Legislature(2021 - 2022)GRUENBERG 120
02/16/2022 01:30 PM House JUDICIARY
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| Audio | Topic |
|---|---|
| Start | |
| HB172 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 172 | TELECONFERENCED | |
HB 172-MENTAL HEALTH FACILITIES & MEDS
1:33:12 PM
CHAIR CLAMAN announced that the only order of business would be
HOUSE BILL NO. 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." [Before the committee, adopted on 5/14/21 as a working
document, was the proposed committee substitute (CS) 32-
GH1730\I, Dunmire, 5/14/21 ("Version I").]
CHAIR CLAMAN stated that before moving to adopt the proposed
committee substitute (CS) to HB 172, the committee will first
hear the summary of changes and sectional analysis.
1:34:06 PM
EMMA POTTER, Staff, Representative Matt Claman, Alaska State
Legislature, summarized the proposed CS for HB 172, on behalf of
the prime sponsor, House Rules Standing Committee, by request of
the governor. She stated that the changes in the proposed CS
include efforts to protect patients' rights by shortening the
length of time patients can be held without judicial review.
She stated that hearings should occur within 72 hours of arrival
at a crisis stabilization facility, a crisis residential
facility, or for a 30-day hold. She stated that the proposed CS
would also create different levels of proof for detention. She
explained that the burden of proof at a crisis residential
center would be "probable cause," while for involuntary
commitment it would be "clear and convincing evidence." She
noted that another update in the proposed CS is that a maximum
stay would be increased from five days to seven days in a crisis
residential facility, and this would be based on Medicaid
coverage limits. She added that the parties who would receive
notice of an ex-parte petition for the 72-hour hearing include
the respondent, the respondent's attorney, the respondent's
guardian (if applicable), the petitioner's attorney (if
applicable), and the attorney general. She referenced AS
01.10.060(a) regarding the conforming changes and the definition
of a peace officer.
1:37:12 PM
HEATHER CARPENTER, Senior Policy Advisor, Office of the
Commissioner, Department of Health and Social Services, on
behalf of the prime sponsor, House Rules Standing Committee, by
request of the governor, provided the sectional analysis
[included in the committee packet] for the proposed CS for HB
172, which read as follows [original punctuation provided]:
Section 1: Amends AS 12.25.031(a) to add a "crisis
residential center" as another facility a peace
officer may deliver a person to as an alternative to
arrest. An officer may, at their discretion, deliver a
person to a crisis stabilization center, crisis
residential center, or evaluation facility instead of
arresting them if the officer believes that the person
is suffering from an acute episode of mental illness
and if the person voluntarily agrees to be taken to a
crisis stabilization center or evaluation facility.
Section 2: Conforming amendment AS 12.25.031(b) to add
a "crisis residential center" as another facility a
peace officer may take a person into emergency custody
under AS 47.30.705 as an alternative to arrest.
Section 3: Conforming amendment to AS 12.25.031(c) to
include "crisis residential center" in the alternative
to arrest statutes (AS 12.25.031); makes it clear that
delivery of a person to a crisis stabilization center,
a crisis residential center, or an evaluation facility
under these provisions does not constitute an
involuntary commitment under AS 47.30 or an arrest.
Section 4: Conforming amendment to AS 12.25.031(d),
alternative to arrest statutes; requires a mental
health professional to make reasonable efforts to
inform the arresting officer before they release a
person delivered to a crisis stabilization center,
crisis residential center, or an evaluation facility
under this provision if the officer has specifically
requested notification.
Section 5: Conforming amendment to AS 12.25.031(f) to
include "a crisis residential center" in the
alternative to arrest statutes (AS 12.25.031)
Section 6: Conforming amendment to AS 12.25.031(g) to
include "a crisis residential center" in the
alternative to arrest statutes.
Section 7: Amends the alternative to arrest statutes
(AS 12.25.031) to update the definition of "crisis
stabilization center" to have the meaning given in AS
47.30.915, which is updated in Section 22.
Section 8: Adds a definition for "crisis residential
center" to the alternative to arrest statutes in AS
12.25.031.
Section 9: Conforming amendment to AS 18.65.530(c) to
add "a crisis residential center" to the Mandatory
arrest for Crimes for Domestic Violence, Violation of
Protective Orders, and Violation of Conditions of
Release statutes (AS 18.65.530). This section of law
provides that a peace officer is not required to make
an arrest under AS 18.65.530(a) if the officer has
authorization from a prosecuting attorney in the
jurisdiction in which the offense under investigation
arose to deliver the person to a crisis stabilization
center, a crisis residential center, or an evaluation
facility as provided in AS 12.25.031.
Section 10: Conforming amendment to AS 18.65.530(g) to
add "a crisis residential center" to the Mandatory
Arrest for Crimes Involving Domestic Violence,
Violation of Protective Orders, and Violation of
Conditions of Release statutes (AS 18.65.530). This
section requires a peace officer who delivers a person
to a crisis stabilization center, a crisis residential
center, or evaluation facility to leave their contact
information with the crisis stabilization center or
evaluation facility and, if notified of a release from
crisis stabilization under AS 12.25.031(d), to make
reasonable efforts to inform the victim of a crime
under (a)(1) and (2) of AS 18.65.530.
1:41:07 PM
MS. CARPENTER continued her overview of the sectional analysis,
which read as follows [original punctuation provided]:
Section 11: Amends AS 47.30.705(a) to expand the
category of who can cause a person to be taken into
custody for delivery to a crisis stabilization center,
a crisis residential center, evaluation facility, or
treatment facility. The new language would allow a
"health officer" as newly defined in Section 22, the
existing "mental health professional" as defined in AS
47.30.915(13), or a physician assistant licensed by
the State Medical Board to practice in this state, in
addition to a peace officer to take someone into
custody. Clarifies that a person is taken "into
custody" by a peace officer or health officer and then
delivered to the nearest crisis stabilization center,
crisis residential center, evaluation facility or
treatment facility. Clarifies that a person taken into
custody may not be placed in jail or other
correctional facility except for protective custody
purposes while they await transportation to a crisis
stabilization center, crisis residential center,
evaluation facility, or treatment facility.
Section 12: Adds a new subsection (c) to AS 47.30.705
that requires a peace officer or health officer to
prioritize delivery to a crisis stabilization center
if one exists in the area served by the peace officer
or health officer.
Section 13: Adds a new section AS 47.30.707 for
admission to and detention at a crisis stabilization
center or crisis residential center with the following
options and rights for a patient:
(a) Requires a mental health professional to examine
the patient (respondent) delivered to a crisis
stabilization center within 3 hours after arrival when
a patient (respondent) is delivered pursuant to AS
47.30.705 and specifies that a hold may last no longer
than 23 hours and 59 minutes.
(b) Creates a new process for evaluation,
stabilization, and treatment at crisis residential
centers which provides a less restrictive alternative
to traditional involuntary commitment holds at a
Designated Evaluation and Treatment Facility (DET) or
the Alaska Psychiatric Institute (API). If there is
probable cause to believe the person's crisis could be
stabilized by admitting to a crisis residential
center, the mental health professional in charge at
the 23-hour, 59-minute crisis stabilization center can
apply to the court for an ex parte detention order
after which the person could be detained at a crisis
residential center for no more than 7 days.
Adds a new section AS 47.30.708 for admission to and
detention at a crisis residential center with the
following options and rights for a patient:
(a) Requires a mental health professional to examine
the patient's (respondent) mental and physical
condition within 3 hours after arrival.
(b) Allows the mental health professional who performs
the emergency examination under (a) to admit the
patient (respondent) to the crisis residential center
if:
1. The patient (respondent) is mentally ill and that
condition causes the respondent to be gravely disabled
or to present a likelihood of serious harm to self or
others; and
2. The patient's (respondent's) acute behavioral
health crisis will be resolved during admission to the
crisis residential center.
(c) Allows the mental health professional to apply for
an ex parte order under AS 47.30.700 if admission is
made to a crisis residential center and a judicial
order has not been obtained. Sets forth that the court
will grant an application if there is probable cause
to believe that the patient's (respondent's) acute
behavioral health crisis will be resolved during
admission to a crisis residential center.
(d) Requires the court to set a time for a 72-hour
evaluation hearing to be held if needed within 72
hours after the patient's (respondent's) arrival to
the crisis stabilization center or crisis residential
center, whichever is earlier, if a court grants
admission to a crisis residential center under (c).
Sets out the parties the court must notify of the time
and place of the hearing. Provides for the computation
of time of the 72-hour period, which does not include
Saturdays, Sundays, and legal holidays. Requires
hearings to be held at the crisis residential center
in person by contemporaneous two-way video conference
or by teleconference.
(e) Sets forth the requirements for a petition filed
in court for a 30-day commitment or for detention at a
crisis stabilization center. Requires a petition for a
30-day commitment to confirm with AS 47.30.730, which
is the statute regarding petitions for 30-day
commitment to a treatment facility. Specifies the
items that must be included in any petition.
(f) Provides for the court reviewing a 30-day
commitment petition under (d) to hold the next hearing
in accordance with AS 47.30.735. If the 30-day
commitment petition is granted, allows the patient
(respondent) to remain at the crisis residential
center until admission to a designated treatment
facility.
(g) Provides for patients' rights listed in AS 47.30-
735(b)(1)-(9) when the court is reviewing a petition
for detention under (d) to a crisis residential
center. Allows the court to order a patient
(respondent) to be detained at a crisis residential
center for up to seven days from the date of first
admission to a crisis stabilization center or crisis
residential center if the court has probable cause to
believe:
A. The patient (respondent) is mentally ill and that
condition causes the respondent to be gravely disabled
or to present a likelihood of serious harm to self or
others; and
B. The patient's (respondent's) acute behavioral
health crisis will be resolved during admission to the
crisis residential center. Adds a new section AS
47.30.709. Rights of respondents at crisis
stabilization centers and crisis residential centers;
psychotropic medication; time.
(a) Requires that if at any time during an involuntary
hold at a crisis stabilization center or crisis
residential center, the patient (respondent) no longer
meets the standards for a stabilization hold or
detention, that they no longer be held or detained and
the court notified if applicable.
(b) Provides for the patient's (respondent's) rights
when being involuntarily held at a crisis
stabilization center or crisis residential center.
(c) Allows for the patient (respondent) to convert to
voluntary status for care.
(d) Allows a crisis stabilization center or crisis
residential center to administer crisis psychotropic
medication consistent with the practice permitted in
AS 47.30.838 for evaluation and designated treatment
facilities.
(e) Adds language to clarify how time is calculated in
this section for the 23-hour, 59- minutes holding
period at a crisis stabilization center and the seven-
day detention at a crisis residential center. In this
section "professional person in charge" has the
meaning given in AS 47.30.915(17).
1:48:59 PM
MS. CARPENTER drew attention to Section 14, page 8, beginning on
line 17 of the analysis and explained that it would provide
clarifying edits to AS 47.30.710. Pertaining to examination and
hospitalization, the proposed CS would remove references to
"crisis stabilization center". These would be the same changes
as in Section 13. She explained that a medical professional,
after an examination, would be permitted to decide whether an
individual should be admitted to a crisis residential center,
hospital, or hospitalized in an emergency room. She explained
that Section 15, page 9, on line 8 would add a subsection to
require an application for an ex parte order, should a judicial
order not be in place. If the patient is readmitted to an
evaluation facility after discharge from a subacute mental
health facility, it would require a mental health professional
to apply for an ex parte order. This applies when the
individual is not willing to stay [in the facility] voluntarily
and should remain in the facility until the court issues a
decision on the ex parte petition. She noted that when a
patient is readmitted, the 72-hour clock is reset.
MS. CARPENTER directed attention to Sections 16, 17, and 18,
which read as follows [original punctuation provided]:
Section 16: Amends AS 47.30.715 to clarify that orders
for evaluation are directed to "evaluation facilities"
and to require admission of the patient (respondent)
for a 72-hour evaluation to determine if a petition
for 30-day commitment should be filed. Clarifies the
individuals that are required to be notified by the
court of the hearing arrangements.
Section 17: Amends AS 47.30.805(a), a computation of
time statute, to include computation for proceedings
or transportation to a crisis residential center. Adds
a new computation for a seven-day detention at a
crisis residential center.
Section 18: Amends AS 47.30.838(c) to include crisis
stabilization center and crisis residential center as
a type of facility authorized to administer
psychotropic crisis medication when there is a crisis
situation where the patient requires immediate
medication to prevent significant physical harm to
themselves or others. Current law allows a facility to
administer three periods of crisis medication without
further court approval but also states a facility
should consider the patient's view on how to manage
future crises.
MS. CARPENTER added that currently the statute only applies to
evaluation facilities, treatment facilities, or the Alaska
Psychiatric Institute. She noted the other facilities which
could be included are the Fairbanks Memorial Hospital, the Mat-
Su Regional Medical Center, and the Bartlett Regional Hospital.
MS. CARPENTER continued the sectional analysis, which read as
follows [original punctuation provided]:
Section 19: Adds a new section to AS 47.30 to require
the department to adopt regulations to implement these
changes to the involuntary commitment statutes.
Section 20: Amends AS 47.30.915(7) to clarify that
"evaluation facility" means a department-designated
hospital or crisis residential center that has been
designated to perform evaluations, or a medical
facility operated by the federal government that
performs evaluations.
MS. CARPNTER noted that a "health care facility" could
include a hospice facility; however, the department would
never designate this type of facility as an evaluation
facility, and the proposed CS would clarify the meaning as
facilities designed to perform evaluations for a federal
facility or tribal operated medical facility. She
expressed the importance of the term "designated," as this
would apply only to facilities with adequate time to
perform a 72-hour evaluation to determine whether criteria
are met for a 30-day commitment. She continued the
sectional analysis, which read as follows [original
punctuation provided]:
Section 21: Amends the definition of "peace officer"
in AS 47.30.915(15) to have the meaning given in AS
01.10.060(a).
Section 22: Amends AS 47.30.915 to provide
definitions:
"crisis residential center" means a subacute mental
health facility that has a maximum stay of seven days.
"crisis stabilization center" means a subacute
mental health facility that has a maximum stay of 23
hours and 59 minutes.
"health officer" means a state, municipal, or other
local health officer, public health nurse, emergency
medical technician, paramedic, firefighter, or a
personal authorized by the court to carry out AS
47.30.660-47.30.915. This definition removed these
provider types from the current definition of "peace
officer" found in AS 47.30.917(7) and creates a new
term for them.
"subacute mental health facility" is defined in AS
47.32.900. Section 23: Amends the licensing statutes
in AS 47.32.010(b) to change "crisis stabilization
centers" to "subacute mental health facilities."
Section 23: Amends the licensing statutes in AS
47.32.010(b) to change "crisis stabilization centers"
to "subacute mental health facilities."
Section 24: Adds a new paragraph to AS 47.32.900 to
define "subacute mental health facilities" in the
licensing statutes and provides for "crisis
residential centers" and "crisis stabilization
centers" as subtypes of "subacute mental health
facilities."
MS. CARPENTER added that "health officer" would be a new
term and would include a peace officer, an emergency
medical technician, a paramedic, or a firefighter.
1:55:21 PM
MS. CARPENTER concluded the sectional analysis, which read as
follows [original punctuation provided]:
Section 25: Repeals AS 47.32.900(5), the current
definition for "crisis stabilization centers" since it
is replaced with the new definition in Section 24.
Section 26: Adds a new section to the uncodified law
to clarify that DHSS will consider previously issued
"crisis stabilization center" licenses as a license
for "subacute mental health facility."
Section 27: Adds a new section to the uncodified law
to allow the department to adopt transition
regulations to implement this act.
Section 28: Provides for an immediate effective date
for the bill.
1:56:10 PM
REPRESENTATIVE SNYDER moved to adopt the proposed CS for HB 172,
32-GH1730\W, Foote, 2/16/22, ("Version W"), as a working
document. There being no objection, Version W was before the
committee.
1:57:18 PM
REPRESENTATIVE KURKA questioned the purpose of Version W.
MS. CARPENTER answered that, following consultation with
stakeholders, including the Alaska Mental Health Trust
Authority, the Disability Law Center, and the Public Defender,
it was determined to modify language to clarify the 72-hour hold
would begin on a patient's arrival at a facility. She added
that the hospitalization statute, AS 47.37.10, would add clarity
to the law. She noted that other drafting changes had been
made.
REPRESENTATIVE KURKA questioned whether the sectional analysis
presented pertained to Version W.
CHAIR CLAMAN answered yes. He added that, under the original
version of the bill, a person could be held for five days
without an ex parte order or judicial order. Patient advocates
had expressed concerns and encouraged language to mandate a
hearing within 72 hours.
2:00:31 PM
REPRESENTATIVE SNYDER, regarding a judicial hearing, expressed
the understanding of the timing when a guardian should be
contacted; however, she questioned the timing requirement
pertaining to the arrival of a patient at a facility. She
questioned the current practice versus the proposed changes.
She expressed awareness concerning complexities for individual
circumstances.
2:02:02 PM
STEVEN BOOKMAN, Senior Assistant Attorney General, Human
Services Section, Civil Division (Anchorage), Department of Law,
responded that the [notification of guardians] would be found
within the current [patient] rights statute; this does not
specify when a guardian would be notified, only that the
guardian shall be notified. He referred to page 5, Section 708,
on line 30, which directs the court to set a timeframe for a
hearing when a petition to commit a patient to a crisis
residential center occurs. He further referred to page 6, on
line 3, which directs the court to notify a respondent's
guardian, if known, of the timing of the hearing. He added that
the hearings occur within short timeframes.
MR. BOOKMAN, in response to a question from Representative
Eastman, answered that the respondent, or patient, would request
a hearing. He added that most patients are voluntarily admitted
to facilities. In response to a follow-up question, he answered
that, should the patient be an adult with a guardian, the
designated guardian would be the patient's ward. He added that,
should the patient be a minor and no parent can be located, the
hearing would be scheduled, and the minor and the attorney would
decide how to proceed.
2:06:55 PM
REPRESENTATIVE EASTMAN noted that the bill would address
individuals who are experiencing a behavioral crisis and those
who are gravely disabled. He questioned how the proposed bill
would pertain to the latter.
MR. BOOKMAN responded by noting that the bill would pertain to
those who are in immediate danger in the short term. He gave
examples, including an individual who may not understand [harsh]
weather, those who may have a physical medical problem, such as
a neglected injury, or an individual who may not understand
safety, such as walking into traffic. He noted that there
exists a definition of "grave disability" in AS 47.30.915.
REPRESENTATIVE EASTMAN noted that different facilities have
differing resources and tools. He questioned whether it would
be more appropriate to transport an individual to the nearest
facility.
MS. CARPENTER answered that the nearest facility would be
selected if it was appropriate. She noted that it would depend
on the facilities available in a particular community, and the
individual's needs. She noted that a system would be
established for care closer to home, as this would reduce
transportation costs and allow a patient to receive treatment
closer to home.
REPRESENTATIVE EASTMAN pointed out page 11, line 11, pertaining
to federal evaluation facilities and asked for the definition of
"evaluation."
MS. CARPENTER stated that the evaluations would be those
described in AS 47.30.660 through AS 47.39.15, which are
specific to involuntary commitment and the 72-hour evaluation.
She stated that there exists an available list of definitions,
and she offered to follow up with this to the committee. She
added that a hospital would inform the department and request
that it perform evaluations, as a designated evaluation and
treatment facility. The court would be notified, and the
hearing could result in treatment for 30 days. She stated that
a crisis evaluation center would have the resources necessary to
provide a seven-day treatment. She added that federal
facilities could include tribal facilities under authority of
the federal government.
2:13:18 PM
REPRESENTATIVE EASTMAN asked whether the department would
maintain a list of the types of hospitals and facilities which
meet the criteria. He asked the rationale of the bill having
not included federal facilities on the list.
MS. CARPENTER answered that no medical facilities in Alaska meet
the criteria and are operated by the federal government.
CHAIR CLAMAN announced that HB 172 was held over.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 172 Work Draft Committee Substitute v. W 2.16.2022.pdf |
HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM HJUD 2/23/2022 1:30:00 PM HJUD 2/25/2022 1:30:00 PM |
HB 172 |
| HB 172 Transmittal Letter 4.9.2021.pdf |
HJUD 5/14/2021 1:00:00 PM HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM HJUD 2/23/2022 1:30:00 PM |
HB 172 |
| HB 172 Sectional Analysis v. W 2.16.2022.pdf |
HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM HJUD 2/23/2022 1:30:00 PM |
HB 172 |
| HB 172 Additional Document - Introduction Presentation to HJUD Committee 5.14.2021.pdf |
HJUD 5/14/2021 1:00:00 PM HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM HJUD 2/23/2022 1:30:00 PM |
HB 172 |
| HB 172 Supporting Document - Letters Received by 5.14.2021.pdf |
HJUD 5/14/2021 1:00:00 PM HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM HJUD 2/23/2022 1:30:00 PM |
HB 172 |
| HB 172 Opposing and Amend Letters and Testimony Received by 2.15.2022.pdf |
HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM |
HB 172 |
| HB 172 Fiscal Note DFCS-IMH 2.11.2022.pdf |
HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM HJUD 2/23/2022 1:30:00 PM |
HB 172 |
| HB 172 Fiscal Note DOH-MS 2.11.2022.pdf |
HJUD 2/16/2022 1:30:00 PM HJUD 2/21/2022 1:00:00 PM HJUD 2/23/2022 1:30:00 PM |
HB 172 |