ALASKA STATE LEGISLATURE  SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  February 28, 2014 1:34 p.m. MEMBERS PRESENT Senator Bert Stedman, Chair Senator Peter Micciche, Vice Chair Senator Pete Kelly MEMBERS ABSENT    Senator Kevin Meyer Senator Johnny Ellis COMMITTEE CALENDAR  SENATE CONCURRENT RESOLUTION NO. 13 Urging the governor to establish and support programs designed to eradicate the occurrence of fetal alcohol spectrum disorder from the state. - MOVED CSSCR 13(HSS) OUT OF COMMITTEE SENATE CONCURRENT RESOLUTION NO. 14 Relating to health and social service best practice models and identifying citizen networks to achieve solutions to health and social problems in the state. - MOVED CSSCR 14(HSS) OUT OF COMMITTEE PREVIOUS COMMITTEE ACTION  BILL: SCR 13 SHORT TITLE: FETAL ALCOHOL SPECTRUM DISORDERS SPONSOR(s): SENATOR(s) KELLY 02/07/14 (S) READ THE FIRST TIME - REFERRALS 02/07/14 (S) HSS 02/26/14 (S) HSS AT 1:30 PM BUTROVICH 205 02/26/14 (S) Heard & Held 02/26/14 (S) MINUTE(HSS) 02/28/14 (S) HSS AT 1:30 PM BUTROVICH 205 BILL: SCR 14 SHORT TITLE: H&SS REGIONAL BEST PRACTICE MODELS SPONSOR(s): SENATOR(s) KELLY 02/07/14 (S) READ THE FIRST TIME - REFERRALS 02/07/14 (S) HSS 02/26/14 (S) HSS AT 1:30 PM BUTROVICH 205 02/26/14 (S) Heard & Held 02/26/14 (S) MINUTE(HSS) 02/28/14 (S) HSS AT 1:30 PM BUTROVICH 205 WITNESS REGISTER HEATHER SHADDUCK, Staff Senator Pete Kelly Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented changes to SCR 13 and SCR 14 on behalf of the sponsor. MARK HAMILTON, former-President University of Alaska Anchorage, Alaska POSITION STATEMENT: Provided information related to SCR 13 and SCR 14. ACTION NARRATIVE 1:34:33 PM CHAIR BERT STEDMAN called the Senate Health and Social Services Standing Committee meeting to order at 1:34 p.m. Present at the call to order were Senators Micciche, Kelly, and Chair Stedman. SCR 13-FETAL ALCOHOL SPECTRUM DISORDERS  1:35:02 PM CHAIR STEDMAN announced that the first order of business would be SCR 13. This is the second hearing on the resolution. On February 26 the committee heard from the sponsor, held public testimony, and set the resolution aside. The intent today is to adopt a committee substitute and look to the will of the committee. 1:35:49 PM SENATOR KELLY moved to adopt the CS for SCR 13, labeled 28- LS1398\N, as the working document. CHAIR STEDMAN objected for discussion purposes. 1:36:23 PM HEATHER SHADDUCK, Staff, Senator Pete Kelly, Alaska State Legislature, Juneau, Alaska, presented changes to SCR 13 on behalf of the sponsor. She said the difference between version N and the old version U can be found on page 2, line 1. Version U said that the state currently maintains a high quality screening for Fetal Alcohol Spectrum Disorder (FASD). Version N replaces that with "a high quality diagnostic system." Currently, there is no screening tool for FASD, but the state has a gold standard in the diagnostic system. 1:36:50 PM At ease 1:36:57 PM CHAIR STEDMAN asked if that was the only change. MS. SHADDUCK said yes. CHAIR STEDMAN removed his objection to adopting version N. There being no further objection, version N was before the committee. 1:37:32 PM SENATOR KELLY said the resolution came from an idea that cropped up in a Senate Finance Committee overview on the Mental Health Trust Authority. From that a leadership team was established which is pulling together an operational plan. He requested testimony from Mr. Hamilton. MARK HAMILTON, former-President, University of Alaska, Anchorage, Alaska, provided information related to SCR 13. He said he has been working on SCR 13 since last May. The team has come up with an executable plan. He named the components necessary when looking at FASD; early identification and trust. He related that the team has worked with the First Alaskans Institute that has an existing group of individuals that support village internship programs. The team will utilize them to help identify the kind of "go-to" person in every village, a person with close ties and trust of the people of the village. He provided a hypothetical example of how the natural helper might assist someone to find help via the Indian Health Service. He noted a combined study from UAA and UC-San Diego to research the acceptability of free pregnancy test dispensers in women's bathrooms in places that serve alcohol. These can detect pregnancy within about six days, and the fetus attaches at about 13 days. He stressed the importance of early discovery. If a healthy child is delivered, the state has saved about $900,000. 1:42:44 PM MR. HAMILTON explained an awareness media campaign, emphasizing the importance of social pressure. Another strategy is to target men to support women during their pregnancy. He said on the pregnancy dispenser will be a slogan, "If you know you are pregnant, we know you'll do the right thing." He pointed out that 90 percent of women who discover they are pregnant do stop drinking. 1:44:31 PM SENATOR MICCICHE asked about the importance of early intervention and the susceptibility of the fetus at early development stages. MR. HAMILTON stated that the data shows that it is "Russian Roulette." It depends on the timing of alcohol use because there are specific days of embryo development that are most damaging. Alcohol is one of the few reactants that dissolve the brain. He said four states have laws to remand pregnant women who drink during pregnancy. He suggested starting with developing a culture of intervention. CHAIR STEDMAN noted upcoming hearings on substance abuse issues. He requested a brief history of Mr. Hamilton's career. MR. HAMILTON shared his work history as the President of the University of Alaska and a 31-year military career, retiring as a Major General in the U.S. Army. CHAIR STEDMAN commented on his skills and unique position to help do away with FASD. 1:48:14 PM SENATOR MICCICHE said it does not surprise him that Mr. Hamilton would be involved in this issue. He shared a personal story. 1:48:58 PM SENATOR KELLY said that the topic of FASD "breaks your heart." He recalled a presentation about a baby that had brain damage from alcohol abuse. There is no hope after the effects of alcohol have done damage. He stressed the desperation to eradicate fetal alcohol. CHAIR STEDMAN noted one zero fiscal note from the Legislature. 1:51:11 PM SENATOR KELLY moved to report the CS for SCR 13 from committee with individual recommendations and attached zero fiscal note. CHAIR STEDMAN announced that without objection, CSSCR 13(HSS) is reported from the Senate Education Standing Committee. SCR 14-H&SS REGIONAL BEST PRACTICE MODELS  1:52:09 PM CHAIR STEDMAN announced that the final order of business would be SCR 14. He said this is the second hearing on the resolution. On February 26 the committee heard from the sponsor, took public testimony, and held the resolution in committee. The intent today is to adopt a committee substitute and look to the will of the committee. SENATOR KELLY moved to adopt the CS for SCR 14, labeled 28- LS1397\N, as the working document. CHAIR STEDMAN objected for discussion purposes. 1:52:29 PM HEATHER SHADDUCK, Staff, Senator Pete Kelly, Alaska State Legislature, Juneau, Alaska, described changes in SCR 14 on behalf of the sponsor. She said there are two changes in the resolution. On page 1, line 4, it used to say, "Whereas, the rate of alcohol-related deaths in the state is 185 percent higher." That was based on an older Alaska score card, therefore, the percentage has been changed to "152 percent" in version N, which reflects the latest score card. The second change is on line 6, "71 percent higher" is changed to "93 percent higher." CHAIR STEDMAN removed his objection. There being no further objection, version N was before the committee. 1:53:42 PM MS. SHADDUCK related that the resolution provides for natural helpers and the goal to create regional best practice models that the Governor and the Commissioner can put into effect. She concluded that SCR 14 provides a community-based solution. 1:54:28 PM CHAIR STEDMAN noted there was one zero fiscal note from the Legislature. SENATOR KELLY summarized that the resolution reflects the desire of the leadership team to not look to government, but to communities, for solutions. The leadership team intends to raise money from the private sector. Through the budget process, funds will be requested for developing the best practices and creating the networks. It is not designed as a government program, but recognizes the networks that already exist. The plan is to find the people who are addicted, and train and empower people who care and will reach out to them. He shared a story about the superintendent from Kotzebue who had identified a group of young people as those who others turned to. Previously, Kotzebue had six suicides per year, then a leadership team was formed and the number of suicides decreased to zero. He said similar natural helper groups exist in other regions. This summer helpers who can be identified and trained will be identified. Next, best practices will be identified. 1:59:22 PM SENATOR STEDMAN said there was public testimony previously. MARK HAMILTON, former-President, University of Alaska, Anchorage, Alaska, provided information related to SCR 14. He said community intervention is so much better than government programs. A study shows that the government agency is number 9 or 10 on the list of who to trust or go to for help. The elders are the natural helper group and will be accepted. SENATOR KELLY described a story from Representative Ben Nageak regarding how to get in people's faces when there is an important issue. 2:01:41 PM SENATOR KELLY moved to report the CS for SCR 14, labeled 28- LS1397\N, from committee with individual recommendations and attached zero fiscal note. CHAIR STEDMAN announced that without objection, CSSCR 14(HSS) is reported from the Senate Education Standing Committee. 2:02:18 PM There being no further business to come before the committee, Chair Stedman adjourned the Senate Education Standing Committee at 2:02 p.m.