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Trust Beneficiaries

Beneficiaries of The Trust include the following broad groups of individuals:

It is the duty of The Trust to provide leadership in advocacy, planning, implementing and funding of a Comprehensive Integrated Mental Health Program that provides services and programs to better the lives of Trust beneficiaries. The program also may include services for populations broader than The Trust’s beneficiary groups without expanding the beneficiary groups. For instance, the program may include prevention or early intervention services for individuals at risk of becoming Trust beneficiaries. The Trust considers prevention of these conditions, where possible, to be part of its mandate.

People with mental illness

Statutory definition [AS 47.30.056(d)]: Persons with the following mental disorders:

Schizophrenia;
Delusional (paranoid) disorder;
Mood disorders;
Anxiety disorders;
Somatoform disorders;
Organic mental disorders;
Personality disorders;
Dissociative disorders;
Other psychotic or severe and persistent mental disorders manifested by behavioral changes and symptoms of comparable severity to those manifested by persons with mental disorders listed in this subsection; and
Persons who have been diagnosed by a licensed psychologist, psychiatrist, or physician licensed to practice medicine in the state and, as a result of the diagnosis, have been determined to have a childhood disorder manifested by behaviors or symptoms suggesting risk of developing a mental disorder listed in this subsection.

People with developmental disabilities

Statutory definition [AS 47.30.056(e)]: People with the following neurologic or mental disorders:

Cerebral palsy;
Epilepsy;
Mental retardation;
Autistic disorder;
Severe organic brain impairment;
Significant developmental delay during early childhood indicating risk of developing a disorder listed in this subsection;
Other severe and persistent mental disorders manifested by behaviors and symptoms similar to those manifested by persons with disorders listed in this subsection.

GCDSE definition: The Governor's Council on Disabilities and Special Education uses the state's definition of a person with a developmental disability, which is consistent with the federal definition used to define Trust beneficiaries. The state’s definition identifies an individual with a developmental disability as someone who experiences a severe, chronic disability that:

Is attributable to a mental or physical impairment or combination of mental and physical impairments;
Is manifested before the person attains age 22;
Is likely to continue indefinitely;
Results in substantial functional limitations in three or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency; and
Reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services that are of lifelong or extended duration and are individually planned and coordinated.

People with chronic alcoholism

Statutory definition [AS 47.30.056(f)]: People with the following disorders:

Alcohol withdrawal delirium (delirium tremens);
Alcohol hallucinosis;
Alcohol amnesiac disorder;
Dementia associated with alcoholism;
Alcohol-induced organic mental disorder;
Alcoholic depressive disorder;
Other severe and persistent disorders associated with a history of prolonged or excessive drinking or episodes of drinking out of control and manifested by behavioral changes and symptoms similar to those manifested by persons with disorders listed in this subsection.

ABADA definition: The Advisory Board on Alcohol and Drug Abuse has developed an operational definition of alcoholism with psychosis that translates the above data into assessment features collected in the State's Management Information System, which is collected by all state-funded treatment programs along with those previously funded by the Indian Health Service and those private providers who choose to collect and report the data. These criteria are:

Alcohol is first drug of choice (information collected from initial assessment).
Client assessed as either dysfunctional or dependent.
Client reports consuming alcohol at least six days per week (this question is eliminated for persons receiving services while incarcerated in the penal system).

People with Alzheimer’s disease and related dementia

Statutory definition [AS 47.30.056(g)]: People, who as a result of their senility, exhibit one or more of the following mental disorders:

Primary degenerative dementia of the Alzheimer type;
Multi-infarct dementia;
Senile dementia;
Pre-senile dementia;
Other severe and persistent mental disorders manifested by behaviors and symptoms similar to those manifested by persons with disorders listed in this subsection.

ACoA definition: The Alaska Commission on Aging finds that, in the case of Alzheimer's disease, there is no definitive diagnostic test and the diagnosis becomes one of exclusion. In defining the population for which they advocate, the commission includes people with Alzheimer’s disease, stroke, frail with no cognitive impairment, and other Alzheimer's disease and other related dementia (ADRD) including supranuclear palsy, cerebral atrophy, Huntington's chorea, brain tumor, attention deficit disorder with cognitive impairment, Pick's disease, multiple sclerosis, organic brain disorder, multi-infarct dementia, Parkinson's disease, cancer-related dementia, hydrocephalus, and hypoxia.

Few people with cognitive impairments related to other diagnoses qualify in this population: people with alcohol-related dementia, chronic mental illness, major depression, brain injury, developmental disability, developmental disability-related Alzheimer's, and AIDS-related dementia. The common denominator among these diagnoses is cognitive impairment, except for the frail category.

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