ALASKA STATE LEGISLATURE  SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  March 20, 2009 1:22 p.m. MEMBERS PRESENT Senator Bettye Davis, Chair Senator Joe Paskvan, Vice Chair Senator Joe Thomas MEMBERS ABSENT  Senator Johnny Ellis Senator Fred Dyson OTHER LEGISLATORS PRESENT  Representative Les Gara COMMITTEE CALENDAR  Foster Care Legislative Summit PREVIOUS COMMITTEE ACTION  No previous action to record. WITNESS REGISTER REPRESENTATIVE GARA Alaska State Legislature Juneau, AK POSITION STATEMENT: Commented on Foster Care issues. AMANDA METIVIER, Statewide Coordinator Facing Foster Care in Alaska (FFCA) POSITION STATEMENT: Helped present FFCA issues. PETER PECORA Casey Family Programs and the University of Washington POSITION STATEMENT: Commented on foster care issues. KAYLEE DAY, Statewide Coordinator Facing Foster Care in Alaska (FFCA) POSITION STATEMENT: Related her experience in foster care. SHILO VALLE Facing Foster Care in Alaska (FFCA) POSITION STATEMENT: Related his experience in foster care. ANTHONY BARRIL Facing Foster Care in Alaska (FFCA) POSITION STATEMENT: Related his experience in foster care. BARB DEXTER Anchorage School District POSITION STATEMENT: Explained Anchorage School District's Child in Transition Homeless Project. BETH SNYDER Anchorage School District POSITION STATEMENT: Provided information on Anchorage School District's Child in Transition Homeless Project. TAMMY SANDOVAL, Director Alaska Office of Children's Services Department of Health and Social Services POSITION STATEMENT: Participated in the discussion on foster care. JOHN HENDERSON U.S. Department of Health and Human Services Children's Bureau in Region 10 POSITION STATEMENT: Participated in the discussion on foster care. BILL HOGAN, Commissioner Department of Health and Social Services POSITION STATEMENT: Participated in the discussion on foster care. ACTION NARRATIVE 1:22:39 PM CHAIR BETTYE DAVIS called the Senate Health and Social Services Standing Committee meeting to order at 1:22 p.m. Present at the call to order were Senators Paskvan and Davis. ^Foster Care Legislative Summit Foster Care Legislative Summit  CHAIR DAVIS announced the Foster Care Legislative Summit to be the first and only order of business. REPRESENTATIVE GARA said this summit is largely sponsored by Facing Foster Care Alaska (FFCA), a group of foster youth and alumni of foster care who are trying to bring some foster care system issues to the public's attention and suggesting how they can be fixed. He said the Casey Family Foundation is also involved. 1:27:47 PM CHAIR DAVIS said she would like to start with a presentation by Facing Foster Care. AMANDA METIVIER, Statewide Coordinator, Facing Foster Care in Alaska, and Kaylee Day, a statewide FFCA coordinator, Telora Thompson, Shilo Valle, FFCA member, Anthony Barril, FFCA member, Peter Pecora, Casey Family Programs and the University of Washington, introduced themselves. MS. METIVIER said the FFCA is a statewide organization made up of youths in and from the foster care system ages 15 and up. Last year they brought in foster youth from all over Alaska to talk about what could better the lives of kids in foster care. "These were not just wants; I think these were needs, too." The first issue she wanted to discuss was tuition waivers for all foster youth who age out of foster care. Currently the state provides 10 tuition waivers, but that is not enough. Another issue was more support for youth pursuing post secondary education including vocational and technical schools, job training, and transitional living. MS. METIVIER related that it is so hard to find placements for teenagers that one dubbed it as "foster homeless" and so the last issue she wanted to highlight was extending Medicaid to 21 years old so they won't be just cut off at 20 years when they age from the system. At this time they only have coverage to the age of 19. SENATOR THOMAS joined the committee. 1:32:31 PM PETER PECORA, representing the Casey Family Programs and the University of Washington, highlighted some of the findings of studies related to foster care with special emphasis on a recent foster care study of alumni in Alaska. He said that while there are many challenges in child welfare today, practical strategies to improve outcomes are being established; it is a hopeful time to be in the field. MS. METIVIER said the Alaska alumni study showed that 79 percent of the alumni interviewed finished high school through either a diploma or GED; about 15 percent completed a GED with 63 percent receiving a diploma and 4.5 percent completing college. She said that many kids in foster care opt out of high school because they move so much they can't keep up as they lose credits, friends, teachers, each time they change schools. She asked the kids on the panel to relate how they thought being in foster care affected their education. 1:35:43 PM KAYLEE DAY, FFCA, Juneau, Alaska, said foster care affected her in a positive way. Before she went to foster care she was about to drop out as a freshman in high school. She was placed with her aunt who insisted that she graduate from high school. She went from being two years behind to graduating only two credits late. SHILO VALLE, FFCA, Juneau, Alaska, said foster care made school difficult for him, because it stressed him out. He never knew where he was going to stay or what he would eat and what would happen next. ANTHONY BARRIL, FFCA, Juneau, Alaska, said foster care was very hard, because he moved from home to home. He is doing well now and is only three credits away from graduation. MR. VALLE clarified that he is a senior in high school; he has his own apartment and lives on his own. He works 40 hours a week to support himself, but he can never get all of his homework done. He has been accepted to a school down south, but has to come up with $27,000 to pay for it. The thought that a lack of money will keep him from going to school worries him a lot. MS. METIVIER said the unemployment rate among foster care kids was 29.6 percent for alumni compared to 7.1 percent in the general population at the time of the alumni study. She remarked that young people in foster care don't get a lot of job experience because it's hard to keep a job when you are moving around or when you have to go through a lot of red tape like getting your social worker to sign off on a work permit, which could take weeks. 1:39:17 PM MR. PECORA said when kids are placed in foster care, the trauma can interfere with their educational development. A foster parent's first priorities are food, safety and shelter and then getting that child to school. This is a challenge because they are already behind in many cases. Many kids need to learn ordinary life skills as well. He said if a child doesn't have educational skills or family members who can provide opportunities for employment, 1 out of 5 alumni experience one or more days of homelessness within a year of leaving foster care. In Alaska, that rate is 30 percent or 3 out of 10. Alumni are in a fragile economic situation in other ways; 39 percent of the alumni in the Alaska study lack health insurance coverage, double the national average (18 percent). 1:42:44 PM MR. PECORA said the study indicated the rate of teen pregnancy is very high - 57 percent of young women in foster care had been pregnant before age 19, and it's a little hard to start your career if you have an unplanned pregnancy or fathered a child. This is a major issue. MS. METIVIER touched on the housing piece a little more, because she said youth who "bounce around in foster care" have no stability; for many of them Covenant House is their family. If they have a stable place in foster care, they are likely to extend foster care with that family and have someone to call when they need help. MR. VALLE said that three months before he was going to age out of foster care he was living in a tent on Thane. He tore his ACL and luckily he still had health insurance. He knew he couldn't stay in a tent all summer; so two weeks after his knee surgery he went back to hard labor for Trail Mix, Inc. He said it was very hard; he couldn't wash his clothes, he was constantly in work clothes and got up to cold mornings. He would go to work, ice his knee, come back to the tent go to sleep, and repeat that routine every day. Now he lives on his own and works full time. CHAIR DAVIS asked why he was living in a tent when he was still in foster care. MR. VALLE replied that there was nowhere to put him and he refused to go back to Cornerstone, the emergency housing facility, where he was treated like a convict. CHAIR DAVIS asked if he shared his feelings with the division. MR. VALLEY replied yes. 1:47:05 PM MS. DAY related that she was living with her grandmother when she aged out of foster care; her grandmother didn't want her to live with her anymore, and so she had to find somewhere else to stay. Fortunately, she had an aunt who allowed her to stay for a year before she found her own place. She had some support from OCS, but not as much as she wished she had. MS. METIVIER related that she was lucky because her foster family let her continue to live with them while she finished college. 1:48:30 PM REPRESENTATIVE GARA asked what benefits are available for a person aging out of foster care to pay for housing. MS. METIVIER answered that OCS through the Independent Living Program has funds for the first 2 months rent and half of the next two months' rent up to age 18. She said that predictors of success are stable placements, one healthy adult relationship with someone who can be a mentor, increased access to extracurricular activities because after leaving foster care (that has many appointments), suddenly there is nothing to engage them, and life skills development. She said that OCS has an independent living program that does great, but it doesn't have enough resources. In closing, she asked the panel to each tell them one thing that helped them succeed as an adult. MR. VALLE said one thing that helped him succeed as an adult is that he had one person who helped him no matter what. Stephanie Day was and is always there for him - "She helped me with everything." MS. DAY said she was fortunate enough to have family, but not all foster youth that age out have that. More support is the one thing that helped her succeed. MS. METIVIER said that more financial support to the OCS Independent Living Program is the primary thing kids need after aging out. CHAIR DAVIS said she wants the public to know that the legislature is not just listening, but planning how it can take action. She said the House and Senate have introduced SB 105 and HB 126 to address some of these issues. 1:55:35 PM MR. PECORA underscored the importance of very focused independent living skills as children leave foster care. They also need to recognize that when kids are placed more permanently with families they are more stable, and those connections set them up for success. 1:59:08 PM BARB DEXTER, Anchorage School District, said they worked with the McKinney Vento Liaison since 1993 on the Anchorage School District's Child in Transition Homeless Project. She explained that the McKinney Vento Public Assistance Act is the primary piece of federal legislation dealing with education of children and youth experiencing homelessness in U.S. public schools. It was reauthorized as Title 10, Part (c) of No Child Left Behind in January 2002. The McKinney Vento Act deals with a group of about 100 homeless children and youth like Mr. Valle was talking about, as well as kids awaiting foster care - where a placement wasn't available. Youth who age out of the program at 18 sometimes move into shelters because another foster care placement isn't available even though they aren't out of high school yet. So, they started a dialogue in 2000 with the local OCS office to talk about areas of overlap and, with the help of Casey Family Program, they have developed a committee called The Education and Foster Care Committee that works with the court services, OCS, the school district, and a number of other agencies dealing with foster care in Alaska to talk about these upcoming issues. 2:01:15 PM BETH SNYDER, Anchorage School District, added that today's panel had spoken eloquently about how frequent moving affects youths' success or lack of it. The educational impact of each school change is significant and disruptive; they may lose days or weeks of school in the process. She said positive gains have been seen by helping kids stay in their school of origin. 2:03:26 PM MS. DEXTER added that tailoring programs to meet the specific needs of older youth so they obtain a diploma is important, things like making sure records follow. 2:04:29 PM MS. SNYDER said that transportation is a key component of insuring school stability and that is a cost their district has taken that on related to McKinney Vento, but that isn't true everywhere. MS. DEXTER said that McKinney Vento mandates her district to provide transportation to schools of origin, but no McKinney Vento funds are provided to do that. In addition, there is specific need for [indisc.] to recognize the special population such as children in foster care. She emphasized that school stability helps them achieve placement stability. 2:06:23 PM REPRESENTATIVE GARA said he appreciated Ms. Snyder's and Ms. Dexter's efforts in this area. CHAIR DAVIS appreciated their concern and advised them that legislation is under way, but she recognized, as well, that the funding just isn't there. She said she hopes there will be money in the stimulus package for transportation. 2:08:00 PM MS. SNYDER commented that they have seen students who fall under the McKinney Vento have a higher incidence of staying in their foster placement when they can be kept in their school of origin. 2:08:53 PM JOHN HENDERSON, U.S. Department of Health and Human Services, Children's Bureau in Region 10, introduced himself. TAMMY SANDOVAL, Director, Alaska Office of Children's Services (OCS), Department of Health and Social Services (DHSS), introduced herself. MR. HENDERSON encouraged the committee to read the Children and Family Service's final report that came out last week for which he would provide the highlights. He said the review was done in Alaska on 9/8/08, and says the state has 90 days to develop a program improvement plan (PIP) to correct the areas that aren't in conformity with national standards. The plan through regulation has to provide PIPs for each non-conforming element for each of the case review outcomes as well as the systemic factors. In addition, certain areas have to be prioritized in the plan, and the first one has to be child safety. He said they recently came out with a new technical bulletin that is more specific about the amount of improvement that must be made as well as which items need a quantifiable performance goal that can be measured over the course of the PIP. The state did well in case review item 5: foster care re-entry at a 91-percent strength. That means that 91 percent of the kids who come into the foster care system and then returned home didn't go back to foster care. This is good, but it has been found that reunification takes longer in Alaska than the national standard would expect. He cautioned that to sustain the good reentry rate, kids can't be returned home too soon. Another area the state did well in (90 percent or better) were item 11 - proximity of foster care placements, and item 12 - placing siblings together. This has to do with Alaska's practice of using relatives for placements. Often these placements turn into permanent placements where Alaska also has a good showing. Alaska was also found in substantial conformity with its data system, known as ORCA. This is a very important data collection tool for management and supervisors to get feedback on their performance. MR. HENDERSON said other areas need improvement like safety, terms of content and the timing of the PIP. Timeliness of investigation, at 56-percent strength, is another area that needs improvement. The state does pretty well with emergent response investigation and less well with those responses that don't require that emergent response time. Repeat maltreatment, at 81 percent, needs to be addressed significantly as well. Safety 2 has a couple of areas; item 3 - Services to prevent removal from home is at 51 percent strength. Item 4 - Risk of harm at 39 percent - speaks to the state's ability to ameliorate the risk to a child in being placed out of the home. 2:19:07 PM MR. HENDERSON said another outcome area, permanency 1, has the most challenges even though some areas have some strengths like (item 5) reentry and stability of placement (72.5 percent). He pointed out that the state needs to find out what the contributing factors are so that strategies can be designed through the PIP process to focus on those areas. The rest of the items in permanency 1 have to do with establishing the permanency goal in a timely way (at 45 percent). He explained that the state was usually pretty good about establishing a permanency goal at the beginning of a case, but as it goes along, the goals often weren't re-evaluated. When they are talking about performance indicators, the Child Welfare Agency must work in partnership with the Court Improvement Project and the courts at large to see any improvement. 2:21:36 PM Timeliness of reunification was at 33 percent and they looked for that to be achieved within one year; adoption was at 18 percent and they looked for that to be achieved within two years. Other planned living arrangements associated with older youth scored 60 percent, much higher than any of the other goals in the review process. Proximity in placement with siblings had a good showing at 90 percent. Children having an opportunity to visit with parents was at 62 percent, preserving connections with parents was at 83 percent, relationship of a child who is in care with the parent is at 47 percent. One other outcome that is very concerning is wellbeing 1. A couple of areas were 19 and 20 - case worker visits with children and case workers visits with parents. Those outcomes are at 23 percent. The state has started working on that already, which is good. 2:24:12 PM Education scored at 76 percent (as opposed to 95 percent standard). Physical health was at 71 percent; mental health was at 55 percent. Again, he said, resolving these issues will take collaborative relationships between the community and the child welfare system. 2:25:11 PM In addition to the outcomes, seven systemic areas were addressed in the report. The ORCA system is one; all of the others including case review, quality assurance, staff training, services array, agency responsiveness to the community, foster parent licensing and recruitment need improvement. The case review is one area that they really want to work on with the state. This has to do with court proceedings and hearings including administrative hearings. Quality assurance has a very good case review process in place, but he has observed a greater need for a circular QA system feeding from ORCA to management and back to the field. MR. HENDERSON said the area of training has some geographical challenges as well as staff turnover and capacity challenges. In the area of services array the state relies substantially on capacity and resources in the community. Agency responsiveness to community was good at the local level, but the state had no formalized process that incorporated the work that was being done at the local levels to feed into the state planning process. He said that foster parent licensing and recruitment had a number of practice applications for licenses with variances and some issues around timeliness of completing criminal history checks will be addressed more emphatically; the PIP to address th these issues is due on May 4. 2:29:21 PM MR. HENDERSON said they are encouraging attention to the areas of implementation of the safety model, the process to go along with the quality assurance and monitoring, assessment and case planning practices and policy, worker contact, system capacity around workforce, supervision and staff training and QA. He summarized that Alaska is looking at a tremendous number of things on their federal plate - its PIP which is due May 4th, a children and family services plan due June 30th with a one-year report as well as a five-year prospective plan, and secondary federal Title 4E (social services statute about funding for foster care maintenance and administration) review in July. This will be tough to get done. Again he encouraged everyone to look at the report online. 2:31:23 PM MS. SANDOVAL thanked the youth who spoke to their situations here today. This kind of feedback is necessary to improve the process, she said. 2:34:43 PM With regard to the Child and Family Services Review (CFSR), she said, while they aren't meeting the standard of 95 percent, progress has been made with placement stability. Now the gaps need to be identified. Thankfully ORCA can help provide that kind of data. MS. SANDOVAL noted that the practice model and safety decision making model have improved some, though not enough, particularly on repeat maltreatment rates. It's true that implementation of the practice model has been slow. The federal government asked states and tribes to meet last week because implementation centers were put in place around the country to help with systems reform; and that has been one of the missing pieces. Staff turnover has made that hard. She said this review can build on the last one and real progress can be made especially with ORCA data. Front-line workers have improved worker visits up to 55 percent in January and 60 percent in February. 2:39:11 PM MS. SANDOVAL said there is no work you can do without first visiting the child and family; so it all starts with worker visits. She was glad Mr. Henderson mentioned "service array" because it isn't all just OCS; it's all of the agencies and the legislature that make a difference. She said the commissioner has brought together the divisions and encouraged collaboration, and later today a workgroup on youth transitioning out of care will meet. 2:41:36 PM In closing, she said, the PIP has started with over 50 participants coming to the PIP kickoff in January. Providers with strategies and ideas about how to improve the system formed work groups around the three themes established by the federal government to standardize practices for enhanced safety, for enhanced permanency planning, and for enhanced capacity of families to provide for their children's needs. What has been presented today are all things they must continue to be aware of going forward. 2:44:29 PM CHAIR DAVIS agreed that child safety and home visits are areas the legislature will want to hear more about and noted improvements in the turnover rate. MS. SANDOVAL said the extended training has just started and she hopes that will continue to help improve the turnover rate. 2:45:42 PM REPRESENTATIVE GARA vented that one reason for the turnover and the fact that the OCS can't meet with families every month is because it doesn't have enough stable staff and the positions don't pay enough! He asked what the of the administration's salary review is and if that is on track for this fall. MS. SANDOVAL replied that whenever she asks the administration about the review, she is told that it is on track. REPRESENTATIVE GARA said Senator Davis had long pushed for extending foster care until age 21, and now there is federal money to do that. That could be part of the solution, and they have talked about extending housing assistance payments for one year after coming out of foster care. He knows OCS is cash- strapped, but he wanted to know what they are doing about the mentorship idea. MS. SANDOVAL replied that she knows that type of partnership is needed, and there isn't one answer to his question. She believes that expanding the pool of foster homes and making good matches is a good start, like with relative placements and fostering success in those placements. 2:49:57 PM Additionally, she said, it's the involvement of other people - clubs, school employees, social workers; there isn't just one solution. Think about "forever families" as communities and that it is all about building relationships. 2:51:48 PM CHAIR DAVIS said she is sorry she didn't invite any case workers or social workers to join them. She feels they need to have conversations with them too. She invited Commissioner Hogan to speak. 2:52:55 PM COMMISSIONER HOGAN, Department of Health and Social Services (DHSS), thanked all for their presentations. He related that the bottom line for them is making sure kids stay in their own families unless they really need to be removed, and if they go into foster care that they go to quality foster care homes that create a real family, and that when they leave they have opportunities to become productive citizens. The department needs to use what they know works based on evidence-based or best practices. COMMISSIONER HOGAN said his background is in behavioral health and what youth with serious emotional disturbance and adults with chronic mental illness need is a connection to somebody - family and community. Extracurricular activities and sports are also important, especially for kids in foster care when their lives are very structured. He also appreciated Representative Gara's emphasis on independent living and school stability and hoped the Anchorage program could be expanded statewide. He expressed his thanks to people in OCS who talked about their experiences saying, "It's a tough job." But it is incumbent upon the state to ensure the OCS people can do their jobs. 2:56:33 PM SENATOR PASKVAN said this is a new area for him and what he learned today is that the system is trying to improve. He heard that children need first to have a human connection; they need to remain in a school or have their records follow them; and they need a chance to succeed as they age out. 2:58:17 PM CHAIR DAVIS thanked the youth who came forward today and reminded them that they have other avenues than the social workers they have worked with over the years. "We're here to help you. There are 60 members of the Legislature and every one of them would be willing to hear some of the concerns and issues that you want to address." 2:58:58 PM REPRESENTATIVE GARA thanked the people from Facing Foster Care and Senator Davis who has taken up the mantle of children's issues for way longer than he has. "This wouldn't have happened without her." He said it is not a coincidence that there has been more discussion about the need for reform in the state. The new organization that has been created by Alaska's youth is the new catalyst that has made it all happen. 3:00:14 PM There being no further business to come before the committee, Chair Davis adjourned the meeting at 3:00 p.m.