The4th meeting of the Subcommittee on Families and Children of the Interim Joint Committee on Health and Welfare was held on Monday, December 17, 2007, at 10:00 AM, in Room 131 of the Capitol Annex. Representative Tom Burch, Chair, called the meeting to order, and the secretary called the roll.
Guests: T.J. Delahanty for the University of Kentucky, Cooperative Extension Service; Joann Lianekhammy for the Department of Community Based Services; Brenda Chandler and Dr. Steve Davis for the Department for Public Health; Michelle Woods for the Office of the Secretary of State; Nikole Worke for KDLA; Carol Baughman for the Kentucky Department of Libraries and Archives; Jessica Amburgery, Student; Cherie Graham, parent; Rebecca DeJarnette for Youth Enhancement Services; Ken Schwendeman for the Justice and Public Safety Cabinet; Jason Dunn for the Department of Community Based Services; Patrick Yewell for the Administrative Office of the Courts; Pat Dudgen for OEH, Cindy Heine for the Prichard Committee; Ed Monahan for the Catholic Conference of Kentucky; Nancy McKee for Wyeth; Bill Cooper for the Department of Aging and Independent Living; Brigitte Ramsey for the United Way of Greater Cincinnati; Marla Montell for the Cabinet for Health and Family Services; and Patty Dempsey for the ARC of Kentucky
LRC Staff: DeeAnn Mansfield, Ben Payne and Cindy Smith.
The first item on the agenda was a presentation on the outcomes of the HANDS program from Dr. Steve Davis, Deputy Commissioner, Department for Public Health and Brenda Chandler, Coordinator of the HANDS program. Dr. Davis said that the HANDS program is a voluntary home visitation program for first time at-risk parents regardless of income. He said that the program started with 15 pilot programs in 1998 and expanded to all 120 counties by 2003, and that HANDS is funded with $8 million in tobacco settlement dollars allocated to the early childhood development fund. He said this $8 million yields $20 million in federal matching dollars through the Medicaid program. He said that program participation can be prenatal until the child reaches 2 years of age. and that the goals of HANDS is to have positive pregnancy outcomes, optimal child growth and development, safe homes for children, and to improve family self sufficiency. Dr. Davis also presented data showing that HANDS participants have fewer premature births, fewer birth defects, lower infant mortality, lower emergency room usage, less child abuse and neglect, and greater family self-sufficiency that non-HANDS participants in Kentucky, and in the country overall. He said that the Kentucky HANDS program has been recognized nationally by receiving the only grant nationally from the March of Dimes and the Johnson and Johnson Company to study ways to prevent pre-term births.
Cindy Heine, Associate Executive Director, Prichard Committee for Academic Excellence and Edward Monahan, Executive Director, Catholic Conference of Kentucky testified in support of the HANDS program and its expansion to include 3 year olds and all births, not just first births.
Senator Stine asked what the main causes of low birth weight babies are. Dr. Davis said that tobacco use is the single, most preventable cost. Other factors are substance abuse and physical abuse.
Senator Stine said the link between tobacco use and low birth weight babies is an easy way to justify using tobacco settlement funds for early childhood programs. Dr. Davis said from the beginning, 25 percent of the master settlement money went to early childhood programs. He feels there needs to be an expansion in the allotted money for the program as soon as it can be.
Senator Stine asked how information about the HANDS program is disbursed. Dr. Davis said that state and local health departments use all means possible to get the word out about HANDS to anyone that would benefit from the program. If doctors have patients that would benefit from the program, all they have to do is place a call to their county health department, which in turn follows up with the patient.
Senator Stine asked what the percentage of Medicaid recipients is in the HANDS program. Dr. Davis said about 88 percent of them are Medicaid recipients.
Representative Burch stated that in the past few sessions, legislators have tried to allocate money that goes to the HANDS program to other areas, and said that the money must be left intact. In fact, he would like to see it increased and he can't think of a better need than the HANDS program.
Next on the agenda was a presentation on the report required by 2006 Senate Joint Resolution 184 which established the Kentucky Youth Development Council by TJ Delahanty, Youth Development Specialist, University of Kentucky, Commissioner Mark Washington, who served as chair of the council, and Jessica Amburgy, staff for the council. Mr. Delahanty said that the Kentucky Youth Development Coordinating Council (Council) was created by the Cabinet for Health and Family Services after the passage of Senate Joint Resolution 184 in 2006. He said that the strategic plan of the council is "Maximizing our investment in the young people of Kentucky to ensure that they are prepared to be healthy, successful and productive citizens of the Commonwealth". He said that the Council was created to allow all state programs that provide services to young people to work together to use existing resources more efficiently and effectively to improve services and outcomes for young people focusing on the following four areas: coordination, accountability, quality and opportunities. He said that the council and support staff have connected the identified statewide programs that serve young people ages 8 to 24 to an online resource center that will become the Kentucky Youth Development Clearinghouse. He said that the Clearinghouse will become a resource for youth, parents, and professionals that will describe the work of the Council and connect citizens of the Commonwealth to all the statewide youth services, best practices, youth program standards, quality improvement assessment and improvement tools and training and professional development opportunities.
Commissioner Washington said that the council will include in its annual report to the Governor and Legislature a recommendation to create an infrastructure to support the Council and its activities with a dedicated budget sufficient enough for full time staff for the Council, for the Kentucky Youth Development Clearinghouse, provide youth development training and technical assistance and research to demonstrate and improve the quality services for young people. He said that a Center for Youth Development that will provide the infrastructure of the Council to effectuate its vision.
Representative Burch asked if there was any duplication with the 101 statewide programs. Commissioner Washington said that each of the 101 programs resulted from a need from youth. He noted that there is probable duplication in some areas and that there is possibly non-use of some of the programs. He stated those are two of the reasons that a center would be so valuable.
Next on the agenda was a presentation on the report required by 2007 House Joint Resolution 137, by Sandra Brock, Executive Director, Office of the Ombudsman, Cabinet for Health and Family Services House Joint Resolution 137 directed the cabinet to provide resources and support to track and report on trends in the receipt, review, and resolution of citizen complaints about child protection programs and services. Ms. Brock presented the complaint resolution flowchart showing the process through which citizen complaints move through the system. She indicated House Joint Resolution 137 authorized the ombudsman's office to track all complaints against each family service worker and supervisor by county and report any occurrence of ten or more complaints for a single county within a six-month period. She said that the cabinet is required to investigate these reports. She reported that the office received 3,421 citizen complaints for Protection and Permanency from October, 2006 to October, 2007; 221, or 6 percent were justified and corrective action plans were prepared and that the number of justified complaints rose from 25 in October, 2006 to 131 in October, 2007. She said that the southern Bluegrass region had the highest number of justified complaints, 60, and the highest number of unresolved complaints, 34. She explained that unresolved complaints are those where the regional administration of the Department for Community Based Services does not agree that a complaint has merit and that the complaint is then reviewed by the central office of the Department for Community Based Services for further consideration. Ms. Brock indicated that 2007 House Joint Resolution 137 improved the office's ability to effectively investigate and resolve complaints. She indicated that the Ombudsman's Office may be more effective if it had the authority to push for more immediate resolution of justified complaints.
Senator Buford asked if it is possible that the program is underutilized and he asked how the 800 numbers are posted for the children. Ms. Brock said the numbers are posted in all the DCBS offices. Senator Buford stated that he thought the program would be more utilized if the numbers were more easily accessible to the children that may need to call.
Representative Burch asked if Ms. Brock had any ideas for how the Ombudsman's office could run more smoothly. Ms. Brock said it is very important that the Ombudsman's staff report directly to the Cabinet secretary. She also said there are cases when it would be better if more than just suggestion could be made as far as the outcome is concerned.
Representative Burch asked if there are problems in long-term care homes if the owners are talked to first before anything is done. Ms. Brock said that is what is always done because they hope to resolve the issues before closure of the home is necessary. She indicated that more information will be presented on long-term care homes during the Interim Joint Committee on Health and Welfare meeting in the afternoon.
The meeting was adjourned at 11:35 a.m.