JOINT HOUSE & SENATE HEALTH, EDUCATION & SOCIAL SERVICES March 6, 1996 9:10 a.m. HOUSE MEMBERS PRESENT Representative Cynthia Toohey, Co-Chair Representative Con Bunde, Co-Chair Representative Al Vezey Representative Gary Davis Representative Tom Brice Representative Caren Robinson HOUSE MEMBERS ABSENT Representative Norman Rokeberg SENATE MEMBERS PRESENT Senator Lyda Green, Chairman Senator Loren Leman, Vice-Chairman Senator Mike Miller SENATE MEMBERS ABSENT Senator Johnny Ellis Senator Judy Salo COMMITTEE CALENDAR Presentation by "Building Bridges" WITNESS REGISTER The following offered testimony: Jeanne Peschier, Rose Brown, Dorothy Richel, Mary Hunter, Cheryl Herringshaw, Jeanette Grasto, Kate Cross-Das, Claire Hurt, Jaymie Murphy, Donna Hart, Andrea Richey, Dr. Karen Jackman, Rebecca Fiaro, Gary Constantine, Shirley Boyer, Robin Bennett, Mary Poore, Tricia Edwards, Jared Zitwer, Jeanne Hall, Buz Daney, Jan McGilvary ACTION NARRATIVE TAPE 96-15, SIDE A Presentation by "Building  Bridges"  Number 001 CO-CHAIR TOOHEY called the Joint House & Senate Health, Education and Social Services (HESS) Committee to order at 9:10 a.m. and invited the first presenters to come forward and begin. JEANNE PESCHIER told the committee that the support and help she received from her counselor, case manager, and staff at Seward Life Action Council helps make her life as complete as possible; she would be lost without the council. Ms. Peschier informed the committee that she has Anxiety Disorder and Depression which require ongoing treatment. Receiving services locally allows Ms. Peschier to stay in the community with her husband and her friends. Community mental health centers provide effective, efficient, and vital mental health care. Ms. Peschier mentioned that she had married two and a half years ago and she looks forward to having a family some day as well as entering the work force again. Ms. Peschier asked that the support she needs to accomplish those goals not be taken away. REPRESENTATIVE BUNDE inquired as to where Ms. Peschier's accent was from. JEANNE PESCHIER said her accent was from Boston. Number 124 ROSE BROWN, from the Kenai Peninsula, informed the committee that she had her first breakdown her last year in college along with two suicide attempts. After being homeless, in women's shelters, and on skidrow, Ms. Brown was finally diagnosed 10 years ago. The medication helped, but she continued to move around and attempt suicide at least once a year. After finding the Community Outreach Center on the Kenai Peninsula, she has lived in one place for five years and is buying her own home. Ms. Brown is a Consumer Specialist with advocacy, empowerment and peer counseling. She informed the committee that she is also a member of Alaska's Mental Health Consumer Board and Secretary of the I Can Group of Consumers in the Community Outreach Program which is a national model program. Ms. Brown felt that without this program she would be institutionalized or dead. In conclusion, Ms. Brown thanked the legislature for its support in the past. REPRESENTATIVE BUNDE asked what a Consumer Specialist is. ROSE BROWN explained that a consumer specialist advocates for consumer's across a wide range of areas. REPRESENTATIVE ROBINSON inquired as to what portion of the program Ms. Brown felt was the most helpful for her. ROSE BROWN noted that working with a psychiatrist to determine the correct combination of medication to remain stable as well as the employment the program offered her after several years of volunteering were both helpful. Number 160 DOROTHY RICHEL, member of the Kenai Alliance, discussed her mentally impaired twin sister who since moving to Alaska 10 years ago has been able to maintain her own apartment for over 10 years. The Community Outreach Program dignifies the consumer's life with appropriate activities and direction. In the last 10 years, her sister has only had one hospitalization in API. Without the caseworkers, her sister would not have had support through that crisis. Ms. Richel informed the committee that the programs and activities are geared toward social involvement, growth, living skills, and medication management. Ms. Richel emphasized the importance of these clients fitting in the community. Currently, there are negotiations for hospital beds in the community hospital in order to avoid housing mental clients in jails while they wait to go to Anchorage. The Soldotna group has made it possible for mentally impaired individuals, like her twin sister, to survive their lifetime of treatment. Ms. Richel hoped that the ongoing programs would continue to receive support. All of those programs are needed. Number 201 MARY HUNTER, a single mother of two boys, informed the committee that she had been going to the Community Outreach Program (COP) which is affiliated with the Central Peninsula Counseling Service Center (CPCS) for one year and three months. Ms. Hunter has severe anxiety attacks and Depression which lead to her drinking. Now she is on medication and seeing a psychiatrist one a month, a psychologist twice a month and her case manager whenever she needs. Ms. Hunter noted that she was attending Double Trouble which points out how mental disorders lead to addictions such as alcohol and drugs. She also attends Women's Self-esteem Groups. Ms. Hunter feels that all this support has made her functional. COP has taught her how to cope with life crises without alcohol or drugs. Ms. Hunter pointed out that staying on her medication and sobriety is not only reflected within herself, but also her children. Without COP and the I Can Group, Ms. Hunter felt that the recent crises she experienced would have left her suicidal, drinking, in jail, or APH. With these support groups Ms. Hunter was able to work through her crises in a healthy and productive way. She only wished that she had found COP earlier. REPRESENTATIVE ROBINSON inquired as to the services offered to Ms. Hunter's children. MARY HUNTER said that CPCS offers about anything for her children. CPCS has a large amount of resources and information on a wide variety of areas. Number 263 CHERYL HERRINGSHAW informed the committee that she is a Consumer and Family Advocate for her 13-year-old son who is diagnosed with Attention Deficit Hyperactivity Disorder, Manic Depressant, and Oppositional Behavior Syndrome. Ms. Herringshaw is with AYI, a division of Family-Centered Services of Alaska. AYI, a wrap around service, provides numerous services which are available for both she and her son. Ms. Herringshaw's son receives services such as one-on-one counseling with a psychiatrist once a week, an aid in the classroom with him in public school and someone to help her son work on his social skills three nights a week. The family also receives services such as counseling and 24 hour crisis intervention. Without all the services that AYI provides, Ms. Herringshaw believed that she and her son would not be together. Ms. Herringshaw emphasized that with these services, her son would become a productive adult. AYI are a preventive measure for problems later in adulthood. In conclusion, Ms. Herringshaw asked that her son continue to be given the support to be a productive adult like everyone else. REPRESENTATIVE BRICE asked how Ms. Herringshaw gained access to the services she is using. CHERYL HERRINGSHAW said that she began with the Fahrenkamp Center. In order to receive AYI services, the child must be hospitalized at least three times. AYI is the last resort before the child is sent out-of-state for long-term institutional or residential care. She found out about this through the school district. Number 317 JEANETTE GRASTO, President of the Fairbanks Alliance for the Mentally Ill and Vice-President of the Alaska Alliance for the Mentally Ill, discussed her family's history of mental illness. Her brother's illness kept him from having a life and it was devastating to see that happening to her 16-year-old daughter. A mixture of private services and the Children's Advocates from the Fahrenkamp Center proved successful for her daughter. Currently, her daughter is a successful college sophomore and on her way to becoming a productive citizen. She informed the committee that in November her 17-year-old son, who has Attention Deficit Disorder, had his first manic attack and was eventually unable to attend school. He was sent to the Youth Day Treatment Program which is a special school ran by Family Centered Services for Mentally Ill Children in the Fahrenkamp Center. Youth Day was exactly what her son needed because the teachers understand his mental illness and her son is learning to understand it as well. Her son has been mainstreamed back into public school except for one hour a day group sessions and activities. She explained that parent advocates want their special children to receive the help they need in their communities. It is cost effective to meet mental health needs within the community. With the correct support, the more costly programs such as jail and hospitalization could be avoided. She believed that suicide was the cost of inadequate mental health services. What would you choose if it were your child? She thanked the committee for the opportunity to speak. REPRESENTATIVE BRICE asked if Ms. Grasto's child had to go to Anchorage. JEANETTE GRASTO said that her son had not been hospitalized because Fairbanks offered what her son needs. Number 365 KATE GROSS-DAS, Fairbanks Alliance for the Mentally Ill, informed the committee that she was Manic Depressant. This illness affected her in her last year of graduate school at the University of Rhode Island. She was hospitalized many times and prescribed many different medications. She completed her Masters in English Literature in 1986, although her illness had not yet been diagnosed. The next eight years involved many more hospitalizations. In the last two years, the Fairbanks Community Mental Health Center has provided treatment, counseling, and vocational training as well as the correct combination of medication. Currently, Ms. Gross-Das is on the verge of teaching and working at the university. She discussed how her life has become meaningful. Ms. Gross-Das emphasized that mental illness affects all people in all walks of life. Imagine all those lost, homeless, and not yet capable of understanding their mental illness; the numbers are shocking. She pointed out that good mental health guarantees a strong society. Denial of a mental illness prolongs and aggravates the illness. Ms. Gross-Das urged the committee not to cut the already reduced financial aid to Alaska's mental health program. Number 398 CLAIRE HURT, from Kodiak, said that her family has a history of mental illness. The Kodiak Mental Health Center, Kodiak Alliance for the Mentally Ill, and the Disability Law Center in Anchorage have given her needed support. She hoped that support of these programs would be continued. She indicated that those programs have made her life better. JAYMIE MURPHY informed the committee that she is a Wasilla mother of one. She emphasized that the services she receives are very important. Without the support of the community services' network, many of her goals such as employment would not have been reached. She explained that she works with Temporary Solutions which contracts with local businesses in the Mat-Su community to provide community services. Ms. Murphy also works with Daybreak which is a facility for the mentally ill where she is training to become a Certified Occupant Specialist Assistant. Without the network of services she receives, Ms. Murphy did not believe her employment would have been possible. Ms. Murphy stressed that the co-payment program for medication is very necessary. Without medication, more people would be hospitalized which costs more than community services. Community mental health services are necessary and provide critical intervention in order to avoid hospitalization in many cases. In conclusion, Ms. Murphy asked the committee to remember the mentally ill while in session. CO-CHAIR TOOHEY announced that House HESS would hear HB 318, which is the advanced mental health directives, tomorrow. She invited any interested persons to attend. Number 444 DONNA HART, from Wasilla, discussed the time after her parents' death when her brothers and sisters wanted to place her in a group home in the lower 48. She decided to move to Alaska, where three of her children live, because she did not want to be in a group home. Ms. Hart has major Depression and a Learning Disability. Currently, Ms. Hart helps with the Foodbank and is a member of Alaska's Mental Health Board. She urged the committee not to cut the funds to the mental health programs. ANDREA RICHEY, from Willow, discussed her long family history in Alaska. She informed the committee that she was the mother of six daughters of which her 12-year-old has a mental illness. She discussed how her daughter's mental illness has been a story of pain, faith, and hope. The legislature plays the biggest part in the role of hope by providing home and community based mental health services. She said that her daughter is making great progress, but it is not without cost. The cost is mental, emotional, physical, spiritual as well as financial. Ms. Richey explained that, although she works, she also depends on Medicaid to access mental health treatment. As a mother of a family of eight, Ms. Richey understood fiscal constraints. Community based services not only provide hope, but they also make sense financially. Without community based services, Ms. Richey said that her daughter would require, the more expensive route of repeated hospitalization and eventually institutionalization. Her daughter would become a lost community resource. Lets not lose our resources; do not cut the programs that are working. Number 514 DR. KAREN JACKMAN, a Psychiatrist and Medical Director of Norton Sound Health Corporation's Community Mental Health Center in Nome, stated that a lot of new services have been provided including a new village-based counseling program. Still, there are important needs that are unmet in this area. Services are needed for the elderly, the chronically mentally ill, the children and their families. Dr. Jackman pointed out that the mentally ill are a diverse group of people. Mental illness does not discriminate on any basis, everyone is susceptible to mental illness. Dr. Jackman emphasized that the legislators and their families may someday be effected by decisions the legislature makes concerning the care and lives of the mentally ill. CO-CHAIR TOOHEY believed that very few of the people present had not been touched by mental illness. REBECCA FIARO, member of the Juneau Alliance for the Mentally Ill (JAMI), said that she had been diagnosed with Chronic Depression and Addiction by Juneau Mental Health. During 1994-1995, Ms. Fiaro was hospitalized about 10 times. She discussed how outreach services had helped her through her crisis. Due to the support from these agencies, Ms. Fiaro said that she was no longer depressed and for the first time she is drug-free. Her thoughts have turned to college and she feels happy to be alive. Currently, Ms. Fiaro is living in JAMI housing which provides round-the-clock support. A lot of people need the services that JAMI provides in order to be healthy. Number 567 GARY CONSTANTINE, member of the Juneau Iris Alliance for the Mentally Ill, explained that Iris is a family based organization which advocates for mental health consumers and family members. Mr. Constantine informed the committee that a large portion of the mental health community is currently not receiving services in Juneau. Juneau mental health services are not providing services to the high-functioning, or rather at-risk, group suffering from mental illness. Many mentally ill people appear to be fine to the general public while a closer look at their private lives reveals fractured families, a poor or nonexistent employment history, no occupational focus, and consistent stories of a lack of resources for assistance. Mr. Constantine emphasized that assistance for these people could be empowered to rebuild their lives. This segment of mental health consumers are not eligible to be clients at Juneau's local provider organizations. This group is also not eligible for medical, psychiatric, or medication assistance because they are not eligible for Medicaid. All these expenses must be paid by the consumer, but since they often live at or below the poverty level they do not receive the necessary care to remain stable. Furthermore, these people are not eligible for job training through DVR. Mr. Constantine pointed out that historically, provider information organizations' hiring of such individuals is practically nonexistent in Juneau. Job placements are most often made in the "Three Fs": filth, food, and filing. The consumer does not have the adequate education or experience which can consistently be attributed to problems with their disorders. TAPE 96-15, SIDE B Number 561 Mr. Constantine said that often such people are very intelligent and would do well in other jobs outside the "Three Fs," but prejudice and lack of any support severely limits their employment opportunities. There is a tremendous need of funding for this population. Mental health organizations need to learn to dedicate resources in order to assist this at-risk population. Assistance to this at-risk population could allow these people to learn and develop cognitive employment and living skills to succeed and become independent. If this at-risk group is not served, society will surely be left with a large population of elderly, destitute, unemployable, chronically depressed people who were once high- functioning individuals. SHIRLEY BOYER, from Anchorage, said that she and her four children are all mental health consumers. She informed the committee that she became a citizen of Alaska five and a half years ago because of the beauty of the state, the people and the culture, and the efforts of Alaska to produce a comprehensive mental health system. People with mental illness need family and community support as well as community based programs. She appreciated the efforts for the funding of those programs; however, many programs are not yet funded, especially for children. One of the programs not available in Alaska is long-term residential treatment for children. She discussed her 15-year-old son's placement in a long-term residential treatment center in Texas. Ms. Boyer is devastated by this situation; she wants to comfort her child as would any parent. Number 553 ROBIN BENNETT, one of Ms. Boyer's children, asked if any of the legislators had children. When a baby cries, the parent wants to comfort the baby and give it a bottle. The children in Alaska are crying, but the parents cannot give them the bottle because it is not available in Alaska. These children are sent to another state. These children do not understand why, especially if the child is mentally unstable. Mr. Bennett indicated that such children could become resentful of their parents for sending them away which does not help the child. Long-term treatment in Alaska would be more beneficial for the child than being sent away merely for the fact that the family would be near. Furthermore, what about those who do not speak English and are sent outside of Alaska for treatment? Mr. Bennett did not believe the treatment would be very beneficial. In conclusion, Mr. Bennett stressed that Alaska needs the bottle; Alaska needs a long-term treatment center. MARY POORE, a COM-Peer Coordinator at the South Central Counseling Center in Anchorage and a Certified Health Education Specialist, said that she was representing some 680 chronically or severely mentally ill people who either have Schizophrenia or Bipolar Disease. She related the following story of Lloyd Peck, a mental health consumer who has returned to the community to help provide services for the mentally ill. Mr. Peck discussed his life in Alaska and how after high school he worked in the summers to pay for college. Mr. Peck served as a Forestry Technician in fire control for four summers. He attended college at UAF and UAA, seeking a degree in geology. In 1977, the stress of college and his summer job broke his health. Since then, Mr Peck has received outpatient services for Chronic Schizophrenia from the South Central Counseling Center. About two years ago, Mr. Peck decide to become a volunteer for the COM-Peer Program as well as a member of the Anchorage Alliance for the Mentally Ill. Mr. Peck urged Alaska's legislators to support the South Central Counseling Center's safety network for the treatment of the mentally disabled. Furthermore, he encouraged public education so that the social stigma of mental illness could be erased and the tension eased on patients in order that their treatment would be more effective. Number 488 Ms. Poore reiterated that mental illness touches everyone. For instance, Ms. Poore graduated at the top of her class at the University of Kentucky. Within one year, she was homeless and diagnosed with Bipolar Disease and Anxiety Disorder. Ms. Poore emphasized that without the community mental health services and the people she works with, she would not be here today. Ms. Poore hoped that the legislators would remember the mentally ill when making budget cuts. TRICIA EDWARDS, from Anchorage, informed the committee that after moving into the Brother Francis Shelter, she had a nervous breakdown and became mentally ill with Schizophrenia. She also received counseling at the shelter through Crossover House, an outreach extension of South Central Counseling. She discussed how she has come to live and work with her mental illness with help from these groups. Ms. Edwards was sure that without these programs she would be dead. Number 465 JARED ZITWER, from Anchorage, thanked the committee for their time in listening to all the mental health consumers. Mr. Zitwer said that he had been fortunate to have used the services funded by Alaska. He indicated that he is doing quite well. The community based mental health system has been very beneficial. Mr. Zitwer has been serving as a member of the Assets Mental Health Advisory Board for almost a year. He discussed the prospects of being a member of the COM Peer Program. Mr. Zitwer emphasized that community based mental health services have benefitted him in a tangible way and he attributes much of his professional and personal growth to those services. He urged the continued funding of those services. JEANNE HALL, from Barrow, discussed the help she has received from South Central Foundation's Quanta House. Ms. Hall identified the following as solutions for the program: jobs, transportation, funding for housing, and funding for education. She thanked the committee for their attention. Number 401 BUZ DANEY, Quanta House, explained that he worked with Ms. Hall at Quanta House where they built a club to provide training for jobs and jobs in the community. South Central Foundation is a tribal health corporation. The club intends to teach responsibility through meaningful work within the club and the community. Members and staff help to make this possible. Although the club's primary focus is Alaska Natives and American Indians, the club is open to anyone with a chronic mental illness. In the past year, a program for their people coming out of the jail system has begun. Mental illness care is needed as well as social and cultural needs. Housing and some transportation has been provided, but the need is greater. Mr. Daney thanked the committee for the assistance that they have received, it has made the difference. CO-CHAIR TOOHEY thanked Mr. Daney and noted that he had an active Mental Health Board that has done a beautiful job. She asked if anyone else would like to testify. Number 370 JAN MCGILVARY, Coordinator for the "Building Bridges Campaign", thanked all of the legislators for this opportunity today. Ms. McGilvary indicated that the energy surrounding this campaign has grown; the network continues to grow. Ms. McGilvary said that the ultimate goal is to provide opportunities to teach people how to advocate for themselves which leads to empowerment. She thanked the committee again. CO-CHAIR TOOHEY thanked everyone for their testimony. There being no further business before the committee, the meeting was adjourned at 10:30 a.m.