Legislature(1999 - 2000)

04/07/1999 01:38 PM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
      SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE                                                                    
                          April 7, 1999                                                                                         
                            1:38 p.m.                                                                                           
MEMBERS PRESENT                                                                                                                 
Senator Mike Miller, Chairman                                                                                                   
Senator Pete Kelly, Vice-Chairman                                                                                               
Senator Gary Wilken                                                                                                             
Senator Drue Pearce                                                                                                             
Senator Kim Elton                                                                                                               
MEMBERS ABSENT                                                                                                                  
All members were present                                                                                                        
COMMITTEE CALENDAR                                                                                                              
SENATE BILL NO. 105                                                                                                             
"An Act determining the facilities constituting a school for                                                                    
purposes of public school funding; and providing for an effective                                                               
     -SCHEDULED BUT NOT HEARD                                                                                                   
SENATE BILL NO. 71                                                                                                              
"An Act relating to licensure by the State Medical Board."                                                                      
     -SCHEDULED BUT NOT HEARD                                                                                                   
SENATE BILL NO. 97                                                                                                              
"An Act relating to confidential mental health records; relating to                                                             
mental health services and programs; relating to liability for                                                                  
payment for mental health evaluation and treatment services; and                                                                
providing for an effective date."                                                                                               
     -HEARD AND HELD                                                                                                            
PREVIOUS SENATE COMMITTEE ACTION                                                                                                
SB 105 -  See HESS Committee minutes dated 3/22/99 and 3/31/99                                                                  
SB 71  -  No previous action to report                                                                                          
SB 97  -  No previous action to report                                                                                          
WITNESS REGISTER                                                                                                                
Ms. Gina Macdonald                                                                                                              
Special Projects Coordinator                                                                                                    
Div. of Mental Health & Developmental                                                                                           
PO Box 110620                                                                                                                   
Juneau, AK  99811-0620                                                                                                          
POSITION STATEMENT:  Commented on SB 97                                                                                         
Ms. Karen Perdue, Commissioner                                                                                                  
Department of Health & Social Services                                                                                          
PO Box 110601                                                                                                                   
Juneau, AK  99811-0601                                                                                                          
POSITION STATEMENT:  Commented on SB 97                                                                                         
Mr. Doug Pomeray                                                                                                                
Fairbanks Community Mental Health Center                                                                                        
122 1st Avenue, #5                                                                                                              
Fairbanks, AK  99709                                                                                                            
POSITION STATEMENT:  Commented on SB 97                                                                                         
Gail Ballou                                                                                                                     
745 8th Avenue                                                                                                                  
Fairbanks, AK  99701                                                                                                            
POSITION STATEMENT:  Commented on SB 97                                                                                         
Mr. Bob Briggs, Staff Attorney                                                                                                  
Disability Law Center                                                                                                           
230 So. Franklin St. #209                                                                                                       
Juneau, AK  99801                                                                                                               
POSITION STATEMENT:  Commented on SB 97                                                                                         
Ms. Beverly Fonoti                                                                                                              
1220 28th Avenue                                                                                                                
Fairbanks, AK  99701                                                                                                            
POSITION STATEMENT:  Supported SB 97                                                                                            
Ms. Jeanette Grasto                                                                                                             
1369 Ballaine Rd.                                                                                                               
Fairbanks, AK  99709                                                                                                            
POSITION STATEMENT:  Supported SB 97                                                                                            
Mr. Gene Grasto                                                                                                                 
1369 Ballaine Rd.                                                                                                               
Fairbanks, AK  99709                                                                                                            
POSITION STATEMENT:  Supported SB 97                                                                                            
Mr. James Shill                                                                                                                 
Charter North Hospital                                                                                                          
2530 DeBarr Road                                                                                                                
Anchorage, AK  99508                                                                                                            
POSITION STATEMENT:  Commented on SB 97                                                                                         
Mr. Walter Majoros, Executive Director                                                                                          
Alaska Mental Health Board                                                                                                      
431 N. Franklin St., Ste. 201                                                                                                   
Juneau, AK  99801-1121                                                                                                          
POSITION STATEMENT:  Supported SB 97                                                                                            
Ms. Pat Clasby                                                                                                                  
Alaska State Hospital                                                                                                           
 & Nursing Home Association                                                                                                     
211 4th St., Ste. 114                                                                                                           
Juneau, AK  99801                                                                                                               
POSITION STATEMENT:  Supported on SB 97                                                                                         
Mr. Mike Powers                                                                                                                 
Fairbanks Memorial Hospital                                                                                                     
1283 View Pointe                                                                                                                
Fairbanks, AK  99709                                                                                                            
POSITION STATEMENT: Supported SB 97                                                                                             
Mr. Jeff Jesse, Executive Director                                                                                              
Alaska Mental Health Trust Authority                                                                                            
550 W. 7th Avenue, Ste. 1820                                                                                                    
Anchorage, AK  99501                                                                                                            
POSITION STATEMENT:  Supported SB 97                                                                                            
ACTION NARRATIVE                                                                                                                
TAPE 99-17, SIDE A                                                                                                              
Number 001                                                                                                                      
                  SB 105-PUBLIC SCHOOL FUNDING                                                                                  
               SB  71-PHYSICIAN LICENSURE CHANGES                                                                               
CHAIRMAN MILLER called the Senate Health, Education and Social                                                                  
Services (HESS) Committee to order at 1:38 p.m. and said HESS would                                                             
only take up SB 97 today.  SB 71 would be heard Monday, April 12.                                                               
            SB  97-MENTAL HEALTH; RECORDS; TREATMENT                                                                            
CHAIRMAN MILLER invited department staff to begin the testimony on                                                              
SB 97.                                                                                                                          
MS. GINA MACDONALD, Division of Mental Health & Developmental                                                                   
Disabilities, stated that SB 97 has two major parts.  The first                                                                 
part clarifies the authority of the department to collect                                                                       
information from mental health services provided in community                                                                   
mental health centers statewide.                                                                                                
Ms. Macdonald passed out a 1997 document from the Legislative Audit                                                             
Division that reviewed community mental health care and services.                                                               
Its first section contains the auditor's recommendations and the                                                                
second, the DHSS response to those recommendations. The                                                                         
Legislature,  Mental Health Trust Authority, Mental Health Board,                                                               
mental health consumers and the department all feel it's very                                                                   
important to collect information about mental health services to                                                                
identify what is bought with the funding and how effective the                                                                  
services are. The first part of SB 97 intends to make clear the                                                                 
department's authority to collect that information in order to                                                                  
measure outcomes of service.                                                                                                    
The second part of SB 97 clarifies the eligibility criteria and                                                                 
payment procedures of an existing program that pays for services                                                                
for in-patient hospital care for persons at risk of harming                                                                     
themselves or others, or who are severely impaired by mental                                                                    
illness.  They are hospitalized in community hospitals throughout                                                               
the state for emergency evaluation or for continued 30-day                                                                      
treatment.  The department pays for those services for people who                                                               
have no income and no other source of payment. The department feels                                                             
it is critical to do that at this time because of the downsizing of                                                             
API.  The private sector facilities must take on some of the                                                                    
emergency mental health function of hospitalizing people for short-                                                             
term care.  This can be accomplished by paying the facilities on                                                                
the basis of eligibility of particular patients.                                                                                
MS. MACDONALD said that Ms. Shannon O'Fallon of the Department of                                                               
Law would address the first part of the bill, and she would answer                                                              
questions on the second part.                                                                                                   
SENATOR KELLY stated that he intends to amend the confidentiality                                                               
portion out of the bill and separate the two parts, maybe even in                                                               
a separate bill. Since it will be put into a different CS, he                                                                   
suggested it may save time to not take testimony on                                                                             
confidentiality, and hear comments on the eligibility requirements.                                                             
Number 090                                                                                                                      
CHAIRMAN MILLER responded that a number of individuals are                                                                      
concerned about the reporting requirements which will "bog down"                                                                
the bill.  The second part of the bill is also important. He said                                                               
he was willing to take some testimony on why people believe the                                                                 
reporting requirements should be in the bill, "knowing it's going                                                               
to be a political land mine trying to pass it."                                                                                 
MS. MACDONALD replied it's the committee's call, but the department                                                             
feels both parts of the bill are critical to delivering mental                                                                  
health services.  The department could address two separate bills.                                                              
SENATOR KELLY invited Commissioner Perdue to speak on the                                                                       
confidentiality portion of the bill.                                                                                            
MS. KAREN PERDUE, Commissioner of the Department of Health & Social                                                             
Services, expressed appreciation to Senator Kelly for sponsoring                                                                
the bill.  Last year the legislative auditor wrote a number of                                                                  
recommendations for the department to pursue in the community                                                                   
mental health area to gain more accountability. Many millions of                                                                
dollars are being spent in the General Fund and in the Medicaid                                                                 
Program. The current data systems don't allow a full check on                                                                   
public funds to ensure there isn't double billing.  The department                                                              
wasn't able to answer some of the auditor's questions about double                                                              
billings if a program was getting GF grants and Medicaid money.                                                                 
The department has worked through a lot of confidentiality issues,                                                              
and put forth regulations to address them.                                                                                      
The Fairbanks Community Mental Health Center (FCMHC) was                                                                        
particularly concerned because they didn't believe the laws fully                                                               
cover asking questions and getting the information in a                                                                         
confidential manner.  The FCMHC filed a suit in court challenging                                                               
the department's regulations.  The FCMHC has told the Commissioner                                                              
they believe the public has a right to understand there is                                                                      
accountability, and the FCMHC doesn't disagree with that.                                                                       
The solution is to provide a statutory basis for the department's                                                               
actions, to comply with the auditors, have accountability, and be                                                               
fully compliant with law.  It would save the department money in                                                                
litigation.  The statute has been put forward for these reasons,                                                                
although it can be peeled out of the bill.  The Designated                                                                      
Evaluation & Treatment (DET) portion of the bill is time-critical                                                               
as the API is being downsized. COMMISSIONER PERDUE said on the                                                                  
record that "the legislative auditor has my feet to the fire, and                                                               
I'd like to be able to say that we are following her                                                                            
SENATOR KELLY responded that his first priority is for the DET                                                                  
portion of the bill to move forward because it is time-critical.                                                                
This would ensure the bill doesn't bog down with another issue of                                                               
great value that might cause neither portion to pass.                                                                           
COMMISSIONER PERDUE stated she understood, and would appreciate                                                                 
moving this bill through this year.  However, if the bill has to be                                                             
split, that's what needs to done.  The confidentiality issue, which                                                             
is complicated, does need to be addressed.                                                                                      
Number 185                                                                                                                      
SENATOR ELTON asked if splitting the bill would affect the fiscal                                                               
SENATOR KELLY answered he didn't think so.                                                                                      
CHAIRMAN MILLER asked Ms. Shannon O'Fallon, on-line in Ketchikan,                                                               
who was going to talk on the first part of the bill regarding                                                                   
confidentiality, if she had any comments.                                                                                       
MS. O'FALLON responded she would speak to other parts of the bill.                                                              
MR. DOUG POMERAY, Fairbanks Community Mental Health Center, stated                                                              
he has a number of concerns around the confidentiality portion of                                                               
the bill.  Since the committee may remove it, he didn't have any                                                                
relevant comments at this time.                                                                                                 
MS. GAIL BALLOU, Fairbanks, said that she also would address the                                                                
confidentiality issue at a later time.                                                                                          
MR. BOB BRIGGS, Staff Attorney with the Disability Law Center in                                                                
Juneau, skipped over the issue of confidentiality to address the                                                                
issue of DET services in Alaska.  He explained the center has an                                                                
on-going lawsuit with the department involving a consumer seeking                                                               
enforcement and implementation of an existing statute.  However,                                                                
the center recognizes in implementing that statute that one                                                                     
solution may be to change the system. The center has been                                                                       
supportive of the department's effort to arrive at changes in the                                                               
DET system.                                                                                                                     
In its present form the bill has problems Mr. Briggs did not fully                                                              
address in written comments to the committee.  These comments were                                                              
submitted with anticipation of proposed amendments to the bill that                                                             
were worked out with providers, the Department of Law and DHSS.                                                                 
Most of the amendments are good ones, and without the amendments,                                                               
MR. BRIGGS said there are significant equal protection problems in                                                              
the bill.  He asked if the committee wanted him to focus on equal                                                               
CHAIRMAN MILLER replied, "certainly."                                                                                           
MR. BRIGGS said he would speak in general terms.  If the will of                                                                
the Legislature is to continue providing assistance  to people who                                                              
lack the ability to pay for the cost of mental health treatment,                                                                
then it must be done in a way that does not arbitrarily omit                                                                    
certain people from eligibility.  The focus of the department has                                                               
been on facilities designated as evaluation and treatment                                                                       
facilities. In practice, these are facilities with a contract with                                                              
the department.  If a person who needs mental health commitment                                                                 
happens to go to a facility without a contract with DHSS, it raises                                                             
the question of their eligibility.                                                                                              
MR. BRIGGS said he has advocated with the department and in the                                                                 
proposed amendments to solve most of the equal protection problems.                                                             
As long as a person receives evaluation and treatment services                                                                  
under AS 47.30.660 through 47.30.915 throughout the bill in terms                                                               
of eligibility, the equal protection problems are resolved.  But if                                                             
eligibility is focused at a designated facility, you must be sure                                                               
the designated facility is one that encompasses all facilities                                                                  
where a person might receive mental health treatment under the                                                                  
above referenced title.                                                                                                         
Number 267                                                                                                                      
SENATOR KELLY asked Mr. Briggs if the amendments, as they stand,                                                                
resolve the problems or take care of most of the problems.                                                                      
MR. BRIGGS said one definition in the bill presents a potential                                                                 
equal protection problem.  On page 6 of the proposed amendments,                                                                
the new definition of "evaluation facility" differs from the                                                                    
definition of "evaluation facility" that exists in AS 47.30.915.                                                                
On page 5 of the proposed amendments, the cross-reference to the                                                                
definition of "designated treatment facility" incorporates an                                                                   
existing definition.  The amendments before the committee propose                                                               
a new definition of the phrase "evaluation facility" that he                                                                    
suggested is a potential equal protection problem because there's                                                               
reference to a health care facility that has been designated by the                                                             
department, including a facility licensed or operated by the                                                                    
federal government. MR. BRIGGS said he'd defer to others about                                                                  
whether it's an all-inclusive definition, but until it's decided                                                                
it's all-inclusive of the people who would receive services under                                                               
AS 47.30.670 through 47.30.915, he doesn't see the purpose for a                                                                
new definition of "evaluation facility."                                                                                        
SENATOR KELLY asked Mr. Briggs if he raised this question with the                                                              
department and if it's an oversight or a point of disagreement. He                                                              
also asked people testifying later on to address this point.                                                                    
MR. BRIGGS replied it's probably an oversight resulting from a                                                                  
hurried meeting to finish the amendments.  This definition wasn't                                                               
The other portions of the bill not addressed by the amendments are                                                              
basically clean-ups.  The eligibility language refers to people who                                                             
have the ability to contribute to the cost of their care.  He                                                                   
supports the concept of determining someone's ability to pay and                                                                
only extending benefits to those who lack the ability to pay.  That                                                             
standard is already in the existing statute, but the bill proposes                                                              
a different model under which anyone who has the ability to pay                                                                 
even $10 a month might not be eligible.  Therefore, the bill won't                                                              
accomplish its intended purpose. He proposed language to the                                                                    
department and Senator Kelly's staff that would encompass the                                                                   
concept of ability to pay.  Mr. Briggs offered to work with anyone                                                              
on a version that would encompass that but not create ambiguities                                                               
regarding eligibility.                                                                                                          
SENATOR ELTON asked if he is suggesting having a definition that                                                                
allows people to pay according to their ability, because the                                                                    
existing language would exclude them from paying anything at all.                                                               
MR. BRIGGS said that's exactly what he is saying.  The second issue                                                             
relates to the appeal procedures in the bill.  Current language in                                                              
the bill would allow the department to suspend an appeal of a                                                                   
denial of the application for benefits in limbo indefinitely.  One                                                              
way the department can suspend an appeal is to ask itself for                                                                   
information.  He requested that the committee tighten up the appeal                                                             
procedure portions of the bill.                                                                                                 
MR. BRIGGS raised a third point, saying there should be a clear                                                                 
statement of release from liability upon payment of charges.  He                                                                
suggested adopting something similar to Medicaid law.  Medicaid law                                                             
requires that a provider who accepts a Medicaid payment accepts it                                                              
as 100% payment and prohibits billing the patient for uncovered                                                                 
charges. In practice, most providers are scrupulous and do not try                                                              
to make a double recovery.  But hospital billing is complicated                                                                 
and it's entirely possible to bill from some other source for a                                                                 
procedure the hospital has already received payment for.                                                                        
He brought up a fourth issue touched on earlier, stating that in                                                                
order to avoid equal protection claims, the bill should be careful                                                              
to refer to eligibility based on receiving evaluation or treatment                                                              
under AS 47.30.670 through 47.30.910.  If this benefit is                                                                       
designated only to people receiving treatment at specified                                                                      
facilities, it raises equal protection issues.                                                                                  
Finally, the bill uses a phrase "household income."  A large                                                                    
percentage of the consumers live together but are not married.  MR.                                                             
BRIGGS suggested defining income used for determining eligibility                                                               
based on "family income" because a person who doesn't owe a duty of                                                             
support should not lawfully be counted in determining a person's                                                                
eligibility, especially if that program is based on financial need.                                                             
He offered to work on a concept of "family income" and stated he                                                                
could quickly arrive at a proposed definition consistent with the                                                               
direction in past legislation.                                                                                                  
Number 368                                                                                                                      
SENATOR ELTON remarked that some people living in non-family                                                                    
situations might feel a moral obligation to help financially.  He                                                               
hoped the definition wouldn't preclude those people from helping                                                                
if they wished to.                                                                                                              
MR. BRIGGS replied it's a delicate issue that focuses on the                                                                    
eligibility standard and the concept of "household income."  In the                                                             
current language in the bill, the eligibility standard is based on                                                              
185% of the poverty line for the household income.  The more                                                                    
broadly the language is defined, the more people are going to be                                                                
eligible.  If defined more narrowly to only people who are married,                                                             
then fewer people will be eligible for the program.  He suggested                                                               
picking a standard that is consistent and, to stay safe, making it                                                              
"family income."  If the committee chooses to stay with "household                                                              
income," it is potentially a legal issue, raising an equal                                                                      
protection argument, if someone applies for this benefit and then                                                               
is found ineligible because they happen to live together in an                                                                  
unmarried state.                                                                                                                
Number 393                                                                                                                      
MS. BEVERLY FONOTI, Fairbanks resident and parent advocate for                                                                  
improved mental health programs, urged passage of SB 97 in its                                                                  
entirety.  It would provide the necessary checks and balances and                                                               
improve accountability.                                                                                                         
MS. JEANETTE GRASTO, President of NAMI Alaska and NAMI in                                                                       
Fairbanks, stated the organization, with a membership of 500,                                                                   
supports passage of both sections of this bill. A quality mental                                                                
health system is not possible without sufficient data. She stated                                                               
it's an issue of accountability and questioned whether services are                                                             
being provided.                                                                                                                 
MR. GENE GRASTO, Fairbanks, stated he supports this bill and the                                                                
changes made by the Disability Law Center, in its entirety.                                                                     
MR. JAMES SHILL, representing Charter North Hospital in Anchorage,                                                              
discussed Charter North's involvement in the downsizing of API.                                                                 
One of the three options for the replacement of API is the purchase                                                             
of Charter North. The hospital was involved in the Mental Health                                                                
Trust Authority meeting in December when many providers,                                                                        
beneficiaries and the community lent their support to community-                                                                
based treatment with DET.  Charter North supports DET, with a                                                                   
caveat of adequate community funding.  Most people in the                                                                       
behavioral health care field agree the nationwide movement toward                                                               
community treatment of the mentally ill is a beneficial treatment                                                               
method. However, if API is downsized without adequately funding                                                                 
those community resources, causing the beneficiaries to end up in                                                               
the judicial system or wandering the streets, then Charter North                                                                
would have to withdraw its support.                                                                                             
MR. WALTER MAJOROS, Executive Director of Alaska Mental Health                                                                  
Board, thanked Senator Kelly on behalf of the board for introducing                                                             
this bill. He addressed his comments to the DET portion of the                                                                  
bill, but stated for the record that the board supports both parts                                                              
of SB 97, considering access to records very important.  The                                                                    
state's management information system, and the safeguards and                                                                   
policies enacted around the Aurora System adequately protect the                                                                
confidentiality of consumers.  It's critically important for the                                                                
department to have client data to assist in future planning and to                                                              
present information on outcomes and services to the Legislature and                                                             
to the Trust Authority and other stakeholders.                                                                                  
He said the board supports the current bill because it would                                                                    
clarify the statutory framework regarding the department's                                                                      
responsibility for funding statewide DET services and who is                                                                    
eligible to receive payment for services.  The board is partnering                                                              
with the Trust Authority and DHSS to reduce API from a 79-bed to a                                                              
54-bed facility. Currently, emergency mental health services and                                                                
acute care in community hospitals in the Anchorage area don't exist                                                             
but will be the central aspect to a system complementing API in                                                                 
serving those with crises and co-occurring substance abuse crises.                                                              
This bill will provide a statewide system, promoting more local and                                                             
regional responses, where currently the services are only available                                                             
in Juneau and Fairbanks.  Dislocation from communities is difficult                                                             
for people and, in many cases, worsens their crisis.  Consumers                                                                 
prefer services closer to home and their natural support services.                                                              
DET services would also be cost-effective and open up a revenue                                                                 
source.  API cannot capture Medicaid reimbursement for people                                                                   
between ages 18-64, whereas if the same type of service is provided                                                             
in a community-based hospital which is not classified as an IMD                                                                 
(Institute for Mental Disease) it can get Medicaid reimbursement                                                                
for those age groups.  He pointed out that API receives federal                                                                 
DISH funding that will be dramatically reduced over the next few                                                                
MR. MAJOROS stated the board supports the proposed amendments, and                                                              
he offered to work with the Disability Law Center if any further                                                                
amendments are needed.                                                                                                          
Number 553                                                                                                                      
MS. PAT CLASBY, representing Alaska State Hospital and Nursing Home                                                             
Association (ASHNHA), said ASHNHA applauds the sponsor for                                                                      
introducing SB 97. She discussed the evolution of care of the                                                                   
mentally ill, the role of state hospitals during the past decade,                                                               
and services in an out-patient community setting.  Individuals who                                                              
become acutely psychotic need acute but sporadic and brief                                                                      
hospitalization; if they can access a local hospital their stay is                                                              
shorter and can tie in the community treatment team and involve the                                                             
family. It's humane, modern medicine. This bill would allow mental                                                              
health consumers to access the local hospitals that serve other                                                                 
psychiatric individuals who have private insurance or Medicaid                                                                  
coverage. It clarifies the Fairbanks demonstration project that                                                                 
began 12 years ago, and the statute.                                                                                            
TAPE 99-17, SIDE B                                                                                                              
Number 586                                                                                                                      
MS. CLASBY said in conclusion, ASHNHA has worked with the                                                                       
Administration to address some concerns in the way it was drafted,                                                              
and has submitted multiple amendments.  She thanked the committee,                                                              
and urged the passage of the bill this session in order to have a                                                               
smaller state hospital and treat the mentally ill closer to home.                                                               
SENATOR KELLY asked if the amendments are new concerns, or ones                                                                 
that the stakeholders didn't agree on.  MS. CLASBY replied the                                                                  
first concerns were substantive and came from the hospitals, and it                                                             
would have been difficult to move the bill forward if some of those                                                             
weren't addressed. Now, the next set of amendments are from the                                                                 
Disability Law Center. She said discussion will lead to resolution                                                              
because these are technical in nature, and none jeopardize moving                                                               
forward with a modern DET system.                                                                                               
SENATOR KELLY said his enthusiasm about the bill will be based on                                                               
the ASHNHA's ability to come to agreement with other stakeholders                                                               
on those issues.                                                                                                                
MR. MIKE POWERS, Administrator at Fairbanks Memorial Hospital                                                                   
(FMH), stated FMH endorsed the bill.  He understood the carving out                                                             
of the confidentiality issue and agrees with the general thrust of                                                              
what's been said before the committee today, but wanted to point                                                                
out a couple things from the Fairbanks community's perspective.                                                                 
With the downsizing of API and the effort to see patients closer to                                                             
home, there has been a spike in the Fairbanks mental health census                                                              
during the past 18 months.  Five years ago FMH had major concerns                                                               
with the lack of methodology for payment, and worked closely with                                                               
Commissioner Perdue and Karl Brimner. This bill helps solidify a                                                                
collaborative relationship.                                                                                                     
Number 548                                                                                                                      
MR. JEFF JESSE, Executive Director of Alaska Mental Health Trust                                                                
Authority, thanked Senator Kelly on behalf of the trustees for                                                                  
sponsoring the bill and, as Senate subcommittee chair, providing                                                                
leadership on the budget and issues important to the development of                                                             
an effective mental health system.  He said Alaska is justifiably                                                               
proud to be one of only a few states having no institutional care                                                               
for people with developmental disabilities because of the array of                                                              
alternative community-based systems.                                                                                            
The Trust Authority believes the state still needs a centralized                                                                
state facility,  but it can minimize the need for that type of                                                                  
care.  This bill is required to create the foundation for                                                                       
community-based services. All the stakeholders are now willing to                                                               
work out differences.                                                                                                           
Although there are remaining issues on confidentiality, some                                                                    
consensus was voiced today on the need to provide confidentiality.                                                              
MR. JESSE stated "we cannot allow confidentiality to be used as a                                                               
shield to avoid accountability and the ability to ensure proper                                                                 
quality and effectiveness of our programs."  If the will of the                                                                 
committee splits that issue into a separate bill, he said the trust                                                             
authority would support it.                                                                                                     
Number 515                                                                                                                      
CHAIRMAN MILLER stated the sponsor would hold SB 97 and bring back                                                              
a CS addressing issues brought up today.  He asked that the members                                                             
turn in their lists of nominees for confirmation, and adjourned at                                                              
2:31 p.m.                                                                                                                       

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