Legislature(2007 - 2008)BUTROVICH 205

03/19/2007 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SCR 4 PUBLIC HEALTH AND HEALTH COMPACT TELECONFERENCED
Moved CSSCR 4(HES) Out of Committee
*+ SB 38 SALVIA DIVINORUM AS CONTROLLED SUBSTANCE TELECONFERENCED
Moved SB 38 Out of Committee
*+ SB 100 SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS TELECONFERENCED
Moved SB 100 Out of Committee
         SB 100-SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS                                                                      
                                                                                                                                
2:01:42 PM                                                                                                                    
CHAIR BETTYE DAVIS announced SB 100 to be up for consideration.                                                                 
                                                                                                                                
SENATOR  ELLIS, sponsor  of SB  100,  cited statistics  regarding                                                               
alcohol abuse  in Alaska, and  said that it's no  revelation that                                                               
the  issue  is huge,  tragic  and  expensive.  The bill  is  long                                                               
overdue, and the state of Washington  (WA) has set an example for                                                               
what SB 100  could do in Alaska. There is  growing recognition of                                                               
the  link   between  substance  abuse  and   mental  illness.  As                                                               
resources allow,  these would be  the priorities outlined  in the                                                               
bill:  treatment   for  incarcerated  sufferers,   children,  and                                                               
certain populations.  The bill also mandates  priority treatments                                                               
for  pregnant women  in in-state  programs, and  provides a  non-                                                               
discrimination clause  for effective faith-based  programs, which                                                               
have  shown  to be  very  helpful  in  prisons and  other  public                                                               
institutions when state services are lacking.                                                                                   
                                                                                                                                
He  continued to  explain that  section eight  of the  bill would                                                               
create a  facility for involuntary  commitments. The state  of WA                                                               
has shown  that it's  an effective solution  for many  people; it                                                               
would not  be for  street inebriates, but  rather people  who are                                                               
severe  substance abusers  who are  dangerous  to themselves  and                                                               
others.  This  bill would  simply  expand  the existing  program,                                                               
which is currently underused; it  proposes a small number of beds                                                               
and a  secure facility. People  often walk out  of detoxification                                                               
facilities  and  return  to  the  same  abusive  lifestyles;  the                                                               
population of these  repeat offenders is around  40 in anchorage.                                                               
A University  of Alaska Anchorage  study recommended  that forced                                                               
interventions  towards  these  users could  be  effective.  These                                                               
high-end users constantly cycle through  the system at great cost                                                               
to the state.                                                                                                                   
                                                                                                                                
He said that the bill could  be a vehicle for working together to                                                               
find a better approach to treating this issue.                                                                                  
                                                                                                                                
2:12:32 PM                                                                                                                    
                                                                                                                                
SENATOR DYSON asked  which part of the bill  addresses the faith-                                                               
based-initiative funding.                                                                                                       
                                                                                                                                
SENATOR ELLIS  replied that the  provision is  in line 30  of the                                                               
bill.                                                                                                                           
                                                                                                                                
SENATOR  DYSON  commented  that  faith-based  programs  are  very                                                               
effective,  and asked  if that  provision  of the  bill might  be                                                               
challenged in any way.                                                                                                          
                                                                                                                                
SENATOR ELLIS said that he'll have  the Department of Law look at                                                               
the language of the bill.                                                                                                       
                                                                                                                                
SENATOR  DYSON  commented  on  a   program  in  Anchorage  that's                                                               
currently underused because it's faith-based.                                                                                   
                                                                                                                                
SENATOR  ELLIS said  that  the bill  has a  fiscal  note of  $1.9                                                               
million  for the  secure-bed  facility, and  that  it would  make                                                               
sense to have the beds co-located with a detoxification program.                                                                
                                                                                                                                
2:16:07 PM                                                                                                                    
                                                                                                                                
SENATOR COWDERY asked when the pilot  program in WA state will be                                                               
completed.                                                                                                                      
                                                                                                                                
KATE HERRING, aide to Senator Ellis,  said that the WA program is                                                               
just now  getting underway and will  be completed in 2  years. WA                                                               
has had  the facilities  for years  now, and  the new  program is                                                               
just for a secure facility.                                                                                                     
                                                                                                                                
SENATOR COWDERY asked how SB 100 differs from the WA bill.                                                                      
                                                                                                                                
MS.  HERRING said  that the  language  in Alaska's  bill is  less                                                               
colloquial, and that the one  main difference is that Alaska only                                                               
sets up one pilot program versus WA's two.                                                                                      
                                                                                                                                
2:18:30 PM                                                                                                                    
                                                                                                                                
SENATOR  DYSON said  that some  people  in Juneau  who have  been                                                               
using an involuntary commitment  program are claiming significant                                                               
success.                                                                                                                        
                                                                                                                                
SENATOR ELLIS said that he would look for data on this.                                                                         
                                                                                                                                
2:19:42 PM                                                                                                                    
                                                                                                                                
SONIA SUBANI, with  AARP Alaska, asked if  the committee received                                                               
her letter of support.                                                                                                          
                                                                                                                                
CHAIR DAVIS replied that they had.                                                                                              
                                                                                                                                
MS.  SUBANI said  that substance  abuse is  prevalent in  Alaska,                                                               
particularly  among older  citizens. Currently  there's only  one                                                               
treatment  center for  older Alaskans  in Anchorage;  often abuse                                                               
problems are  confusing to a  lot of people and  are misdiagnosed                                                               
by  those treating  them. The  AARP  is also  concerned with  how                                                               
abuse affects grandchildren  of its members, who  often live with                                                               
the grandparents because of their own parents' problems.                                                                        
                                                                                                                                
2:23:10 PM                                                                                                                    
                                                                                                                                
NATHAN  JOHNSON, Division  Manager  for  the Anchorage  Municipal                                                               
Department of  Health and Social  Services (DHSS), said  that the                                                               
department  continually struggles  with  treating  abuse and  the                                                               
bill will  help its efforts  greatly. The Alaskan  statistics for                                                               
alcohol and drug  related issues are high,  and treatment ability                                                               
is critical  to reduce costs.  The lifetime financial cost  for a                                                               
baby  with Fetal  Alcohol  Syndrome, for  example,  is almost  $3                                                               
million. A limited number of  people are responsible for the bulk                                                               
of  drug and  alcohol  abuse incidents  in  Anchorage; they're  a                                                               
major burden  on tax  dollars and a  more comprehensive  means of                                                               
treating them is necessary.                                                                                                     
                                                                                                                                
2:26:00 PM                                                                                                                    
                                                                                                                                
MIKE FORD,  with the Alaska  Native Health Board, said  that this                                                               
area of  concern deserves  a sharper  focus, and  the individuals                                                               
being discussed today are a major cost and should be targeted.                                                                  
                                                                                                                                
2:27:33 PM                                                                                                                    
                                                                                                                                
LONNIE WALTERS, Chair  of the Advisory Board on  Alcohol and Drug                                                               
Abuse, related his history with  involuntary commitment work, and                                                               
said  that  he  has  never  seen  more  success  than  with  such                                                               
programs. The  system won't necessarily burden  the court system,                                                               
because  people can  often be  persuaded  to enter  on their  own                                                               
recognizance.   Cuts  in   treatment   funding  for   involuntary                                                               
commitment have made the waiting list incredible long.                                                                          
                                                                                                                                
He  concluded by  saying that  he  wholeheartedly recommends  the                                                               
program and its high success rate.                                                                                              
                                                                                                                                
2:31:02 PM                                                                                                                    
                                                                                                                                
SENATOR ELTON asked what the commitment process entails.                                                                        
                                                                                                                                
MR. WALTERS said  that state laws need to  be carefully consulted                                                               
before  the  involuntary  commitment  process is  used,  and  the                                                               
Alaskan  and   Washingtonian  laws  are  very   similar.  In  his                                                               
experience, he  would obtain letters  of support from  family and                                                               
friends of individuals.                                                                                                         
                                                                                                                                
SENATOR  ELTON asked  if  Mr. Walters,  in  his past  involuntary                                                               
commitment   experience,  had   remained  involved   through  the                                                               
patient's process and treatment.                                                                                                
                                                                                                                                
MR. WALTERS said that he did not,  and gave an example of how the                                                               
program worked in WA.                                                                                                           
                                                                                                                                
SENATOR ELTON asked how Mr.  Walters felt about turning a patient                                                               
over to people unfamiliar with their particular case.                                                                           
                                                                                                                                
MR. WALTERS said  that it's not a problem with  a good counselor,                                                               
and   that  the   counselors  were   provided  with   information                                                               
beforehand;  such programs  have the  highest success  rates he's                                                               
ever seen.                                                                                                                      
                                                                                                                                
2:35:35 PM                                                                                                                    
                                                                                                                                
MARGARET  LOWE, with  the Alaska  Mental  Health Trust  Authority                                                               
(AMHTA), said that substance abuse  is very often linked to child                                                               
abuse, and the state is in  great need of more treatment options.                                                               
Far  more money  needs to  be spent  on treatment  facilities and                                                               
personnel to make a difference in the future of the state.                                                                      
                                                                                                                                
JEFF  JESSE, Chief  Executive Officer  for the  AMHTA, said  that                                                               
he's  pleased with  the bill  and impressed  with the  grants for                                                               
evidence-based  programs  and   the  prioritization  of  pregnant                                                               
women; in the  long run, there will be  significant cost savings.                                                               
The  pilot program  is important  because 20  percent of  chronic                                                               
substance  abusers  cases  incur  80 percent  of  the  associated                                                               
costs; they need to be held accountable for their behavior.                                                                     
                                                                                                                                
2:40:20 PM                                                                                                                    
                                                                                                                                
MATT  FELIX, with  the National  Council on  Alcoholism and  Drug                                                               
Dependence, said that  during the years when  the Juneau Hospital                                                               
did involuntary commitments the  program was very successful. The                                                               
most chronically  addicted were committed,  and many of  them are                                                               
still sober today;  they needed to be forced to  turn their lives                                                               
around. Addiction isn't a choice, but a loss of control.                                                                        
                                                                                                                                
2:42:58 PM                                                                                                                    
                                                                                                                                
SENATOR ELTON asked for the elements that lead to commitment.                                                                   
                                                                                                                                
MR. FELIX said  that laws protect civil rights very  well, so the                                                               
process before court is lengthy;  loss of control must be proved,                                                               
as  well  as  the  chance  of  rehabilitation.  The  program  was                                                               
successful in  Juneau because it  was a city program  with access                                                               
to the city lawyers.                                                                                                            
                                                                                                                                
2:44:36 PM                                                                                                                    
                                                                                                                                
SENATOR THOMAS said that hopefully  the program will do some good                                                               
because the present situation needs  to be changed; he asked what                                                               
the problem  is with  convincing people to  agree to  funding the                                                               
program, and  what effort is needed  to show that the  program is                                                               
effective.                                                                                                                      
                                                                                                                                
MR. FELIX said that per  capita alcohol consumption has fallen to                                                               
under a gallon annually in  Alaska, partially due to awareness of                                                               
abuse  problems. He  added that  addiction  is better  understood                                                               
now, and treatment is getting to be more effective.                                                                             
                                                                                                                                
SENATOR THOMAS asked  if alcohol abuse is being  replaced by drug                                                               
abuse.                                                                                                                          
                                                                                                                                
MR. FELIX  said that alcohol is  a drug of choice,  and in Alaska                                                               
it's the major problem.                                                                                                         
                                                                                                                                
2:50:09 PM                                                                                                                    
                                                                                                                                
SENATOR  THOMAS  moved  to  report SB  100  from  committee  with                                                               
individual  recommendations and  attached  fiscal note(s).  There                                                               
being no objection, the motion carried.                                                                                         
                                                                                                                                

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