Last Post for Dewey

People of the world!

Today is the LAST day of the 2^nd session of the 26^th Alaskan Legislature!  I have enjoyed working here in Juneau very much, and would wholeheartedly encourage other inquisitive minds to come check it out here, either as a constituent, or most spectacularly as a First Alaskans Institute Public Policy Fellow! 

For me, one of the most enlightening things about working here is just being able to learn about and understand some of the real impacts all of the people coming in from throughout the state effectively have on public policy.  Surprising for me to learn when I first got here was that for the most part, our legislators are very open and receptive to visitors, especially if they are from their home districts.  
           
            For example, somebody called in about an important borough wide issue
            concerning mining in our district, and my boss immediately got on the radio to
            speak about it and create some discussion around that particular issue.  Although
            he is physically removed from the on-the-ground happenings while session is
            going on, he is still in touch enough to have community members, not just paid
            lobbyists, to call him up and tell him what’s important and going on at the
            moment as well as longer term projects.  

Other things I have enjoyed include meeting with people to hear about genuine concerns to their family, community, and groups of people as a whole.  One day last month I met with someone who was advocating for greater quality and success in the foster care system.  She was telling me some statistics gathered through Alaska Kids Count, how 65% of youth in foster care currently are Alaska Native (on the rise from 62% at last count), and Alaskan youth under 18 make up only 15% of the state’s population.  These statistics emphasize and show the VERY REAL need for quality work in tribal child welfare efforts. This is just one of the several moments here in the capitol building that crafted my experience here in a short 15 week session.

The truth is there are several anecdotes I would like to share with the group and those interested in learning more, because this has honestly been quite an incredible experience, but time does not allow, and since it is now currently 12:11am on April 19, technically we are past the timeframe which the legislature has agreed to conform to in these recent years.  So time has run out.  Hopefully as a group, we’ve been able to give blog followers some insight into the process of living and working down in Juneau in the “belly of the beast” of state government, and that it has been somewhat insightful.  With that, I will say, take good care, see you again, until I see you again, au revoir, chau!

 

Nikoosh: Public Policy in DC

Way back in March I dropped a brief line about being in DC, see Energy and Collaboration post. There were promises to devulge all the details later but alas this session has been busy and you know the rest of the story… With only a day left in this year’s legislative session, I am on my way back to Juneau from another trip to DC, the epicenter of public policy.

I have been in the application process for a Science + Technology Policy Fellowship with the American Association for the Advancement of Science (AAAS). In March, I had to prepare a memo on the public’s concern over the link between autism and vaccinations and present the memo to a large panel of interviewers. Most of the stress over the memo was actually creating it and getting it turned in a week before I made the trek to DC. I practiced my 5 minute presentation and answered hypothetical interviewer questions the two days before my 30-minute panel. It was nice to feel as though I rocked that presentation and then get confirmation of that when I was invited back for a whole week of interviews.

Washington, DC::March 2010

This was good and bad news; on one hand it was a great opportunity that had the potential to help me transition to a career in policy and on the other it meant that I was going to miss the culmination of all the hard work we had put in these last three months. The choice was clear. I need to go and off I went to our Nation’s capital in an attempt to wow policy world with both my policy and scientific experience.

In all, I had some 8 interviews over the course of 5 days. Some of those were follow up interviews at my top two choices – not that my declaring my top choices matter much.

Now I am just waiting. Seems like this was not unlike last week at the Capitol building – there was a lot of waiting. Waiting for bills to be called up in Finance. Waiting for late night floor sessions. Waiting for bills to be transmitted from the other body. Life is good and often involves waiting.

Countdown T-Minus 6 Days!

We have started the last week of the session! I can already tell it’s going to be a crazy week. It’s approaching 8:00 PM and all the Reps. are still on the House Floor voting on different bills. Right now the House just passed HJR 42 which amends the Alaska State Constitution and establishes a transportation infrastructure fund. Following the floor session, House Finance will meet and hear SB 222. Good thing our office ordered take-out for dinner.

Last week I was able to witness the release of the Senate version of the state capital budget: SB 230. This is a very anticipated bill because it includes all the projects in the state budget related to construction and infrastructure development. Money is allocated for various items such as the purchase of heavy equipment, road refurbishment, feasibility studies for community halls, to dock construction. We spent a lot of time in Senate Finance waiting for the 104 page bill, and once it was released, spent the rest of the time scouring the document identifying projects in District 36. The bill will now cross over to the House and undergo further scrutiny.

Spring is definitely in the air. This weekend I was able to enjoy the last weekend of snowboarding at Eagle Crest. Look at that sunshine!

Another thing I have been able to do is hike around Juneau. It is pretty amazing the mountains you can ascend so close to downtown. Last weekend I hiked up Perseverance trail which was one of the first roads in Alaska. Juneau was one of the first big mining towns and all over the city you can see remnants of times past.  Everytime I reach the top of a peak, I am so in awe of the view. It’s just amazing! Below is a picture of me overlooking downtown Juneau from Mt. Roberts.

In my last post I mentioned I was presenting to the House Fisheries Committee. Below is a picture of me presenting HCR 15 to the committee. I was anxious all week but I think I did OK maintaining composure…and not fainting. 🙂

I am very excited about the coming week and looking forward to going home. It will be nice to see my family and everyone else in the community. I have to say, it will be a little sad to leave the little life I have built here and the routine I have established, but like they say, “A rolling stone never gathers moss.” Until next time, Charisse signing out!

Nikoosh: History of Overhauling Health Care

I cannot resist sharing this great time line of health care reform in the U.S. Thanks NY Times for getting fancy with the flash media.

History of Overhauling Health Care, NY Times 2010

Nota Bene:

• The last major health reform legislation became law in 1965 and it created the Medicare + Medicaid Programs.
  • signed by Pres. Johnson, idea originated from Pres. Truman
  • Highly controversial, this piece of legislation was attacked then as being socialized medicine.
  • For more details, see NY Times Article — A History of Overhauling Health Care: Nearly 100 years of legislative milestones and defeats or click on the image above.

Nikoosh: National Health Care Reform Bill

The federal health care reform bill has the talk of the nation in March. As someone who has specific interests in health care policy, a relevant Ph.D. (neuroscience), and a boss who is the co-chair of the Health and Social Services committee (HSS), I spent quite a bit of time reviewing the health care bill. HB 423, heard in HSS and Judiciary committee, aimed to establish public policy that would eliminate the requirement for individual mandates in the state and HSS also held a caucus that provided a great overview of what the Patient Protection and Affordable Care Act would be requiring the state to do in the next 10 years.

Over the next year a lot of changes will occur and I think that makes people uncomfortable and resistant. But we have embrace change, innovation, and collaboration as a way to build a better future for our children and grandchildren. Learn a bit more about the changes with this short synopsis of HR 3590:

U.S. Capitol building on the night of Health Care Reform, March 2010

• The Patient Protection and Affordable Care Act (HR 3590) signed into law on Tuesday, March 23, 2010 is the first major piece of health reform legislation since 1965.
  • Reconciliation bill Health Care and Education Affordability Act of 2010 (HR 4872), amended HR3590 March 25, 2010.
• The recently passed HCR bill is very similar to a Republican health reform bill, S 1770, which was introduced in 1993 as an alternative to Pres. Clinton’s proposed employer mandated health care plan.
• S 1770 was considered major reform and included the following similar principles[1]:
  • Individual mandates requiring everyone to have health insurance.
  • Prohibited insurance companies from denying coverage for individuals with preexisting conditions.
  • Established purchasing pools so individuals and small businesses could pool together to lower premiums.[2]
  • Extended health care coverage by including a shared responsibility requirement for both individuals and employers.
  • Set a minimum benefits package.
  • Measures to make the health care system more efficient.
• S 1770 was introduced by Sen. John Chafee, R-RI, and co-sponsored by 21 senators[3].
  • They included Ted Stevens and current GOP Sens. Robert Bennett (Utah), Chuck Grassley (Iowa), Christopher Bond (Missouri), Orrin Hatch (Utah).

Health Care Reform in Alaska[4]

Birdhouse - AK recycled

• Once the growth rate of health care costs are slowed, it will be more profitable for businesses to expand employment – creating 700 – 1,200 new jobs in AK each year.
• Improves Medicare benefits for 59,400 Medicare beneficiaries in Alaska.
• 10% payment bonus for primary care providers who treat Medicare patients.
  • Idea from Sen. Charles Grassley (R-Iowa), Sen. Begich (Holmes + Gara) also worked on this provision.

Increases financial investment in Alaska Community Health Centers. More than 80,000 Alaskans make more than 300,000 visits to CHCs each year.

---

[1] Republicans Spurn Once-Favored Health Mandate, Julie Rovner, Morning Edition, February 15, 2010. Accessed online www.wbur.org/npr/123670612, March 30, 2010.

[2] Paul Starr, What Happened to Health Care Reform? The American Prospect no. 20 (Winter 1995): 20-31. Accessed online, www.princeton.edu/~starr/20star.html, March 30, 2010.

[3] Health Insurance Reform Mythbuster – ‘Democrats’ Health Insurance Reform Is Socialism and a Government Takeover’, Speaker Nancy Pelosi’s website, March 19, 2010. Accessed online, www.speaker.gov/newsroom/factcheck?id=0150, March 30, 2010.

[4] Health Reform in Alaska: Here’s What the New Law Means, U.S. Senator Mark Begich, Spring 2010.

Ultramafic and Serpentine What?

This past Tuesday was a very exciting day in the Joule office.  Four committee hearings in one day, three on the House side, and one accompany bill on the Senate side, made for a busy weekend and overall week.

The bill that I was tasked with carrying, or paving the way for and doing my best to ensure expedient  passage through the legislative process, is called HB 333 – An Act Related to Naturally Occurring Asbestos.  This bill was introduced earlier in the session, and along with reading reports and assisting with teleconference meetings, I had the opportunity to testify on the record for the House Transportation committee.  I had been following another house bill the previous two weeks, so I was familiar with the general mood and operation of the seven member committee.  They are generally a jolly and chat worthy bunch, even with a bill as unusual as this one.  

This was a bit of a contentious bill, because it publicly aired some of the recent shortcomings of big government agencies in meeting the needs of rural Alaskans exposed to health threatening levels of asbestos which put critical state projects such as road maintenance and airport rehabilitation particularly in the community of Ambler east of Kotzebue in the NW region of our state.  Ambler has been trying to address this problem since it was first discovered by routine soil testing in 2003.  The three sister agencies the Department of Environmental Conservation, the Department of Transportation, and the Department of Health and Social Services have experienced “pointed and unfriendly conversations” on the standard operating procedures related to dealing with Naturally Occurring Asbestos (NOA).

So, I walked through the main points of the bill, emphasizing the overall importance not just to communities such as Ambler in our district, but statewide.  Why doesn’t the state address these needs now and figure out a way to deal with NOA before heavy construction projects (Road to Nome, or Big Natural Gas Pipeline anyone?) are put into motion.

This was definitely a learning experience for me. I didn’t even know that asbestos was pushed up from mineralogy in certain areas.  In rich mineral areas where ultramafic and serpentine ore occur (hah, say that five times fast!), where we find jade and limestone, zinc, copper, gold, we also find harmful substances like NOA.  Thanks go out to our super staff for prepping me with over 10 mock committee testimony sessions!  I was confident and feeling good, thanks to intense preparation and a great team!  The bill was passed out of Transportation committee and may be heard in finance before the session ends.  What’s important is that the three agencies who must work to deal with this problem, committed on the record and together to address this problem and find solutions for Ambler by June 1, and develop Standard Operating Procedures (SOPs) in the near future.  Let’s hope decision makers from those agencies keep their word and collectively deal with this issue now! 

Nikoosh: Air is a little warmer…

days are a little longer.

A brightly colored crocus near the Capitol Building.

Nikoosh: House Bill 392 – Direct Incentives for Medical Providers

Last week on March 23rd and the 25th a bill that I have been working on was heard in the House Health + Social Services Committee. The bill is scheduled to be heard in House Finance Thursday, April 8th.  I will be reviewing my testimony and doing a bit of fiscal note studying this weekend. In the meantime, here is my sales pitch for HB 392!

View of a neighboring peak from Mount Roberts' Trail, Juneau AK; picture taken by TEB 04.02.10.

HB 392 (Sponsor Representative Herron) is the house companion to Senate Bill 139 (Sponsor Senator Olson). These identical pieces of legislation propose a program that would help recruit medical providers to areas of health care shortage. Alaska has long faced a heath care provider shortage, which is expected to worsen. The lack of health care providers is apparent in urban and rural regions across the state (see table 1).

Table 1. Estimated Vacancy Rate for 4 Medical Professions in Urban vs. Rural Areas:

Estimated Vacancy Rate:	Urban	Rural
Registered Nurse	6.9%	16.1%
Family Nurse Practitioner	13.3%	36.4%
Dental hygienist	3.6%	10.0%
Physical Therapists	13.5%	31.6%

Data from Alaska Health Workforce Vacancy Study Research Summary (2007), by Alaska Center for Rural Health

• HB 392 creates a support-for service program in the Dept of Health and Social Services that would be directed by the Commissioner and an advisory body.
• Support-for-service programs are successfully used in 44 states to recruit and retain a competent and sustainable health care work force.
• The bottom line is that financial incentives of various types – loan repayment, moving costs, housing assistance and tax breaks – can influence a provider’s decision to practice in Alaska.
• HB 392 will provide a combination of loan repayment or cash incentives for up to 90 applicants per year in 10 different health care occupations.
•  The amount of monetary incentive will vary with each slot, according to the category of health care provided and the location.
• The advantages of this program are that we can recruit both early career and experienced, mid-career professionals due to the program structure combining loan repayment and direct incentives.
• Once HB 392 goes into effect, it will immediately begin to remedy the shortage of health care professionals within the state of Alaska.

Already April!

IN THE BUILDING

Great news!  Last Thursday, the House of Representatives unanimously passed the resolution I’ve been working on, HJR 48, which asks for the passage of two Congressional bills that would increase funding for programs that help victims of crime.   Right now I am preparing for next Wednesday, our office has two bills back to back that were referred to Senate Judiciary.  I feel way better about presenting this time around, the Finance committee can be intimidating, especially for the first time carrying a bill. 

This week was a pleasure for me because Senator Mark Begich was in Juneau to address a joint session of the state Legislature.  I thought he had a lot of good things to say and it was nice being able to catch up with his staff who I haven’t seen since last fall when I was an intern in the Senator’s Anchorage office.   Read more: http://www.adn.com/2010/03/31/1206875/begich-addresses-joint-legislative.html#ixzz0jzL0is0k

Another very cool thing to happen was meeting hockey player Kerry Weiland who won a silver medal at the Olympics.  She let me hold the medal, which it was heavier than I expected, good for her and AK!

 IN JUNEAU

Last Friday, the other fellows and I went to the Gold Medal Basketball tournament to help with outreach efforts for the 2010 Census, the energy at the tournament was amazing.  Between games and before the final semi-final game, our group talked to the crowds about the importance of the Census for our communities.  It was fun for all of us to be there!  If you haven’t already, please fill it out and send it in!  “I am Alaska Native and I COUNT”

Personally, I am very excited for the historical national health care reform legislation getting signed into law.   This is going to bring a lot of positive changes to Alaska!

Charisse: Laws and Sausage making

At this stage in the session, I’ve spent a lot of time sitting in on different committee hearings as bills are heard, testified on and passed on to other committees. I have been able to listen to testimony, amendments being offered, adopted, and amended a second time. This process reminds me of a saying:  

“Laws are like sausages. It is better not to see them being made.”  

Prior to this fellowship all I paid attention to were the laws that affected me, which is very limited in scope. Furthermore, I did not think about the process behind it. My time here has given me the opportunity to get an inside look at policy making and the arduous undertaking required. I have to say I have a new profound respect for the policy-making process and the people behind it. The one detail to ensure is that sound policy is being created. Good policy creates public value, benefits organizations/individuals, and examines long-term intended and unintended consequences. As I reflect on state and federal policy, I know that I don’t agree with all of it. I take solace in the fact that policy is ever-evolving and often needs to be changed to be relevant to our world today.  

Hopping off my philosophical soap box…  

It’s hard for me to believe that my time in Juneau is steadily coming to an end. We’ve completed 10 weeks and have 3 to go. That’s nuts! In these last three weeks, our office will need to stay on our toes as House Finance meets twice a day and floor sessions occur everyday. I learned it is important to pay meticulous attention to any amendments being added to bills. Sometimes they can slip under the radar and become attached to the bill without many aware of it.  

Tomorrow I am going to be in the hot seat. I will be testifying in front of House Fisheries on HCR 15. I am nervous but looking forward to testifying in front of a committee. I can only hope my preparation efforts pay off.  

I wanted to share a few accomplishments over the last few weeks:

1. Successfully running a 10k (6.2 miles) with four other people in the building.
2. Helping name the best home-made salad dressing EVER with the title: “Legi Dressing.”
3. Hosting the ‘First Alaskans’ three point contest at the Gold Medal basketball tournament to bring awareness to the 2010 Census.

…Below are a few pictures taken over the last few weeks…  

The View from the 5th Floor of the Capitol.

Snowboarding at Eagle Crest - what a day! That 20 minute hike was worth it. 🙂

Charisse, Nikoosh and Barbara. A few of my fellow fellows.

So in closing, I think everyone should learn about policy making, and sausage making for that matter. Because you know…you are what you eat. Charisse signing out!