03/01/2001 03:03 PM House HES
| Audio | Topic |
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
March 1, 2001
3:03 p.m.
MEMBERS PRESENT
Representative Fred Dyson, Chair
Representative Peggy Wilson, Vice Chair
Representative John Coghill
Representative Vic Kohring
Representative Sharon Cissna
Representative Reggie Joule
MEMBERS ABSENT
Representative Gary Stevens
COMMITTEE CALENDAR
HOUSE BILL NO. 91
"An Act relating to the membership and quorum requirements of
the State Medical Board."
- MOVED HB 91 OUT OF COMMITTEE
HOUSE BILL NO. 114
"An Act relating to abuse of inhalants."
- HEARD AND HELD
PREVIOUS ACTION
BILL: HB 91
SHORT TITLE:ADD PHYSICIAN ASST TO STATE MEDICAL BOARD
SPONSOR(S): REPRESENTATIVE(S)FATE
Jrn-Date Jrn-Page Action
01/24/01 0158 (H) READ THE FIRST TIME -
REFERRALS
01/24/01 0158 (H) L&C, HES, FIN
02/12/01 (H) L&C AT 3:15 PM CAPITOL 17
02/12/01 (H) Moved Out of Committee
MINUTE(L&C)
02/14/01 0313 (H) L&C RPT 6DP 1NR
02/14/01 0313 (H) DP: KOTT, CRAWFORD, HAYES,
MEYER,
02/14/01 0313 (H) ROKEBERG, MURKOWSKI; NR:
HALCRO
02/14/01 0313 (H) FN1: (CED)
03/01/01 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 114
SHORT TITLE:INHALANT ABUSE
SPONSOR(S): REPRESENTATIVE(S)KAPSNER
Jrn-Date Jrn-Page Action
02/07/01 0263 (H) READ THE FIRST TIME -
REFERRALS
02/07/01 0263 (H) HES, JUD, FIN
02/21/01 0392 (H) COSPONSOR(S): STEVENS
02/27/01 (H) HES AT 3:00 PM CAPITOL 106
02/27/01 (H) Heard & Held
02/27/01 (H) MINUTE(HES)
02/28/01 0473 (H) COSPONSOR(S): MURKOWSKI
03/01/01 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE HUGH FATE
Alaska State Legislature
Capitol Building, Room 416
Juneau, Alaska 99801
POSITION STATEMENT: Sponsor for HB 91.
TOM WILSON, Physician Assistant
Alaska Academy of Physician Assistants
PO Box 74187
Fairbanks, Alaska 99707
POSITION STATEMENT: Testified in support of HB 91.
ED HALL, Physician Assistant
Alaska Academy of Physician Assistants
PO Box 74187
Fairbanks, Alaska 99707
POSITION STATEMENT: Testified in support of HB 91.
REPRESENTATIVE MARY KAPSNER
Alaska State Legislature
Capitol Building, Room 424
Juneau, Alaska 99801
POSITION STATEMENT: Sponsor for HB 114.
JIM HENKELMAN, Statewide Outreach Coordinator
Inhalant Intervention Project
Yukon-Kuskokwim Health Corporation
2957 Yale Drive
Anchorage, Alaska 99608
POSITION STATEMENT: Testified in support of HB 114.
ROBERT BUTTCANE, Legislative & Administrative Liaison
Division of Juvenile Justice
Department of Health & Social Services
PO Box 110635
Juneau, Alaska 99811
POSITION STATEMENT: Testified on HB 114.
VALERIE THERRIEN
Governor's Advisory Board on Alcoholism & Drug Abuse
779 8th Avenue
Fairbanks, Alaska 99710
POSITION STATEMENT: Testified on HB 114.
JERRY LUCKHAUPT, Legislative Legal Council
Legislative Legal and Research Services
Legislative Affairs Agency
State Capital
Juneau, Alaska 99801-1182
POSITION STATEMENT: Answered questions on HB 114.
ALVIA "STEVE" DUNNAGAN, Lieutenant
Division of Alaska State Troopers
Department of Public Safety
5700 East Tudor Road
Anchorage, Alaska 99507
POSITION STATEMENT: Testified on HB 114.
BARBARA BRINK, Director
Public Defender Agency
Department of Administration
900 West 5th Avenue
Anchorage, Alaska 99501
POSITION STATEMENT: Testified on HB 114.
ERIC TOMASINO
Governor's Advisory Board on Alcoholism & Drug Abuse
PO Box 4281
Palmer, Alaska 99645
POSITION STATEMENT: Testified on HB 114.
ACTION NARRATIVE
TAPE 01-22, SIDE A
Number 0001
CHAIR FRED DYSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:03 p.m.
Members present at call to order were Representatives Dyson,
Wilson, Coghill, and Cissna. Representatives Kohring, and Joule
joined the meeting as it was in progress.
HB 91-ADD PHYSICIAN ASST TO STATE MEDICAL BOARD
CHAIR DYSON announced that first order of business would be
HOUSE BILL NO. 91, "An Act relating to the membership and quorum
requirements of the State Medical Board."
Number 0090
REPRESENTATIVE HUGH FATE came forth as sponsor of HB 91. He
stated to the committee:
House Bill 91 is based on a request brought forward by
the Alaska Academy of Physician Assistants. The
Alaska State Medical Board supports House Bill 91.
House Bill 91 adds one licensed physician assistant to
the State Medical Board and changes the quorum for
meetings, from four to five [members].
Currently, there is no representation of physical
assistant licensees to the board, even though
consideration of physician assistant licensure,
regulations, and discipline are frequent topics.
Physician assistants are also an increasingly
significant factor in providing medical care.
Participation of a physician assistant would
strengthen and support the State Medical Board and
contribute to its decision-making process by providing
valuable opinions representing a wider spectrum of
medical practitioners in Alaska.
REPRESENTATIVE COGHILL asked what the fiscal note amount would
be.
REPRESENTATIVE FATE answered that the fiscal note would be
$3,000, which entails per diem and travel for members of that
board.
Number 0282
CHAIR DYSON asked if anyone has opposed, or will oppose, the
bill.
REPRESENTATIVE FATE responded that there is no opposition. He
stated that the medical board licensure is for the bill and the
medical association is neutral.
CHAIR DYSON asked if it is reasonable to say that the folks in
the medical community have had a fair opportunity to comment on
the bill.
REPRESENTATIVE FATE said that they have. He said that the State
Medical Board, and the Physician Assistant Association have gone
on record that they are in favor of the bill. He added that the
physician assistants have been participating in an ad-hoc
position on the medical board for the last four years for two
reasons: to get themselves up to speed in order to familiarize
themselves with the medical board, and to prove to the medical
board that they can be part of that board in good conscious.
Number 0409
REPRESENTATIVE CISSNA asked why it hasn't happened before, since
it seems like such a good idea.
REPRESENTATIVE FATE said that there has been friction between
the medical board and an auxiliary of the healing profession.
He said that he served on the Board of Dental Examiners when
hygienists first appeared. He remarked that there was natural
friction [at first], but then there was a real benefit.
Number 0515
TOM WILSON, Physician Assistant, Alaska Academy of Physician
Assistants, testified via teleconference in support of HB 91.
He stated that there have been approximately 250 PAs (physical
assistants) licensed in the state for more than 20 years, and
they currently have no representation as licensees on the State
Medical Board. He said that [PAs] see approximately 50,000
Alaskans every month for medical care. He added that the State
Medical Board voted in Juneau on February 19, 2001, in favor of
the addition of a physician assistant to the medical board.
MR. WILSON expressed that this has been a very long process of
over four years of having a PA attend every medical board
meeting for the full two-day sessions. He stated that this year
[the Alaska Academy of Physician Assistants] has decided that it
has served its apprenticeship and understands the commitment and
responsibilities of being a member of the State Medical Board.
He said [PAs] feel that since they have matured and developed an
extremely good relationship with the medical board [it is
reasonable] to ask the state to change the statute and add a PA
to the medical board. He concluded that he thinks the medical
board is eager to have their input because they represent a
large number of licensees as well as patients.
Number 0663
CHAIR DYSON asked whether [PAs] practice under the supervision
of a physician.
MR. WILSON answered yes, that's by state law. He said it's the
philosophy of a PA to work in a PA/MD team. By law, PAs cannot
practice medicine unless they have a collaborative relationship
with a physician.
Number 0716
ED HALL, Physician Assistant, Alaska Academy of Physician
Assistants, testified via teleconference in support of HB 91.
Addressing the question of why it is happening now as opposed to
20 years ago, he remarked that this has been a growing process,
and it has just been in the past year that [PAs] have felt they
have done their apprenticeship and have the understanding as
well as the full support of the medical board.
Number 0766
REPRESENTATIVE COGHILL made a motion to move HB 91 from the
committee with individual recommendations and attached fiscal
notes. There being no objection, HB 91 moved out of the House
Health, Education and Social Services Standing Committee.
HB 114-INHALANT ABUSE
CHAIR DYSON announced the next order of business as HOUSE BILL
NO. 114, "An Act relating to abuse of inhalants."
Number 0803
REPRESENTATIVE MARY KAPSNER, Alaska State Legislature, came
forth as sponsor of HB 114. She explained she was offering an
amendment that would change [the charge of inhalant abuse] from
a class B misdemeanor to a violation.
Number 0882
REPRESENTATIVE JOULE made a motion to adopt Amendment 1, 22-
LS0130\C.1, Luckhaupt, 2/28/01, which read:
Page 1, line 5:
Delete "crime"
Insert "offense"
Page 2, lines 1 - 3:
Delete all material and insert:
"(d) Abuse of inhalants is a
violation."
There being no objection, Amendment 1 was adopted.
Number 0924
JIM HENKELMAN, Statewide Outreach Coordinator, Inhalant
Intervention Project, Yukon-Kuskokwim Health Corporation (YKHC),
came forth to testify in support of HB 114. He clarified that
the [Inhalant Intervention Project], in development, is a
statewide project. He said that [the YKHC] has felt for a long
time the need to get a handle on youth who are using and abusing
inhalants, to get a comprehensive assessments completed, and to
determine the level of treatment that [the youth] may require.
MR. HENKELMAN explained that [the Inhalant Intervention Project]
is a three-pronged project, whereby [YKHC] will be providing
information sessions, training conferences throughout Alaska for
communities that request their services in identifying inhalant
abusers, and providing brief assessments. He said that [YKHC]
will also be providing short-term intervention within
communities that request it, which will try and address the
children's needs and do further assessment of the children who
are identified as in need. Finally, he said, [YKHC] will have
the residential program, which is currently scheduled to open
August 31.
Number 1091
CHAIR DYSON recaptured a conversation he had earlier with Mr.
Henkelman. He stated that Mr. Henkelman had said there are some
people whose first exposure [to inhalants] causes organic brain
damage, while others, who have been [inhaling] for 25 or 30
years, have some appearance of a normal behavior when they are
not "huffing." Users will experience euphoria, the feeling of
power and hallucinations, and have memory problems. He said he
asked Mr. Henkelman if there were any patterns of adults or
older kids getting [younger] kids [to use inhalants] in order to
exploit them. He said that Mr. Henkelman said [he didn't know],
but that it is logical for that to be one reason why people
would [get kids to use inhalants]. Also, Mr. Henkelman told him
that research may find that there's evidence now of permanent
genetic damage that may be transferred to a subsequent child.
Chair Dyson said that [he and Mr. Henkelman] also discussed how
people damaged from "huffing" have problems similar to those of
children with FAS (Fetal Alcohol Syndrome) and FAE (Fetal
Alcohol Effects), and that many have significant behavior
problems in school and for parents.
Number 1242
REPRESENTATIVE COGHILL asked when this project would be
completed.
MR. HENKELMAN replied that ground was broken in August [2000]
for the construction of the residential facility in Bethel, and
completion is expected in August [2001]. He said that [YKHC] is
in the process of hiring staff and will be spending most of the
summer with staff training. He added that the funding [for the
project] is through the Center for Substance Abuse Treatment in
Washington, D.C., and is a three-year funding package.
REPRESENTATIVE COGHILL asked if [YKHC] anticipates an immediate
filling of space available, and what they anticipate for the
workload.
MR. HENKELMAN answered that the facility has 16 beds, but he is
not sure if 16 people [will be admitted] in the first admission
[group]. He said they might take a smaller number for the first
group, in order to get [YKHC's] feet on the ground. He added
that they are anticipating groups of 16 to go through every
three to four months.
Number 1350
REPRESENTATIVE COGHILL asked what the treatment would be beyond
the three months.
MR. HENKELMAN replied that part of the work he is doing with
statewide communities is to improve their capacity to deal with
this problem. Through training and support from the program,
[YKHC] will require that, prior to a community referring a child
to treatment, [the community tell YKHC] who the primary support
person for the child during treatment will be. That person will
join treatment for at least one week of the cycle and be there
in the community for the child after treatment is completed.
MR. HENKELMAN added that [YKHC] will also be working with the
community treatment providers, such as a school, church or
mental health substance-abuse facility, based on the child's
individual needs, to have services available as an after-care
plan. He remarked that [YKHC] wants this plan tentatively in
place prior to the child actually starting treatment, so as the
child is going through treatment and specific needs are
identified, [YKHC] will know who, in the community, to give that
information to so that person can carry on the treatment after
the child is out. He said that [YKHC] hopes to do some follow-
up work from the residential program, but it won't it be so much
working with the actual individual as it will be working with
the treatment providers in the community that are providing the
follow-up care.
Number 1430
REPRESENTATIVE COGHILL asked what the different levels of care
are.
MR. HENKELMAN replied, as with any treatment program, there
needs to be an individualized treatment plan, based on the
child's need. If the child has only used inhalants once or
twice, the hope would be that [the child] could be dealt with in
the community, instead of in a four-month residential program.
He stated that someone who has been chronically inhaling will
have any number of neurological, cognitive, and physical
problems [and will have to go through "detox"]. The "detox"
process for inhalants takes at least four to six weeks for the
liver to process out the neurotoxins absorbed by the fatty
tissues. He said the program would use steam baths, which have
been effective in other programs, in combination with other
treatments in order to "detox" as quickly as possible. Then,
based on the neurological, psychological, and cognitive testing,
an ongoing, year-round school program will evaluate how the
child is currently functioning. He added that records from the
[child's] school could provide a good idea of what deficits have
occurred as a result of the inhalants.
REPRESENTATIVE COGHILL asked how [YKHC] fits in on training
other communities in Alaska.
MR. HENKELMAN answered that he is currently scheduled to do
presentation in at least a half-dozen conferences over the next
six months around the state. He said that he just did a
presentation for the foster parent training in Bethel.
Number 1640
REPRESENTATIVE WILSON remarked that sometimes it takes several
months for [a person] to "detox" before he or she is actually
treated. She asked if there are going to be people moving in
[while one group is still in "detox"].
MR. HENKELMAN replied that they would provide treatment in the
program for the four to six weeks of the "detox" during the
initial part; however, the ability to really start
recompensating won't happen until they are "detoxed." He added
that a focus of the program will be to teach skills to
compensate for whatever deficits [the intakes have as a result
of inhalant abuse].
REPRESENTATIVE WILSON asked what will happen after three years
[after they have used the program money].
MR. HENKELMAN responded that [YKHC] is working with folks in
Washington [D.C.] in order to establish ongoing funds. He said
they suspect most of the kids coming into the program will be
eligible for Medicaid.
Number 1716
REPRESENTATIVE CISSNA asked, since there are FAS- and FAE-type
symptoms from "huffing," whether these children also have poor
judgment skills. She also asked what happens to the kids [of
people who are "huffing"].
MR. HENKELMAN answered that one of the highest risk-groups for
using inhalants is the FAS and FAE kids because their judgment
is impaired. For those who aren't [FAS or FAE kids], as soon as
they start using inhalants it seems that the ability to use
their judgment and their impulse control is destroyed early on.
He said he had heard that FAS and FAE kids have very little
childhoods memory, but that kids who are "huffing" can remember
their childhood up to the point that they started "huffing."
REPRESENTATIVE CISSNA asked if children [of "huffers"] are going
to have more problems than an FAS or FAE child and whether
there's a way to address that.
MR. HENKELMAN said absolutely, but there is very little research
on the genetic effects of inhalants. He said that it would not
surprise him if some of the problems that kids diagnosed as
being FAS or FAE are having were results of their parents having
"huffed." He added that a study, conducted a year or two ago,
said if a 19-year-old had been "huffing" and had done
significant damage to himself, the cost to the state would be in
the area of $1.4 million for ongoing care.
Number 1894
ROBERT BUTTCANE, Legislative & Administrative Liaison, Division
of Juvenile Justice, Department of Health & Social Services
(DHSS), came forth and stated that he thinks [Amendment 1] still
allows for the opportunity to identify these kids, impose some
level of accountability, and then to intervene in a way to
assess, educate, and refer them to appropriate treatment. He
mentioned that [DHSS] is looking at this from a standpoint of:
"Let's do what we can do today, and in that, let's take the
small steps that we can to start dealing with this issue more
effectively."
MR. BUTTCANE stated that in Alaska many of the treatment
facilities are not fully equipped right now to deal the problems
of inhalant abuse. Some substance-abuse treatment programs have
taken in [inhalant users], but there needs to be assistance in
building greater capacities to address the specific issues
related to inhalant abuse. He said he was pleased to hear Mr.
Henkelman talk about [YKHC's] plans and thinks they are exactly
what is needed - training and educating people, including
villages, parents, and care providers.
Number 1978
MR. BUTTCANE referred to the phraseology, on page 2, lines 1-3
of the bill, that a person found guilty of a violation of this
offense would be subject to a fine, which could then be
suspended on the condition that the afflicted person be required
to successfully complete an inhalant abuse treatment program.
He said the difficulty that [DHSS] has with this is that the
treatment resources are still limited and not available
everywhere around the state. He added that [DHSS] has submitted
a fiscal note based on what might be done in terms of an
intensive outpatient treatment.
REPRESENTATIVE COGHILL informed Mr. Buttcane that that language
was taken out with [Amendment 1.]
MR. BUTTCANE replied that that would then negate [DHSS's] need
for a fiscal note. He clarified that a requirement for
treatment by the court generated the fiscal note, so that if
that were a discretionary move, then there wouldn't be a fiscal
impact on the [DHSS].
Number 2051
MR. BUTTCANE stated that amending the current alcoholism [and
drug] commitment statutes and adding inhalant abuse recognizes
that some of these abusers will require significant
environmental controls, such as locked doors and secured
confinement. However, using the existing alcoholism and drug
abuse statute could pose a risk to some inhalant-inflicted
individuals. He stated that the question was posed of whether
it would be good for [the village public safety officer (VPSO)]
to be able to do a protective-custody hold in a jail cell if he
or she found someone passed out from having used inhalants. The
problem of putting somebody in jail, in order for that person to
get sober, is that the afflicted person may be worse off in 11
hours than when he or she first was put in.
MR. BUTTCANE added that because of the complexities with this
substance abuse issue, many people need medical supervision and
not to be put in a small village jail or holding facility
without medical care. He said the [DHSS] is concerned that
using the provisions available for the alcohol and drug issues
for inhalant abuse could be dangerous in some situations. He
suggested perhaps developing involuntary commitment procedures
that relate specifically to inhalant abuse, taking into account
some of these instances that might require longer periods of
emergency hold as well as longer periods of treatment in secure
or "locked" programs.
Number 2144
REPRESENTATIVE JOULE asked if [an inhalant abuser] would have to
be put into locked protective custody, according to the way the
bill is written. He suggested if this is only a violation and
not a criminal offense, perhaps just a safe space should be
provided.
MR. BUTTCANE replied that it wouldn't necessarily mean that [the
custody] would have to be locked. He said the [DHSS] is
concerned that by including this as a provision for protective
custody, people may be inclined to treat it in the same manner
as when someone is trying to sober up, and put the person in
locked or unlocked facilities in the village that didn't have
the medical supervision specific to the issues of inhalant
abuse.
REPRESENTATIVE WILSON remarked that she is not familiar with
people who have been "huffing," but she is familiar with people
who come in the emergency room after breathing something that
has damaged their lungs. She said that many times when that
happens, at first it doesn't appear to be much of a problem, but
as the lungs develop fluid in order to protect themselves from
the irritants, it can take several hours before this condition
gets worse. She asked if this is the type of situation [Mr.
Buttcane] is referring to [with inhalant users].
MR. BUTTCANE responded that he does not know the full extent of
the impact of inhalants. He said it is his understanding that
complications could occur from inhalants that wouldn't
necessarily be manifested with alcohol intoxication.
Number 2258
REPRESENTATIVE CISSNA asked whether a good reason to secure a
person would be if there was possible danger in the immediate
aftermath of "huffing."
MR. HENKELMAN replied that there may be some concern. He said
that Representative Wilson was accurate in noting some of the
problems it could create. He added that some of the problems
are with the heart because inhalants create irregular heart
rhythms.
Number 2317
CHAIR DYSON said that in his community the cops pick up somebody
who has passed out, and the protocol requires them to take [the
person] to where there is medical expertise to figure out
whether or not the person is drunk, in a diabetic coma, or
suffering from trauma, and so on. He asked why it would be any
different for someone who is passed out because of huffing.
MR. BUTTCANE replied that in actual practice it might not be
[different], and [police officers] would follow a procedure in
which they consult with the village health aide, who might make
a determination that given the person's condition, he or she
needed to be transported to a regional medical facility as
opposed to simply being housed in the local lock-up facility.
The concern is that if this is included in the protective
custody section of the alcohol and drug commitment provisions,
it may give people a false sense that medical concern is not
present and that it is OK to have the person "sober up" in an
adult jail in the village without really being aware of any
medical consequences.
TAPE 01-22, SIDE B
Number 2356
MR. BUTTCANE remarked that the involuntary commitment scheme
that is used in the drug and alcohol chapter requires a
demonstration of extreme chronic behaviors. He added that it is
a standard of proof that can't be afforded to apply to an
inhalant abuser.
CHAIR DYSON asked if there is anything in the bill that deals
with involuntary commitment.
MR. BUTTCANE answered that Sections 3-7 [deal with involuntary
commitments]. He said that [Sections] 3 and 7 are most
problematic and need to be looked at in order to decide if this
is the way to do business. The position of [DHSS] is that it is
not advised. The alcohol commitment statute and the mental
health commitment statute don't fit with what's being dealt with
in the inhalant issue. He suggested that it might be better to
start from scratch and craft something that really is responsive
to this particular need.
Number 2287
CHAIR DYSON asked if Mr. Buttcane senses that people who have
been "huffing" are represented in the corrections population or
in the criminal element in [Alaskan].
MR. BUTTCANE responded that he believes there are people who
have suffered the ill effects of inhalant abuse both in the
adult and juvenile criminal systems, but he doesn't know the
numbers. He remarked that Representative Joule had asked [at
the last meeting] if there have been situations in which the
DHSS had funded any inhalant-abuse intervention or prevention
efforts. He said what [DHSS] has been able to determine is that
the Division of Alcohol & Drug Abuse did provide funding from
the Alaska Mental Health Trust Authority for inhalant-abuse
prevention. When those funds lapsed, requests for continued
funding were not approved.
REPRESENTATIVE JOULE asked to whom the requests had been made.
MR. BUTTCANE answered that he believes they were to the
legislature.
Number 2105
VALERIE THERRIEN, Governor's Advisory Board on Alcoholism & Drug
Abuse (ABADA), came forth and commented on the issues that
[ABADA] had reviewed. First of all, she said she is concerned
about [inhalant abuse under the bill] being backed down to an
offense [Amendment 1], because talking with people from the
juvenile justice committee who are in corrections, she learned
that if the purpose of this bill is to be able to put someone
into custody, it has to be a misdemeanor. For example, if a
VPSO is trying to get somebody into treatment so that the person
is not out on the street "huffing," and if an offense does not
permit the VPSO to take custody of that person, then this might
not be the right approach. She stated that if an offense means
that a person could be put into some type of protective custody,
that would certainly ameliorate the concerns of a lot the
members of [ABADA]. She added that [ABADA] had approved the
bill as it stood, with [inhalant abuse] being a misdemeanor.
Because of the concern of the criminalization of this, she had
asked that the matter be split into two issues: the issue of
criminalization and the issue of whether or not inhalants should
result in an involuntary commitment. She said that "both
portions passed."
MS. THERRIEN continued, stating that second if subsection (d)
[of Section 1 of the bill] is eliminated, then she is not sure
whether Section 2 would be consistent because it talks about
violation of statutes. She said that [ABADA] was concerned with
the ability of the facilities to have the capacity to treat.
She suggested, if it is possible, that during the four to six
weeks of detoxification, [patients] be put in a treatment
facility for drugs and alcohol and then go into the treatment
facility for inhalant abuse, as a way of using extra beds, so as
not to overcrowd the facility.
Number 1961
MS. THERRIEN stated that [ABADA] discussed whether or not a
[five-year-old child] can be charged with an offense or
misdemeanor. She remarked that [the ABADA] was very concerned
about what liabilities the state would have if a VPSO picked
somebody up and put him or her into a place that wasn't a jail
without medical facilities or nurses.
Number 1865
MS. THERRIEN asked Jerry Luckhaupt, legislative counsel, whether
somebody could take a person into protective custody if
[inhalant abuse] were an offense opposed to a misdemeanor.
JERRY LUCKHAUPT Legislative Legal Counsel, Legislative Legal and
Research Services, Legislative Affairs Agency, came forth and
replied that a violation doesn't indicate any criminality. This
would be governed by a maximum-fine provision of $300. If
[inhalant abuse] happens in an officer's presence, the officers
can, theoretically, take somebody into custody, but it usually
doesn't happen. People are usually taken into protective
custody under Title 47, where it refers to alcohol and drug
abuse. If a police officer finds someone out on the street who
appears obviously intoxicated, in most cases that person is not
being arrested for the intoxication, but for some other offense.
If that person is intoxicated, that issue is usual dealt with
first. The incentive is to protect the person when he or she
can't protect himself or herself.
MS. THERRIEN remarked that [ABADA] is hearing that the VSPOs
don't feel they have any authority to take people off the street
and either put them in a place where they can be treated or put
them into jail, because it's not against the law. She asked, in
regard to the protective hold, how someone could be arrested,
and if someone could be arrested under a violation.
Number 1686
MR. LUCKHAUPT responded that he can't speak for the VPSOs and
how [an arrest could happen]. He said that VPSOs don't
necessarily have a real power of arrest under Title 11; instead,
they have public safety duties. A public safety professional
who comes across someone who is unconscious can't leave that
person there but must intervene.
CHAIR DYSON asked if reducing this to a violation reduces the
capacity to take [inhalant users] into protective custody.
MR. LUCKHAUPT answered that if a person is obviously
intoxicated, [peace officers] still have an obligation to do
something, but not under criminal law.
CHAIR DYSON stated that the second question Ms. Therrien raised
was what the lower age limit was for this process not to
proceed.
MR. LUCKHAUPT responded that there is not a true age of majority
for that purpose. He said that someone under 18 is a minor, and
if the person is 16 or even 15, there is potential criminal
liability.
Number 1553
CHAIR DYSON clarified that the question was: what is the lowest
age limit to [charge] a child for a crime?
MR. LUCKHAUPT answered that traditionally, it depends upon when
the child is able to develop the requisite mens rea to actually
understand that what he or she is doing is a crime. Many times
that has been defined, by some states, as low as age 12.
CHAIR DYSON asked whether a child under 12 could be charged for
shoplifting.
MR. LUKHAUPT replied that a child probably is not going to have
the requisite mens rea to be convicted of that crime.
Number 1481
REPRESENTATIVE WILSON said that she is concerned with Section 2,
page 2, line 7, which says:
... this chapter and the Alaska Delinquency Rules do
not apply and the minor accused of the offense shall
be charged, prosecuted, and sentenced in the district
court in the same manner as an adult;
REPRESENTATIVE WILSON asked, since there are five and eight-
year-olds involved with inhalants, how the foregoing language
plays in with this.
MR. LUCKHAUPT replied that it "trumps" all this. In order to
[be convicted of a crime], the person has to be competent.
Usually before the age of 12, a child does not have the
requisite competence to be able to commit a crime. Society
assumes that children cannot reach that requisite mental state.
REPRESENTATIVE WILSON asked whether this language is fine
because it will not apply to a person that young.
MR. LUKHAUPT answered that it is going to depend on the
particular child involved. He stressed that he is "99.9
percent" sure that a five-year-old can't be charged and
convicted with these offenses.
Number 1315
REPRESENTATIVE JOULE stated that in many communities in rural
areas, there is usually a VPSO, some sort of a village person
who works with a regional health program, or a health aide. He
noted that in Section 4 it states that a person should be
treated at a private treatment facility or [another] appropriate
health facility or service for emergency medical. He asked
whether a village clinic would be an appropriate health facility
if that area were in contact with medical teams.
MR. LUCKHAUPT responded that he isn't sure; however, if there is
a health clinic in the village, he thinks that is where a person
would be taken for the initial protection.
MS. THERRIEN concluded that questions need to be answered as far
as how to physically make sure people are taken care of. She
remarked that maybe there needs to be a waiver of liability, or
a respirator in every village. She stated that there is a
difference between the civil aspect and the criminal aspect.
Number 0999
CHAIR DYSON asked Lieutenant Dunnagan, if moving this down to a
violation limits the ability to take someone into custody.
ALVIA "STEVE" DUNNAGAN, Lieutenant, Division of Alaska State
Troopers, Department of Public Safety, testified via
teleconference. He answered that someone would not be arrest
under a violation unless he or she refused to sign a ticket or
refused to appear [in court].
CHAIR DYSON asked what would happen if someone is incapacitate,
and can't rationally decide whether to sign the violation.
LIEUTENANT DUNNAGAN replied that the person could be taken in
[to custody] under Title 47, but the incapacitation has to be so
extreme that if nothing is done, that person will possibly die
or be seriously injured. If that were the case, the person
would initially go to some kind of medical facility, whether it
is a clinic or a health aide. All the clinics and health aides
in rural Alaska are tied to major medical facilities. Usually,
the health aide will call the physician in charge of that
village and discuss the situation. If the doctor deems it
necessary, the person is transferred from the village to the
medical facility in a major area.
Number 0884
CHAIR DYSON asked Lieutenant Dunnagan at what age he won't
arrest a young child involved in criminal activity.
LIEUTENANT DUNNAGAN answered that it is not a general practice
to arrest minor children for anything; instead, they could be
arrested and then released to their parents. If a 14- or 15-
year-old committed a serious crime, he or she could be taken
into custody and to a youth facility.
CHAIR DYSON clarified that this bill is trying to provide
[public safety officers] and VPSOs a basis under the law in
which to deal with a child who is seven or eight years old and
[using inhalants]. He asked Lieutenant Dunnagan what he could
do [for a young child] with out criminalization.
LIEUTENANT DUNNAGAN replied that a seven- or eight-year-old who
was [using inhalants] would be taken to his or her parents, and
possibly paperwork would be processed to the juvenile
authorities.
CHAIR DYSON asked if Lieutenant Dunnagan really has any more
authority than he himself does to intervene, unless it becomes a
matter of law.
LIEUTENANT DUNNAGAN replied that from a legal standpoint, no.
Number 0734
CHAIR DYSON asked if it is Lieutenant Dunnagan's experience that
older children or young adults recruit [young] children to get
involved in "huffing" in order to exploit them.
LIEUTENANT DUNNAGAN answered that he didn't know of any cases
with inhalants.
CHAIR DYSON asked Lieutenant Dunnagan if he sees anything that
the legislature needs to know in order to proceed.
LIEUTENANT DUNNAGAN replied that he thinks everybody needs to
think about what the term "incapacitated" means. He added that
he doesn't see any problems with the bill as it is written, or
with the amendment, because at least now there will be a tool to
issue a citation, thereby causing a child to go to court with
his or her parents and talk about that problem.
Number 0606
REPRESENTATIVE JOULE asked whether, even with the bill amended,
as a violation, there is anything keeping state troopers or
VPSOs from dealing with the parents and the local health
officials.
LIEUTENANT DUNNAGAN answered no, that there is nothing that
could prohibit that.
REPRESENTATIVE JOULE asked if it would become a standard
operating procedure that [the state troopers and VPSOs] would go
directly to the parents and health aides to report this type of
incident.
LIEUTENANT DUNNAGAN replied that he thinks that would happen
whether a citation was issued or not.
Number 0468
BARBARA BRINK, Director, Public Defender Agency, Department of
Administration, testified via teleconference. She stated that
if this is a misdemeanor and a person is arrested, he or she
would go to jail; within 24 hours, that person would be entitled
to have bail set. Unless the person were a danger to society,
he or she would be let out on his or her own recognizance. She
said she doesn't think it is beneficial to use the criminal
sanction as a way of holding somebody to provide treatment. She
expressed that jail is a time to punish an offender, and she
thinks that having an amendment to move this down to a violation
would still accomplish many things. For instance, a VPSO would
be able to stop the activity, remove the materials or inhalants
from the child, take that child to his or her parents' home, and
issue a citation so that the parents and the child would have to
go to court and meet the judge.
REPRESENTATIVE COGHILL asked how Ms. Brink would apply Title 47,
as a defender, and how she thinks a judge would view these Title
47 measures in this bill.
MS. BRINK replied that the Public Defender Agency doesn't have a
lot of experience in the civil commitment or protective custody
hearings involving alcohol because [public defenders] don't get
appointed in those situations. She said that she is learning
along with everyone else how different the use of inhalants is
from the use of alcohol, and it seems as if there should be a
specific track for [inhalant users] in order to take care of the
individuals' problems brought on by inhalant abuse.
Number 0262
REPRESENTATIVE COGHILL remarked that he agrees with Mr. Buttcane
that it is necessary to look at a different category, because
the only similarity [between inhalant users and alcoholics] is
intoxication.
CHAIR DYSON asked Ms. Brink if she senses that there may be some
civil rights issues when dealing with protective custody and
involuntary commitment.
MS. BRINK replied that there are always those issues when
restraining someone against his or her will. She said she
thinks that was one of the appealing parts of tying this in to
the civil commitment statute because those statutes have built-
in due-process protections.
Number 0146
CHAIR DYSON called an at-ease at 4:37 p.m. The meeting was
called back to order at 4:42 p.m.
Number 0075
ERIC TOMASINO, Governor's Advisory Board on Alcoholism & Drug
Abuse, came forth to testify on HB 114. He stated that over the
last several years [inhalant abuse] has been an issue the
[ABADA] has always talked about. He shared that during [the
ABADA's] public testimony, people come and testify about
inhalant abuse going on in their villages and local communities.
He said that today a mother testified that last Saturday she
took her son to a skateboarding park in Juneau.
TAPE 01-23, SIDE A
MR. TOMASINO continued, stating that as [this woman and her son]
drove into the parking lot, they saw [a boy] "huffing' in the
parking lot. He said that the mother called the police;
however, the police responded by saying there was nothing they
could do.
Number 0051
REPRESENTATIVE JOULE commented that he understands the
frustration that law enforcement feels, but there used to be a
time when law enforcement entailed a lot of public service. He
said it seems to him that they have missed the opportunity to
provide a public service.
CHAIR DYSON asked Mr. Tomasino if he had seen people recruiting
younger kids with inhalants in order to exploit them.
MR. TOMASINO replied yes, that when he was a drug user as a
young teenager and experimenting with inhalants, he would
recruit his friends to "huff" gas with him.
CHAIR DYSON clarified that he was asking if people were
recruiting kids in order to exploit them, not to get more kids
to [inhale], in order to have sex with them or have them commit
crimes.
MR. TOMASINO answered that he had never thought of it in that
respect and was not aware of it.
Number 0206
CHAIR DYSON remarked that the committee was going to suspend the
hearing on HB 114. [HB 114 was held over.]
CHAIR DYSON stated that during the last meeting he distributed a
copy of a bill that eliminated ways that seniors are
disqualified from the longevity bonus. It would allow [seniors]
to be out of the state for 60 days instead of 30 days. He asked
the committee for permission to make it a committee bill. [No
objection was stated.]
ADJOURNMENT
Number 0319
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:47 p.m.
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