state system a long time. A panel of five people means five copies of information. The requirement to notify people results in time to prepare notification; calling, sending out notification as well as locating absentee parents. Contact needs to be made with the Native organizations in cases involving the Indian Child Welfare Act. MS. WORLEY believed that coordinating volunteers, providing technical assistance to do the training would be required. Volunteerism, while it is a wonderful concept, is not free and sometimes more effort and money is put into training and assisting volunteer programs than the cost of hiring someone. The case review is a fairly complicated process involving many pieces. A key for the department is that they want the process to meet the requirements of the Title IV-E to avoid duplication. It has taken the state almost five years to meet full compliance with the Title IV-E rules. The DFYS has been able to collect all the federal money available. Number 1592 REPRESENTATIVE BRICE stated that currently the annual budget for the current pilot program is about $120,000 and $130,000, not the $451,000. This amount drives the price down to about a $100 a case. The $451,000 represents a number which is spread out around the state and would represent all cases. Number 1652 MS. WORLEY said the numbers for the entire southcentral region, which is not just Anchorage, are 800 cases. The $120,000 amount represents only a third of the cases in the Anchorage office. The 1,200 cases refer to cases statewide. MS. SWENSON said the program should be fully implemented within the next two years with an extra year of flexibility if needed. Number 1696 REPRESENTATIVE PORTER stated that this is the only budget where he would overlook the fact that there will be savings and suggested not trying to get that back because of other needs which are not currently being met. When this panel system is up and running; the state board is overseeing the organization, development, training and the position of volunteers, he asked how much time the board would meet per month. Number 1732 MS. WORLEY explained that this is a Department of Administration program, it enables an arms length review of DFYS. She would not want to address the state board's role. Number 1763 MS. SWENSON said the board will have to meet a number of times within the first few months to determine regulations, set their policies, appoint panel members, increase the panel members in Anchorage and do training for the new panels in Fairbanks. Fairbanks will be the only part of this program set up during the first year. She could not say what the hours would be, but it represents a lot of work for one year so she envisioned it as being a half time or more job. Number 1788 REPRESENTATIVE PORTER commented that he had difficult trying to figure out the need to have a representative, an attorney, from the Office of Public Advocacy and someone from the Public Defender's Agency attend these meetings. Number 1802 MS. SWENSON explained that those are non-voting members on the state board. Those people do not have to attend to make a quorum. Number 1813 REPRESENTATIVE PORTER understood the need to have legal advice. Number 1816 MS. WORLEY said the reason for their participation was that these are the agencies represented in a Child Protective Services (CPS) case, each with a different perspective, a different part of a review. The Office of Public Advocacy would act as a guardian ad litem. The attorney general is the representative for DHSS, giving stating when a case can be moved forward. The public defender oftentimes represents the parents. The goal of the state board was to ensure input from all of these different segments, to represent and speak out for the different people involved in a child protective services case. She did not view it as legal advice to the board, but a different representation as policies and procedures are worked out in the board. Number 1871 REPRESENTATIVE PORTER said the Office of Public Advocacy is the guardian ad litem, but they also take conflict cases from the Public Defender Agency so they are capable of providing both perspectives; criminal defense and guardian ad litem. Usually DFYS would not go after the Department of Law's advice, so he did not know why those representatives needed to be there all the time. These agencies are involved in a lot of important functions, to the extent that we keep drawing off their resources is harmful to everything. Number 1897 MS. SWENSON explained that those people were on the original board and this inclusion of representatives is in current statute. If he wanted to change this, the bill could be amended. TAPE 97-29, SIDE A Number 0000 CHAIRMAN BUNDE announced that no decision will be made today on CSHB 127(HES). HB 153 - ALIENS AND ASSISTANCE PROGRAMS Number 0071 CHAIRMAN BUNDE announced the next item on the agenda was HB 153, "An Act relating to the eligibility of aliens for state public assistance and medical assistance programs affected by federal welfare reform legislation; and providing for an effective date." Number 0113 JAY LIVEY, Deputy Commissioner, Office of the Commissioner, Department of Health and Social Services, said this bill grandfathers in all of those legal aliens, who were in the country as of August 22, 1996, into the Medicaid program, Adult Public Assistance and Alaska Temporary Assistance Program (ATAP). This is the date when the federal welfare reform passed. Congress put restrictions on the programs for which legal aliens would be eligible. This reform says that for food stamps and Supplemental Security Income, which are federally funded programs, legal aliens would no longer be eligible no matter when they entered the country. Congress also said, for those programs which are half state funded and half federal funded, that states have a choice. A state can choose to grandfather in all of those aliens who are covered as of August 22, 1996, and then choose to exclude aliens who come in after August 22, 1996. MR. LIVEY explained that the proposed legislation grandfathers in those legal aliens, who arrived into the country before August 22, 1996, into those type of programs; Medicaid and ATAP. He said the other program grandfathered in is Adult Public Assistance (APA) which is a general fund program. Legal aliens arriving after August 22, 1996, would not be eligible for these programs for five years. Number 0315 MR. LIVEY stated that there is a fiscal note for each program. For APA and ATAP, some people are currently eligible because they are in the program and arrived in the country before August 22, 1996. The DHSS has provided negative fiscal notes for those programs because, over time, that pool of people will slowly become smaller as people leave the programs due to the general attrition of the programs. Those two programs have a negative fiscal note. There is a zero fiscal note for the Medicaid program because the state has to affirmatively choose, through the Governor's legislation, to continue the provision of eligibility. If the Governor's bill doesn't pass, then people are not eligible for Medicaid. Technically however, the Medicaid provision is not based on the Governor's bill passing. The fiscal note talks about a slight savings if this bill doesn't pass. If the bill passes, the savings that accrue are not due to the bill passing and so the fiscal note is zero. The savings which accrue is a DHSS budget item. Number 0485 REPRESENTATIVE BRICE made a motion to move HB 153 with individual recommendations and accompanying fiscal notes. Hearing no objection, HB 153 was moved from the House Health, Education and Social Services Standing Committee. HJR 29 - FUNDING FOR PROSTATE CANCER RESEARCH Number 0516 CHAIRMAN BUNDE announced the next item on the agenda as HJR 29, Supporting an increase in federal funding for prostate cancer research. Number 0526 REPRESENTATIVE KIM ELTON, sponsor of HJR 29, stated that he was piggy backing on the hard work and the commitment of a lot of people in his community and around the state. Prostate cancer is the second most common form of cancer among males in the United States. One of out every five men will be afflicted with this cancer. This year, an estimated 334,500 men will be diagnosed with the disease and the disease will cause over 41,800 deaths. This resolution asks the President to increase funding for prostrate cancer programs as prostate cancer remains an enigma to the medical community. He wanted HJR 29 to accompany an effort by the American Cancer Society and people all across the United States who are trying to deliver a million signatures to the President by Father's Day in June of 1997. Number 0711 CHAIRMAN BUNDE added that 80 or 90 percent of all males will die with prostrate cancer. Number 0745 REPRESENTATIVE DYSON made a motion to move HJR 29. Hearing no objections HJR 29 was moved from the House Health, Education and Social Services Standing Committee. ADJOURNMENT There being no further business to conduct, CHAIRMAN BUNDE adjourned the meeting of the House Health, Education and Social Services Standing Committee at 4:40 p.m.