Legislature(2021 - 2022)

2021-04-12 House Journal

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2021-04-12                     House Journal                      Page 0589
HB 172                                                                                                                        
HOUSE BILL NO. 172 by the House Rules Committee by request of                                                                   
the Governor, entitled:                                                                                                         
     "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."                                                                                                    
was read the first time and referred to the Judiciary, Health & Social                                                          
Services, and Finance Committees.                                                                                               
The following fiscal note(s) apply:                                                                                             
1.  Zero, Dept. of Public Safety                                                                                                
2.  Fiscal, Dept. of Health & Social Services                                                                                   
3.  Fiscal, Dept. of Health & Social Services                                                                                   
The Governor's transmittal letter dated April 9 follows:                                                                        
"Dear Speaker Stutes:                                                                                                           
Under the authority of Article III, Section 18, of the Alaska                                                                   
Constitution, I am transmitting a bill relating to subacute mental health                                                       
facilities (AS 47.30).                                                                                                          
Subacute mental health facilities are facilities designed to evaluate,                                                          
stabilize, and treat an individual experiencing behavioral health crisis                                                        

2021-04-12                     House Journal                      Page 0590
in a short-term, intensive, and recovery-oriented way so that the                                                               
individual has the chance to avoid inpatient hospitalization. Although                                                          
two such facilities exist in current law – a crisis stabilization center                                                        
and a crisis residential center - this bill would further define those                                                          
facility types and set out what each may do in relationship to existing                                                         
in-hospital evaluation and treatment options in the context of                                                                  
involuntary commitment.                                                                                                         
Currently, law enforcement, emergency medical services, and                                                                     
hospitals are being relied on to serve individuals experiencing a                                                               
behavioral health crisis. Expanding subacute facilities and crisis                                                              
stabilization services will allow law enforcement to focus on crime                                                             
prevention and public safety, rather than psychiatric crises and provide                                                        
an opportunity to divert these individuals to the appropriate level of                                                          
behavioral health treatment.                                                                                                    
Without these services, law enforcement is often the first to respond to                                                        
individuals having a behavioral health crisis, which is largely outside                                                         
of their primary scope of training. Increasing the availability of crisis                                                       
stabilization services will also help to better align public safety                                                             
resources within the Department of Corrections, and the Alaska Court                                                            
This bill adds a new section to AS 47.30 that would solely address                                                              
subacute mental health facilities, including how an individual may be                                                           
admitted and detained, the rights and notification available to an                                                              
individual, and how a facility may administer psychotropic medication                                                           
to an individual.                                                                                                               
Specifically, this bill allows for admission to, and a stabilization hold,                                                      
of an individual at a crisis stabilization center for up to 23 hours and                                                        
59 minutes. It also requires that a mental health professional examine                                                          
an individual within three hours of the individual’s arrival at the                                                             
center. If the professional person in charge has a probable cause belief                                                        
that a detained individual’s crisis will be resolved during admission to                                                        
a crisis residential center, a mental health professional would have to                                                         
apply to the court for permission for the crisis residential center to                                                          
detain the individual for a period of up to 120 hours. The stay at the                                                          
facility would be for evaluation, stabilization, and treatment.                                                                 

2021-04-12                     House Journal                      Page 0591
If the professional person in charge at a crisis residential center has a                                                       
probable cause belief that an individual’s behavioral health crisis                                                             
requires hospitalization for evaluation, a mental health professional                                                           
would be required to apply to the court for an order authorizing                                                                
hospitalization for evaluation. In this way, the bill would lay out the                                                         
role of each subacute mental health facility and the terms by which an                                                          
individual receives progressive care.                                                                                           
To achieve the benefit of using subacute mental health facilities as a                                                          
diversion to hospitalization, this bill refines AS 47.30.705(c) by                                                              
requiring a peace officer to take an individual to a crisis stabilization                                                       
center if one exists in the service area served by the peace officer, even                                                      
if an evaluation facility is available. “Service area” helps define the                                                         
reach of this section now that emergency medical technicians,                                                                   
paramedics, and firefighters are added to the definition of “peace                                                              
officer” in Section 12.                                                                                                         
This bill would make subacute mental health facilities a new type of                                                            
licensed facility, and it directs the Department of Health and Social                                                           
Services to adopt regulations to implement the provisions of this bill                                                          
and existing statutes in AS 47.30.700 – 47.30.915.                                                                              
I urge your prompt and favorable action on this measure.                                                                        
Mike Dunleavy