Legislature(2001 - 2002)
03/22/2001 03:05 PM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
HB 115-EMERGENCY COMMITMENT ORDERS CHAIR DYSON announced that the first order of business would be HOUSE BILL NO. 115, "An Act allowing a physician assistant or advanced nurse practitioner to certify the need for emergency treatment as a result of intoxication." Number 0128 REPRESENTATIVE WILSON moved to adopt CSHB 115, version 22- LS0059\F, Ford, 2/15/01, as the working document before the committee. There being no objection, Version F was before the committee. REPRESENTATIVE MARY KAPSNER, Alaska State Legislature, testified as sponsor of HB 115. She informed the committee that she had three amendments to offer the committee. Amendment 1, 22- LS0059\F.3, Ford, 3/22/01, read as follows: Page 2, line 3: Delete "master" Insert "clinical" REPRESENTATIVE COGHILL asked Representative Kapsner to provide a comparison of what a master social worker is versus a clinical social worker. REPRESENTATIVE KAPSNER answered that the two are the same. This [amendment] merely cleans up the language. REPRESENTATIVE CISSNA related her understanding that there is different training, licensure, and coursework. ANNE HENRY, Special Projects Coordinator, Division of Mental Health & Developmental Disabilities, Department of Health & Social Services, explained that a licensed clinical social worker means that the individual has a master's degree plus two years of experience in order to receive the clinical license. Number 0284 REPRESENTATIVE COGHILL moved that the committee adopt Amendment 1. There being no objection, Amendment 1 was adopted. CHAIR DYSON referred to his amendment labeled 22-LS0059\F.2, Ford, 3/22/01. He explained that this amendment would allow a person to be considered for an involuntary commitment if the person is a danger to his or her own unborn child, specifically in cases of fetal alcohol syndrome (FAS). He noted the need to change the "on an" language throughout the amendment to "their own". The amendment with the aforementioned change read as follows: Page 1, line 5, following "intoxication;": Insert "relating to commitment based on intoxication or alcohol or drug abuse;" Page 2, following line 5: Insert a new bill section to read: "* Sec. 2. AS 47.37.180(a) is amended to read: (a) An intoxicated person who (1) has threatened, attempted to inflict, or inflicted physical harm on another or their own unborn child, or is likely to inflict physical harm on another or their own unborn child, unless committed, or (2) is incapacitated by alcohol or drugs, may be committed to an approved public treatment facility for emergency treatment. A refusal to undergo treatment does not constitute evidence of lack of judgment as to the need for treatment." Renumber the following bill sections accordingly. Page 2, line 27, following "another": Insert " or their own unborn child" Page 2, line 28, following "another": Insert " or their own unborn child" The committee took a brief at-ease from 3:12 p.m. to 3:14 p.m. Number 0540 DIANA WEBBER, Director, Yukon Koyukuk Mental Health Galena, said that HB 115 is an excellent bill. She then turned to the issue of delivering mental health services in rural Alaska. She informed the committee that some of the highest levels of alcohol abuse and fetal alcohol syndrome exist in her area. She emphasized that community mental health centers in rural Alaska face great difficulty in obtaining licensed master's [level] clinical providers. Therefore, Ms. Webber suggested broadening the list of providers to include the same level of master's providers that Medicaid approves to bill for clinical work, which would include some unlicensed master's-level providers, such as master's in counseling psychology. She explained that it is very difficult for master's-level providers in rural Alaska to get licensed because they don't have the same face-to- face access to psychologists, psychiatrists, and social workers who could supervise them. CHAIR DYSON suggested to Ms. Webber that she discuss that with Representative Kapsner after the meeting and perhaps an amendment could be made in the Senate. Chair Dyson said he felt it was too late in the process to do this now. Chair Dyson requested that Ms. Webber speak to why this legislation is valuable and how difficult it is to do involuntary commitments. MS. WEBBER explained that currently, in her area, involuntary commitments can only be authorized by a psychologist or a psychiatrist, which her area does not have. Therefore, such folks have to be convinced to go to Fairbanks in order to be committed. Ms. Webber clarified that the current law does not serve areas that are underserved by medical professionals. Ms. Webber emphasized, "I wholeheartedly endorse adding master's- level clinicians, in some form or other, to be able to make those clinical decisions regarding commitment. It would be very helpful to us." Number 0772 CHAIR DYSON requested that Mr. Ford, the drafter of the legislation, inform the committee of his reasoning for inserting "relating to commitment based on intoxication or alcohol or drug abuse;" on page 1, line 5. MIKE FORD, Attorney, Legislative Counsel, Legal and Research Services Division, Legislative Affairs Agency, explained that the problem was that the title wasn't broad enough. He said, "We included a reference to allow including the language on lines 6 through 12 [of the amendment labeled F.2]." CHAIR DYSON said the decision to broaden the title to include Section 2 [of the amendment labeled F.2] is Representative Kapsner's decision. REPRESENTATIVE KAPSNER said that although this is a worthy idea, she felt her bill was becoming a "Christmas tree." Initially, the bill was introduced to allow mid-level practitioners to sign the commitment papers for involuntary commitment. Then [the title] was broaden to include mental health professionals, and now it is being linked with FAS. Therefore, Representative Kapsner expressed the need to maintain the original intent of the legislation. Perhaps [what is proposed in amendment F.2] can be done at a later time, in another bill. Representative Kapsner also expressed concern with the possibility of HB 115 dying with the inclusion of Chair Dyson's amendment [F.2]. CHAIR DYSON clarified that the committee has before it CSHB 115, Version F, as amended by Amendment 1. REPRESENTATIVE KAPSNER informed the committee that she had one other minor amendment. At the prior hearing on HB 115, the committee had added the language "medical examiners" on page 3, line 4. She related her understanding that a medical examiner is a person who examines people after they have died. Therefore, she suggested changing "medical examiners" to "medical providers" on page 3, line 4. REPRESENTATIVE WILSON moved that the committee adopt the following amendment: Page 3, line 4: Delete "examiners" Insert "providers" [No objection was stated.] Number 1042 REPRESENTATIVE COGHILL moved to report CSHB 115, version 22- LS0059\F, Ford, 2/15/01, as amended out of committee with individual recommendations and the accompanying zero fiscal note. There being no objection, CSHB 115(HES) was reported from the House Health, Education and Social Services Standing Committee.