ALASKA STATE LEGISLATURE  JOINT MEETING  SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE  HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE  April 12, 2007 4:07 p.m. MEMBERS PRESENT  SENATE HEALTH, EDUCATION AND SOCIAL SERVICES Senator Bettye Davis, Chair Senator Joe Thomas, Vice Chair Senator Kim Elton Senator Fred Dyson HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES Representative Peggy Wilson, Chair Representative Anna Fairclough Representative Mark Neuman Representative Sharon Cissna Representative Berta Gardner MEMBERS ABSENT  SENATE HEALTH, EDUCATION AND SOCIAL SERVICES Senator John Cowdery HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES Representative Bob Roses, Vice Chair Representative Paul Seaton OTHER LEGISLATORS PRESENT  Senator Con Bunde Senator Johnny Ellis   COMMITTEE CALENDAR  Overview: Reclaiming Futures project HEARD PREVIOUS COMMITTEE ACTION No previous action to record. WITNESS REGISTER Tom Begich, project director Reclaiming Futures Anchorage, AK POSITION STATEMENT: Presented overview William Hitchcock, judicial fellow Reclaiming Futures Anchorage, AK POSITION STATEMENT: Participated in overview Laura Burney Nissen, director Reclaiming Futures Portland, OR POSITION STATEMENT: Participated in overview Nolan Ogle-Endresen Anchorage, AK POSITION STATEMENT: Participated in overview Linda Moffitt, juvenile justice fellow Reclaiming Futures Anchorage, AK POSITION STATEMENT: Participated in overview Andre Rosay, evaluation committee Reclaiming Futures Anchorage, AK POSITION STATEMENT: Participated in overview Karin Schaff, treatment fellow Reclaiming Futures Anchorage, AK POSITION STATEMENT: Participated in overview ACTION NARRATIVE CO-CHAIR PEGGY WILSON called the joint meeting of the Senate and House Health, Education and Social Services Standing Committees to order at 4:07:14 PM. Present at the call to order were Senator Thomas and Co-Chair Davis; Representatives Fairclough, Neuman, Cissna, and Co-Chair Wilson. Senator Elton Senator Dyson and Representative Gardner arrived soon thereafter. ^OVERVIEW: RECLAIMING FUTURES PROJECT  CO-CHAIR Wilson announced the committee would hear a presentation on reclaiming futures. TOM BEGICH, project director of Reclaiming Futures (RF), introduced himself and his co-presenters, and showed a video with subjects of the RF project and the process they go through to get their lives back in track. 4:17:40 PM LAURA NISSEN, RF director, said that the state of Alaska is looking for ideas on how to keep its young people from joining gangs, and RF can help with this. She commended the work of the Anchorage RF team, and said that it is becoming a national leader in the program. She outlined the history of the RF project, which was begun in reaction to a trend of more and more youth entering juvenile detention facilities. The program has reinvented the juvenile justice system by holding kids accountable for mistakes and offering them help to get out of the cycle. The program has focused on what kids with problems need to be successful; Anchorage became one of ten nation-wide test communities in 1999. 4:21:37 PM She said that the model of RF is flexible enough to work for a variety of different communities. She explained the different steps of the RF program, including drug screenings, psychological assessments, development and initiation of care plans, service engagement, and transitioning into a support-free life. Few communities provide this level of attention across the United States, but they are all effective in reducing crime and associated costs. 4:27:59 PM She cited data to show the positive effect of the RF project across the country; there have been improvements across all sites in the country and in Anchorage. Locally, an evaluation team found that youth with individual service plans in the program were nine times more likely to complete treatment; service contacts aided in treatment completion as well. She concluded by saying that young people are successfully completing this program, and are accessing positive community opportunities in new ways. She added that there is a lot of work to be done with the program and against youth addiction; RF is ready to move from a pilot program to a full-on national program. She assured the committee that such a program would be a great success in Juneau; the program is like a bridge across a dangerous canyon for a lot of youth. 4:32:51 PM MASTER WILLIAM HITCHCOCK, Children's Court Master for the Anchorage Superior Court and judicial fellow for RF, said that a court must be willing to commit to the program for the system of care to be built; he related his history with the project, and talked about how RF made the juvenile court take a broader look at its disciplinary techniques. Screening was improved, and different arms of the courts began to work together more effectively. Instead of re-punishing kids because of their failures, progress in life skills was tracked. Management of the cases has been greatly improved with the individualized service plans. He explained the service plan process in more detail, and said that he often hears back from kids as they move through and complete the RF process. 4:38:31 PM He said that the process relies on collaborative community work, and many communities all over the state could make this successful. He introduced Nolan Ogle-Endresen, a graduate of the Anchorage RF program. 4:39:35 PM NOLAN OGLE-ENDRESEN, a graduate of the Anchorage RF program, explained his history with youth probation, which didn't provide support or structure. He began the RF program at the age of 16, and it changed his life in myriad ways. The structure was immediate and all-encompassing, unlike his previous encounters with juvenile justice. When he left the program he reencountered his problems with drugs and alcohol, but had the skills he needed to overcome them on his own; he said he wishes that the program could be there for all the people who need it. His life and future are bright because of RF. 4:44:05 PM CO-CHAIR WILSON thanked Mr. Ogle-Endresen. MR. BEGICH thanked the committee again, and said that it's a pleasure to see graduates of the program like Mr. Ogle-Endresen. He said that the program can change the way the justice system operates for juveniles; many of RF's elements of treatment are being applied across the board in Anchorage, and the tools are effective elsewhere. Youth aren't just held accountable for their actions, but are treated as well. Over 98 percent of the kids entering the juvenile justice system in Anchorage now are being treated with elements of the RF program. The original funding received by RF from the Robert Wood Johnson Foundation was used to develop the tools of the program, not for the actual treatment; now the well-planned template can be used across the state. The treatment is working because it's meaningful. 4:48:28 PM He said that there are similar efforts across the country that stress evidence-based treatment; those approaches are important, as well as reallocation of resources. In this case, the system has been supportive of the program's efforts. He encouraged the committee to continue to support treatment-based services funding, because it's so effective; $3,000 worth of treatment is the same as $40,000 worth of incarceration. The cost of the justice system continues to rise, but RF is an approach that keeps kids from returning to the system in the long run. As new RF sites come online, they should be embraced and supported. There are many individuals involved in the program who aren't necessarily state employees; they're just interested in working with the program. Breaking the cycle of substance abuse will keep kids from returning to the justice system. 4:53:52 PM SENATOR DYSON asked for elaboration on how the program could integrate with the Office of Children's Services (OCS) and the Department of Juvenile Justice (DJJ). MR. BEGICH said that Department of Health and Social Services (DHSS) Commissioner Karleen Jackson has been very supportive of the program and a shared approach towards communication. 4:55:06 PM MASTER HITCHCOCK said that there are sometimes cases of dual jurisdiction where a child is in need of aid and is also a delinquent. A lot of the kids in the RF program need mental health care, and the OCS has been helpful from the beginning with providing this treatment. MR. BEGICH added that kids in the child welfare system are often part of the juvenile justice system as well, and he's hopeful that positive impacts in one area will lead to others. 4:57:07 PM REPRESENTATIVE GARDNER asked for clarification on how the RF model is being used with other youth outside the program. MR. BEGICH said that kids coming through the system without the benefit of RF were tracked to see their treatment progression. 98 percent were receiving evidence-based treatment, which shows that the system is changing for the better. REPRESENTATIVE GARDNER asked if there is trouble finding treatment beds, and if there is a wait for mental health treatment services. MR. BEGICH said that the RF has recently received additional funding for mental health assessments, and said that Karin Schaff could better answer the question. KARIN SCHAFF, treatment fellow for the RF, said that capacity in the program is an issue, but with collaborations it has been hugely improved. She detailed the improvements in the mental health aspect of the program. MR. BEGICH added that swiftness in responding to need is important to keeping people's faith in the program. 5:00:43 PM CO-CHAIR DAVIS asked for information on how cases are found and funded. MR. BEGICH explained where initial funding came from, and how it was used to come up with a business plan for RF. Treatment funding has been received from different foundations and from the Alaska Mental Health Trust Authority (AMHTA). He said that the numbers of youth treated by RF will be greatly increasing. 5:03:35 PM LINDA MOFFITT, juvenile justice fellow with the RF, said that the program was originally designed for youth within the juvenile justice system. Now there are two tracks, including those youth who haven't ever been to court. Other changes include increased initial screenings, additional mental health screening, and assessors going to the DJJ every week to monitor youth; this increases the likelihood of kids staying in the program. She added that a local policy has been instituted that determines when a youth will come in for assessment; the process has become more objective than subjective. The change in focus to a more results-based approach is a major improvement in the DJJ. 5:06:56 PM MR. BEGICH said that now that every youth in the DJJ system will be getting a screening, more people will be affected by the program. 5:07:38 PM CO-CHAIR DAVIS asked who trains the probation officers in RF skills. MR. BEGICH replied that he will be training staff tomorrow in the capitol; training is easily replicable and the skill set is transferable. 5:08:25 PM REPRESENTATIVE CISSNA said that outcome measures need to be tracked over a period of time to determine how effective a program is, and asked how long the program has been collecting evidence. She referenced a study done in the Alaska that showed that fidelity to model is a problem. 5:10:05 PM MS. NISSEN said that RF is an amalgamation of several other evidence based approaches; the six steps of the model were broken into two parts: a national model, and local models. The data output from local program has yet to come out, but it's evident that the system can be changed. What's not known yet is whether the outcomes are positive. 5:12:12 PM REPRESENTATIVE CISSNA said that system change isn't necessarily evidence-based; treatment programs have shown little fidelity to models in the past, and RF appears to be changing only the system thus far. 5:13:30 PM MS. SCHAFF said that the data was tracked beginning in 2003, and tracking will continue; all tracking has built-in fidelity measures, so RF will be staying true to the model. 5:14:20 PM REPRESENTATIVE CISSNA said that there must be a way to evaluate the system, and asked how to get more information about the actual measures. MS. SCHAFF said that she will provide that information to the committee. 5:15:08 PM REPRESENTATIVE NEUMAN said that he sees a connection between RF and the OCS; he asked for an explanation of the relationship, and how evaluation data would change between different areas of the state. MR. BEGICH said that the OCS has been highly involved in RF and is working with a case-management approach. The partnership will depend on how they can be involved in the future; they're both in the same family of work. He added that the program has an active evaluation committee which uses tracking mechanisms. 5:18:12 PM ANDRE ROSAY, evaluation committee member with the RF, said that the evaluation is taking two directions: reviewing old files, and current youth in the program. The committee found that youth having family or friend helpers leads to completed treatment; a shared web-based system is the second part of the evaluation, which can be used throughout the state. The model will be as applicable in other communities. 5:19:48 PM CO-CHAIR WILSON asked if helpers are paid or if they volunteer. MR. BEGICH said that they're people identified by the youth as a person of trust involved in their life outside the program. These helpers are instrumental in getting the youth through the program. RF is developing an advisory group of program graduates and their families to become paid professional helpers. 5:21:47 PM CO-CHAIR WILSON asked if there were small communities in the original pilot programs. MR. BEGICH replied that there were; all the sites were different. CO-CHAIR WILSON asked how critical a job would be to the youth succeeding in or after the program, and commented that that finding a job can be difficult in Alaska. MR. BEGICH replied that he believes that a key component to success is graduation; skills and opportunities do need to be built, so his opinion is that the job connection is critical. 5:25:12 PM CO-CHAIR WILSON asked if the program will give kids enough self esteem to help them succeed in a small village. MR. OGLE-ENDRESEN said that the program does its best to give kids a post-graduation support group. MR. BEGICH talked about his history working with graduates of the program. 5:27:20 PM MR. OGLE-ENDRESEN said that he feels good about the RF program. MS. NISSEN said that the job issue is a good example of how no one system can solve the whole problem. Youth employment coalitions are interested in the RF because it prepares the kids for employment aid; a youth leadership opportunity is what kids need to become productive members of communities. CO-CHAIR DAVIS commented that Mr. Ogle-Endresen seems to have made opportunities for himself. 5:29:49 PM She added that she hopes expansion of RF will be possible, and thanked the committee for the presentation. REPRESENTATIVE FAIRCLOUGH said that she likes hearing from young men and women who have opportunities to advance themselves and their lives. She complimented Mr. Ogle-Endresen on his testimony. 5:31:26 PM REPRESENTATIVE GARDNER said that children can't be given self- esteem; one has to learn it. CO-CHAIR DAVIS asked if the program wanted to ask for anything from the committee. MR. BEGICH said that he wants to see the legislature share in the program and be supportive of it; funding needs to go to evidence-based programs; eventual resource reallocation may be needed; and innovative change needs to be embraced and accepted. CO-CHAIR WILSON said that the committee has been working on health care spending for months, and using results-based programs has been one of the main goals. There being no further business to come before the committee, she then adjourned the meeting at 5:36:43 PM.