HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE April 28, 1998 3:15 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. 426 "An Act relating to the establishment of Operation About Face as an alternative type of juvenile detention and treatment." - HEARD AND HELD CS FOR SENATE CONCURRENT RESOLUTION NO. 11(FIN) Creating the Long-Term Care Task Force. - PASSED CSSCR 11(FIN) FROM COMMITTEE HOUSE BILL NO. 434 "An Act requiring drug testing for applicants for and recipients of assistance under the Alaska temporary assistance program; and providing for an effective date." - HEARD AND HELD (* First public hearing) PREVIOUS ACTION BILL: HB 426 SHORT TITLE: JUVENILE BOOT CAMP PROGRAM SPONSOR(S): REPRESENTATIVES(S) MULDER Jrn-Date Jrn-Page Action 2/16/98 2334 (H) READ THE FIRST TIME - REFERRAL(S) 2/16/98 2334 (H) HES 4/28/98 (H) HES AT 3:00 PM CAPITOL 106 BILL: SCR 11 SHORT TITLE: LONG-TERM CARE TASK FORCE SPONSOR(S): SENATOR(S) SHARP, Duncan, Ward, Adams, Ellis, Hoffman, Kelly, Taylor, Wilken, Torgerson, Mackie, Green; REPRESENTATIVE(S) Hudson Jrn-Date Jrn-Page Action 4/11/97 1102 (S) READ THE FIRST TIME - REFERRAL(S) 4/11/97 1102 (S) HES, FIN 3/02/98 (S) HES AT 9:00 AM BUTROVICH ROOM 205 3/02/98 (S) MINUTE(HES) 3/04/98 (S) MINUTE(HES) 3/04/98 2732 (S) HES RPT CS 4DP SAME TITLE 3/04/98 2732 (S) DP: WILKEN, LEMAN, WARD, GREEN 3/04/98 2732 (S) FN TO SCR & CS (LAA) 3/04/98 2732 (S) ZERO FNS TO SCR & CS (DCED, GOV) 3/10/98 2819 (S) COSPONSOR: WARD 3/18/98 (S) FIN AT 9:00 AM SENATE FINANCE 532 3/19/98 (S) FIN AT 10:00 AM SENATE FINANCE 532 3/19/98 (S) MINUTE(RLS) 3/19/98 2895 (S) FIN RPT CS 3DP 2NR SAME TITLE 3/19/98 2895 (S) DP: SHARP, PHILLIPS, ADAMS 3/19/98 2895 (S) NR: PARNELL, DONLEY 3/19/98 2895 (S) PREVIOUS FN (LAA) 3/19/98 2895 (S) PREVIOUS ZERO FN (GOV, DCED) 3/20/98 2918 (S) RULES TO CALENDAR 3/20/98 3/20/98 2921 (S) READ THE SECOND TIME 3/20/98 2922 (S) FIN CS ADOPTED UNAN CONSENT 3/20/98 2922 (S) COSPONSOR(S): ADAMS, ELLIS, HOFFMAN 3/20/98 2922 (S) KELLY, TAYLOR, WILKEN, TORGERSON 3/20/98 2922 (S) MACKIE, GREEN 3/20/98 2922 (S) PASSED Y18 N- E2 3/20/98 2925 (S) TRANSMITTED TO (H) 3/23/98 2701 (H) READ THE FIRST TIME - REFERRAL(S) 3/23/98 2701 (H) HES, FINANCE 3/23/98 2715 (H) CROSS SPONSOR(S): HUDSON 4/09/98 (H) HES AT 3:00 PM CAPITOL 106 4/09/98 (H) MINUTE(HES) 4/28/98 (H) HES AT 3:00 PM CAPITOL 106 BILL: HB 434 SHORT TITLE: DRUG TESTING OF WELFARE RECIPIENTS SPONSOR(S): REPRESENTATIVES(S) ROKEBERG Jrn-Date Jrn-Page Action 2/18/98 2354 (H) READ THE FIRST TIME - REFERRAL(S) 2/18/98 2354 (H) HES, JUDICIARY 4/23/98 (H) HES AT 3:00 PM CAPITOL 106 4/23/98 (H) MINUTE(HES) 4/28/98 (H) HES AT 3:00 PM CAPITOL 106 WITNESS REGISTER REPRESENTATIVE ELDON MULDER Alaska State Legislature Capitol Building, Room 501 Juneau, Alaska 99801-1182 Telephone: (907) 465-2647 POSITION STATEMENT: Testified as sponsor of HB 426. ROBERT BUTTCANE, Administrative Juvenile Probation Officer Department of Health and Social Services P.O. Box 110630 Juneau, Alaska 99811 Telephone: (907) 465-3228 POSITION STATEMENT: Testified on HB 426. JOHN CYR, President NEA-Alaska 114 Second Street Juneau, Alaska 99801 Telephone: (907) 586-3090 POSITION STATEMENT: Testified in support of HB 426. MARILYN WILSON, Legislative Assistant to Senator Bert Sharp Alaska State Legislature Capitol Building, Room 516 Juneau, Alaska 99801-1182 Telephone: (907) 465-3004 POSITION STATEMENT: Presented sponsor statement for CSSCR 11(FIN). MARIE DARLIN, Legislative Chairman National Association of Retired Federal Employees 415 Willoughby Avenue, Number 506 Juneau, Alaska 99801 Telephone: (907) 586-3637 POSITION STATEMENT: Testified in support of CSSCR 11(FIN). VERA GAZAWAY, Representative Older Persons Action Group 515 Willoughby Avenue, Number 415 Juneau, Alaska 99801 Telephone: (907) 586-1777 POSITION STATEMENT: Testified in support of CSSCR 11(FIN). REPRESENTATIVE NORM ROKEBERG Alaska State Legislature Capitol Building, Room 24 Juneau, Alaska 99801-1182 Telephone: (907) 465-4968 POSITION STATEMENT: Testified as sponsor of HB 434. RON KREHER, Special Assistant Division of Public Assistance Department of Health and Social Services P.O. Box 110640 Juneau, Alaska 99811-0640 Telephone: (907) 465-3349 POSITION STATEMENT: Testified on HB 434. ACTION NARRATIVE TAPE 98-49, SIDE A Number 0001 CHAIRMAN CON BUNDE called the House Health, Education and Social Services Standing Committee meeting to order at 3:15 p.m. Members present at the call to order were Representatives Bunde, Dyson, Kemplen and Brice. Representatives Green and Porter arrived while the meeting was in progress. Representative Vezey was absent. HB 426 - JUVENILE BOOT CAMP PROGRAM Number 0063 CHAIRMAN BUNDE said the first order of business to come before the Committee was HB 426, "An Act relating to the establishment of Operation About Face as an alternative type of juvenile detention and treatment." He asked Representative Mulder to come forward to present his bill. Number 0080 REPRESENTATIVE ELDON MULDER, Alaska State Legislature, sponsor of HB 426, said for the past several years, the Alaska National Guard has been running the Challenge Program which is addressed and focused toward juveniles who are at risk. House Bill 426 takes it one step further and proposes the "Operation About Face" program to run side-by-side with the Challenge Program. The "Operation About Face" Program would focus on juveniles who are actually confined or placed in juvenile facilities, but would allow them the opportunity to go into a 22-week program similar to a boot camp program as a means of confinement and to rehabilitation. He said Alaska had the luxury of learning from other states and HB 426 is a model used by many states. He noted a couple states have done very well with the program while other states have failed because too many kids were thrown into the program without adequate oversight and supervision or after-care. This legislation focuses on adequate supervision throughout the program and supervision in after care. Number 0195 REPRESENTATIVE MULDER said the purpose of House Bill 426 is to allow the Department of Health and Social Services to provide an alternative means of dealing with juvenile offenders. An "Operation About Face" Program is designed to take first time juvenile offenders and provide them with the skills and attitudes they will need to become productive Alaskans. The program will consist of a 22-week period of intense military-style physical training, work, and discipline and a period of after-care consisting of not less than six months of intensive probation supervision and services. The program would include education, job training and placement, community service, substance abuse counseling and treatment, health and mental health care and continuous individualized case management. Once a juvenile is assigned to the custody of the department, the department will select which juveniles they feel will most benefit from the program. Juveniles may be assigned to the program if the juvenile: 1) has not been adjudicated delinquent, or committed to the custody of the department more than once; 2) is over 16 years of age but not more than 18 years of age at the time of placement; 3) has been committed to the custody of the department for not less than 160 days; 4) has not been convicted of or adjudicated delinquent for a sexual offense; and 5) has not previously completed the program. REPRESENTATIVE MULDER stated these last five points focus on the strengths of the programs that have been successful. He didn't believe this legislation at this late date would move all the way through the legislative process, but he expressed his appreciation to the committee for hearing the bill. He didn't view this bill as a final solution to the problem of juvenile detention, but rather as a piece of the puzzle that provides an alternative to simply throwing kids behind bars. Number 0360 CHAIRMAN BUNDE asked if Representative Mulder conceptualized this as being a parallel program to the Challenge Program or would these kids be intermingled with the Challenge Program. REPRESENTATIVE MULDER said it would be parallel. CHAIRMAN BUNDE said his experience with the Challenge Program has been very positive, but he wanted to relate an experience: "I went to one of their first graduations and these kids were really spiffed up and looking great and after it was all over, there was lots of hugging and carrying on and I ran into two of these guys in the men's room and they were hugging each other and they were so happy and for former, what I would have called for a lack of a better term, "street toughs", they were pretty emotional and one said to the other, 'Man, we made it; we got our GEDs and we're not in jail.' At first I thought boy, what an indictment of the program, but then I thought, they're right - they wouldn't have their GED and they probably would be in jail." He said this program is keeping some kids out of jail, and the program being proposed by Representative Mulder is a parallel program that would keep kids from going back to jail. REPRESENTATIVE MULDER said that was absolutely true. He added the Challenge Program has been far more successful than he imagined and because of its success, he believed it made good sense to run a program utilizing the same instructors, the same regiment, at the same location, but the separation of fence, but utilizing that same primary focus that "Challenge" is going toward. Number 0472 CHAIRMAN BUNDE asked if the funds for this program would come from the Department of Correction's budget or new money. REPRESENTATIVE MULDER said it's new money, and it's one of the hurdles that need to be overcome. He noted there are proposals to expand MacLaughlin Youth Center again, as well as other juvenile facilities around the state and as he started looking at the matrix at what needs to be done in terms of juvenile corrections, he believed this is one piece that should be explored. Number 0523 REPRESENTATIVE TOM BRICE asked, "Why not specifically -- delinquents who have been adjudicated for a sexual offense -- in my talking and dealing with all these folks, those are probably the people that need the most intensive work." REPRESENTATIVE MULDER said it was mostly from the predation factor; that this is reduced down to a somewhat minimum security operation and nothing would ruin a program faster than to have an unwanted encounter and because both sexes are involved in the program, most successful states have stayed away from including individuals convicted of those types of crimes as participants in the program. Number 0597 REPRESENTATIVE J. ALLEN KEMPLEN asked the reason why Representative Mulder chose 16 as the age for participants in the program. REPRESENTATIVE MULDER said it was in the model and basically those are the individuals addressed in the Challenge Program. He added the Challenge Program currently is applied to youth 16-, 17- and 18-years-old and it is his intent to run this program parallel to the Challenge Program. Number 0650 REPRESENTATIVE KEMPLEN remarked one of the issues he has come across is the need for programs designated for youth at a younger age. He recently learned that the sixth grade is a transition period in the development of youth and Anchorage, for example, has a fairly substantial momentum to create middle schools for sixth, seventh and eighth grades because they are recognizing that as a transition period for kids. His constituents have often expressed the need for this type of program for 11- and 12-year-old kids, which is the critical phase of development. He noted that most programs are for 16- and 17-year-old kids, after they're locked into the juvenile pattern. He asked if there was any opportunity to make this type of program applicable to a younger age group in terms of operating as a parallel path to compliment the Challenge Program. REPRESENTATIVE MULDER said Representative Kemplen had brought up a lot of good points, most of which he agreed with in terms of being able to attack the problem as early as possible. He was attempting to stay within the constraints of the focus of Challenge and provide that parallel so as not to create a lot of new operational expenses; it certainly could be a lot more expensive than what's projected now. He said the Department of Health and Social Services may be the appropriate agency to discuss the potential opportunities for the younger age groups. He commented his focus has really been to create the parallel track and in so doing, it not only helps with this program, but because there's a certain amount of economy and size being provided to the program, it helps make the Challenge Program more cost efficient. That is a concern of his because the federal government is putting more of the financial burden of the Challenge Program on to the state, so if that program can be more fully utilized to not only run these at risk youth, but also the juvenile detainees, it would make that program more efficient and more justified. CHAIRMAN BUNDE asked Mr. Buttcane from the Department of Health and Social Services to come before the committee at this time. Number 0930 ROBERT BUTTCANE, Administrative Juvenile Probation Officer, Department of Health and Social Services, said the department's official position is to oppose HB 426 because of some technical issues, but conceptually strongly supports the boot camp concept. He commented that as Representative Mulder had pointed out, the Challenge Program is a proven, successful program that really is a viable option for a number of young people. The program proposed in this bill, "Operation About Face" has shown some promise and potential in other states. The Office of Juvenile Justice Delinquency Prevention has studied this type of program and has found it is an effective intermediate intervention when it is coupled with a strong after-care component, which HB 426 does provide. He said one of the technical problems the department has with HB 426 is that because it's written as an alternative to juvenile institutional placement, the department doesn't know if it would be able to generate sufficient numbers of referrals to justify an operational budget or the expenditure of building facilities to house this kind of program. He didn't see that as an insurmountable problem in that when looking at some of the other kinds of offender populations that could be channeled into this program, he thought some of those practical needs could be met in terms of getting sufficient numbers to justify the development and operation of a program. MR. BUTTCANE said the department has discussed this with the people from the Challenge Program, as well as the National Guard and everyone is supportive of the concept, but further discussions regarding the details are needed. Number 1075 MR. BUTTCANE said with regard to Representative Kemplen's concern about younger adolescents, typically mixing an older adolescent group with a younger population is not advisable for a number of reasons: different cognitive developmental stages, different issues, et cetera. That's not to say that the younger offender population needs should be ignored, but quite honestly, the department's resources have been devoted to the middle or later adolescent offender populations. He added this type of program nationwide has been more successful with the older adolescent population and is geared to that type of offender population which he thought should be continued, but efforts should be made to enhance the resources for the other age group through some other venue. Number 1118 REPRESENTATIVE BRICE said inasmuch as the proposal is to run the Challenge and Operation About Face side-by-side, he wondered if there would be a problem housing adjudicated juvenile delinquents with minors who have not been adjudicated a delinquent. MR. BUTTCANE said it was his understanding there would be two separate programs so the adjudicated youth would be housed separately and would actually be going through a more intense type of program than what the population currently enrolled in the Challenge Program would be subject to. He noted there are some differences between the two programs in terms of the national development of these different programs - the Challenge Program is seen more as a voluntary intermediate intervention approach, whereas the Operation About Face Program is one where the court and the youth corrections entities have compelled the person's attendance in that program, although there is some level of willingness on the part of the participant or they wouldn't be necessarily be selected. The levels of freedoms, the levels of choices, the willingness to participate in certain activities or components of the program are different when looking at the adjudicated population as opposed to those who have voluntarily agreed to participate. He reiterated they really are two separate groups and it's his understanding the department would look at a whole new program, hopefully, running parallel to the Challenge Program but there wouldn't be the intermingling of the populations. Number 1222 REPRESENTATIVE KEMPLEN asked if the department's data indicates a number of adjudicated youth in early adolescence or is it not until later on in the youthful years. MR. BUTTCANE didn't recall what the numbers were for Alaska, but there has been an increase in the numbers of younger adolescents being adjudicated delinquent, but that doesn't constitute the majority of youth that are adjudicated in the state; the majority still fall in the middle adolescent range of ages 15-16. He added in general, the department is seeing an increase in the number of younger children being referred into the delinquency system; there's an increase in the numbers of 10- and 11-year-olds coming to attention and absent a real serious violation, the department tries not to adjudicate them delinquent but rather try to work with them through other means and avenues. He added those resources need to be improved and enhanced which is being looked at by the department. He noted there's a lot of family work involved with the younger adolescents as opposed to the older adolescents - it's a different approach, a different program perspective. His personal experience has been that when an 11- or 12-year-old delinquent is adjudicated, it's almost condemning them to a life though the delinquency system so a number of options are tried to keep them out of the formal delinquency system. REPRESENTATIVE KEMPLEN reiterated that early adolescence is the period of time that really needs to be focused on in terms of adequate services being available to meet their needs. He asked Mr. Buttcane to provide him with information on what programs the department has available for the early adolescence group. CHAIRMAN BUNDE thanked Mr. Buttcane for his comments and asked John Cyr to come forward to present his remarks at this time. Number 1400 JOHN CYR, President, NEA-Alaska, said NEA-Alaska is in favor of this type of alternative program. He stated the state needs to take a hard look at this issue and figure out how to build a program. There are too many young people in this age bracket and younger who need that kind of special care, so the more that can be done to build alternative programs for these children, the better off the state will eventually be. Number 1440 CHAIRMAN BUNDE asked if anyone else wished to testify on HB 426. There being no additional witnesses, he closed public testimony and said HB 426 would be held in committee. CSSCR 11(FIN) - LONG-TERM CARE TASK FORCE Number 1460 CHAIRMAN BUNDE announced the next item on the agenda was CSSCR 11 (FIN), Creating the Long-Term Care Task Force. He asked Marilyn Wilson to come forward to present CSSCR 11(FIN). Number 1450 MARILYN WILSON, Legislative Assistant to Senator Bert Sharp, Alaska State Legislature, read the following sponsor statement into the record: "As Alaska's senior community grows, it is necessary that we plan for the long-term care and needs of these citizens. While it is the desirable goal of most families to provide home care for their elderly parents, the reality is that most will live in a long-term care facility. Either way, the costs of providing long- term care is becoming insurmountable to the state and to our private citizens. In an effort to assure our senior citizens are getting the best care possible, the legislature in 1996, established a working group to analyze long-term care services available in the state and their projected costs. Senate Concurrent Resolution 11 will create a long-term care task force. Their mission is to review the findings of the working group and to develop an equitable plan for providing an actuarially sound and affordable long-term care options for all of Alaska's senior citizens. I urge your support in passing this very important and necessary resolution." CHAIRMAN BUNDE asked if there were questions of the sponsor's representative. Number 1527 REPRESENTATIVE BRICE said the legislature passed a moratorium on long-term care a couple years ago and there was a provision within that bill that established yet another long-term care task force. He asked how the working group established in CSSCR 11 related to the findings of the previous task force. MS. WILSON asked if Representative Brice was referring to the long- term care working group? REPRESENTATIVE BRICE affirmed that. MS. WILSON said, "This is the findings that the task force has to look at and take into consideration." CHAIRMAN BUNDE asked Marie Darlin to come before the committee to present her testimony at this time. Number 1575 MARIE DARLIN, Legislative Chairman, National Association of Retired Federal Employees, testified in support of CSSCR 11(FIN). She said resolutions had been passed at the last two statewide conventions in support of this legislation. It is the association's position that the study done in 1996 was merely the beginning and this needs to go forward in the establishment of the state's plan for long- term care for the senior population. She pointed out there are other individuals besides senior citizens who need long-term care. CHAIRMAN BUNDE thanked Ms. Darlin for her comments and asked Vera Gazaway to present her comments at this time. Number 1630 VERA GAZAWAY, Representative, Older Persons Action Group, said the Older Persons Action Group has also studied in-home health care and endorses almost to the word, the comments of the previous speaker. CHAIRMAN BUNDE thanked Ms. Gazaway and asked if there was further testimony on CSSCR 11(FIN). Hearing none, he closed public testimony. Number 1687 REPRESENTATIVE BRICE said the Governor's Council on Special Education Disabilities is considered the coordinating council for the state of Alaska for individuals with disabilities. He asked what that council's involvement is with the long-term task force? MS. WILSON said the Commissioner of the Department of Health and Social Services serves as a nonvoting member of the Long-Term Care Task Force and while it's not addressed in CSSCR 11(FIN), she thought it would be up to the commissioner to make that decision. CHAIRMAN BUNDE asked if there were further questions. Hearing none, he asked the wishes of the committee. Number 1750 REPRESENTATIVE JOE GREEN made a motion to move CSSCR 11(FIN) from committee with individual recommendations and attached fiscal notes. There being no objection, CSSCR 11(FIN) moved from the House Health, Education and Social Services Standing Committee. HB 434 - DRUG TESTING OF WELFARE RECIPIENTS Number 1770 CHAIRMAN BUNDE announced the next item on the agenda was HB 434, "An Act requiring drug testing for applicants for and recipients of assistance under the Alaska temporary assistance program; and providing for an effective date." He asked Representative Rokeberg to come before the committee. Number 1778 REPRESENTATIVE NORM ROKEBERG, Alaska State Legislature, sponsor of HB 434, expressed his appreciation for the committee's interest in HB 434 and introduced his staff intern, Randy Lorenz, who has been working on this legislation. He pointed out there were proposed amendments to be considered by the committee. He noted the committee had heard public testimony at a previous meeting. Number 1835 CHAIRMAN BUNDE made a motion to adopt Amendment 1 which reads: Page 2, lines 2-3, following "to" delete "reduction or elimination of benefits" and insert "benefit reductions". REPRESENTATIVE BRIAN PORTER objected for discussion purposes. CHAIRMAN BUNDE asked Ron Kreher to come forward to speak to Amendment 1. Number 1865 RON KREHER, Special Assistant, Division of Public Assistance, Department of Health and Social Services, explained that Amendment 1, in essence, cleans up this piece of legislation in that it eliminates a possible conflict between the family self-sufficiency provisions and the existing provisions regarding the imposition of sanctions which are intended to be directed toward the noncomplying individual, resulting in a reduction of benefits to the household as opposed to the elimination of benefits for the household. The concern is the elimination of benefits to the household could have a fairly severe impact on the dependents in that household by taking away all the cash assistance. Number 1898 REPRESENTATIVE ROKEBERG said he doesn't look kindly on the amendment inasmuch as what he was endeavoring to do with this particular piece of legislation was to give the department a tool to inform the recipients of public assistance their benefits would be in jeopardy if the recipient did not join a program through the self-sufficiency plan and adhere to the requirements of the department. He noted that Section 1 merely indicates there's a revision to the statement that a recipient would be signing prior to receiving benefits; therefore, Representative Rokeberg's intention is to put the recipient on notice that the use of alcohol or a controlled substance would subject the recipient to elimination of benefits. Number 1955 REPRESENTATIVE FRED DYSON observed as long as the language is permissive, he didn't see a problem with indicating that elimination of benefits is a possibility. MR. KREHER said there wasn't a real problem with that, but the concern is that it may cause some confusion in other statutes regarding the imposition of sanctions; it's more of a technical concern. He explained the division's procedure for notifying clients of the potential for sanctions, the procedure to levy sanctions, the cumulative impact of sanctions and the process by which the department notifies clients of the impact of noncompliance is sufficient at this time. He didn't believe the threat of elimination of benefits would do any more than is already being done through the current sanction process. Number 2044 REPRESENTATIVE KEMPLEN said, "The notion of elimination of benefits grew from the notion of benefit reductions, it seems to me that inserting the language of elimination really gives more power to the state and I guess, I've heard from a number of Alaskans that they are concerned about the power of the state - or that the state has too much power - and I'm not sure that giving the state personnel this type of discretionary authority really addresses the concerns raised by a number of different Alaskans that we've heard in a number of different bills that have come before this committee." CHAIRMAN BUNDE asked if there was further questions or discussion. He called an at-ease at 3:55 p.m. inasmuch as other committee members had been called to another committee for a vote. CHAIRMAN BUNDE reconvened the committee at 4:03 p.m. He asked if there was further discussion on Amendment 1. Hearing none, he asked for a roll call vote. Representatives Kemplen, Green and Bunde voted in favor of Amendment 1. Representative Dyson voted against it. Therefore, Amendment 1 was adopted by a vote of 3-1. Number 2115 CHAIRMAN BUNDE made a motion to adopt Amendment 2 which reads: Page 2, line 13, following".": Insert "If a blood test administered during an assessment conducted under this subsection indicates the presence of alcohol or a controlled substance, the person tested is liable for the cost of the blood test." REPRESENTATIVE GREEN objected for discussion purposes. Number 2130 REPRESENTATIVE ROKEBERG said the department does not use blood tests or urine analysis for this particular screening or assessment. Number 2147 CHAIRMAN BUNDE withdrew Amendment 2. He made a motion to adopt Amendment 3 which reads: Page 1, line 4, following ",": Insert "relating to family self-sufficiency plans;" Page 2, line 7: Delete "a new subsection" Insert "new subsections" Page 2, following line 13: Insert a new subsection to read: "(e) The family self-sufficiency plan for a family that includes a person who is unmarried and pregnant must include provisions that require the department to provide, and the person to accept, parenting classes, appropriate prenatal care, and family planning education." REPRESENTATIVE GREEN objected for discussion purposes. REPRESENTATIVE ROKEBERG asked for an explanation regarding the intent was of Amendment 3. CHAIRMAN BUNDE said, "The family self-sufficiency plan includes single parents or unmarried people that - the unwed mother, to use the archaic term, I guess - and as long as they are having kids, they probably should sit down and give some thought to a family plan." Number 2198 MR. KREHER said generally, he thought the intent was sound, but his biggest concern with the language is that it is almost a mandatory provision. Because the division has clients in areas where these services may not be available, he suggested the language might be more workable for the division if it read something like, "must as appropriate." He said while many of the rural areas have services provided through the Native corporations where this could be provided, it may not be possible in all situations. He wouldn't care to see this as a condition for a family self-sufficiency plan and the department not be able to provide the services. CHAIRMAN BUNDE asked where Mr. Kreher was suggesting the verbiage be added. MR. KREHER responded after the word "must". REPRESENTATIVE DYSON suggested as an alternative, to insert "as available" at the end of the sentence. MR. KREHER indicated that would be workable, also. He pointed out the division has not as yet generated a fiscal note for this bill because the division is still in the planning stages for the service delivery model. He did, however, suspect this amendment would add some cost. Number 2257 REPRESENTATIVE GREEN said, "That's where I was coming from too. This is bound to add some cost - somebody's got to do this and in the amendment that was withdrawn, there was a requirement that the person would pay for that and I would suggest that before I could accept this, I would think that there should also then be some sort of provision that the person who is going to get this training should pay for that training." CHAIRMAN BUNDE observed these are people are on welfare. REPRESENTATIVE GREEN understood that, but if Chairman Bunde felt it was necessary this be done in order for these people to continue getting welfare, then it should be at the expense of the individual. MR. KREHER said, "As the Chair indicated, these are people who are literally living on the fringe. I think it would certainly create an additional burden to the household and may in fact hinder efforts at self-sufficiency if we were to require them to pay for services that we, in essence, are by statute, required to provide to individuals in order for them to achieve self-sufficiency. I believe there's another amendment in this package that addresses providing specific services as part of the self-sufficiency plan. While it's already addressed in the statute, anything that we do that's designed to promote self-sufficiency, encourage employment, we are in essence, obligated to provide certain supportive services so that people can pursue those activities." It was his opinion the department would not support a requirement for people to pay for these types of services. Number 2320 REPRESENTATIVE ROKEBERG agreed with the intention of the amendment; however, it's his understanding the committee substitute was drafted so it would not have a fiscal note. Inasmuch as this amendment would clearly have a fiscal impact, he would have to oppose it. CHAIRMAN BUNDE asked if there was further discussion. TAPE 98-49, SIDE B Number 0004 CHAIRMAN BUNDE asked for a roll call vote. Representatives Dyson, Kemplen and Bunde voted to adopt Amendment 3. Representative Green voted against it. Therefore, Amendment 3, as amended was adopted by a vote of 3-1. CHAIRMAN BUNDE made a motion to adopt Amendment 4 which read: Page 2, line 8: Delete "adult participants" Insert "family members who are 16 years of age or older" Page 2, line 10: Delete "the participant" Insert "a family member" Page 2, line 11" Delete "participant" Insert "family member" Number 0076 REPRESENTATIVE GREEN objected for discussion purposes. MR. KREHER stated his belief that the intent of this amendment was most likely a realization it is quite possible, given that there are other household members other than the adults who might have a problem with chemical dependency or alcohol abuse. His biggest concern is primarily the added fiscal impact. He explained that currently under the family self-sufficiency plan, the only members who are required to sign the plan are the adults. The intent of the plan is to promote the employability of the adults in the household so the family can achieve self-sufficiency. While it appears the positive side of this amendment is that it would be preparing dependent children for that eventuality as well, this would require the screening of many more individuals. The department estimates the most simple screening would add an additional 15 minutes to an interview or the development of the family self-sufficiency plan, which doesn't seem like much on an individual basis, but it adds up quite quickly considering the volume of applications. He noted there would be additional impacts to the Medicaid program if those children were required to go to treatment or through an in-depth assessment. There is also some question regarding the availability of facilities for the children. Number 0225 CHAIRMAN BUNDE asked at what age does the department determine an individual to be an adult. MR. KREHER responded 18 and emancipated or married minors. CHAIRMAN BUNDE noted the lack of a quorum and called an at-ease at 4:15 p.m. He reconvened the meeting at 4:17 p.m. Number 0285 REPRESENTATIVE ROKEBERG said the department had indicated this was not appropriate because family members are not part of the payees who have reduced benefits; they're indirect recipients. They don't sign on the plan and therefore, children under the age of majority are family members, not the actual plan participants. CHAIRMAN BUNDE commented that gets to be a policy call. He added, "The parents are -- I think you said, many of these children may be in danger of substance abuse and probably could use some screening. The parents are using and I assume there's an increased likelihood that the children are using. The policy call becomes if the children are using, are we going to make the parents pay the penalty of reduced benefits." MR. KREHER said that would be the end result if in the family self- sufficiency plan it was specified that a child had to attend assessment and treatment and the child is noncompliant, then in essence, the adults who signed the plan would be out of compliance. He said there could potentially be a number of ramifications such as causing some sort of internal rift amongst the family. Number 0400 CHAIRMAN BUNDE said he could see it coming from two angles: One, parents will have to be more in tune with what their children are doing; and two, it gives the child a hammer over the parents. Number 0439 REPRESENTATIVE GREEN asked if a family on welfare has a reasonably behaved child, but tests positive for chemical dependency, does that eliminate the family or the child under this amendment? MR. KREHER explained, "The legislation, as it stands now, would just require screening and assessment, not testing. If that individual child was screened and it was found that he had a substance abuse issue and it was determined that it was to the benefit of the family, the way this amendment reads, that the child would have to submit to screening and assessment and if the child then either refused or didn't comply with the conditions of the treatment plan, then yes, the penalty would be levied against the family by reducing the household benefit." CHAIRMAN BUNDE asked if there was further questions or discussion. Hearing none, he asked for a roll call vote. Representative Bunde voted in favor of the amendment. Representatives Dyson, Kemplen and Green voted against it. Therefore, Amendment 4 failed by a vote of 3-1. Number 0594 REPRESENTATIVE KEMPLEN made a motion to adopt Amendment 5 which reads: Page 1, line 13: After "self-sufficiency" Insert, "including child care, transportation to and from job interviews and work related activities, and transitional health care coverage." CHAIRMAN BUNDE objected for discussion purposes. REPRESENTATIVE KEMPLEN said Amendment 5 provides child care transportation assistance and transitional health care coverage for recipients. He noted this committee, as well as other committees has heard testimony from individuals that these two issues are critical to participants in the Temporary Assistance Program (ATAP). REPRESENTATIVE ROKEBERG objected to the amendment. He agrees with Representative Kemplen in terms of the importance of helping people out, but he didn't think it was appropriate given the goal is self- sufficiency. MR. KREHER explained under existing statute and regulation, the department is obligated to provide these sorts of services to individuals. He said transitional health care coverage, typically referred to as transitional Medicaid, is a post-ATAP eligibility benefit; in other words once an individual has gone off assistance, they are then eligible for transitional Medicaid coverage. An individual has full Medicaid coverage while receiving ATAP. He said if the intent of the amendment is to address the time period when a person becomes self-sufficient and off the system, the existing statute already provides for that. If Representative Kemplen's thought is to ensure that provisions of the self- sufficiency plan are set in statute, he suggested the verbiage should read "including but not limited to" because there are other services that can be provided to individuals. In essence, these services are already mandated by statute in an effort toward self- sufficiency and employment. REPRESENTATIVE ROKEBERG interjected that it would be redundant. Number 0781 REPRESENTATIVE KEMPLEN inquired if the department currently provides transportation to and from job interviews and work related activities to ATAP recipients. MR. KREHER responded yes. He added the department cannot require any ATAP recipient to engage in a work activity if transportation is a barrier and the department can provide a means to overcome that barrier either by providing vouchers for gasoline, bus tokens or in some instances provide support to repair a vehicle. He noted there are limits, depending on the budget. REPRESENTATIVE KEMPLEN withdrew Amendment 5. Number 0836 REPRESENTATIVE KEMPLEN made a motion to adopt Amendment 6 which reads: Page 2, line 4, Before "fails" Insert "substantially" REPRESENTATIVE GREEN objected for the purpose of discussion. REPRESENTATIVE ROKEBERG pointed out this raises a much higher level and asked Mr. Kreher to explain the impact. MR. KREHER said his biggest concern is the definition of "substantially." He said at first glance, it appears the intent is to almost provide a safeguard to clients so there has to be some demonstration of gross failure to comply with the conditions of the self-sufficiency plan. Currently, under statute, individuals have the right to demonstrate good cause if a penalty is levied against them for failure to comply with the family self-sufficiency plan. He said "substantially" would need to be defined in the Definitions Section for clarification. REPRESENTATIVE KEMPLEN asked how the department currently determines (indisc.) fails to comply? MR. KREHER explain, "It's - I'm on the verge on saying it's kind of black and white thing. The family self-sufficiency plan defines the steps an individual is going to take. If for instance the first step is going to work search, the second step is getting their GED, if we get notification from the contractor or the division employee responsible for work search that this person has not showed up for five days out of ten, that would be noncompliance - a failure to comply with the plan and we would notify them that they were out of compliance and we were going to levy a sanction against them and impose a penalty. In that notice, they are told that if they can demonstrate and document good cause for that, then we would not impose the sanction. The onus is on the client to demonstrate why they weren't there - I was at a doctor's appointment, my kid was sick, I didn't have transportation, child care fell through, whatever. Because we are emphasizing personal responsibility through this whole program, we try to convince the client that if something goes wrong and you can't comply with the condition of your family self-sufficiency plan, contact your case worker immediately." He stated his belief that good cause provisions provide adequate protection for individuals who for good reason haven't complied with a factor in their self-sufficiency plan. Number 1017 REPRESENTATIVE KEMPLEN said, "So it seems to me that the inserting the verbiage such as "substantially" doesn't materially affect the ability of the agency to administer the Temporary Assistance Program and to require adherence to the self-sufficiency plan and the substantially fails, as was mentioned, it does sort of raise the bar a little so it's not a black or white type of thing - either/or - but it moves it to a different level of and I think that would by how the department interprets it, but at the very least, at least two criteria would be met rather than the impression that I have received from your comments that all it would take would be just the noncompliance with one criteria and it could be stated they are out of compliance with the plan." MR. KREHER said Representative Kemplen was correct - an individual would only have to mess up on one aspect of their family self- sufficiency plan and suffer a potential penalty as a result. The amendment would require a bit more finesse on the part of the case managers and the eligibility staff to use prudent judgment to determine whether or not there was intent for noncompliance. REPRESENTATIVE ROKEBERG suggested this particular amendment does more than raise the bar just a little; it raises it substantially and in his opinion, it would seriously hamper the department's ability to make sanctions come into play for even the benefit reduction, as the bill now has been amended to read. Number 1190 CHAIRMAN BUNDE thought the concern he was hearing was that it might give too much power to the department to abuse their discretion. MR. KREHER said his biggest concern is when the department reaches the point of imposing a sanction on an individual, outside of the arena of good cause, the individual always has the right to request a fair hearing to contest an adverse action taken by the division. Admittedly, he's not an attorney or a hearing officer, but language like "substantially" would cause confusion and cloud the issue to the point that it may hamper the ability to arrive at a clear decision in a fair hearing process. He reiterated his concern that without a clear definition of "substantially", there may be problems with enforcing compliance on the self-sufficiency plans. Number 1268 REPRESENTATIVE DYSON thought the department was already doing what Representative Kemplen was aiming his amendment at; he sensed the department does not disqualify people on details. He agreed the department's argument is exactly right in that it would invite a lot of arguments about what is "substantial." He wasn't supporting the amendment, but believed Representative Kemplen could rest easy knowing the department is doing what he intended by the amendment. REPRESENTATIVE ROKEBERG pointed out that "substantial" has a meaning and term of art in the law; it's very high. MR. KREHER said the department's intent in this process certainly is not to "willy nilly" impose sanctions on individuals. The department has a relatively refined conciliation process and it is the intent of case managers to promote self-sufficiency for these individuals, recognizing that while sanctions are the only mechanism by which to get people's attention, the department's intent is to provide the support needed to become self-sufficient. He added that sanctions are a heavy thing to be imposed on a family and the department gives individuals every opportunity possible to demonstrate good cause for not complying with the family self- sufficiency plan. Number 1365 REPRESENTATIVE KEMPLEN withdrew Amendment 6. Number 1380 REPRESENTATIVE KEMPLEN made a motion to adopt Amendment 7 which reads: Page 2, line 10, After "assessment" Delete "and require the participant to comply with the recommendations of the assessment as a condition of the family self-sufficiency plan." CHAIRMAN BUNDE objected for discussion purposes. REPRESENTATIVE KEMPLEN said the amendment deletes language that would require the participant to comply with the recommendations of the assessment as a condition of the family self-sufficiency plan and would allow the department to screen the adult participants and refer the participant for assessment. He said, "One of the concerns I have about this is the infringement on the individual's right to privacy and it was raised in testimony before the committee that if the recommendation of an assessment is a urine analysis or some sort of specific drug testing technique, that individual would be required to undergo that technique and I don't know if it is necessary for the -- to touch upon that, I think infringement on that individual, no matter if they are poor, their privacy - what I consider as essential privacy rights - and the language that does remain in this subsection gives the department the tools they need in order to adequately address the issue that I believe that Representative Rokeberg is seeking to address with this legislation." REPRESENTATIVE ROKEBERG objected. He said this amendment, on the face of it is very much self-defeating in (indisc.-mumbling). If the ability to provide a sanction for noncompliance resulting in the assessment is taken away, it disserates the entire section. Number 1520 REPRESENTATIVE KEMPLEN said the issue is the assessment; first, is the notion of screening the adult participants and the second is referring them to assessment. The assessment which is conducted by a professional facility will provide sufficient information to the client manager for them to direct the participant to the needed services. It appears to him there are sufficient powers that exist within the language in both this legislation and other statutes regarding ATAP recipients, giving the department and the client managers plenty of power to implement the recommendations of the family self-sufficiency plan. If the results of the assessment provide strong probabilities that the client is at risk for alcohol or controlled substance abuse, the client manager has the ability to require that recipient to attend alcohol classes or controlled substance classes or treatment as part of the family self- sufficiency plan. Number 1612 REPRESENTATIVE GREEN objected to the amendment for the same reason as the sponsor. CHAIRMAN BUNDE asked for a roll call vote. Representative Kemplen voted in favor of the amendment. Representatives Dyson, Green and Bunde voted against it. Therefore, Amendment 7 failed to pass by a vote of 3-1. CHAIRMAN BUNDE noted there were no more amendments for consideration and asked if there was further discussion on CSHB 434. Number 1647 REPRESENTATIVE DYSON said, "On further consideration, I would like to repent of my earlier approval vote on an amendment that was well intended but added more money to the .... It doesn't mean that I don't think these are a good idea, I think that these are a great idea, but within the purview of what the department can do now when it's appropriate and resources are available. Is that correct?" MR. KREHER replied, "Yes." REPRESENTATIVE DYSON made a motion to rescind the committee's action on Amendment 3. CHAIRMAN BUNDE objected and asked for a roll call vote. Representatives Dyson and Green voted to rescind the committee's action on Amendment 3. Representatives Kemplen and Bunde voted against it. Therefore, the vote failed 2-2. Number 1728 REPRESENTATIVE DYSON made a motion to pass CSHB 434(HES) from committee with individual recommendations and attached fiscal notes. REPRESENTATIVE KEMPLEN objected. CHAIRMAN BUNDE asked for a roll call vote. Representatives Dyson, Green and Bunde voted in favor of moving CSHB 434(HES) from committee. Representative Kemplen voted against it. Therefore, CSHB 434(HES) moved from the House Health, Education and social Services Standing Committee on a vote of 3-1. ADJOURNMENT Number 1748 CHAIRMAN BUNDE adjourned the House Health, Education and Social Services Standing Committee at 4:44 p.m.