HB 172: "An Act relating to admission to and detention at a subacute mental health facility; establishing a definition for 'subacute mental health facility'; establishing a definition for 'crisis residential center'; relating to the definitions for 'crisis stabilization center'; relating to the administration of psychotropic medication in a crisis situation; relating to licensed facilities; and providing for an effective date."
00 HOUSE BILL NO. 172 01 "An Act relating to admission to and detention at a subacute mental health facility; 02 establishing a definition for 'subacute mental health facility'; establishing a definition 03 for 'crisis residential center'; relating to the definitions for 'crisis stabilization center'; 04 relating to the administration of psychotropic medication in a crisis situation; relating to 05 licensed facilities; and providing for an effective date." 06 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 07 * Section 1. AS 12.25.031(i)(1) is amended to read: 08 (1) "crisis stabilization center" means a facility licensed as a subacute 09 mental health facility under AS 47.32 that has a maximum stay of 23 hours and 59 10 minutes [MEETS THE DEFINITION OF "CRISIS STABILIZATION CENTER" IN 11 AS 47.32.900]; 12 * Sec. 2. AS 47.30.705(a) is amended to read: 13 (a) A peace officer, a mental health professional, or a physician assistant
01 licensed by the State Medical Board to practice in this state, [A PSYCHIATRIST 02 OR PHYSICIAN WHO IS LICENSED TO PRACTICE IN THIS STATE OR 03 EMPLOYED BY THE FEDERAL GOVERNMENT, OR A CLINICAL 04 PSYCHOLOGIST LICENSED BY THE STATE BOARD OF PSYCHOLOGIST 05 AND PSYCHOLOGICAL ASSOCIATE EXAMINERS] who has probable cause to 06 believe that a person is gravely disabled or is suffering from mental illness and is 07 likely to cause serious harm to self or others of such immediate nature that 08 considerations of safety do not allow initiation of involuntary commitment procedures 09 set out in AS 47.30.700, may cause the person to be taken into custody by a peace 10 officer and delivered to the nearest crisis stabilization center [AS DEFINED IN 11 AS 47.32.900] or the nearest evaluation facility. A person taken into custody [FOR 12 EMERGENCY EVALUATION] may not be placed in a jail or other correctional 13 facility except for protective custody purposes and only while awaiting transportation 14 to a subacute mental health facility, evaluation facility, [CRISIS STABILIZATION 15 CENTER] or treatment facility. However, emergency protective custody under this 16 section may not include placement of a minor in a jail or secure facility. The peace 17 officer or mental health professional shall complete an application for examination of 18 the person in custody and be interviewed by a mental health professional at the 19 subacute mental health facility [CRISIS STABILIZATION CENTER], evaluation 20 facility, or treatment facility. 21 * Sec. 3. AS 47.30.705 is amended by adding a new subsection to read: 22 (c) When delivering a person to the nearest crisis stabilization center or 23 evaluation facility under (a) of this section, a peace officer shall give priority to a 24 crisis stabilization center if one exists in the service area served by the peace officer. 25 * Sec. 4. AS 47.30 is amended by adding a new section to read: 26 Sec. 47.30.707. Admission to and detention at a subacute mental health 27 facility; psychotropic medication; rights; notification. (a) Except as provided in (b) 28 of this section, when a crisis stabilization center admits a person on an emergency 29 basis under AS 47.30.705, the crisis stabilization center may hold the person at the 30 center for a period not to exceed 23 hours and 59 minutes. A respondent who is 31 delivered under AS 47.30.705 to a crisis stabilization center shall be examined by a
01 mental health professional as defined in AS 47.30.915 within three hours after arriving 02 at the center. 03 (b) If the professional person in charge at the crisis stabilization center 04 determines that there is probable cause to believe that the held person's acute 05 behavioral health crisis will be resolved during admission to a crisis residential center 06 and the person is not willing to remain at the crisis residential center on a voluntary 07 basis, a mental health professional shall submit an ex parte application to the court for 08 detention at the crisis residential center. Based on the application, the court shall either 09 grant the application or order that the respondent may not be detained. If the court 10 grants the application, the respondent shall be delivered to, admitted to, and detained 11 at a crisis residential center for a period of not more than 120 hours for evaluation, 12 stabilization, and treatment. The respondent shall remain at the crisis stabilization 13 center until admission to a crisis residential center. 14 (c) If the professional person in charge at the crisis residential center 15 determines that the respondent's acute behavioral health crisis requires hospitalization 16 for evaluation, a mental health professional shall apply for an ex parte order 17 authorizing hospitalization for evaluation. The respondent shall remain at the crisis 18 residential center until admission to a hospital performing the evaluation. 19 (d) If at any time during detention at a subacute mental health facility the 20 professional person in charge determines that the respondent does not meet the 21 standard for a stabilization hold or detention, the respondent may no longer be held or 22 detained. The court shall be notified if applicable and, if reasonably possible, the 23 petitioner shall be notified. 24 (e) When detained at a subacute mental health facility, a respondent has the 25 following rights: 26 (1) the rights identified in AS 47.30.725, as applicable; 27 (2) with the exception of AS 47.30.839 and 47.30.851, the rights 28 identified under AS 47.30.817 - 47.30.865. 29 (f) A respondent subject to an involuntary stabilization hold or detention at a 30 subacute mental health facility under this section may, at any time, convert to 31 voluntary status if the professional person in charge agrees that
01 (1) the respondent is an appropriate patient for voluntary status; and 02 (2) the conversion is made in good faith. 03 (g) A subacute mental health facility may administer psychotropic medication 04 or other treatment to an involuntarily detained respondent only in a manner that is 05 consistent with AS 47.30.838. 06 (h) In this section, computations of a 23-hour, 59-minute holding period or a 07 120-hour detention period include Saturdays, Sundays, and legal holidays, but do not 08 include any period of time necessary to transport the respondent to the subacute 09 mental health facility. 10 * Sec. 5. AS 47.30.710 is amended to read: 11 Sec. 47.30.710. Examination; hospitalization; admission to crisis 12 residential center. A respondent who is delivered under AS 47.30.700 - 47.30.705 to 13 an evaluation facility [, EXCEPT FOR DELIVERY TO A CRISIS STABILIZATION 14 CENTER AS DEFINED IN AS 47.32.900,] for emergency examination and treatment 15 shall be examined and evaluated as to mental and physical condition by a mental 16 health professional and by a physician within 24 hours after arrival at the facility. A 17 respondent who is delivered under AS 47.30.705 to a crisis stabilization center shall be 18 examined by a mental health professional as defined in AS 47.30.915 within three 19 hours after arriving at the center. 20 (b) If the mental health professional who performs the emergency examination 21 under (a) of this section has reason to believe that the respondent is 22 (1) mentally ill and that condition causes the respondent to be gravely 23 disabled or to present a likelihood of serious harm to self or others; [,] and 24 (2) is in need of care or treatment, the mental health professional may 25 (A) hold the respondent at a crisis stabilization center; 26 (B) admit the respondent to a crisis residential center; 27 (C) readmit the respondent to a crisis residential center; if 28 the readmission occurs within 24 hours of an admission under this 29 paragraph, the crisis residential center shall obtain prior authorization 30 from the department; 31 (D) hospitalize the respondent; [,] or
01 (E) arrange for hospitalization, on an emergency basis [. IF A 02 JUDICIAL ORDER HAS NOT BEEN OBTAINED UNDER AS 47.30.700, 03 THE MENTAL HEALTH PROFESSIONAL SHALL APPLY FOR AN EX 04 PARTE ORDER AUTHORIZING HOSPITALIZATION FOR 05 EVALUATION]. 06 * Sec. 6. AS 47.30.710 is amended by adding new subsections to read: 07 (c) If the mental health professional hospitalizes a respondent or arranges for 08 the hospitalization of a respondent under (b) of this section and if a judicial order has 09 not been obtained under AS 47.30.700, the mental health professional shall apply for 10 an ex parte order authorizing the hospitalization for evaluation. 11 (d) If a mental health professional readmits a respondent to a crisis residential 12 center under (b) of this section within 24 hours after a discharge from a crisis 13 residential center, and the respondent is not willing to remain at the crisis residential 14 center on a voluntary basis, the respondent may request a hearing in the superior court 15 to challenge the readmission. If a respondent requests a hearing, the respondent may 16 be represented at public expense by the Public Defender Agency. The court shall set a 17 date, time, and place for the hearing, to be held within 48 hours after the respondent's 18 arrival at the crisis residential center. The court shall notify the facility, the 19 respondent, the respondent's attorney, and the prosecuting attorney of the hearing 20 arrangements. Unless otherwise ordered by the court upon receipt of the hearing 21 request, the respondent shall remain at the crisis residential center until the court 22 issues a decision on the readmission, at which time the crisis residential center shall 23 detain or release the respondent under AS 47.30.707. 24 * Sec. 7. AS 47.30.715 is amended to read: 25 Sec. 47.30.715. Procedure after order. When an evaluation [A] facility 26 receives a proper order for evaluation, it shall accept the order and, when it may 27 safely do so, the respondent for an evaluation period not to exceed 72 hours. The 28 facility shall promptly notify the court of the date and time of the respondent's arrival. 29 The court shall set a date, time, and place for a 30-day commitment hearing, to be held 30 if needed within 72 hours after the respondent's arrival, and the court shall notify the 31 facility, the respondent, the respondent's attorney, and the prosecuting attorney of the
01 hearing arrangements. Evaluation personnel, when used, shall similarly notify the 02 court of the date and time when they first met with the respondent. 03 * Sec. 8. AS 47.30.805(a) is amended to read: 04 (a) Except as provided in (b) of this section, 05 (1) computations of a 72-hour evaluation period under AS 47.30.715, 06 [OR] a 48-hour detention period under AS 47.30.685, a 48-hour hearing deadline 07 under AS 47.30.710, or a 24-hour readmission period under AS 47.30.710 do not 08 include Saturdays, Sundays, legal holidays, or any period of time necessary to 09 transport the respondent to the treatment facility or crisis residential center; 10 (2) a 30-day commitment period expires at the end of the 30th day 11 after the 72 hours following initial acceptance; 12 (3) a 90-day commitment period expires at the end of the 90th day 13 after the expiration of a 30-day period of treatment; 14 (4) a 180-day commitment period expires at the end of the 180th day, 15 after the expiration of a 90-day period of treatment or previous 180-day period, 16 whichever is applicable. 17 * Sec. 9. AS 47.30.838(c) is amended to read: 18 (c) If crisis situations as described in (a)(1) of this section occur repeatedly, or 19 if it appears that they may occur repeatedly, the evaluation facility, subacute mental 20 health facility, or designated treatment facility may administer psychotropic 21 medication during no more than three crisis periods without the patient's informed 22 consent only with court approval under AS 47.30.839. Regardless of whether the 23 patient has executed advance an health care directive under AS 13.52 or has 24 authorized an agent or surrogate under AS 13.52 to consent, if a patient is 25 capable of giving informed consent and gives informed consent for more than 26 three crisis periods, the evaluation facility, designated treatment facility, or 27 subacute mental health facility may administer psychotropic medication based on 28 that informed consent even if, at the time of the crisis period, the patient refuses 29 crisis medication. After the crisis period is over, if the patient is capable of giving 30 informed consent, the patient may withdraw consent for additional crisis 31 medication.
01 * Sec. 10. AS 47.30 is amended by adding a new section to read: 02 Sec. 47.30.912. Regulations. The department shall adopt regulations to 03 implement AS 47.30.700 - 47.30.915. 04 * Sec. 11. AS 47.30.915(7) is amended to read: 05 (7) "evaluation facility" means a hospital or crisis residential center 06 [HEALTH CARE FACILITY] that has been designated or is operated by the 07 department to perform the evaluations described in AS 47.30.660 - 47.30.915 [, OR A 08 MEDICAL FACILITY LICENSED UNDER AS 47.32 OR OPERATED BY THE 09 FEDERAL GOVERNMENT]; 10 * Sec. 12. AS 47.30.915(15) is amended to read: 11 (15) "peace officer" includes a state police officer; [,] municipal or 12 other local police officer; [,] state, municipal, or other local health officer; [,] public 13 health nurse; [,] United States marshal or deputy United States marshal; [, OR A] 14 person authorized by the court; emergency medical technician; paramedic; or 15 firefighter; 16 * Sec. 13. AS 47.30.915 is amended by adding new paragraphs to read: 17 (21) "subacute mental health facility" has the meaning given in 18 AS 47.32.900; 19 (22) "crisis residential center" means a subacute mental health facility 20 that has a maximum stay of 120 hours; 21 (23) "crisis stabilization center" means a subacute mental health 22 facility that has a maximum stay of 23 hours and 59 minutes. 23 * Sec. 14. AS 47.32.010(b) is amended to read: 24 (b) This chapter and regulations adopted under this chapter apply to the 25 following entities: 26 (1) ambulatory surgical centers; 27 (2) assisted living homes; 28 (3) child care facilities; 29 (4) child placement agencies; 30 (5) foster homes; 31 (6) freestanding birth centers;
01 (7) home health agencies; 02 (8) hospices, or agencies providing hospice services or operating 03 hospice programs; 04 (9) hospitals; 05 (10) intermediate care facilities for individuals with an intellectual 06 disability or related condition; 07 (11) maternity homes; 08 (12) nursing facilities; 09 (13) residential child care facilities; 10 (14) residential psychiatric treatment centers; 11 (15) runaway shelters; 12 (16) rural health clinics; 13 (17) subacute mental health facilities [CRISIS STABILIZATION 14 CENTERS]. 15 * Sec. 15. AS 47.32.900 is amended by adding a new paragraph to read: 16 (23) "subacute mental health facility" means a facility, or a part or unit 17 of a facility, that has been designed to evaluate, stabilize, and treat, on a short-term, 18 intensive, and recover-oriented basis and without the use of inpatient hospitalization, 19 individuals experiencing an acute behavioral health crisis, including a 20 (A) crisis stabilization center, as defined in AS 47.30.915; and 21 (B) crisis residential center, as defined in AS 47.30.915. 22 * Sec. 16. AS 47.32.900(5) is repealed. 23 * Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to 24 read: 25 TRANSITION: LICENSING. Notwithstanding AS 47.32.010(b), as amended by sec. 26 14 of this Act, the Department of Health and Social Services shall consider any license issued 27 to a facility with the facility type under AS 47.32.010 identified as a crisis stabilization center 28 that is issued before the effective date of this Act and that is valid on the effective date of this 29 Act, a license for a subacute mental health facility until that license is renewed, suspended, or 30 revoked. 31 * Sec. 18. The uncodified law of the State of Alaska is amended by adding a new section to
01 read: 02 TRANSITION: REGULATIONS. The Department of Health and Social Services may 03 adopt regulations to implement this Act. The regulations take effect under AS 44.62 04 (Administrative Procedure Act) but not before the effective date of the law implemented by 05 the regulation. 06 * Sec. 19. Section 18 of this Act takes effect immediately under AS 01.10.070(c).