JOINT SENATE AND HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE March 19, 1997 3:40 p.m. SENATE MEMBERS PRESENT Senator Gary Wilken, Chairman Senator Johnny Ellis SENATE MEMBERS ABSENT Senator Loren Leman, Vice-Chairman Senator Lyda Green Senator Jerry Ward HOUSE MEMBERS PRESENT Representative Con Bunde, Chairman Representative Joe Green, Vice-Chairman Representative Fred Dyson Representative Al Vezey Representative Tom Brice Representative J. Allen Kemplen HOUSE MEMBERS ABSENT Representative Brian Porter COMMITTEE CALENDAR PRESENTATION BY "BUILDING BRIDGES" WITNESS REGISTER Testimony was offered by the following persons: Jan McGillivary, Anchorage; Pat Kouris, Anchorage; Rebbecca Brennan, Kodiak; Cheryl Wheat, Fairbanks; Bernie Janzen, Wasilla; DeAnn Heide, Cordova; Jeri Lanier, Fairbanks; Mary Synoground, Fairbanks; Crystal Choate, Soldotna; Steve Bue, Anchorage; Patricia Edwards, Anchorage; Joseph Coolidge, Anchorage; Richard Warrington, Kenai; Sig Torgramsen, Anchorage; Tina McKinney, Fairbanks; Susan Berg, Anchorage; Jacquolene Townsend, Juneau; Vannessa Roney, Kenai; Frankie Doulin, Anchorage; Sabrina Rodgers, Juneau; Ken Lemieux, Juneau; and Vince Osterhaut, Juneau ACTION NARRATIVE TAPE 97-30, SIDE A Number 001 CHAIRMAN WILKEN called the Joint Senate and House Health, Education and Social Services Committee to order at 3:40 p.m. After welcoming guests and introducing members of the joint committee, Chairman Wilken invited the first presenters to come forward and begin. JAN MCGILLIVARY, Coordinator of the "Building Bridges" Campaign for Mental Health for 1997 explained it is a group of mental health consumers, their family members, their advocates and providers that have traveled to Juneau four years in a row to educate about issues affecting Alaskans who experience mental illnesses and emotional disturbances. Ms. McGillivary said the "Building Bridges" group is in support of budget recommendations as forwarded earlier by the Alaska Mental Health Board and the Alaska Mental Health Trust Authority, and they encourage the restoration of Medicaid cuts that have made previously, specifically in the options that cover eye glasses, hearing aids and acute dental needs. Further, they encourage the continued support for community-based mental health services. Number 075 PAT KOURIS of Anchorage said her purpose in appearing before the committee was to request that funding for community-based mental health services be maintained, and to speak on behalf of her son who started having mental problems at the age of 21 and is currently in the Alaska Psychiatric Institute (API) in Anchorage. He is now 24 years old and is well on the road to recovery and participating in transitional community-based services. Ms. Kouris pointed out that it is much less expensive to treat her son and others with mental illness in the community with supportive mental health services rather than in the hospital setting. She said one of the reasons these services are necessary is because of the stigma of mental illness and the need for someone to act as a buffer on the journey of recovery to full participation in a meaningful life. Number 175 REBBECCA BRENNAN of Kodiak said previous to her slide into depression she was a working mother who was active in many community organizations and projects. She was eventually diagnosed with manic depression, has been hospitalized five times, and has attempted suicide two times. Because of allergies and drug sensitivities it has been very hard for the doctors to get the right mix of drugs for her, and she is currently taking 19 drugs per day. As a result of her illness, she has had to quit her job and go on long-term disability. Her husband is a state employee, but they have found that Aetna, the state's insurance carrier, has severely limited benefits for persons with mental nervous disorders, limiting it to a $50,000 life time benefit. She pointed out the cost of one of her hospital visits was $25,000. Number 250 CHERYL WHEAT of Fairbanks stated she is a consumer of mental health services, having been diagnosed with major depression, anxiety and post-traumatic stress disorder (PTSD). She related that when she had her mental breakdown her financial circumstances changed dramatically: she lost her good credit rating, she couldn't pay her debts, and she recently filed for bankruptcy. Before she qualified for Medicaid she could not afford the medicine, therefore, she did not take any and her condition continued to go downhill. Once Medicaid kicked in, her doctor prescribed drugs which helped her and allowed her to function in her own home, as well as work part time. Ms. Wheat said that if not Medicaid, adult public assistance and her social security disability, she would either be living on the streets, in API, or in jail. Last year she received a grant for dental work, and her eyes are bothering her now, but she has been told that no grant money is available at this time to have her eyes checked. Ms. Wheat noted that last year the Alaska Mental Health Trust Authority offered $1 million to provide for some services that have been cut by Medicaid if the state and federal governments would each match the $1 million, and she questioned why the Legislature hasn't acted on this offer as yet. She said it seems like good business sense to her, a $1 million investment for a $3 million return on services. Number 295 CHAIRMAN BUNDE commented that the reduction is Medicaid services has been a sore spot for a lot of legislators, and he has been told by the chairman of the House Finance Committee that there will be specific legislation addressing Medicaid benefits for eye glasses, hearing aids and dental work. Number 304 REPRESENTATIVE BRICE pointed out the legislation doesn't make specific recommendations for those services, and the Legislature still has not addressed the whole Medicaid options list, so he thinks it is premature at this point in time to say that those options will be paid. Number 325 BERNIE JANZEN of Wasilla informed the committee that she is the adoptive mom of two reactive attachment disorder children. She said the violent behaviors that can occur without warning causes her family to live in a battlefield, not knowing when the next grenade is going to go off. These children are bright, charming and totally self-absorbed, and they are children who have no remorse. She cautioned that unless reactive attachment disorder children are treated through mental health, they will be reactive attachment adults, and the over-populations of prisons who house undiagnosed RAD adults is overwhelming. She said there is hope for these children with appropriate mental health treatment, and she urged support for the recommendations of the Alaska Mental Health and Trust Authority budgets. Number 366 DEANN HEIDE of Cordova said she has been diagnosed as chronic major depression, anxiety disorder and post-traumatic stress disorder. Prior to her diagnosis she was director of nursing of hospitals, but has lost her licensure because of her mental illness. Over the last five years she has been hospitalized multiple times, and due to the limited local community resources, she has been handcuffed and jailed overnight prior to being transported to API. She noted she makes $20 too much a month on her disability to qualify for Medicaid assistance, and therefore five months of her disability went toward her own medical care. Currently, she has recovered adequately to work part time at a domestic violence and sexual assault center. Most of her time is donated hours because she is virtually unemployable in her community. Ms. Heide said with the new welfare initiatives Alaska has written a draft called the Alaska Plan. There are 7,000 people in the state eligible to go work in the first year of that, but in that plan there are no incentives, nothing offered to individuals to employ the disabled. She said she would like to see the Alaska Plan address the disabled. Number 400 JERRY LANIER of Fairbanks said two of her three children are severely emotionally disturbed. Her oldest son, who is now 21 years old, started receiving services when he was 12 years old. Because of the help he received when he was younger, he is now completely functional, on his own, has a job, and is not needing any support services from the state. However, her daughter was assaulted and in need of counseling, but with all of the budgets cuts that have occurred and because her mother makes $10 a month too much for Medicaid services, the daughter has not been able to receive the same help that her brother received. Ms. Lanier has had to send her daughter out of state to live with her parents who are now helping raise her child, and her greatest hope is that the Medicaid funding is put back in place and that grants become available again so that her daughter can return home and receive the services she needs with her family. Number 432 MARY SYNOGROUND of Fairbanks stated she has been in the mental health system since 1957. In 1988 her doctor provided her with a counselor and a case manager to help her stabilize and get out of the hospital. She has maintained her mental health since then, and she said it is much cheaper to provide these out-patient services to people like her than it is to keep them in hospitals. Number 444 CRYSTAL CHOATE of Soldotna said the state of Alaska has set an excellent example of taking care of its own, and she asked the committee to remember the mentally ill from the seriously incapacitated to the mildly depressed souls. She said they would be lost without the Medicaid assistance for the programs they participate in. The community outreach program of the Central Peninsula Counseling Services has helped her by socializing with others who have experienced the same rejection from society because of their illness, and it has made her realize that she is not alone. If she hadn't found the community outreach program through a friend, she would have been hospitalized, her children would have been put in foster care at a greater cost to the state than the Central Peninsula Counseling Services provide for her now. She told of the affects her illness had on family and friends, but she said that has all changed over the past year with the positive impact of the assistance she has received. Ms. Choate urged the continued funding of programs for the mentally ill and reinstatement of Medicaid funding for sight, hearing and dentistry. Number 492 STEVE BUE of Anchorage told of his being diagnosed three years ago as paranoid schizophrenic, hearing voices and the fear for his life. He said because of medications available, treatment provided by South Central Counseling Center and the support of his family, he is alive and living a normal life. He works 20 hours a week and he is a taxpayer. He emphasized that without mental health services provided by the state he would not be here today. Number 498 PATRICIA EDWARDS of Anchorage said her untreated schizophrenia and depression left her homeless and close to death. With assistance from South Central Counseling Center she has been placed on medications to control her illness. She said her community-based mental health center has helped her receive housing assistance while she has been volunteering to improve her working skills. She expressed her appreciation to the Legislature for making it possible for her to have another chance and for the time it takes to recover. Number 515 JOE COOLIDGE of Anchorage spoke of his mental illness and how little things make him nervous. He said talk about making cuts to Medicare and Medicaid scares him. Before being diagnosed as manic depressive, he worked and supported him family. After being sent to API several times his wife divorced him. He told of how various community counseling programs have helped him get his life back together. Number 558 RICHARD WARRINGTON of Kenai told of his traumatic brain injury (TBI), the invisible disability, which he received in 1978. He was recently appointed to the National Brain Injury Association Ambassador Program, representing the TBI survivors and the families of survivors around the state of Alaska. There are approximately 700 to 1,000 Alaskans who receive a TBI each year. He has been in Alaska for 12 years and has experienced the lack of knowledge, support or assistance in all agencies for TBI survivors in the state. He said he was appearing before the committee to advocate for the brain injured and their families, to secure and develop community-based services, to support research leading to better outcomes that enhance the lives of people who have sustained a brain injury, and to promote prevention of brain injury through public awareness, education and legislation. He pointed out that the TBI Act was signed into law in 1996, and the state of Alaska is eligible to receive funds through this Act, but first it must set up an advisory board to appropriate these funds. TAPE 97-30, SIDE B Number 585 SIG TORGRAMSEN of Anchorage told of how he started having problems when he was 17 years old and started seeing counselors. The problem continued for years before he actually received any psychiatric medication of any kind. He went through a heavy equipment training school, becoming a journeyman operator; however, his handicap has become worse so he is not capable of being an operating engineer anymore. He noted he has been hospitalized over 42 times in the past 23 years, and he said that if it wasn't for places like API and South Central Counseling Center, he'd probably be dead. He urged continued mental health funding for counseling centers and community-based mental health support systems. Number 560 SUSAN BERG of Anchorage said she is both a consumer of mental health and medical services and a psychiatrist. She told of traveling from New York and being severely beaten in Seattle, Washington. She said she has been at the bottom of the pile at API and at the top. She wants to go to work because she is doctor who can generate income, not just collect Medicaid and Medicare. She said she needs the help and support to get back into the work force because of the stigma attached to her illness. Number 542 TINA MCKINNEY of Fairbanks informed the committee that four years ago she took physical custody of her sister's two boys, ages 4 and 8, who had severe emotional disabilities. She then spent nearly $10,000 in legal fees to gain legal custody. The boys have a history of violence, repeated sexual assaults by men and women, pornography, physical abuse, etc. She said the boys are intelligent, funny and insightful, but they are also violent, destructive, they lie and steal, and they act out sexually. Among services received for the boys are home-based activity therapy, crisis intervention, a team approach to case coordination and respite care. Ms. McKinney said without these services, she would be unable to maintain a full-time job and safely maintain her children in her home. She also told of her sister's and mother's mental problems, and she urged support of community-based mental health services so that families like hers can break the cycle of abuse and mental illness. Number 516 JACQUOLENE TOWNSEND of Juneau said besides being a mental health consumer she is a mental health professional. She said she never finished high school, left home, was homeless and did a lot of inappropriate things. She was on welfare and eventually got her GED, then she became an LPN, then she became an RN, then she got a degree in psychology and became a certified psychiatric nurse. Her medications cost between $150 and $200 a month, but she has good health insurance and can pay for them. She pointed out that back in the late seventies and the early eighties there was good support for people who were mentally ill, and she stressed the need to find a way to help these people who don't have medical insurance buy their medications and keep them employable. Number 482 VANNESSA RONEY of Kenai said she was dually diagnosed borderline personality, manic depressive about six years ago. After being in and out of hospitals for 10 years, she finally got that diagnosis. Then after spending several years feeling sorry for herself, she was referred to the community outreach program through the Central Peninsula Counseling Services which changed her life. The program showed her her life doesn't end with mental illness, it begins anew. She was a college graduate, but she didn't have a job, and through this program she learned self-worth and it gave her hope and ambition. She said she wanted to thank anybody who has voted for funds for the mentally ill because she feels like she owes them her life and her gratitude. Number 445 FRANKIE DOULIN of Anchorage related that after living many years in Morningside and API she now lives in her own home with a friend. Her case manager in Anchorage has helped her in many ways such as getting her daily medications, paying bills, taking her to the doctor, taking her shopping, etc. She said she would be lost without her case manager, and she implored the committee members not to take away her case manager or other Medicaid benefits. Number 417 SABRINA RODGERS of Juneau, speaking on behalf of the Juneau Alliance For The Mentally Ill (JAMI), lives in a half-way house for the mentally disabled. She spoke to the need for financing for housing for the mentally disabled, which is called MICA housing because it is an alcohol and drug free environment. Approximately 200 mentally ill clients need continued support through JAMI, which offers numerous programs that provide opportunities to its clients. She asked that the Legislature take a proactive approach in preventative funding because hospitalization is much more costly than local care. Number 398 KEN LEMIEUX of Juneau expressed his appreciation for the help, and friendship he has received over the last 11 years as a mentally ill client. Number 391 VINCE OSTERHAUT of Juneau said that since the age of 15 he has made 23 suicide attempts, and he estimated that the state of Alaska has probably paid close to half a million dollars to cover his hospitalizations and emergency surgery. He said he is currently homeless, and that there is a need for more services and housing in the community. He receives social security, but he would rather be a working, functioning member of society. However, there is a stigma attached to mental illness. He has worked in jobs where because he has a preexisting condition, he is denied medical insurance. He stressed the importance of the mentally ill being functioning members of society, not just locked up in places like API and medicated until they can't even remember their own names. He said he has slipped through the cracks in the system because he is what is called "high functioning" and 90 percent of the services are aimed towards "low functioning" clients. Number 345 CHAIRMAN WILKEN and CHAIRMAN BUNDE expressed their appreciation to the "Building Bridges" people who appeared before the joint committee. The meeting then adjourned at 4:52 p.m.