Legislature(2019 - 2020)ADAMS 519

03/19/2020 01:30 PM FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 290 ALTERNATIVE TO ARREST: MENTAL HEALTH CTR. TELECONFERENCED
Heard & Held
+ HB 247 SPORT FISHING ENHANCEMENT SURCHARGE TELECONFERENCED
Heard & Held
+= HB 131 APPROPRIATION LIMIT TELECONFERENCED
<Bill Hearing Canceled>
+ Bills Previously Heard/Scheduled TELECONFERENCED
                  HOUSE FINANCE COMMITTEE                                                                                       
                      March 19, 2020                                                                                            
                         1:36 p.m.                                                                                              
                                                                                                                                
                                                                                                                                
1:36:31 PM                                                                                                                    
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair  Johnston   called  the  House   Finance  Committee                                                                    
meeting to order at 1:36 p.m.                                                                                                   
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Neal Foster, Co-Chair                                                                                            
Representative Jennifer Johnston, Co-Chair                                                                                      
Representative Dan Ortiz, Vice-Chair                                                                                            
Representative Ben Carpenter                                                                                                    
Representative Andy Josephson                                                                                                   
Representative Gary Knopp                                                                                                       
Representative Bart LeBon                                                                                                       
Representative Kelly Merrick                                                                                                    
Representative Colleen Sullivan-Leonard                                                                                         
Representative Cathy Tilton                                                                                                     
Representative Adam Wool                                                                                                        
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
None                                                                                                                            
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Representative  Matt Claman,  Sponsor; Sophie  Jonas, Staff,                                                                    
Representative Matt Claman.                                                                                                     
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Steve  Williams,  Chief  Financial  Officer,  Alaska  Mental                                                                    
Health  Trust  Authority;   Al  Wall,  Deputy  Commissioner,                                                                    
Department  of Health  and  Social  Services; Robin  Minard,                                                                    
Chief  Communications  Officer,  Mat-Su  Health  Foundation,                                                                    
Wasilla;   Kacy  Schroeder,   Assistant  Attorney   General,                                                                    
Criminal  Division,  Department  of  Law;  Cornelius  Simms,                                                                    
Lieutenant,  Alaska  State  Troopers, Department  of  Public                                                                    
Safety;  Gennifer Moreau,  Director, Division  of Behavioral                                                                    
Health,  Department  of  Health and  Social  Services;  Doug                                                                    
Vincent-Lang,  Commissioner, Department  of  Fish and  Game;                                                                    
Brian Frenette, Assistant Director, Division of Sport Fish,                                                                     
Department of Fish and Game.                                                                                                    
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
HB 247    SPORT FISHING ENHANCEMENT SURCHARGE                                                                                   
                                                                                                                                
          HB 247 was HEARD and HELD in committee for                                                                            
          further consideration.                                                                                                
                                                                                                                                
HB 290    ALTERNATIVE TO ARREST: MENTAL HEALTH CTR.                                                                             
                                                                                                                                
          HB 290 was HEARD and HELD in committee for                                                                            
          further consideration.                                                                                                
                                                                                                                                
Co-Chair Johnston reviewed the meeting agenda.                                                                                  
                                                                                                                                
HOUSE BILL NO. 290                                                                                                            
                                                                                                                                
     "An   Act  establishing   an   alternative  to   arrest                                                                    
     procedure  for  persons  in acute  episodes  of  mental                                                                    
     illness;  relating to  emergency  detention for  mental                                                                    
     health evaluation; and relating  to licensure of crisis                                                                    
     stabilization centers."                                                                                                    
                                                                                                                                
1:37:25 PM                                                                                                                    
                                                                                                                                
Co-Chair Johnston requested a bill introduction from the                                                                        
sponsor and staff.                                                                                                              
                                                                                                                                
REPRESENTATIVE MATT CLAMAN, SPONSOR, introduced the bill                                                                        
with prepared remarks:                                                                                                          
                                                                                                                                
     Those living  with serious mental health  disorders are                                                                    
     subject to  periodic recurrent  psychiatric emergencies                                                                    
     or  crises that  require prompt  medical attention  and                                                                    
     stabilization.  Factors  such  as the  lack  of  timely                                                                    
     access  to essential  services and  supports, substance                                                                    
     abuse  disorders,  unstable housing  and  homelessness,                                                                    
     and poverty exacerbate these crises.                                                                                       
                                                                                                                                
     In Alaska and  across the nation we  face challenges in                                                                    
     how  we address  people  in  crisis. Current  treatment                                                                    
     options for  those in  crisis are  largely concentrated                                                                    
     at  either end  of the  behavioral health  continuum of                                                                    
     care,  with long-term  outpatient treatment  options at                                                                    
     one  end  of  the   spectrum  and  intensive  inpatient                                                                    
     treatment  options  at  the other.  When  comprehensive                                                                    
     community-based    mental     health    services    are                                                                    
     insufficient,  the  burden  of dealing  with  those  in                                                                    
     crisis  often falls  on  individuals and  organizations                                                                    
     whose primary duties lay  outside the traditional scope                                                                    
     of   psychiatric    stabilization.   Police   officers,                                                                    
     hospital     emergency    departments,     correctional                                                                    
     facilities, and  social service providers are  often on                                                                    
     the  frontline of  dealing  with  those experiencing  a                                                                    
     behavioral   health  crisis.   These  individuals   and                                                                    
     organizations are  already at capacity in  dealing with                                                                    
     their  primary functions  in public  safety and  health                                                                    
     services.                                                                                                                  
                                                                                                                                
     House  Bill 290  is the  first  step in  adding a  much                                                                    
     needed   intermediate   treatment  option   for   those                                                                    
     suffering from  a mental health crisis.  Created by the                                                                    
     National Association of  State Mental Health Directors,                                                                    
     the   National  Council   for  Behavioral   Health,  RI                                                                    
     International, and Suicide  Prevention Groups and known                                                                    
     as  the   "Crisis  Now"  model,   crisis  stabilization                                                                    
     centers  are  community-based interventions  to  better                                                                    
     serve  those  experiencing intermediate  mental  health                                                                    
     crises.                                                                                                                    
                                                                                                                                
     These  facilities are  open 24  hours a  day, 7  days a                                                                    
     week, 365  days a  year; are  staffed by  mental health                                                                    
     professionals; have  a no wrong door  approach; and are                                                                    
     designed  to provide  prompt  mental health  evaluation                                                                    
     and  stabilization. Crisis  stabilization centers  have                                                                    
     already  proved to  be a  successful community  tool in                                                                    
     other states including Arizona and Washington.                                                                             
                                                                                                                                
1:40:27 PM                                                                                                                    
                                                                                                                                
Representative Claman  noted that  the Alaska  Mental Health                                                                    
Trust Authority (AMHTA) paid to  bring a number of people to                                                                    
take  a  tour  in  Arizona. He  acknowledged  that  Co-Chair                                                                    
Johnston had attended  the tour. He shared that  he had been                                                                    
in Arizona on other matters and  had done a tour himself. He                                                                    
reported that the  facility in the Phoenix  suburb of Peoria                                                                    
was  operated by  a private  group.  He stated  it had  been                                                                    
inspiring to  see how well  the facility worked and  to hear                                                                    
from police officers about how  satisfied they were with the                                                                    
option for dealing  with people with a  mental health crisis                                                                    
and as an  alternative to dealing with people  they may have                                                                    
to  otherwise arrest.  He  continued  reading from  prepared                                                                    
remarks:                                                                                                                        
                                                                                                                                
     No  facilities  currently  exist   in  Alaska.  HB  290                                                                    
     authorizes   the  Department   of  Health   and  Social                                                                    
     Services  to write  regulations to  permit and  license                                                                    
     crisis  stabilization  centers   in  Alaska.  Once  the                                                                    
     regulations  are  in  place,  it  is  anticipated  that                                                                    
     interested  providers  will open  crisis  stabilization                                                                    
     centers in Alaska's communities.                                                                                           
                                                                                                                                
     House   Bill  290   also   gives   our  public   safety                                                                    
     professionals  an  essential   alternative  to  improve                                                                    
     public  safety.   It  amends   the  Code   of  Criminal                                                                    
     Procedure to  allow police  officers who  have probable                                                                    
     cause  to arrest  an individual  to elect  to take  the                                                                    
     person  to   a  crisis   stabilization  center   as  an                                                                    
     alternative  to jail.  Using  the crisis  stabilization                                                                    
     alternative would  require the  police officer  to find                                                                    
     that  the person  was experiencing  a mental  health or                                                                    
     substance abuse  crisis and that treatment  at a crisis                                                                    
     intervention  center would  lead  to  a better  outcome                                                                    
     from both  a treatment  and public  safety perspective.                                                                    
     House Bill 290  ensures that even if a  person is taken                                                                    
     to  a crisis  stabilization center,  they can  still be                                                                    
     prosecuted for alleged criminal activity.                                                                                  
                                                                                                                                
Representative   Claman   thanked   AMHTA   for   committing                                                                    
resources to  urge getting  crisis stabilization  centers in                                                                    
Alaska. His office had worked  with the Department of Health                                                                    
and  Social Services,  particularly  Deputy Commissioner  Al                                                                    
Wall. He reported that a number  of changes had been made to                                                                    
the original bill version to  address concerns raised by the                                                                    
Department of Law, Criminal and  Civil Divisions. His office                                                                    
had  long discussions  with the  Alaska Network  on Domestic                                                                    
Violence and Sexual Assault and  had made adjustments to the                                                                    
bill in regard  to their concerns. Additionally,  they had a                                                                    
number  of calls  with the  Anchorage Police  Department. He                                                                    
shared that all  of the groups were supportive  of the bill.                                                                    
He asked his staff to present the sectional analysis.                                                                           
                                                                                                                                
1:43:04 PM                                                                                                                    
                                                                                                                                
SOPHIE JONAS, STAFF, REPRESENTATIVE  MATT CLAMAN, reviewed a                                                                    
sectional analysis (copy on file):                                                                                              
                                                                                                                                
                                                                                                                                
     Section 1                                                                                                                  
     AS 12.25.030.  Grounds For Arrest By  Private Person or                                                                    
     Peace Officer Without Warrant                                                                                              
     Amends AS  12.25.030 by adding a  new section providing                                                                    
     peace  officers  with  an  alternative  to  arrest.  An                                                                    
     officer may,  at their discretion, deliver  a person to                                                                    
     a  crisis stabilization  center or  evaluation facility                                                                    
     instead of arresting them if  the officer believes that                                                                    
     the  person  is  suffering  from an  acute  episode  of                                                                    
     mental illness  or if the person  voluntarily agrees to                                                                    
     be   taken  to   a  crisis   stabilization  center   or                                                                    
     evaluation facility.  Taking an individual to  a crisis                                                                    
     stabilization   center  or   evaluation  facility,   as                                                                    
     provided for in this  section, does not bar prosecution                                                                    
     of the  individual for alleged criminal  activity or on                                                                    
     charges for the original grounds for arrest.                                                                               
                                                                                                                                
     Section 2                                                                                                                  
     AS  18.65.530  Mandatory  Arrest For  Crimes  Involving                                                                    
     Domestic Violence, Violation  of Protective Orders, and                                                                    
     Violation   of  Conditions   of   Release.  Amends   AS                                                                    
     18.65.530(c) by  adding a  subsection providing  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   or  an                                                                    
     evaluation  facility  as  provided in  AS  12.25.031(b)                                                                    
     because   the   person   is  subject   to   involuntary                                                                    
     commitment under AS 47.30.705.                                                                                             
                                                                                                                                
     Section 3                                                                                                                  
     AS 18.65.530 Adds a new  subsection (g) to AS 18.65.530                                                                    
     that requires a peace officer  who delivers a person to                                                                    
     a  crisis stabilization  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.                                                                                                                 
                                                                                                                                
     Section 4                                                                                                                  
     AS  47.30.705  Mental  Health Emergency  Detention  for                                                                    
     Evaluation  Amends AS  47.30.705 by  clarifying that  a                                                                    
     person  who  is  gravely  disabled  or  suffering  from                                                                    
     mental  illness and  poses immediate  harm  to self  or                                                                    
     others  may  be  delivered to  a  crisis  stabilization                                                                    
     center  or  to  an  evaluation center  pursuant  to  AS                                                                    
     47.30.700.                                                                                                                 
                                                                                                                                
1:45:31 PM                                                                                                                    
                                                                                                                                
Ms. Jonas continued to review the sectional analysis:                                                                           
                                                                                                                                
     Section 5                                                                                                                  
     AS 47.30.710 Mental Health Examination                                                                                     
     Amends AS  47.30.710(a) to  provide for  an examination                                                                    
     by a medical professional  within three hours for those                                                                    
     brought to crisis stabilization centers.                                                                                   
                                                                                                                                
     Section 6                                                                                                                  
     AS   47.32.010   Centralized  Licensing   and   Related                                                                    
    Administrative Procedures Purpose and Applicability                                                                         
     Amends  AS 47.32.010(b)  to allow  licensing of  crisis                                                                    
     stabilization centers under Chapter 32.                                                                                    
                                                                                                                                
     Section 7                                                                                                                  
     AS    47.32   Centralized    Licensing   and    Related                                                                    
     Administrative Procedures                                                                                                  
     Amends AS 47.32.900 to expand  the definition of crisis                                                                    
     stabilization   centers  to   include  23-hour   crisis                                                                    
     stabilization,  crisis  residential centers,  and  sub-                                                                    
     acute facilities.                                                                                                          
                                                                                                                                
     Section 8                                                                                                                  
     Uncodified Law of the State of Alaska                                                                                      
     Amends sec.  6 of this  act to allow the  Department of                                                                    
     Health   and   Social   Services,   before   a   crisis                                                                    
     stabilization    center    is   licensed    under    AS                                                                    
     47.32.010(b),  to issue  a  provisional  license to  or                                                                    
     reimbursement to a crisis stabilization center.                                                                            
                                                                                                                                
Ms. Jonas thanked the committee for the opportunity to                                                                          
present.                                                                                                                        
                                                                                                                                
1:46:31 PM                                                                                                                    
                                                                                                                                
Co-Chair Johnston asked members to hold questions until                                                                         
after hearing from invited testifiers.                                                                                          
                                                                                                                                
STEVE WILLIAMS, CHIEF FINANCIAL OFFICER, ALASKA MENTAL                                                                          
HEALTH TRUST AUTHORITY (via teleconference), spoke in                                                                           
support of the bill. He read from a prepared statement:                                                                         
                                                                                                                                
     The trust supports  HB 290. As you  are aware, Alaska's                                                                    
     psychiatric continuum of care  is not a full continuum.                                                                    
     It  currently relies  on the  most  expensive level  of                                                                    
     care,   API,  and   at   other   times  expensive   and                                                                    
     inappropriate levels of  care, hospital emergency rooms                                                                    
     and Alaska jails, to address  the needs of Alaskans who                                                                    
     are in acute  psychiatric crisis. This is  not the best                                                                    
     way to  expend the state's limited  financial resources                                                                    
     or provide care to Alaskans in a medical crisis.                                                                           
                                                                                                                                
     Currently,   the  Department   of  Health   and  Social                                                                    
     Services,  law  enforcement agencies,  local  hospitals                                                                    
     and  nonprofit  behavioral   health  providers,  tribal                                                                    
     health organizations  and the  trust, and  many others,                                                                    
     are    collaborating    to   develop    community-based                                                                    
     psychiatric    crisis    service   components.    These                                                                    
     components are based on the  best practice model called                                                                    
     Crisis  Now  and  those components  include  a  24-hour                                                                    
     crisis  call center,  a 24/7  mobile  crisis team,  and                                                                    
     crisis stabilization centers that  operate 24 hours per                                                                    
     day, 365  days a  year, and accept  all persons  with a                                                                    
     no-refusal policy.                                                                                                         
                                                                                                                                
     These   crisis   stabilization  centers   provide   law                                                                    
     enforcement   an  option   to  divert   someone  in   a                                                                    
     psychiatric   crisis  to   a   location  with   trained                                                                    
     professionals  and peers  who can  address their  needs                                                                    
     rather than  having a law enforcement  officer wait for                                                                    
     hours at an emergency room  or have a person handcuffed                                                                    
     in  the  back  of  their patrol  car  for  hours  until                                                                    
     treatment services  are available or they  might end up                                                                    
     inappropriately  in a  jail.  Rather,  the officer  can                                                                    
     appropriately  and efficiently  meet the  needs of  the                                                                    
     individual in  psychiatric crisis  by taking them  to a                                                                    
     psychiatric stabilization center,  allowing the officer                                                                    
     to  return to  the street  to perform  more traditional                                                                    
     public safety duties and minutes.                                                                                          
                                                                                                                                
     HB 290 provides  some of the critical  policy tools for                                                                    
     law   enforcement   and   the  healthcare   system   to                                                                    
     effectively  implement these  much  needed services  to                                                                    
     dramatically enhance  our psychiatric  crisis continuum                                                                    
     of care. The trust believes  HB 290 will help the State                                                                    
     of   Alaska  move   forward   with  implementation   of                                                                    
     community  solutions to  better respond  to individuals                                                                    
     in a mental  health or substance use  related crisis to                                                                    
     get  them  to  the   proper  services  to  receive  the                                                                    
     appropriate interventions  by individuals appropriately                                                                    
     trained. If  you're interested  in learning  more about                                                                    
     the Crisis Now  model, I would encourage  members to go                                                                    
     to crisisnow.com and on their  homepage there's a short                                                                    
     two to three  minute video that explains  the model and                                                                    
     how it operates.                                                                                                           
                                                                                                                                
1:50:12 PM                                                                                                                    
                                                                                                                                
Representative Sullivan-Leonard referenced  the fiscal note.                                                                    
She asked if  AMHTA was in a position  to financially assist                                                                    
with the endeavor.                                                                                                              
                                                                                                                                
Mr. Williams answered that  AMHTA had historically committed                                                                    
funding  and would  continue to  financially  assist in  the                                                                    
development and  implementation of  the model.  Trustees had                                                                    
allocated over  $2 million to  the effort and the  trust was                                                                    
committed  for the  long haul  to ensure  the services  were                                                                    
available in Alaska.                                                                                                            
                                                                                                                                
Representative  Carpenter  had   questions  related  to  the                                                                    
victim of a crime.                                                                                                              
                                                                                                                                
Representative Claman  requested to hold  the constitutional                                                                    
questions until invited testimony was completed.                                                                                
                                                                                                                                
AL  WALL,  DEPUTY  COMMISSIONER, DEPARTMENT  OF  HEALTH  AND                                                                    
SOCIAL  SERVICES (via  teleconference),  discussed that  the                                                                    
Department  of Health  and Social  Services  (DHSS) had  put                                                                    
forward  an  1115  Medicaid waiver.  He  detailed  that  the                                                                    
waiver was in  part to fill in the gaps  in the continuum of                                                                    
care for behavioral health. The  efforts for the 1115 waiver                                                                    
would   need   the   structure   of   things   like   crisis                                                                    
stabilization  in order  for  its  implementation, which  he                                                                    
believed  was supported  by the  legislation. He  noted that                                                                    
the  department  had  been  happy  to  work  with  the  bill                                                                    
sponsor.                                                                                                                        
                                                                                                                                
Mr.  Wall  communicated  that crisis  stabilization  was  an                                                                    
essential  piece  of any  continuum  of  care and  it  would                                                                    
successfully  shift  the  bulk   of  the  efforts  currently                                                                    
underway. He elaborated that  behavioral health efforts were                                                                    
generally focused  on crisis and  acuity. He  explained that                                                                    
because there  were some gaps  in service in  the behavioral                                                                    
health  continuum of  care,  they tended  to  wait until  an                                                                    
individual was in absolute crisis  and showed up in the back                                                                    
of  a  squad  car  or  in the  emergency  room  before  they                                                                    
received any  care. The incident  typically resulted  in the                                                                    
person being  arrested or in  need of  inpatient psychiatric                                                                    
care. Crisis  stabilization centers  would be a  step toward                                                                    
stabilization  in community,  which  was  less expensive  to                                                                    
care for individuals and had  been proven to be better care.                                                                    
Historically, the  more stabilization focused  care provided                                                                    
in community for people, the better the outcomes had been.                                                                      
                                                                                                                                
1:53:59 PM                                                                                                                    
                                                                                                                                
Mr. Wall  addressed the department's  two fiscal  notes. The                                                                    
first  note was  related to  regulatory oversight  of a  new                                                                    
type  of  license.  He elaborated  that  any  facility  that                                                                    
touched  Medicaid  or  had patients,  needed  oversight  for                                                                    
licensure. The  department did surveys and  investigation of                                                                    
harm if needed,  which required personnel that  needed to be                                                                    
funded. There  was also the implementation  of billing codes                                                                    
in  the   MMIS  [Medicaid  Management   Information  System]                                                                    
computer system  for the new  provider type.  He highlighted                                                                    
that  significant  savings   were  anticipated  through  the                                                                    
effort. He explained that the  longer the state waited until                                                                    
a   person  was   in  absolute   need  of   acute  inpatient                                                                    
psychiatric  care,  the  more  it cost  the  state  and  the                                                                    
individual.  He  reported  that   the  care  at  an  instate                                                                    
psychiatric hospital  was much more expensive  and typically                                                                    
involved an  emergency room visit and/or  court time, lawyer                                                                    
fees,  and   jailtime.  He  reiterated  that   savings  were                                                                    
expected, but he  did not have a specific  amount to include                                                                    
in the fiscal note.                                                                                                             
                                                                                                                                
1:55:35 PM                                                                                                                    
                                                                                                                                
Representative Knopp  asked if  there were any  positions in                                                                    
DHSS  funded through  AMHTA. He  was skeptical  of any  more                                                                    
unrestricted general funds (UGF)  going to any positions. He                                                                    
stated he would  be more receptive to the idea  if they were                                                                    
funded through  AMHTA. He asked  if it would be  feasible to                                                                    
incorporate the  crisis stabilization center on  the grounds                                                                    
at  the Alaska  Psychiatric Institute  (API). He  asked what                                                                    
the statewide plan  would be. He wondered if  there would be                                                                    
a crisis center in multiple regions throughout the state.                                                                       
                                                                                                                                
Mr.  Wall  replied  that  AMHTA  helped  fund  a  number  of                                                                    
positions in  DHSS related to various  issues. He elaborated                                                                    
that typically AMHTA funded half  a position, with the other                                                                    
half funded by  the state. In regard to the  bill topic, the                                                                    
effort was  not isolated. He explained  that coexisting with                                                                    
a  crisis  stabilization  center  there  would  need  to  be                                                                    
coordination  and  communication  regarding  which  patients                                                                    
were  going  were.  The  coordination  may  or  may  not  be                                                                    
directly  in the  crisis  stabilization  center, meaning  it                                                                    
likely  not  a person  in  a  specific crisis  stabilization                                                                    
center, but there would still  need to be someone "directing                                                                    
traffic."                                                                                                                       
                                                                                                                                
Mr. Wall detailed that if  a crisis stabilization center had                                                                    
a  person who  needed to  go to  inpatient psychiatric  care                                                                    
there  would have  to be  a coordinator  assisting with  the                                                                    
process. He shared  that the position was part  of the Morse                                                                    
Plan and  was partially funded  through the trust.  He noted                                                                    
that it  was not specifically  in the bill, but  the efforts                                                                    
of  crisis  stabilization  were not  isolated  -  the  issue                                                                    
required coordination  across DHSS  and with  the Department                                                                    
of Corrections and the Department of Public Safety as well.                                                                     
                                                                                                                                
Mr. Wall  cautioned against thinking  the bill  would result                                                                    
in  a "light  switch  approach" where  on July  1  all of  a                                                                    
sudden there would be crisis  stabilization centers all over                                                                    
the  state and  everything  would be  fixed. He  underscored                                                                    
that would  not occur. The  efforts would be phased  in over                                                                    
time with the  first efforts focusing on  the more populated                                                                    
areas where  the highest need  existed. He referenced  an RI                                                                    
International study  focused on Anchorage and  Fairbanks and                                                                    
relayed  that the  initial phase  of  the work  would be  on                                                                    
Anchorage.  He highlighted  that the  plan was  adaptable to                                                                    
other areas including rural areas.                                                                                              
                                                                                                                                
Mr. Wall shared  that the trips to  Arizona had demonstrated                                                                    
that  the approach  worked if  modified, not  only in  rural                                                                    
areas,  but  also with  tribal  organizations.  If the  bill                                                                    
passed,  the  department planned  on  rolling  out the  1115                                                                    
services beginning with crisis  stabilization centers in the                                                                    
state's  more  populous  urban  areas.  Subsequently,  there                                                                    
would  be  modifications  made  to  accommodate  a  regional                                                                    
approach.                                                                                                                       
                                                                                                                                
1:59:38 PM                                                                                                                    
                                                                                                                                
Representative  Knopp relayed  that earlier  in the  day the                                                                    
committee    had   considered    legislation   related    to                                                                    
administering psychotropic  drugs. He  asked if there  was a                                                                    
need  for  advanced  practice registered  nurses  (APRN)  or                                                                    
registered  nurses in  the crisis  intervention centers.  He                                                                    
asked if that was the case in the facilities in Arizona.                                                                        
                                                                                                                                
Mr.  Wall answered  that Arizona  and the  Crisis Now  model                                                                    
(utilized  by RI  International)  used licensed  independent                                                                    
practitioners. There  were advanced nurse  practitioners and                                                                    
physician assistants  that worked  in the  particular field.                                                                    
He explained  that the  crisis med  bill [SB  120] discussed                                                                    
earlier in  the day had  to do with  involuntary commitments                                                                    
and   individuals    who   are    administered   medications                                                                    
involuntarily.  He clarified  that the  crisis stabilization                                                                    
center setting would be voluntary.                                                                                              
                                                                                                                                
2:01:12 PM                                                                                                                    
                                                                                                                                
Representative  Wool thanked  the bill  sponsor, AMHTA,  and                                                                    
DHSS  for bringing  the legislation  forward. He  noted that                                                                    
the committee had heard a  presentation on the Arizona model                                                                    
from AMHTA  earlier in  the year.  He believed  the approach                                                                    
was  a step  in  the  right direction.  He  remarked on  the                                                                    
testimony that someone could not  be held against their will                                                                    
in one  of the centers.  He reasoned  it was not  like being                                                                    
arrested and put  in jail while law  enforcement figured out                                                                    
where the person  should go. He asked  for confirmation that                                                                    
a  person  had to  be  willing  to go  stay  in  one of  the                                                                    
facilities even if they needed inpatient psychiatric care.                                                                      
                                                                                                                                
Representative  Claman  made  a  correction  to  Mr.  Wall's                                                                    
testimony.  He clarified  that the  provisions  of the  bill                                                                    
allowed a  voluntary placement  in the  crisis stabilization                                                                    
center,  but an  officer  also had  the  authority to  admit                                                                    
someone  subject to  involuntary  commitment  into a  crisis                                                                    
stabilization center for a limited time.                                                                                        
                                                                                                                                
Representative  Wool   referenced  bill  language   about  a                                                                    
23-hour  crisis observation  stabilization center.  He asked                                                                    
if the 23 hours reflected the legally allowable timeframe.                                                                      
                                                                                                                                
Representative Claman replied in the affirmative.                                                                               
                                                                                                                                
Representative  Wool  referenced  bill  language  specifying                                                                    
that  only  a  small  number  may  need  long-term  services                                                                    
through a  subacute residential  crisis center  or inpatient                                                                    
psychiatric care.  He stated  that API  was the  only option                                                                    
available in  Alaska. He detailed  that the facility  had 50                                                                    
beds  and  was  expensive.  He  asked if  the  state  had  a                                                                    
subacute residential crisis center.                                                                                             
                                                                                                                                
Mr. Wall  made clarifying remarks pertaining  to involuntary                                                                    
medication. He  was aware the  bill allowed  for involuntary                                                                    
commitment to  the crisis center. His  remarks had pertained                                                                    
to  the involuntary  administration of  medication addressed                                                                    
by other  legislation [SB 120].  He moved  to Representative                                                                    
Wool's  question and  confirmed there  was a  necessary full                                                                    
continuum of care. He highlighted  that the RI International                                                                    
model  had  four pillars  including  a  call center,  crisis                                                                    
response teams,  crisis stabilization center,  and continuum                                                                    
of care. He explained that  there was a broader application,                                                                    
the  effort was  not  isolated. He  confirmed that  subacute                                                                    
care or "step down units"  were needed - the availability in                                                                    
the state was extremely limited.                                                                                                
                                                                                                                                
Representative  Wool spoke  to involuntary  administering of                                                                    
psychotropic or  antipsychotic drugs. He thought  it sounded                                                                    
like a  physician assistant or APRN  could prescribe dosages                                                                    
against a person's  will for a limited period  of time under                                                                    
a  separate piece  of legislation  [SB  120]. He  referenced                                                                    
Mr. Wall's testimony that the  practice would not be allowed                                                                    
at  the crisis  stabilization centers.  On the  contrary, he                                                                    
thought that  it would be a  policy call for each  center if                                                                    
the other legislation  passed. He noted he  was not weighing                                                                    
in on whether it was a good  or bad idea. He reasoned it may                                                                    
be what was  needed. He asked if the issue  was addressed in                                                                    
either of the bills [HB 290 or SB 120].                                                                                         
                                                                                                                                
2:06:01 PM                                                                                                                    
                                                                                                                                
Mr.  Wall   did  not  believe   the  topic   of  involuntary                                                                    
medication was addressed  in HB 290, nor did  he believe the                                                                    
specific location was addressed in  SB 120. He would have to                                                                    
speak  with the  department's  attorney  Steven Bookman  and                                                                    
follow up with the committee.                                                                                                   
                                                                                                                                
Representative  Wool  clarified that  he  was  not taking  a                                                                    
position on the  issue and reasoned that it may  be what was                                                                    
needed in the facilities.                                                                                                       
                                                                                                                                
Representative  Josephson stated  that  the  bill created  a                                                                    
definition called  a crisis stabilization center  and he was                                                                    
confident  that Senator  Cathy Giessel's  bill [SB  120] did                                                                    
not refer to that. However,  he wondered if someone in acute                                                                    
crisis  taken  to a  crisis  stabilization  center could  be                                                                    
involuntarily administered a drug.                                                                                              
                                                                                                                                
Mr. Wall responded  that he would speak  to the department's                                                                    
legal team  and would follow  up. He highlighted  the system                                                                    
they had visited  in Arizona and detailed  that their entire                                                                    
system was built around  de-escalation and stabilization. He                                                                    
explained that  at the point  on the service  spectrum where                                                                    
people needed  involuntary commitment and  involuntary meds,                                                                    
the number of  people needing services became  a smaller and                                                                    
smaller. Currently, there were  two outcomes for individuals                                                                    
taken  to   an  emergency  room  and   given  a  psychiatric                                                                    
evaluation  due to  their state  of mind.  He detailed  that                                                                    
either the person  was a danger to themselves  or others and                                                                    
gravely disabled and they needed  to be committed to care or                                                                    
they were not.                                                                                                                  
                                                                                                                                
Mr.  Wall explained  that  the  crisis stabilization  center                                                                    
instituted  another  level of  care  focused  on actual  de-                                                                    
escalation and  stabilization of  their crisis in  place. He                                                                    
addressed why  he had been  talking about not  isolating the                                                                    
crisis stabilization center  from the rest of  the system of                                                                    
care. He  detailed that the  call center in Arizona  was the                                                                    
first of the four pillars  of the RI International study and                                                                    
it had  been found to  stabilize the vast majority  of calls                                                                    
prior to  getting to a crisis  stabilization team. Likewise,                                                                    
when  a  crisis  stabilization  team was  needed,  the  team                                                                    
stabilized a  large percentage of  cases before there  was a                                                                    
need  for  going to  a  crisis  stabilization center.  Those                                                                    
individuals who  went to a  crisis stabilization  center had                                                                    
an  ever reducing  percentage need  for inpatient  care. For                                                                    
example,  Arizona had  a far  larger population  than Alaska                                                                    
and it only  had one inpatient psychiatric  hospital as well                                                                    
with a slightly higher capacity than API.                                                                                       
                                                                                                                                
Mr.  Wall  stressed the  effectiveness  of  the approach  of                                                                    
stabilizing   individuals  in   community  without   needing                                                                    
inpatient psychiatric  care. He recognized there  would be a                                                                    
percentage of the population that  would need inpatient care                                                                    
due  to  the  severity  of their  illness,  but  the  crisis                                                                    
stabilization  center   in  Arizona  had   proven  extremely                                                                    
effective  in  reducing  the incidence  rates  of  inpatient                                                                    
psychiatric need and stabilizing individuals in community.                                                                      
                                                                                                                                
2:10:10 PM                                                                                                                    
                                                                                                                                
Representative  Josephson asked  for  a repeat  of the  four                                                                    
pillars.                                                                                                                        
                                                                                                                                
Mr.  Wall replied  that  the four  pillars  included a  call                                                                    
center, crisis response  teams, crisis stabilization center,                                                                    
and continuum  of care. He  elaborated that the  call center                                                                    
acted  as an  air traffic  control  center for  a region  or                                                                    
entire state. The crisis response  teams were comprised of a                                                                    
behavioral health  technician and  a peer or  individual who                                                                    
had a  behavioral health crisis  in their past and  had been                                                                    
trained  to   intervene  with   other  people.   The  crisis                                                                    
stabilization center  was a drop  off center with  "no wrong                                                                    
door" in  terms of admittance.  He elaborated that  a person                                                                    
could  walk in  or be  brought in  by ambulance,  police, or                                                                    
relatives. The fourth pillar was  a more robust continuum of                                                                    
care that  linked into the  crisis stabilization  center and                                                                    
looked  like  a   handoff  -  called  a   "warm  handoff"  -                                                                    
specifically  centered around  the needs  of the  individual                                                                    
being stabilized. Some individuals  had a stronger substance                                                                    
abuse need, while others had  a stronger mental health need,                                                                    
and some individuals may have  a stronger social determinate                                                                    
need.                                                                                                                           
                                                                                                                                
2:11:51 PM                                                                                                                    
                                                                                                                                
ROBIN  MINARD, CHIEF  COMMUNICATIONS OFFICER,  MAT-SU HEALTH                                                                    
FOUNDATION,  WASILLA  (via   teleconference),  testified  in                                                                    
strong support of the bill. She read from prepared remarks:                                                                     
                                                                                                                                
     Foundation shares ownership  in Mat-Su Regional Medical                                                                    
     Center  and we  invest our  share of  the profits  back                                                                    
     into the  community to promote  health and  wellness of                                                                    
     Alaskans  living in  Mat-Su.  I'm  testifying today  in                                                                    
     strong  support  of House  Bill  290  to change  Alaska                                                                    
     statute to  allow for creation of  crisis stabilization                                                                    
     services as an alternative to arrest.                                                                                      
                                                                                                                                
     We support  this legislation because  it paves  the way                                                                    
     for some  of our  most vulnerable residents  to receive                                                                    
     medical  evaluation and  care and  lower cost  settings                                                                    
     than  hospital emergency  departments. This  results in                                                                    
     better outcomes and tremendous cost savings.                                                                               
                                                                                                                                
     As  was  mentioned  earlier by  Representative  Claman,                                                                    
     there's  a  crisis  stabilization in  Maricopa  County,                                                                    
     Arizona,  similar to  what could  be created  in Alaska                                                                    
     and  it's had  stunning results  over ten  years' time.                                                                    
     They've  seen savings  equivalent to  37 full-time  law                                                                    
     enforcement officers because  it's less labor intensive                                                                    
     to  take  people to  a  crisis  stabilization drop  off                                                                    
     center  than to  book  them into  jail.  They've had  a                                                                    
     reduction  of   45  cumulative  years   of  psychiatric                                                                    
     boarding  in hospital  emergency  departments and  that                                                                    
     represents  a  savings  of  $37  million  in  cost  and                                                                    
     they've had  a reduction  of $260 million  in potential                                                                    
     state-paid  acute care  inpatient  expenses. Since  the                                                                    
     prevalence of mental health  and substance use problems                                                                    
     is  increasing in  our  community  and statewide,  just                                                                    
     think  about  what  savings like  that  could  mean  to                                                                    
     Alaska.                                                                                                                    
                                                                                                                                
     The average annual  growth rate for visits  to the Mat-                                                                    
     Su  Regional  Medical  Center Emergency  Department  by                                                                    
     patients  with a  behavioral health  diagnosis grew  20                                                                    
     percent from  2015 to  2017 due in  part to  the opioid                                                                    
     epidemic  and   a  shortage  of   outpatient  treatment                                                                    
     access. Additionally, from 2014  to 2017, the number of                                                                    
     behavioral health assessments  required for patients in                                                                    
    crisis in the ED grew from 349 to more than 1,000.                                                                          
                                                                                                                                
     HB 290 will allow police  to bring patients to a crisis                                                                    
     stabilization  center instead  of a  hospital emergency                                                                    
     room or jail  and will result in  more humane treatment                                                                    
     and  great  cost  savings. In  2013,  with  our  Mat-Su                                                                    
     community  health  needs assessment,  Mat-Su  residents                                                                    
     ranked  health issues  they were  concerned about.  The                                                                    
     top  five  were  all  related   to  mental  health  and                                                                    
     substance use.  As a follow  up to that  assessment, we                                                                    
     conducted a behavioral  health environmental scan where                                                                    
     we looked  at policies  that could address  barriers to                                                                    
     care   and  improve   the   behavioral  health   system                                                                    
     challenges we're  facing. One recommendation  from that                                                                    
     report was to add a  crisis stabilization center to the                                                                    
     behavioral health  continuum of care;  however, current                                                                    
     state statute  does not  allow this  to happen.  HB 290                                                                    
     will change that.                                                                                                          
                                                                                                                                
2:14:51 PM                                                                                                                    
                                                                                                                                
Ms. Minard continued to read from a prepared statement:                                                                         
                                                                                                                                
     System change,  such as  what this  legislation allows,                                                                    
     will  alleviate   suffering  for   people  experiencing                                                                    
     behavioral health  crisis while  delivering significant                                                                    
     cost  savings,   especially  under   Alaska's  Medicaid                                                                    
     program.  The Mat-Su  Health  Foundation  is in  strong                                                                    
     support and we urge you to pass this important                                                                             
     legislation.                                                                                                               
                                                                                                                                
Ms. Minard thanked the committee for its time.                                                                                  
                                                                                                                                
Representative Sullivan-Leonard thought  the Mat-Su Regional                                                                    
Hospital  ER had  a triage  system to  evaluate patients  in                                                                    
crisis mode.  She mentioned the expansion  of the hospital's                                                                    
third floor for behavioral health.  She asked if there was a                                                                    
system in place  where patients were triaged  and then moved                                                                    
on to inpatient or  outpatient behavioral health services at                                                                    
the hospital.                                                                                                                   
                                                                                                                                
Ms. Minard answered,  "Sort of." She elaborated  that the 16                                                                    
behavioral  health beds  were open;  however,  there was  no                                                                    
outpatient  care  or crisis  center.  She  explained that  a                                                                    
person could come  in, but they were trying  to avoid costly                                                                    
inpatient  treatment.  She  detailed  that if  there  was  a                                                                    
crisis stabilization center  where a person could  go for 24                                                                    
hours to  be assessed, it  may be determined the  person did                                                                    
not  need inpatient  care  versus  immediately putting  them                                                                    
into that costly limited setting.                                                                                               
                                                                                                                                
2:16:30 PM                                                                                                                    
                                                                                                                                
Representative  Sullivan-Leonard   asked  if  there   was  a                                                                    
backlog  of patients  in  the emergency  room  as they  were                                                                    
triaged  and  possibly  held  for  inpatient  admittance  or                                                                    
referral to another facility.                                                                                                   
                                                                                                                                
Ms.   Minard  replied   she  could   follow   up  with   the                                                                    
information.  She  confirmed  there   were  times  when  the                                                                    
emergency   department  was   overwhelmed  by   people  with                                                                    
behavioral health and other needs.  The bill would allow the                                                                    
backlog to be alleviated somewhat.                                                                                              
                                                                                                                                
Representative LeBon  thanked Ms. Minard for  her testimony.                                                                    
He asked  if the  Mat-Su Health  Foundation would  be ready,                                                                    
willing, and able to assist  in covering financial costs for                                                                    
a crisis stabilization center.                                                                                                  
                                                                                                                                
Ms.  Minard could  not currently  commit to  covering future                                                                    
operating  costs. She  shared that  the subject  was a  high                                                                    
priority for  the foundation, and  it had  already committed                                                                    
financial  resources  to  get the  project  to  its  current                                                                    
point.                                                                                                                          
                                                                                                                                
Co-Chair  Johnston believed  Mr. Wall  had an  answer to  an                                                                    
earlier question.                                                                                                               
                                                                                                                                
Mr.  Wall communicated  that  he had  spoken  with the  DHSS                                                                    
legal team  and followed  up on questions  by Representative                                                                    
Wool  and Representative  Josephson about  whether a  crisis                                                                    
stabilization  center would  be  able  to administer  crisis                                                                    
involuntary  medication   under  SB  120,  which   had  been                                                                    
discussed earlier in the day.  He explained that it depended                                                                    
on the  designation of the  crisis stabilization  center. He                                                                    
elaborated  that  could  be  administered  at  a  designated                                                                    
evaluation and  treatment center or a  designated evaluation                                                                    
and stabilization center. The  centers were regulated by the                                                                    
state  with   very  specific  psychiatric   credentials  and                                                                    
training.  He  expounded  that  if  a  crisis  stabilization                                                                    
center  went   the  extra  step   to  become   a  designated                                                                    
evaluation  and treatment  center  it would  be possible  to                                                                    
administer involuntary medication at the location.                                                                              
                                                                                                                                
2:19:00 PM                                                                                                                    
                                                                                                                                
Representative  Wool  thought  it sounded  like  the  crisis                                                                    
stabilization centers  were not really set  up for different                                                                    
levels of care and  intervention. He believed a considerable                                                                    
amount of staff would  be needed to involuntarily administer                                                                    
medication.  He  thought   a  person  may  be   taken  to  a                                                                    
psychiatric  facility if  the  situation  escalated to  that                                                                    
level.  He   surmised  it  would  depend   on  a  facility's                                                                    
certification level.                                                                                                            
                                                                                                                                
Mr.  Wall  agreed.  He detailed  that  crisis  stabilization                                                                    
centers were  focused on de-escalation and  stabilization to                                                                    
the greatest  extent possible. There was  a small percentage                                                                    
of the  population whose severity  of illness  would require                                                                    
them   to  receive   inpatient   psychiatric  care.   Crisis                                                                    
stabilization centers would be able  to refer and follow the                                                                    
proper procedure  to get their patients  into inpatient care                                                                    
if  needed.  He  explained that  because  the  stabilization                                                                    
centers would be  keeping so many patients  out of inpatient                                                                    
psychiatric care, it would take  the pressure off the system                                                                    
of  designated evaluation  and  treatment centers  including                                                                    
API  and would  give  more flexibility  and availability  of                                                                    
beds.  The  long-term  goal   of  the  crisis  stabilization                                                                    
centers  was   to  take  the  pressure   off  the  inpatient                                                                    
psychiatric  system   (as  proven  in  other   states).  The                                                                    
conversation would  stop being  about the  lack of  beds and                                                                    
become one  of stabilization  and community.  The department                                                                    
believed the  best route would  be to relieve  pressure from                                                                    
inpatient psychiatric hospitals.                                                                                                
                                                                                                                                
Representative Wool  referenced the language  highlighted by                                                                    
the  bill   sponsor  that  the  centers   would  provide  an                                                                    
alternative  to arrest.  He  stated  his understanding  that                                                                    
being taken to  a center by the police was  not the only way                                                                    
a person  could end up  there. Additionally, a  person could                                                                    
walk in  or be brought in  by a family member.  He asked for                                                                    
verification it  would be like  going to the  emergency room                                                                    
or  an urgent  care  clinic,  but the  center  would be  for                                                                    
psychiatric evaluation.                                                                                                         
                                                                                                                                
Mr. Wall agreed.  He added that if done  properly the crisis                                                                    
centers,  as evidenced  in Arizona,  had a  more significant                                                                    
impact  on  the substance  abuse  population.  There was  no                                                                    
wrong door, regardless of a  person's issue, ability to pay,                                                                    
or how they arrive at a facility.                                                                                               
                                                                                                                                
2:22:10 PM                                                                                                                    
                                                                                                                                
Representative Josephson  referenced the testimony  that the                                                                    
facilities  could be  allowed to  administer  drugs if  they                                                                    
were  designated   evaluation  and  treatment   centers.  He                                                                    
thought  it  sounded like  a  term  of  art. He  reasoned  a                                                                    
facility  could  do   so  if  it  achieved   the  status  in                                                                    
accordance with some regulation  or statutory definition. He                                                                    
was trying to keep track  of who was administering drugs. He                                                                    
asked if his understanding was accurate.                                                                                        
                                                                                                                                
Mr. Wall  responded that  the bill  previously heard  by the                                                                    
committee, SB 120, related  to the involuntary administering                                                                    
of medications in crisis allowed  at a designated evaluation                                                                    
and   treatment   center   or  designated   evaluation   and                                                                    
stabilization center.  The designation was given  by DHSS to                                                                    
hospitals  it  had  an  agreement  with  that  had  specific                                                                    
psychiatric    professional   capability    and   oversight.                                                                    
Hospitals  included  Fairbanks Memorial  Hospital,  Bartlett                                                                    
Regional  Hospital, API,  and more.  There was  a designated                                                                    
evaluation  and stabilization  designation for  a couple  of                                                                    
beds  in  PeaceHealth  Medical Center  in  Ketchikan  and  a                                                                    
couple of beds in  the Yukon-Kuskokwim Health Corporation in                                                                    
Bethel.  The department  had the  designated evaluation  and                                                                    
treatment center or  designated evaluation and stabilization                                                                    
center  oversight agreements  with  specific facilities.  He                                                                    
explained  that if  a crisis  stabilization center  went the                                                                    
extra step  to get  the professional oversight  and capacity                                                                    
needed  to  become  a designated  evaluation  and  treatment                                                                    
center, the facility could enter  into an agreement with the                                                                    
state to do so.                                                                                                                 
                                                                                                                                
2:24:23 PM                                                                                                                    
                                                                                                                                
Co-Chair  Johnston requested  a review  of the  fiscal notes                                                                    
beginning with DOL.                                                                                                             
                                                                                                                                
KACY   SCHROEDER,  ASSISTANT   ATTORNEY  GENERAL,   CRIMINAL                                                                    
DIVISION,  DEPARTMENT OF  LAW  (via teleconference),  shared                                                                    
that  the fiscal  note from  the DOL  Criminal Division  was                                                                    
zero. The division did not  anticipate an increased caseload                                                                    
as  a  result  of  the   legislation.  She  noted  that  the                                                                    
legislation   may   actually   result   in   some   caseload                                                                    
diversions.                                                                                                                     
                                                                                                                                
2:25:15 PM                                                                                                                    
                                                                                                                                
CORNELIUS   SIMMS,   LIEUTENANT,  ALASKA   STATE   TROOPERS,                                                                    
DEPARTMENT OF PUBLIC  SAFETY (via teleconference), addressed                                                                    
the  Department  of  Public  Safety's  indeterminate  fiscal                                                                    
note.  He  explained  that  because   the  centers  did  not                                                                    
currently exist, the Alaska State  Troopers did not know the                                                                    
cost of  potentially having to transport  someone from rural                                                                    
Alaska to one of the  centers. He highlighted the mindset of                                                                    
treating  all  Alaskans  equally regardless  of  where  they                                                                    
lived; individuals  should be  given the  same opportunities                                                                    
for alternative to arrest.                                                                                                      
                                                                                                                                
Representative  Josephson asked  if  the  committee had  the                                                                    
specific fiscal note.                                                                                                           
                                                                                                                                
Co-Chair Johnston responded in the affirmative.                                                                                 
                                                                                                                                
Representative   Tilton  remarked   that  the   fiscal  note                                                                    
referred to  a provision  in the bill  allowing alternatives                                                                    
to  arrest for  a person  a peace  officer believed  in good                                                                    
faith  was  suffering  from  an   acute  episode  of  mental                                                                    
illness. She asked for the definition of the term.                                                                              
                                                                                                                                
Mr. Simms deferred the question to the bill sponsor.                                                                            
                                                                                                                                
Co-Chair Johnston  would hold the question  until the fiscal                                                                    
note review was complete.                                                                                                       
                                                                                                                                
2:27:27 PM                                                                                                                    
                                                                                                                                
GENNIFER  MOREAU, DIRECTOR,  DIVISION OF  BEHAVIORAL HEALTH,                                                                    
DEPARTMENT    OF   HEALTH    AND   SOCIAL    SERVICES   (via                                                                    
teleconference),  was available  for  questions. The  fiscal                                                                    
note associated with  the services was part  of the Medicaid                                                                    
projection  because the  services as  described through  the                                                                    
1115  waiver would  be funded  by  Medicaid. Therefore,  the                                                                    
fiscal note did not include the Medicaid services.                                                                              
                                                                                                                                
2:28:23 PM                                                                                                                    
                                                                                                                                
Representative Josephson  referenced earlier  testimony that                                                                    
that the  bill was not a  light switch. He noted  he did not                                                                    
expect  it to  be.  He asked  if the  bill  would require  a                                                                    
serious capital budget at some point.                                                                                           
                                                                                                                                
Representative Claman replied that  it was his understanding                                                                    
that  AMHTA  was supportive  of  providing  funding for  the                                                                    
capital side. He  noted that he did not speak  for AMHTA. He                                                                    
relayed  that existing  facilities may  provide some  of the                                                                    
space.  For  example,  the   Fairbanks  hospital  group  had                                                                    
suggested they  may not  need to  construct a  new building,                                                                    
but they may dedicate a  certain amount of square footage in                                                                    
their existing  facilities. He spoke  to the fiscal  side of                                                                    
the  cost. He  highlighted  that in  Arizona,  the cost  was                                                                    
associated with  fees for services  that could be  billed to                                                                    
insurance  and  Medicaid.  He reported  that  providers  had                                                                    
found that the model paid for itself.                                                                                           
                                                                                                                                
Representative  Josephson asked  if  the  facility would  be                                                                    
staffed with public or private workers.                                                                                         
                                                                                                                                
Representative Claman  replied that the expectation  was for                                                                    
the centers to be staffed with private workers.                                                                                 
                                                                                                                                
Representative  Josephson asked  if  it  [the employment  of                                                                    
private workers] reflected the typical Arizona model.                                                                           
                                                                                                                                
Representative  Claman  replied  that Arizona  centers  were                                                                    
staffed  with  private  workers.   He  elaborated  that  the                                                                    
Arizona building  housed a  crisis stabilization  center and                                                                    
two sub-acute facilities. There  was initially only one sub-                                                                    
acute facility, but  due to the volume  of incoming clients,                                                                    
a second  sub-acute area had  been built. He added  that the                                                                    
cost was all paid with fee for services.                                                                                        
                                                                                                                                
2:30:38 PM                                                                                                                    
                                                                                                                                
Representative    Carpenter    highlighted    constitutional                                                                    
considerations. He  provided a scenario where  an individual                                                                    
experiencing   an  episode   committed  a   crime  and   law                                                                    
enforcement  got to  decide whether  to make  an arrest  or,                                                                    
with  the  individual's  consent,  take  them  to  a  crisis                                                                    
stabilization   center.   He    asked   how   the   victim's                                                                    
constitutional  rights   that  required  due   process  were                                                                    
considered.  He  listed  the  constitutional  provisions  of                                                                    
condemnation, rights  of a victim,  and restitution,  all of                                                                    
which had to go before a judge to adjudicate or decide.                                                                         
                                                                                                                                
Representative Claman  replied that the question  applied to                                                                    
three  areas  of  the  law.   At  present,  an  officer  had                                                                    
discretion to arrest  or not arrest. He  provided a scenario                                                                    
where  a person  committed  a felony  level  assault and  an                                                                    
officer  believed the  individual was  gravely disabled.  An                                                                    
officer  was trained  to make  the determination  and commit                                                                    
someone under Title  47 and had the discretion  to bring the                                                                    
individual to  the psychiatric hospital or  jail. The victim                                                                    
notification requirements came into  play after charges were                                                                    
filed. He detailed that in  the same sense that a prosecutor                                                                    
would  contact  a  victim  if they  were  going  to  decline                                                                    
prosecution,  there was  not further  notice  required to  a                                                                    
victim.  The  primary  victim notification  provisions  came                                                                    
into  play  once  a  charge  was in  place  and  there  were                                                                    
criminal charges  going forward.  None of the  statute would                                                                    
limit the  prosecution's ability to charge  somebody even if                                                                    
they  went  to  crisis  stabilization.  He  noted  that  two                                                                    
different  places in  the legislation  referred specifically                                                                    
to the issue.                                                                                                                   
                                                                                                                                
Representative   Claman  continued   that  the   third  area                                                                    
involved  domestic  violence   protective  situations  under                                                                    
Title 18.  He detailed  that a domestic  violence call  to a                                                                    
police officer  was one of  the only areas with  a mandatory                                                                    
arrest in statute. Currently, when  a police officer went to                                                                    
a  house with  a  domestic violence  complaint, the  officer                                                                    
could get  permission from the  prosecutor to not  arrest if                                                                    
the  officer did  not believe  they had  probable cause.  He                                                                    
explained it  was the reason there  were on-call prosecutors                                                                    
available to  receive the calls. He  recommended speaking to                                                                    
Ms. Schroeder [with the DOL  Criminal Division) to learn how                                                                    
frequently the  calls occurred. Under current  statute, if a                                                                    
prosecutor  gave authorization,  the  officer  would not  be                                                                    
required to make an arrest.                                                                                                     
                                                                                                                                
Representative  Claman furthered  that Title  18 had  notice                                                                    
provisions related to domestic  violence that were different                                                                    
than  the criminal  code.  Under the  bill,  with regard  to                                                                    
Title  18 domestic  violence  circumstances,  two areas  had                                                                    
been identified with  real potential where there  could be a                                                                    
call in a  domestic violence setting. The first  was with an                                                                    
Alzheimer's  and dementia  type  population  where a  family                                                                    
called  the   police  because   they  were   having  trouble                                                                    
controlling a  family member.  Under the  circumstances, the                                                                    
family may say  the individual needed help and  did not need                                                                    
to go  to jail. He  explained that  the ability to  take the                                                                    
individual to  a crisis stabilization  center could  be what                                                                    
the family was looking for.                                                                                                     
                                                                                                                                
Representative Claman  detailed that the  second environment                                                                    
involved   an   individual   under   long-term   psychiatric                                                                    
treatment who may  have fallen off their  medication and may                                                                    
be having an  acute episode. He provided a  scenario where a                                                                    
twenty  to  thirtysomething  was  having  an  episode  while                                                                    
living at  home with their  parents. He elaborated  that the                                                                    
family had tried  everything and had called  the police, but                                                                    
with the  desire to send  the individual to a  crisis center                                                                    
because jail would only exacerbate  the crisis. He explained                                                                    
that the police  officer would have the  authority to arrest                                                                    
to take them  to the crisis stabilization  center. Under the                                                                    
legislation,   the  officer   would  be   required  to   get                                                                    
permission  from the  prosecutor to  take the  individual to                                                                    
the stabilization  center. He relayed that  if an individual                                                                    
was taken  under Title  18 domestic  violence circumstances,                                                                    
the officer  was required to  have the  crisis stabilization                                                                    
center provide notice  to the officer. He added  that it was                                                                    
limited    in   Title    18   to    involuntary   commitment                                                                    
circumstances.                                                                                                                  
                                                                                                                                
2:36:19 PM                                                                                                                    
                                                                                                                                
Representative Carpenter  had a  question about  the concept                                                                    
of a crime being committed  but not arrested for. He thought                                                                    
Representative  Claman  was saying  that  when  a crime  was                                                                    
committed  and no  arrest was  made, it  meant there  was no                                                                    
follow up  with the victim  because there was no  arrest. He                                                                    
thought it meant  there were no victim rights  and they were                                                                    
technically not the victim because there was no arrest.                                                                         
                                                                                                                                
Representative  Claman did  not  believe  the statement  was                                                                    
accurate.  He  clarified  that  what  triggered  the  victim                                                                    
notification  was  the filing  of  charges.  He stated  that                                                                    
arrest was  not required.  For example, an  individual could                                                                    
be involved in a bar fight  and could be issued a summons by                                                                    
the police officer to come to  court in a week. There were a                                                                    
number of  crimes where  there was  never an  arrest because                                                                    
officers  knew  there  was  no bail  requirement  or  if  an                                                                    
individual  could  post  $200  on the  spot  they  were  not                                                                    
arrested.  He   reiterated  it  was  not   the  arrest  that                                                                    
triggered the victim rights, it was the filing of charges.                                                                      
                                                                                                                                
2:37:50 PM                                                                                                                    
                                                                                                                                
Representative  Carpenter asked  for  verification the  bill                                                                    
did not  preclude a  request for filing  of charges  at some                                                                    
point in time by the victim.                                                                                                    
                                                                                                                                
Representative Claman  answered that  only a  prosecutor had                                                                    
the  right  to file  charges  because  the charges  were  on                                                                    
behalf of the  state. He added that, unrelated  to the bill,                                                                    
in a domestic violence scenario,  a person could be arrested                                                                    
and  brought  to jail  and  a  prosecutor could  decline  to                                                                    
prosecute for  some reason. Under  the scenario,  the victim                                                                    
had the right  to go to court to obtain  a domestic violence                                                                    
restraining order, which was a civil order.                                                                                     
                                                                                                                                
Representative  Carpenter  asked  if   the  bill  set  aside                                                                    
involuntary commitment  under Title 47 and  was not included                                                                    
as part of the legislation.                                                                                                     
                                                                                                                                
Representative  Claman  pointed  to   Section  1(b)  of  the                                                                    
legislation pertaining to  involuntary commitment authority.                                                                    
He detailed that an officer had  the ability to enter into a                                                                    
voluntary  agreement   and  not  arrest.   Additionally,  an                                                                    
officer  had the  ability  to require  an  individual go  to                                                                    
crisis  stabilization  under  the officer's  power  to  hold                                                                    
someone for involuntary commitment.                                                                                             
                                                                                                                                
Representative Carpenter  stated that Title 47  required the                                                                    
involuntary commitment to involve a judge.                                                                                      
                                                                                                                                
Representative   Claman  agreed.   He  elaborated   that  an                                                                    
involuntary  commitment  was  sometimes  referred  to  as  a                                                                    
72-hour hold. He detailed that if  a person was deemed to be                                                                    
a danger  to themselves  or others,  a police  officer could                                                                    
take them in to be placed  in a 72-hour hold for evaluation.                                                                    
He explained  that if  an officer took  the individual  to a                                                                    
crisis  stabilization  center  first,   there  would  be  an                                                                    
examination  in the  first  24 hours.  He  expounded it  was                                                                    
quite  possible the  person would  be stabilized  during the                                                                    
first  24  hours  and  would not  require  holding  for  the                                                                    
remaining 48 hours.                                                                                                             
                                                                                                                                
2:40:24 PM                                                                                                                    
                                                                                                                                
Representative  Carpenter  asked  if the  evaluation  [in  a                                                                    
crisis stabilization center] would be medical.                                                                                  
                                                                                                                                
Representative Claman highlighted  the important distinction                                                                    
between  an examination  and an  evaluation. The  evaluation                                                                    
was a psychiatric evaluation performed  by a psychologist or                                                                    
psychiatrist. The examination done  in the first three hours                                                                    
at a  crisis stabilization  center would  be performed  by a                                                                    
nurse for  an initial  determination. The  examination would                                                                    
not be  the psychiatric finding  that would allow  the state                                                                    
to hold an individual on  involuntary commitment past the 72                                                                    
hours.                                                                                                                          
                                                                                                                                
Representative  Carpenter explained  that he  was trying  to                                                                    
understand  the due  process component.  He stated  that the                                                                    
judicial branch  was supposed to  look out  for individuals'                                                                    
due process. He  stated that currently in  statute there was                                                                    
a requirement  for a judge  to be  involved if a  person was                                                                    
taken involuntarily.  He did  not see that  in the  bill. He                                                                    
believed the bill  allowed a person to  be put involuntarily                                                                    
in a crisis stabilization center without a judge's order.                                                                       
                                                                                                                                
Representative Claman  answered that it was  not included in                                                                    
the  bill  because there  was  no  change to  that  specific                                                                    
structure.  He provided  a scenario  where a  Mr. Smith  was                                                                    
having  an acute  psychiatric episode  and was  a danger  to                                                                    
himself or others - possibly  off his medication. Currently,                                                                    
an officer  in Anchorage  would take  the individual  to API                                                                    
and there would be hearings  within a 72-hour period where a                                                                    
judge would  hear testimony and determine  whether there was                                                                    
probable  cause  to  hold  the   person  for  a  period.  He                                                                    
explained  that taking  an individual  to API  triggered the                                                                    
process  where  a  hearing took  place  within  a  three-day                                                                    
period. The  bill enabled an  initial placement at  a crisis                                                                    
stabilization  center  for  the  first  23-hour  period.  He                                                                    
explained that if a person  was brought in on an involuntary                                                                    
basis, they  would have  the same  statutory rights  for the                                                                    
72-hour evaluation  and examination by a  judge. He detailed                                                                    
it was quite  possible the person may  stabilize soon enough                                                                    
to  negate the  need for  future hearings.  By the  time the                                                                    
court  was ready  to convene  the individual  may feel  much                                                                    
better and the treatment staff  may communicate there was no                                                                    
longer a basis  to hold the individual longer.  The bill did                                                                    
not change the  current 72-hour cycle. The  bill provided an                                                                    
alternative for the  first 23 hours where  someone was held.                                                                    
He detailed that if a  person was not stabilized within that                                                                    
timeframe they  would have  to go to  a facility  that could                                                                    
hold  them  longer -  API  in  Anchorage and  potentially  a                                                                    
subacute facility in Arizona for  a longer hold that was not                                                                    
as  extensive  as API.  Alaska  did  not have  the  subacute                                                                    
option.                                                                                                                         
                                                                                                                                
2:43:42 PM                                                                                                                    
                                                                                                                                
Representative Tilton  asked about the definition  for acute                                                                    
episode  of mental  illness.  She  believed substance  abuse                                                                    
could  be  different from  having  an  acute mental  illness                                                                    
episode.                                                                                                                        
                                                                                                                                
Representative Claman answered  that acute behavioral health                                                                    
crisis in the  bill title was one of the  changes his office                                                                    
had  worked  through  with  the   DOL  Civil  Division.  The                                                                    
language had  been used  because it  was already  defined in                                                                    
statute  and/or regulations.  It was  his understanding  was                                                                    
the  language  encompassed  both.  He deferred  to  DOL  for                                                                    
additional detail.                                                                                                              
                                                                                                                                
Ms. Schroeder  deferred to the question  to the department's                                                                    
Civil Division.                                                                                                                 
                                                                                                                                
Representative  Claman relayed  that he  would coordinate  a                                                                    
response with the department.                                                                                                   
                                                                                                                                
Representative  Josephson  asked  if law  enforcement  could                                                                    
file a  charge and take  a person to a  crisis stabilization                                                                    
center.                                                                                                                         
                                                                                                                                
Representative  Claman  answered   in  the  affirmative.  He                                                                    
anticipated the sequence  would be dropping a  person off at                                                                    
the center first, followed by filing charges.                                                                                   
                                                                                                                                
Representative  Josephson  thought  the  system  would  lend                                                                    
itself  to  a  mature,  intelligent,  sophisticated  officer                                                                    
thinking  about  defenses  to  crimes  under  Title  11  and                                                                    
looking at the  facts. He asked if an officer  could chart a                                                                    
person "all  day long," but  they could be found  not guilty                                                                    
for one reason or another.                                                                                                      
                                                                                                                                
2:46:16 PM                                                                                                                    
                                                                                                                                
Representative  Claman supposed  everything was  possible at                                                                    
some  level.  Based  on  his  conversations  with  Anchorage                                                                    
police about their interest in  crisis stabilization, it was                                                                    
his  understanding  that  there   was  a  certain  group  of                                                                    
individuals  seen  with  some frequency  who  commit  crimes                                                                    
including  shoplifting,  non-felony  assault  behavior,  and                                                                    
various  property crimes.  He elaborated  that the  officers                                                                    
knew some repeat  offenders who they knew to  be people with                                                                    
significant substance and mental  health issues. He believed                                                                    
it  was  more likely  that  an  officer  would look  at  the                                                                    
individuals and consider that it  may be better to take them                                                                    
to  a  crisis stabilization  center  to  get into  a  better                                                                    
health position rather  than taking them to  jail where they                                                                    
would  likely  continue the  cycle  of  being picked  up  by                                                                    
officers in the  future. He continued that  a prosecutor may                                                                    
choose  not to  prosecute,  or  the person  may  do well  at                                                                    
crisis stabilization and the officer  may be comfortable not                                                                    
prosecuting.  Additionally, the  victim  may be  comfortable                                                                    
not prosecuting because  they had seen the  people before as                                                                    
well.  He thought  it  was the  more  likely scenario  where                                                                    
repeat offenders going round  and round without improvement,                                                                    
could benefit from the stabilization centers.                                                                                   
                                                                                                                                
2:47:49 PM                                                                                                                    
                                                                                                                                
Representative Wool  asked about  a scenario where  a person                                                                    
had not  committed any crime,  but they  were at a  bus stop                                                                    
talking to themselves and  making people feel uncomfortable.                                                                    
He reasoned  it may be  a scenario where someone  called the                                                                    
cops and the person obviously  needed some help. He asked if                                                                    
it  would be  a  situation  where the  cops  could tell  the                                                                    
person they did not want to  arrest them or take them to the                                                                    
emergency room, but  they could suggest going  to the crisis                                                                    
stabilization center  to potentially get on  the road toward                                                                    
getting some medication and so forth.                                                                                           
                                                                                                                                
Representative  Claman replied  it  was  a circumstance.  He                                                                    
clarified  that it  would not  be an  alternative to  arrest                                                                    
because at some level the  officer would need probable cause                                                                    
to arrest before  the alternative to arrest  came into play,                                                                    
but the  officer would have the  ability to give a  person a                                                                    
ride  to  the  crisis  stabilization center.  He  added  the                                                                    
option  would be  available for  de-escalating the  bus stop                                                                    
scenario  [provided  by  Representative Wool]  where  people                                                                    
were nervous  about a person's  behavior. He added  that the                                                                    
option  would  be  available to  firefighters  as  well.  He                                                                    
believed that  in the  crisis stabilization  model described                                                                    
by Mr.  Williams and Mr.  Wall, the  first call would  be to                                                                    
the crisis  hotline. He detailed  that a mobile  crisis team                                                                    
may be sent  if the call did not  de-escalate the situation.                                                                    
He  explained that  the  crisis  team was  sent  prior to  a                                                                    
police officer being called and the team may be able to de-                                                                     
escalate  the  situation  without   a  trip  to  the  crisis                                                                    
stabilization center. The team  could take the individual to                                                                    
the  center   if  they  were   unable  to   de-escalate  the                                                                    
situation.                                                                                                                      
                                                                                                                                
Representative  Wool  considered  the rule  where  a  person                                                                    
could be  held involuntarily  for up to  23 hours.  He asked                                                                    
how  long a  person  could remain  in  a center  voluntarily                                                                    
prior to  getting moved to the  next stage. He asked  if the                                                                    
same timeframe pertained to voluntary stays as well.                                                                            
                                                                                                                                
Representative  Claman  replied  that  the  time  limit  was                                                                    
23  hours,  which  pertained partly  to  how  services  were                                                                    
billed with  insurance and Medicaid.  He stated that  one of                                                                    
the  hallmarks of  the facilities  was there  were no  beds,                                                                    
only recliners.                                                                                                                 
                                                                                                                                
2:50:18 PM                                                                                                                    
                                                                                                                                
Representative Knopp  asked for verification a  person could                                                                    
not be held against their will  at one of the facilities for                                                                    
any period of time.                                                                                                             
                                                                                                                                
Representative Claman  responded that under Section  1(a) of                                                                    
the  bill,  placement was  voluntary  as  an alternative  to                                                                    
arrest.  He   clarified  that  Section  1(b)   pertained  to                                                                    
involuntary  commitment where  a person  could be  prevented                                                                    
from walking away.  For example, if an  officer delivered an                                                                    
individual to  a crisis stabilization center  and would fill                                                                    
in  the required  paperwork  specifying  the commitment  was                                                                    
involuntary, the person  would not have the  ability to walk                                                                    
away. He  added that  police officers had  communicated that                                                                    
for the  idea to work they  would need the ability  to place                                                                    
individuals in centers both voluntarily and involuntarily.                                                                      
                                                                                                                                
Co-Chair  Johnston   set  an  amendment  deadline   for  the                                                                    
following day at noon.                                                                                                          
                                                                                                                                
HB  290  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
2:51:44 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:54:54 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
HOUSE BILL NO. 247                                                                                                            
                                                                                                                                
     "An   Act  relating   to  the   fish  and   game  fund;                                                                    
     establishing the  sport fishing  enhancement surcharge;                                                                    
     relating to  the repeal of  the sport  fishing facility                                                                    
     surcharge; providing for an  effective date by amending                                                                    
     the effective  date of sec.  21, ch. 18, SLA  2016; and                                                                    
     providing for an effective date."                                                                                          
                                                                                                                                
2:55:03 PM                                                                                                                    
                                                                                                                                
Co-Chair Johnston asked the commissioner of the Department                                                                      
of Fish and Game if he was presenting the bill.                                                                                 
                                                                                                                                
DOUG  VINCENT-LANG,  COMMISSIONER,  DEPARTMENT OF  FISH  AND                                                                    
GAME (via  teleconference), identified the legislation  as a                                                                    
priority  for the  Department  of Fish  and  Game (DFG).  He                                                                    
introduced the bill with prepared remarks:                                                                                      
                                                                                                                                
     In  2005 the  legislature  approved a  bond measure  to                                                                    
     construct two  sport fish hatcheries, the  William Jack                                                                    
     Hernandez hatchery  in Anchorage  and the  Ruth Burnett                                                                    
     hatchery in  Fairbanks. I  was part  of this  effort to                                                                    
     get this  bond passed.  In order  to receive  the bond,                                                                    
     the  Department of  Fish and  Game crafted  a repayment                                                                    
     plan that  was unprecedented. A surcharge  was added to                                                                    
     sport fishing  licenses, all of which  goes directly to                                                                    
     the repayment  of the bond, less  $500,000 annually for                                                                    
     hatchery  production   in  Southeast   Alaska.  Average                                                                    
     collection from 2013 to 2018 was $6.4 million.                                                                             
                                                                                                                                
     This plan  has worked  so well  that the  department is                                                                    
     paying  this bond  back five  years  early in  calendar                                                                    
     year 2020.  If promises  made at  the inception  of the                                                                    
     bond, the  surcharge would go  away after the  bond was                                                                    
     paid.  The surcharge  and all  associated statutes  are                                                                    
     repealed at the  end of the calendar year  in which the                                                                    
     bond is  paid off.  In remembering that  promise, while                                                                    
     realizing  what   this  funding  source  could   do  to                                                                    
     maintain our  enhancement operations, we  are proposing                                                                    
     a compromise  and reduction to what  is currently being                                                                    
     collected. This  leaves residents  with a  $6 surcharge                                                                    
     and  nonresidents contributing  the lion's  share, over                                                                    
     six times  what residents contribute. This  is about an                                                                    
     18 percent decrease.                                                                                                       
                                                                                                                                
     Additionally, the  department proposed to  collect that                                                                    
     surcharge  in a  separate account  within the  fish and                                                                    
     game  fund,  be accounted  for  and  used only  in  the                                                                    
     state's  sport  fish   hatchery  enhancement  programs,                                                                    
     sport fish hatchery  facilities, and a bit  (due to the                                                                    
     [House]  Fisheries  Committee  amendments)  to  general                                                                    
     sport fish programs statewide.                                                                                             
                                                                                                                                
     Upon repayment of the bond  debt there was an immediate                                                                    
     half  a  million  dollar funding  impact  to  Southeast                                                                    
     Alaska  from loss  of a  surcharge income,  which funds                                                                    
     the  raising and  release of  over 1.4  million chinook                                                                    
     salmon  smolt  at  release sites  targeted  to  benefit                                                                    
     sport  anglers in  Southeast  inside  waters. This  was                                                                    
     done  because at  the time  when the  original hatchery                                                                    
     bond package  was put together,  licenses were  sold in                                                                    
     Southeast  Alaska,  but  we  weren't  contributing  any                                                                    
     enhancement  efforts to  Southeast Alaska.  Losing this                                                                    
     level  of  funding   to  support  existing  enhancement                                                                    
     activities  will  be  detrimental to  Southeast  Alaska                                                                    
     sport anglers.                                                                                                             
                                                                                                                                
     As you  can see  from the fact  sheet in  your packets,                                                                    
     the sport fish enhancement  program released nearly 7.2                                                                    
     million  fish into  nearly  270  locations annually  in                                                                    
     addition  to the  1.4 million  fish  that are  released                                                                    
     through   the  cooperative   agreements  in   Southeast                                                                    
     Alaska.  When   the  Ruth  Burnett  and   William  Jack                                                                    
     Hernandez came online, nearly $5  million of the DJ had                                                                    
     to be redirected  in order to pay  for their operations                                                                    
     and maintenance. Any needed  repairs and maintenance to                                                                    
     date have  come from existing operational  funds and is                                                                    
     usually  done  so  at the  expense  of  other  division                                                                    
     needs.                                                                                                                     
                                                                                                                                
     There  are also  several larger,  more expensive  needs                                                                    
     that were deferred during construction  and have yet to                                                                    
     be addressed.  As the  facilities age,  the maintenance                                                                    
     needs will  grow, thus  putting further  undue pressure                                                                    
     onto  existing programs,  the sport  fish  part of  the                                                                    
     fish  and game  fund,  as well  as  the Dingle  Johnson                                                                    
     federal matching funds. Having  the ability to tap into                                                                    
     a source of  funds to cover these needs  will allow the                                                                    
     division  to   sustain  existing   enhanced  production                                                                    
     without impacts elsewhere.                                                                                                 
                                                                                                                                
     There is  on average,  $6.4 million  generated revenues                                                                    
     from surcharge  collections on sport  fishing licenses.                                                                    
     The   division  currently   allocates  a   little  over                                                                    
     $7   million  to   enhancement  related   programs  and                                                                    
     projects  across  the  division,   with  most  tied  to                                                                    
     operations and maintenance at  the two large facilities                                                                    
     in  Fairbanks  and  Anchorage.  Establishing  this  new                                                                    
     paired down enhancement  surcharge would cover existing                                                                    
     cost  allocated  towards  the enhancement  program  and                                                                    
     allow  the ability  to put  old  programs and  projects                                                                    
     back  in   place.  It   would  also   address  deferred                                                                    
     equipment and maintenance  needs and assure contingency                                                                    
     funds are  available for  unseen events  without having                                                                    
     to  go to  the legislature  for supplemental  or worse,                                                                    
     shut down the facilities.                                                                                                  
                                                                                                                                
Commissioner Vincent-Lang  was available for  any questions.                                                                    
He  relayed that  colleagues were  available  to review  the                                                                    
sectional  analysis and  the fiscal  note  if the  committee                                                                    
desired.                                                                                                                        
                                                                                                                                
Co-Chair Johnston requested a review of the fiscal note.                                                                        
                                                                                                                                
3:00:08 PM                                                                                                                    
                                                                                                                                
BRIAN FRENETTE, ASSISTANT DIRECTOR,  DIVISION OF SPORT FISH,                                                                    
DEPARTMENT OF  FISH AND GAME (via  teleconference), reviewed                                                                    
the  department's fiscal  note. The  expenditure section  of                                                                    
the note was $3,250,000. He  detailed that the services line                                                                    
of  $989,600   covered  salaries  for  the   division's  LTC                                                                    
maintenance staff  responsible for the daily  maintenance of                                                                    
the  two sport  fish  hatchery facilities  in Anchorage  and                                                                    
Fairbanks. The  cost also included project  leader and field                                                                    
staff time  working on the  amendment piece to the  bill for                                                                    
fisheries   management,  research,   and  invasive   species                                                                    
eradication  suppression efforts.  The travel  line included                                                                    
$4,100  for  minor  travel  associated  with  the  fisheries                                                                    
management  research and  invasive  species eradication  and                                                                    
suppression  efforts. The  services  line showed  $1,129,700                                                                    
for the existing surcharge funds  going to Southeast Alaska,                                                                    
for covering  contractual agreements with  private nonprofit                                                                    
hatchery operators  that produce king salmon  to support the                                                                    
region's  sport   fishery.  The  amount  also   covered  the                                                                    
contractual   cost  associated   with   major  repairs   and                                                                    
improvements   at  sport   fish  facilities   in  Southeast,                                                                    
Southcentral, and Interior.                                                                                                     
                                                                                                                                
Mr.  Frenette moved  to the  commodities line  at a  cost of                                                                    
$335,600  for   day-to-day  maintenance  needs,   parts  and                                                                    
supplies at  the sport fish  hatchery facilities as  well as                                                                    
supplies for supporting the  fishery management research and                                                                    
other  field  operations.  The capital  outlay  line  showed                                                                    
$791,000 to  cover larger equipment needing  replacement and                                                                    
field equipment  needed for maintaining  hatchery facilities                                                                    
and   field  operations.   The   revenue  section   included                                                                    
$5,120,000 based  on the reduced license  surcharge of $2.50                                                                    
per license  and using the  recent five-year average  of the                                                                    
number of  licenses sold, which given  the current situation                                                                    
with COVID-19, was very likely to be much less.                                                                                 
                                                                                                                                
Representative Wool referenced  information in members' bill                                                                    
packets  showing the  surcharge  had been  reduced by  $2.50                                                                    
instead of  $5.00. He  asked if the  amount would  have been                                                                    
insufficient to  pay the  fiscal note  if the  surcharge had                                                                    
been reduced by $5.00.                                                                                                          
                                                                                                                                
Mr.  Frenette  asked  Representative   Wool  to  repeat  the                                                                    
question.                                                                                                                       
                                                                                                                                
Representative Wool complied. He noted  that one of the bill                                                                    
documents specified the surcharge  had been reduced by $2.50                                                                    
instead  of the  $5.00  reduction proposed  in the  original                                                                    
bill. He  surmised that  a $5.00  reduction would  result in                                                                    
insufficient revenue to cover the $3.2 million fiscal note.                                                                     
                                                                                                                                
Mr.  Frenette answered  that the  hypothesis may  be correct                                                                    
when  factoring  in  the  inclusion   of  activities  in  an                                                                    
amendment added by the House Fisheries Committee.                                                                               
                                                                                                                                
Co-Chair  Johnston  directed   Representative  Wool  to  the                                                                    
explanation of changes for version U of the bill.                                                                               
                                                                                                                                
Co-Chair Johnston  asked members  if they  needed to  hear a                                                                    
sectional analysis. She directed  members to the analysis in                                                                    
members' packets.                                                                                                               
                                                                                                                                
HB  247  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
Co-Chair Johnston  reviewed the  schedule for  the following                                                                    
morning. They  were hoping  to hear  from people  around the                                                                    
state  about   tools  available  to  address   the  economic                                                                    
situation.  She shared  that if  there was  a bill  from the                                                                    
administration related to economic  recovery, she would like                                                                    
the committee  to have  an idea what  was already  in place.                                                                    
She noted there  were the immediate needs  and the year-long                                                                    
needs. She  asked members to  provide a list  of individuals                                                                    
who may add to the discussion.                                                                                                  
                                                                                                                                
3:07:22 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
3:09:10 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair Johnston  set an amendment  deadline on HB  247 for                                                                    
the following day at noon.                                                                                                      
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
3:09:27 PM                                                                                                                    
                                                                                                                                
The meeting was adjourned at 3:09 p.m.                                                                                          

Document Name Date/Time Subjects
HB 247 Explanation of Changes ver. A to U 3.19.20.pdf HFIN 3/19/2020 1:30:00 PM
HB 247
HB 247 Sectional Analysis - ver. U 3.19.20.pdf HFIN 3/19/2020 1:30:00 PM
HB 247
HB 247 Support Doc - Stocking FAQ 2.19.2 (002).pdf HFIN 3/19/2020 1:30:00 PM
HB 247
HB 247 Support Doc - Surcharge Revenue Breakdown 3.4.20.pdf HFIN 3/19/2020 1:30:00 PM
HB 247
HB 247 Transmittal Letter ver. A 2.12.20.pdf HFIN 3/19/2020 1:30:00 PM
HB 247
HB 290 Sectional Analysis v. E 3.16.2020.pdf HFIN 3/19/2020 1:30:00 PM
HB 290
HB 290 Sponsor Statement v. E 3.16.2020.pdf HFIN 3/19/2020 1:30:00 PM
HB 290
HB 290 Supporting Document - RI Crisis Now Consultation Report 12.13.2019.pdf HFIN 3/19/2020 1:30:00 PM
HB 290
HB 290 Supporting Document - Letters Received by 3.16.2020.pdf HFIN 3/19/2020 1:30:00 PM
HB 290