Legislature(2021 - 2022)BUTROVICH 205

03/29/2022 01:30 PM Senate HEALTH & SOCIAL SERVICES

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Audio Topic
01:33:00 PM Start
01:33:21 PM SB124
03:07:26 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 124 MENTAL HEALTH FACILITIES & MEDS TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         March 29, 2022                                                                                         
                           1:33 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator David Wilson, Chair                                                                                                     
Senator Shelley Hughes, Vice Chair                                                                                              
Senator Mia Costello                                                                                                            
Senator Lora Reinbold                                                                                                           
Senator Tom Begich                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 124                                                                                                             
"An  Act relating  to admission  to and  detention at  a subacute                                                               
mental health  facility; establishing a definition  for 'subacute                                                               
mental health  facility'; establishing  a definition  for 'crisis                                                               
residential  center'; relating  to  the  definitions for  'crisis                                                               
stabilization   center';  relating   to  the   administration  of                                                               
psychotropic  medication  in  a  crisis  situation;  relating  to                                                               
licensed facilities; and providing for an effective date."                                                                      
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 124                                                                                                                  
SHORT TITLE: MENTAL HEALTH FACILITIES & MEDS                                                                                    
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
04/12/21       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/12/21       (S)       HSS, FIN                                                                                               
04/27/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/27/21       (S)       Heard & Held                                                                                           
04/27/21       (S)       MINUTE(HSS)                                                                                            
04/29/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/29/21       (S)       -- MEETING CANCELED --                                                                                 
05/04/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
05/04/21       (S)       Heard & Held                                                                                           
05/04/21       (S)       MINUTE(HSS)                                                                                            
05/05/21       (S)       JUD REFERRAL ADDED AFTER HSS                                                                           
05/06/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
05/06/21       (S)       <Bill Hearing Canceled>                                                                                
03/08/22       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/08/22       (S)       Heard & Held                                                                                           
03/08/22       (S)       MINUTE(HSS)                                                                                            
03/15/22       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/15/22       (S)       Heard & Held                                                                                           
03/15/22       (S)       MINUTE(HSS)                                                                                            
03/17/22       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/17/22       (S)       Heard & Held                                                                                           
03/17/22       (S)       MINUTE(HSS)                                                                                            
03/22/22       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/22/22       (S)       Heard & Held                                                                                           
03/22/22       (S)       MINUTE(HSS)                                                                                            
03/23/22       (S)       JUD AT 1:30 PM BUTROVICH 205                                                                           
03/23/22       (S)       <Bill Hearing Canceled>                                                                                
03/25/22       (S)       JUD AT 1:30 PM BUTROVICH 205                                                                           
03/25/22       (S)       -- MEETING CANCELED --                                                                                 
03/29/22       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
LEON MORGAN, Deputy Commissioner                                                                                                
Department of Public Safety                                                                                                     
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions on SB 124.                                                                             
                                                                                                                                
HEATHER CARPENTER, Health Care Policy Advisor                                                                                   
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions on SB 124.                                                                             
                                                                                                                                
STEVEN BOOKMAN, Senior Assistant Attorney General                                                                               
Human Services Section                                                                                                          
Civil Division                                                                                                                  
Department of Law                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered questions on SB 124.                                                                             
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:33:00 PM                                                                                                                    
CHAIR DAVID WILSON  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:33 p.m.  Present at the                                                               
call to  order were Senators Begich,  Costello, Reinbold, Hughes,                                                               
and Chair Wilson.                                                                                                               
                                                                                                                                
             SB 124-MENTAL HEALTH FACILITIES & MEDS                                                                         
1:33:21 PM                                                                                                                    
CHAIR WILSON announced  the consideration of SENATE  BILL NO. 124                                                               
"An  Act relating  to admission  to and  detention at  a subacute                                                               
mental health  facility; establishing a definition  for 'subacute                                                               
mental health  facility'; establishing  a definition  for 'crisis                                                               
residential  center'; relating  to  the  definitions for  'crisis                                                               
stabilization   center';  relating   to  the   administration  of                                                               
psychotropic  medication  in  a  crisis  situation;  relating  to                                                               
licensed facilities; and providing for an effective date."                                                                      
                                                                                                                                
[SB  124  was  previously  heard   on  4/27/21,  5/4/21,  3/8/22,                                                               
3/15/22, 3/17/22, and 3/22/22.]                                                                                                 
                                                                                                                                
CHAIR  WILSON  stated  that  the   committee  would  continue  to                                                               
consider amendments.                                                                                                            
                                                                                                                                
1:34:17 PM                                                                                                                    
SENATOR  REINBOLD moved  to adopt  Amendment 15,  work order  32-                                                               
GS1730\B.5.                                                                                                                     
                                                 32-GS1730\B.5                                                                  
                                               Ambrose/Dunmire                                                                  
                                                      3/14/22                                                                   
                                                                                                                                
                                                                                                                                
                          AMENDMENT 15                                                                                      
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
          TO:  CSSB 124(HSS), Draft Version "B"                                                                                 
                                                                                                                                
                                                                                                                                
     Page 6, line 5:                                                                                                            
          Delete "does not include"                                                                                             
          Insert "includes"                                                                                                     
                                                                                                                                
                                                                                                                                
     Page 10, line 7, following "facility":                                                                                     
          Insert ", and computations of a 72-hour                                                                           
      evaluation period under AS 47.30.708 do not include                                                                   
         any period of time necessary to transport the                                                                      
     respondent to the treatment facility"                                                                                  
                                                                                                                                
1:34:20 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
1:34:21 PM                                                                                                                    
SENATOR  REINBOLD  explained  that  Amendment  15  would  include                                                               
transportation  time   when  computing  the   72-hour  evaluation                                                               
period.                                                                                                                         
                                                                                                                                
1:34:48 PM                                                                                                                    
CHAIR WILSON asked for the reference in the bill.                                                                               
                                                                                                                                
SENATOR REINBOLD referred to page 10, line 7.                                                                                   
                                                                                                                                
1:35:21 PM                                                                                                                    
SENATOR COSTELLO asked what was meant by transportation time.                                                                   
                                                                                                                                
1:35:27 PM                                                                                                                    
CHAIR WILSON asked  for a description of  transportation time and                                                               
if it begins when the person is picked up or dropped off.                                                                       
                                                                                                                                
1:35:42 PM                                                                                                                    
SENATOR REINBOLD directed attention to  page 6, line 5, and read,                                                               
"The  hearing shall  be  held at  the  crisis residential  center                                                               
...."                                                                                                                           
                                                                                                                                
1:36:33 PM                                                                                                                    
SENATOR  BEGICH expressed  concern with  Amendment 15.  He stated                                                               
that  when working  in  the Juvenile  Justice  System, staff  was                                                               
concerned about  adequate time to  provide counseling  during the                                                               
review.  He  offered  his  belief  that  the  Alaska  Psychiatric                                                               
Institute  time  was 72  hours  for  the  full evaluation  as  an                                                               
optimal  time  for  a  clinical   psychologist  to  evaluate  the                                                               
patient. Amendment 15 would change  the standard. For example, if                                                               
a youth were picked up in  Unalakleet but took two days to obtain                                                               
a  flight,  it would  not  allow  time  for a  complete  clinical                                                               
evaluation. He  suggested that could  limit the  service provided                                                               
to the patient. He explained that  the intent was not to have the                                                               
patient in limbo.  However, including travel time  could harm the                                                               
patient. He  pointed out a technical  error on line 11.  It reads                                                               
"treatment  facility,"   which  should  be   "crisis  residential                                                               
center.                                                                                                                         
                                                                                                                                
1:38:21 PM                                                                                                                    
SENATOR REINBOLD  read, [page  6, lines  4-5 "Computation  of the                                                               
72-hour period  at a crisis  residential center before  a hearing                                                               
does  not include  Saturdays, Sundays,  and legal  holidays." She                                                               
stated that Amendment 15 would insert:                                                                                          
                                                                                                                                
     Page 10, line 7, following "facility":                                                                                     
          Insert ", and computations of a 72-hour                                                                           
      evaluation period under AS 47.30.708 do not include                                                                   
         any period of time necessary to transport the                                                                      
     respondent to the treatment facility"                                                                                  
                                                                                                                                
SENATOR REINBOLD  related that the  language in the bill  goes on                                                               
to say that  the hearing shall be held at  the crisis residential                                                               
center in  person, by  contemporaneous two-way  video conference,                                                               
or  by teleconference.  She wondered  why 72  hours would  not be                                                               
enough.                                                                                                                         
                                                                                                                                
1:39:05 PM                                                                                                                    
SENATOR  BEGICH  explained  that   72  hours  was  necessary  for                                                               
clinical  interaction to  determine  the best  resources for  the                                                               
patient. He  expressed concern that including  the transportation                                                               
time and  Saturdays and Sundays  might mean the clinician  has no                                                               
time for clinical interaction with the patient.                                                                                 
                                                                                                                                
1:39:51 PM                                                                                                                    
SENATOR HUGHES asked  if this includes the travel  time from when                                                               
the law  enforcement officer picks  up the person and  takes them                                                               
to the crisis residential center.                                                                                               
                                                                                                                                
1:40:06 PM                                                                                                                    
SENATOR REINBOLD  responded by reading, "When  under this section                                                               
the court  grants an application  to admit the  respondent within                                                               
the crisis center, the court shall  set a time for the hearing to                                                               
be held  within 72  hours after the  respondent's arrival  at the                                                               
crisis stabilization center                                                                                                     
                                                                                                                                
1:40:27 PM                                                                                                                    
SENATOR HUGHES  asked if  she wanted to  exclude the  travel time                                                               
from the moment the law  enforcement officer picks up the patient                                                               
and takes them to the crisis residential center.                                                                                
                                                                                                                                
SENATOR  REINBOLD  directed attention  to  page  6, line  5.  The                                                               
language  "does  not  include"  would be  deleted  and  the  term                                                               
"includes" would be inserted.                                                                                                   
                                                                                                                                
CHAIR  WILSON acknowledged  that Amendment  15 would  include any                                                               
transportation by law enforcement or emergency medical services.                                                                
                                                                                                                                
1:41:19 PM                                                                                                                    
SENATOR  HUGHES envisioned  that transportation  in Anchorage  or                                                               
Palmer might be 30 minutes.  However, she imagined a person could                                                               
be  stranded in  a village  due to  bad weather,  perhaps for  38                                                               
hours.                                                                                                                          
                                                                                                                                
1:42:03 PM                                                                                                                    
LEON  MORGAN, Deputy  Commissioner, Department  of Public  Safety                                                               
Juneau, Alaska,  related his understanding  the question  was the                                                               
length of  time to  transport someone  to a  crisis stabilization                                                               
center. He  stated that  in urban  Alaska transportation  time is                                                               
short, but it  would vary in Western, Southeast,  and rural areas                                                               
on  the road  system.  He emphasized  that it  is  a priority  to                                                               
transport people on  mental health holds to  the proper facility.                                                               
He estimated it would likely take 24 hours.                                                                                     
                                                                                                                                
1:43:17 PM                                                                                                                    
HEATHER  CARPENTER, Health  Care  Policy  Advisor, Department  of                                                               
Health and  Social Services (DHSS),  Juneau, Alaska,  agreed with                                                               
Deputy  Commissioner Morgan  that the  department sometimes  must                                                               
coordinate or secure  transport from a rural location  or off the                                                               
road system. She recalled a  recent case in Southeast Alaska that                                                               
was outside the Juneau community  where the Designated Evaluation                                                               
and Treatment Center (DET) is  located. In that instance, it took                                                               
over  24 hours  to get  transportation. She  suggested that  if a                                                               
rural  hospital  established  a   crisis  residential  center  in                                                               
Kotzebue, it  might be  necessary to coordinate  a flight  to get                                                               
the  patient to  the center.  She stressed  the necessity  for 72                                                               
hours for the clinical assessment.                                                                                              
                                                                                                                                
1:44:07 PM                                                                                                                    
SENATOR HUGHES  said she shares  Senator Reinbold's  concern that                                                               
someone who  was delayed  by weather could  be detained  for five                                                               
days,  which seemed  like  an infringement.  She  hoped that  the                                                               
providers could  use teleconferencing to provide  counseling when                                                               
the person was  detained by bad weather. She  asked for suggested                                                               
remedies.                                                                                                                       
                                                                                                                                
MS. CARPENTER  stated that the  department uses  telehealth where                                                               
possible. She said in cases  where someone cannot be transported,                                                               
per  the   settlement  with  the   Disability  Law   Center,  the                                                               
department must perform a reevaluation  to ensure that the person                                                               
still meets the  criteria after 48 hours. She stated  that it was                                                               
rare for this to occur. However,  it could take close to 24 hours                                                               
to transport the person by flight and arrive at the facility.                                                                   
                                                                                                                                
1:45:56 PM                                                                                                                    
SENATOR HUGHES  highlighted that most villages  have primary care                                                               
clinics. She suggested  that if a person was held  in the primary                                                               
care center,  treatment could begin using  telehealth. She agreed                                                               
it would  not be the  same as  at the crisis  residential center,                                                               
but  services could  start  and  not put  rural  residents in  an                                                               
unfair situation.                                                                                                               
                                                                                                                                
1:46:45 PM                                                                                                                    
CHAIR  WILSON   stated  that  a   billing  disparity   occurs  in                                                               
telehealth and the legislature was  considering a bill that would                                                               
address  that. However,  many providers  will not  offer services                                                               
without being reimbursed.                                                                                                       
                                                                                                                                
MS. CARPENTER  responded that  it would  depend on  the location.                                                               
She  noted that  not all  patients  would be  transported to  API                                                               
because  they would  use the  three  evaluation treatment  center                                                               
hospitals located in Fairbanks,  Mat-Su (Palmer), and Juneau. She                                                               
offered  to  reach  out to  the  hospitals  regarding  telehealth                                                               
capabilities.                                                                                                                   
                                                                                                                                
1:48:01 PM                                                                                                                    
SENATOR  HUGHES  stated  that   this  section  refers  to  crisis                                                               
stabilization centers,  not hospitals.  She highlighted  that the                                                               
crisis stabilization  centers must conduct hearings  through two-                                                               
way  video conferences.  She offered  her view  that the  primary                                                               
care  clinics, which  are  part of  the  Community Health  Center                                                               
system,  have that  capability.  She did  not  see why  treatment                                                               
couldn't begin  once the law enforcement  officer transported the                                                               
person to  the clinic. She  said she was uncomfortable  that some                                                               
residents would be held for longer than 72 hours.                                                                               
                                                                                                                                
1:49:01 PM                                                                                                                    
SENATOR COSTELLO referred  to the language in the  second part of                                                               
Amendment  15  and asked  the  sponsor  whether she  intended  to                                                               
exclude  the  crisis  evaluation  centers in  that  part  of  the                                                               
amendment.                                                                                                                      
                                                                                                                                
1:49:49 PM                                                                                                                    
SENATOR REINBOLD related a scenario in  which she lost a crown on                                                               
a  Friday, the  dentist is  closed  on Saturday  and Sunday,  and                                                               
Monday was  a holiday. She offered  her view that it  is not fair                                                               
to  the patient  to be  trapped because  of holidays.  She stated                                                               
that her  goal was to help  patients as quickly as  possible. She                                                               
noted that  the department and DPS  said 24 hours is  the typical                                                               
transportation  in rural  Alaska.  She said  Amendment 15  seemed                                                               
very reasonable.                                                                                                                
                                                                                                                                
1:50:48 PM                                                                                                                    
SENATOR  COSTELLO suggested  that  excluding Saturdays,  Sundays,                                                               
and legal  holidays doesn't seem  right because the  person would                                                               
be rushed  to a crisis  residential center during that  time only                                                               
to  wait  for  treatment.  However,  Amendment  15  would  change                                                               
existing  statute. She  referred to  lines 5-7  of Amendment  15,                                                               
which  would delete  new  provisions related  to  detention at  a                                                               
crisis residential center. She expressed  concern that this means                                                               
the person would not be taken to a crisis residential center.                                                                   
                                                                                                                                
1:51:46 PM                                                                                                                    
CHAIR WILSON deferred to Mr. Bookman.                                                                                           
                                                                                                                                
1:52:08 PM                                                                                                                    
STEVEN   BOOKMAN,  Senior   Assistant  Attorney   General,  Human                                                               
Services Section,  Civil Division, Department of  Law, Anchorage,                                                               
Alaska, stated that Senator Costello's  concerns were correct. It                                                               
does not make sense to separate the new and existing facilities.                                                                
                                                                                                                                
1:52:34 PM                                                                                                                    
SENATOR COSTELLO suggested tabling Amendment 15.                                                                                
                                                                                                                                
CHAIR WILSON noted  the bill has two more  committees of referral                                                               
to  fix some  of these  issues. He  suggested that  the committee                                                               
should proceed.                                                                                                                 
                                                                                                                                
1:53:11 PM                                                                                                                    
SENATOR  COSTELLO asked  what currently  happens when  someone is                                                               
brought in for evaluation on  a Saturday, Sunday, or holiday. She                                                               
wondered  whether  the  72  hours  begin  after  the  weekend  or                                                               
holiday.                                                                                                                        
                                                                                                                                
MS. CARPENTER deferred to Mr. Bookman.                                                                                          
                                                                                                                                
MR.  BOOKMAN  responded  that  is correct.  If  the  person  were                                                               
brought to the  facility on a Saturday, the clock  would start on                                                               
Monday.                                                                                                                         
                                                                                                                                
1:53:56 PM                                                                                                                    
CHAIR WILSON  said he shares  Senator Begich's concern  about the                                                               
need  to  provide  health care  professionals  adequate  time  to                                                               
perform an evaluation.                                                                                                          
                                                                                                                                
1:54:06 PM                                                                                                                    
SENATOR REINBOLD  stated that the  intent of Amendment 15  was to                                                               
have the  patient seen within 72  hours, including transportation                                                               
time, regardless of the facility.                                                                                               
                                                                                                                                
1:54:36 PM                                                                                                                    
CHAIR WILSON maintained his objection.                                                                                          
                                                                                                                                
1:54:39 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
1:57:21 PM                                                                                                                    
CHAIR WILSON reconvened the meeting.                                                                                            
                                                                                                                                
1:57:29 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  15, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 15                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
CHAIR WILSON announced that Amendment 15 failed on a vote of 1                                                                  
yea and 4 nays.                                                                                                                 
                                                                                                                                
1:57:53 PM                                                                                                                    
SENATOR HUGHES expressed concern about the additional time                                                                      
patients in rural areas are held before receiving treatment,                                                                    
noting that it could be for eight days.                                                                                         
                                                                                                                                
1:58:20 PM                                                                                                                    
SENATOR REINBOLD moved to adopt Amendment 16, work order 32-                                                                    
GS1730\B.6.                                                                                                                     
                                                                                                                                
                                                 32-GS1730\B.6                                                                  
                                                 Dunmire/Foote                                                                  
                                                      3/14/22                                                                   
                                                                                                                                
                                                                                                                                
                          AMENDMENT 16                                                                                      
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 5, following line 7:                                                                                                  
     Insert a new subsection to read:                                                                                           
          "(c)  The examination under (a) of this section                                                                       
     must include  evaluation of  whether the  respondent is                                                                    
     suffering   from    medication-induced   psychosis   or                                                                    
     psychosis caused by drug  withdrawal. The mental health                                                                    
     professional  shall  consult   with  qualified  medical                                                                    
     personnel to address any findings."                                                                                        
                                                                                                                                
1:58:24 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
1:58:26 PM                                                                                                                    
SENATOR REINBOLD read Amendment 16.                                                                                             
                                                                                                                                
1:59:03 PM                                                                                                                    
SENATOR BEGICH asked whether  qualified  medical personnelwas   a                                                               
medical doctor, a registered nurse, or someone else.                                                                            
                                                                                                                                
CHAIR WILSON offered his view that the term is not defined.                                                                     
                                                                                                                                
1:59:31 PM                                                                                                                    
SENATOR REINBOLD suggested that this  would be addressed in later                                                               
amendments. She stated  her preference was for the  term to refer                                                               
to  licensed  medical  professionals, including  a  psychiatrist,                                                               
psychologist, physician assistant, or physician.                                                                                
                                                                                                                                
1:59:53 PM                                                                                                                    
SENATOR COSTELLO  asked whether this  was the whole point  of the                                                               
evaluation and it would happen anyway.                                                                                          
                                                                                                                                
MS.  CARPENTER answered  that she  was correct  that the  medical                                                               
personnel, including  the mental health professionals  on site at                                                               
these locations would assess what this amendment would require.                                                                 
                                                                                                                                
2:00:18 PM                                                                                                                    
SENATOR REINBOLD  suggested that the mental  health advocates and                                                               
a  psychiatrist she's  worked with  thought it  was important  to                                                               
discriminate between someone  with a medication-induced psychosis                                                               
or psychosis caused by drug withdrawal.                                                                                         
                                                                                                                                
CHAIR WILSON  stated that  there is  no definition  of it  in the                                                               
bill or statute.                                                                                                                
                                                                                                                                
2:01:01 PM                                                                                                                    
SENATOR REINBOLD  responded that  the mental  health professional                                                               
would  be the  person  treating the  patient, or  it  would be  a                                                               
qualified medical person.                                                                                                       
                                                                                                                                
2:01:28 PM                                                                                                                    
SENATOR BEGICH  acknowledged it was redundant  language. He asked                                                               
whether it caused any harm.                                                                                                     
                                                                                                                                
MS.  CARPENTER responded  that the  language "shall  consult with                                                               
qualified medical  personnel" offers some confusion  because that                                                               
term is not  defined. The department believes  the "mental health                                                               
professional"   would  be   considered  the   "qualified  medical                                                               
personnel."                                                                                                                     
                                                                                                                                
2:02:00 PM                                                                                                                    
SENATOR REINBOLD  stated that she  did not think the  term needed                                                               
to  be defined.  She  said  that Amendment  16  was to  determine                                                               
whether  the  episode   was  caused  by  drug   withdrawal  or  a                                                               
medication-induced psychosis.                                                                                                   
                                                                                                                                
MS. CARPENTER  stated that without  a definition,  the department                                                               
would  need to  define it  in  regulation. She  noted that  there                                                               
would not be a statutory definition to reference.                                                                               
                                                                                                                                
2:02:53 PM                                                                                                                    
SENATOR REINBOLD  related her understanding that  a mental health                                                               
professional  would conduct  the examination  and consult  with a                                                               
qualified medical person to address any findings.                                                                               
                                                                                                                                
2:03:37 PM                                                                                                                    
CHAIR WILSON  highlighted that  the issue  could be  who somebody                                                               
would  consult with  if  there  was an  individual  who had  both                                                               
medical and mental health expertise.                                                                                            
                                                                                                                                
SENATOR REINBOLD asked who has the legal ability to do the exam.                                                                
                                                                                                                                
MS. CARPENTER  answered that the "mental  health professionalis                                                                 
defined  in AS  47.30.915(13).  She  paraphrased the  definition,                                                               
which read:                                                                                                                     
                                                                                                                                
          (13) "mental health professional" means a                                                                             
     psychiatrist or physician who is  licensed by the State                                                                    
     Medical Board to practice in  this state or is employed                                                                    
     by  the  federal  government; a  clinical  psychologist                                                                    
     licensed  by  the  state   Board  of  Psychologist  and                                                                    
     Psychological  Associate   Examiners;  a  psychological                                                                    
     associate trained  in clinical psychology  and licensed                                                                    
     by   the  Board   of  Psychologist   and  Psychological                                                                    
     Associate  Examiners; an  advanced practice  registered                                                                    
     nurse or a  registered nurse with a  master's degree in                                                                    
     psychiatric  nursing, licensed  by the  State Board  of                                                                    
     Nursing;  a marital  and family  therapist licensed  by                                                                    
     the   Board   of   Marital  and   Family   Therapy;   a                                                                    
     professional  counselor   licensed  by  the   Board  of                                                                    
     Professional  Counselors;  a   clinical  social  worker                                                                    
     licensed by the  Board of Social Work  Examiners; and a                                                                    
     person who                                                                                                                 
                                                                                                                                
     (A)  has  a master's  degree  in  the field  of  mental                                                                    
     health;                                                                                                                    
                                                                                                                                
       (B) has at least 12 months of post-masters working                                                                       
     experience in the field of mental illness; and                                                                             
                                                                                                                                
       (C) is working under the supervision of a type of                                                                        
     licensee listed in this paragraph;                                                                                         
                                                                                                                                
2:05:23 PM                                                                                                                    
SENATOR REINBOLD asked if the  department was concerned about the                                                               
mental health professional consultation.                                                                                        
                                                                                                                                
MS. CARPENTER responded  that as drafted, Amendment  15, lines 5-                                                               
6,  has  a  qualifier  "shall   consult  with  qualified  medical                                                               
profession" that is not defined.                                                                                                
                                                                                                                                
2:05:52 PM                                                                                                                    
SENATOR  REINBOLD  wondered  why  the  department  wouldn't  want                                                               
someone  with that  expertise. She  said that  the mental  health                                                               
advocates flagged this amendment as critically important.                                                                       
                                                                                                                                
SENATOR HUGHES  related her understanding that  the determination                                                               
was standard procedure.  She  noted that Ms. Carpenter listed the                                                               
"mental health professionals"  and said it would be  odd for them                                                               
to consult with  themselves. She stated that some  of the "mental                                                               
health  professionals" do  not  have  prescribing authority.  She                                                               
asked whether these professionals would  be in touch with medical                                                               
providers as a standard part of this process.                                                                                   
                                                                                                                                
2:08:08 PM                                                                                                                    
MS. CARPENTER  answered yes,  they would be  in touch  with other                                                               
medical personnel, including the  medical "professional person in                                                               
charge," which is also defined. She read:                                                                                       
                                                                                                                                
     (17) "professional  person in charge" means  the senior                                                                    
     mental  health  professional  at  a  facility  or  that                                                                    
     person's designee;  in the absence  of a  mental health                                                                    
     professional  it   means  the  chief  of   staff  or  a                                                                    
     physician designated by the chief of staff;                                                                                
                                                                                                                                
2:08:31 PM                                                                                                                    
SENATOR HUGHES  stated that  since this  is a  standard procedure                                                               
and already occurs, she would like to call the question.                                                                        
                                                                                                                                
2:08:43 PM                                                                                                                    
SENATOR REINBOLD  asked for a  specific statutory  reference. She                                                               
said she was  unsure that this actually would  happen. She stated                                                               
that Amendment 16 would protect patients.                                                                                       
                                                                                                                                
CHAIR WILSON  offered his  view that  the committee  went through                                                               
the explanations.                                                                                                               
                                                                                                                                
SENATOR  HUGHES  stated  that medical  professionals  could  lose                                                               
their licenses  if they  do not  follow standard  best practices.                                                               
She said she was comfortable that this was happening.                                                                           
                                                                                                                                
2:09:37 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  16, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 16                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
CHAIR WILSON  announced that Amendment 16  failed on a vote  of 1                                                               
yea, and 4 nays.                                                                                                                
                                                                                                                                
2:10:00 PM                                                                                                                    
SENATOR  REINBOLD moved  to adopt  Amendment 17,  work order  32-                                                               
GS1730\B.7.                                                                                                                     
                                                                                                                                
                                                 32-GS1730\B.7                                                                  
                                                 Ambrose/Foote                                                                  
                                                      3/14/22                                                                   
                                                                                                                                
                                                                                                                                
                          AMENDMENT 17                                                                                      
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 8, line 9, following "AS 47.30.838":                                                                                  
          Insert ", and only if the crisis stabilization                                                                        
     center or crisis residential center                                                                                        
               (1)  ascertains the date the respondent last                                                                     
     underwent a physical examination;                                                                                          
               (2)  administers the psychotropic medication                                                                     
     only as a last resort; and                                                                                                 
               (3)  conducts an examination based on a                                                                          
     checklist  developed  by   the  department  to  exclude                                                                    
     commonly   known   issues   that  may   contribute   to                                                                    
     conditions   and   symptoms  that   mimic   psychiatric                                                                    
     disorders"                                                                                                                 
                                                                                                                                
2:10:03 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
2:10:05 PM                                                                                                                    
SENATOR  REINBOLD explained  that  Amendment 17  would provide  a                                                               
checklist   for  the   examination   and   require  the   medical                                                               
professional  to  use  the   most  natural  interventions,  using                                                               
psychotropic medications as a last resort.                                                                                      
                                                                                                                                
2:10:53 PM                                                                                                                    
CHAIR WILSON stated that Amendment  17 relates to a discussion on                                                               
a previous amendment, such that  psychotropic medication would be                                                               
administered only  in crisis  situations when  there was  risk of                                                               
immediate harm to  self or others. He offered his  belief that it                                                               
might not  be possible to  ascertain the patient's  last physical                                                               
examination.  He  said  this  provision   does  not  apply  to  a                                                               
residential treatment  center. He referred to  paragraphs (2) and                                                               
(3).  He offered  his view  that  administering the  psychotropic                                                               
medication only  as a  last resort  and conducting  and examining                                                               
based on  a checklist were  current practices. He  clarified that                                                               
psychotropic  medication would  only be  administered for  crisis                                                               
situations, which are life and  death situations. He related that                                                               
medical professionals  would not  administer other  drugs without                                                               
the patient's  consent, and the  patient would be  informed about                                                               
any   side  effects   of  long-term   medications  before   being                                                               
prescribed.                                                                                                                     
                                                                                                                                
2:12:14 PM                                                                                                                    
SENATOR REINBOLD offered  her view that it was  important to know                                                               
a  person's  medical  history  to   provide  a  baseline  and  to                                                               
administer  psychotropic drugs  as  a last  resort because  those                                                               
medications  could  have  serious  side  effects.  She  expressed                                                               
concern that other conditions  might mimic psychiatric disorders.                                                               
She stated these concerns were  flagged by physicians and patient                                                               
advocates.  She  asked  to  read Faith  Myers   letter  into  the                                                               
record.                                                                                                                         
                                                                                                                                
CHAIR  WILSON  denied the  request  and  stated that  Ms.  Myer's                                                               
letter was  available on BASIS  for the  public to read  and that                                                               
the committee needed time to consider the remaining amendments.                                                                 
                                                                                                                                
2:14:44 PM                                                                                                                    
SENATOR COSTELLO offered  her support for paragraph  (3) on lines                                                               
6-8, but pointed  out that the way the amendment  is crafted, the                                                               
crisis residential center cannot  help the individual unless they                                                               
determine  the date  they last  had a  physical examination.  She                                                               
said she  doesn't recall the last  time she had a  physical exam.                                                               
She  expressed concern  that adhering  to these  provisions could                                                               
prevent the patient from receiving treatment.                                                                                   
                                                                                                                                
2:15:29 PM                                                                                                                    
SENATOR  HUGHES related  a scenario  where a  person had  a heart                                                               
attack and medical professionals  needed to administer medication                                                               
to save  the life. Medical  professionals would not have  time to                                                               
review   the   person's   medical  history.   She   related   her                                                               
understanding that a person in  a crisis residential center could                                                               
be  experiencing an  extreme mental  health  episode. She  stated                                                               
that  medical  professionals  need   to  be  able  to  administer                                                               
lifesaving  treatment  in  these  life-and-death  situations  and                                                               
would not have  time to use the checklist to  determine when they                                                               
had  their  last  physical.  She indicated  that  she  would  not                                                               
support Amendment 17.                                                                                                           
                                                                                                                                
2:16:40 PM                                                                                                                    
SENATOR REINBOLD  stated that the  amendment is added at  the end                                                               
of subsection (d) on page 8, [lines 7-9] of Version B. It reads:                                                                
                                                                                                                                
     (d)   A   crisis   stabilization   center   or   crisis                                                                    
     residential   center    may   administer   psychotropic                                                                    
     medication  to   an  involuntarily  held   or  detained                                                                    
     respondent only in a manner  that is consistent with AS                                                                    
     47.30.838.                                                                                                                 
                                                                                                                                
2:17:04 PM                                                                                                                    
SENATOR REINBOLD  emphasized the  importance of  ascertaining the                                                               
medical history  because the respondent  may have a  side effect.                                                               
She related that her previous  pharmaceutical work heightened her                                                               
concerns  about drug  interactions.  She  expressed concern  that                                                               
instead  of saving  someone's life,  medical professionals  would                                                               
administer  drugs that  could potentially  cause an  adverse drug                                                               
reaction and  result in their  death. She maintained  support for                                                               
paragraphs (2)  and (3), which she  read. She said, "I  guess you                                                               
guys   are   really   pro-injecting  people   with   psychotropic                                                               
medications ..."                                                                                                                
                                                                                                                                
SENATOR BEGICH  objected, stating  that this  was not  germane to                                                               
this topic.                                                                                                                     
                                                                                                                                
CHAIR WILSON called for a roll call vote.                                                                                       
                                                                                                                                
2:18:13 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  17, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 17                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
2:18:24 PM                                                                                                                    
CHAIR WILSON announced that Amendment 17 failed on a vote of one                                                                
yea and 4 nays.                                                                                                                 
                                                                                                                                
2:18:34 PM                                                                                                                    
CHAIR WILSON stated Amendment 18 is identical to Amendment 5,                                                                   
which the committee previously adopted.                                                                                         
                                                                                                                                
SENATOR REINBOLD withdrew Amendment 18.                                                                                         
                                                                                                                                
2:18:48 PM                                                                                                                    
SENATOR REINBOLD moved to adopt Amendment 19, work order 32-                                                                    
GS1730\B.10.                                                                                                                    
                                                                                                                                
                                                32-GS1730\B.10                                                                  
                                                      Dunmire                                                                   
                                                      3/15/22                                                                   
                                                                                                                                
                                                                                                                              
                          AMENDMENT 19                                                                                      
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 4, line 29:                                                                                                           
          Delete "the professional person in charge"                                                                            
          Insert "a physician licensed to practice in this                                                                      
     state"                                                                                                                     
                                                                                                                                
     Page 7, line 24:                                                                                                           
          Delete "the professional person in charge"                                                                            
          Insert "a physician licensed to practice in this                                                                      
     state"                                                                                                                     
                                                                                                                                
     Page 7, line 26:                                                                                                           
          Delete "professional person in charge"                                                                                
          Insert "physician"                                                                                                    
                                                                                                                                
     Page 8, line 4:                                                                                                            
          Delete "the professional person in charge"                                                                            
          Insert "a physician licensed to practice in this                                                                      
     state"                                                                                                                     
                                                                                                                                
2:18:50 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
2:18:51 PM                                                                                                                    
SENATOR  REINBOLD explained  that  Amendment 19  provides that  a                                                               
licensed physician would  be in charge by  replacing the language                                                               
"the professional  person in charge"  with "a  physician licensed                                                               
to practice in this state."                                                                                                     
                                                                                                                                
2:19:37 PM                                                                                                                    
CHAIR WILSON  offered his  belief that  Amendment 19  would limit                                                               
the  number  of  physicians  but that  the  state  lacks  medical                                                               
professionals,  restricting the  level  of  care that  evaluation                                                               
centers could  offer. It would  change the definition  of "mental                                                               
health professionals" Ms. Carpenter  read earlier that evaluation                                                               
centers currently use.                                                                                                          
                                                                                                                                
SENATOR REINBOLD stated  that Section 13 adds new  sections to AS                                                               
47.30. She  paraphrased AS 47.30.707  Admission to and hold  at a                                                               
crisis stabilization center.                                                                                                    
                                                                                                                                
     (a) Except as provided in (b) of this section, when a                                                                      
          crisis stabilization center admits  a person on an                                                                    
          emergency  basis under  AS  47.30.705, the  crisis                                                                    
          stabilization center  may hold  the person  at the                                                                    
          center for a period not  to exceed 23 hours and 59                                                                    
          minutes.  A   mental  health   professional  shall                                                                    
          examine  the respondent  within three  hours after                                                                    
          the respondent arrives at the center.                                                                                 
        (b) If the professional person in charge at the                                                                         
          crisis stabilization center  determines that there                                                                    
          is   probable   cause    to   believe   that   the                                                                    
         respondent's acute behavioral health crisis...                                                                         
                                                                                                                                
2:21:01 PM                                                                                                                    
SENATOR REINBOLD  explained that Amendment 19  would require that                                                               
a  physician with  expertise would  be  in charge  to ensure  the                                                               
respondent would receive medical care.                                                                                          
                                                                                                                                
2:21:32 PM                                                                                                                    
CHAIR WILSON  offered his view  that requiring a  physician would                                                               
remove the  ability for  the centers to  use a  licensed advanced                                                               
nurse practitioner that practices psychiatric medicine.                                                                         
                                                                                                                                
2:21:40 PM                                                                                                                    
SENATOR  BEGICH  asked  Mr.  Bookman  to  confirm  that  existing                                                               
statute defines a professional person in charge                                                                                 
                                                                                                                                
2:21:53 PM                                                                                                                    
MR.  BOOKMAN answered  yes, the  definition  in AS  47.30.915(17)                                                               
reads:                                                                                                                          
                                                                                                                                
     (17) "professional  person in charge" means  the senior                                                                    
     mental  health  professional  at  a  facility  or  that                                                                    
     person's designee;  in the absence  of a  mental health                                                                    
     professional  it   means  the  chief  of   staff  or  a                                                                    
     physician designated by the chief of staff;                                                                                
                                                                                                                                
2:22:30 PM                                                                                                                    
SENATOR REINBOLD stated that "chief  of staff" is not necessarily                                                               
a medical position.                                                                                                             
                                                                                                                                
MR. BOOKMAN answered  that  chief of staff  is a  term of art not                                                               
addressed  in these  statutes. A  "chief of  staff" would  be the                                                               
chief of  the medical  staff, and  federal regulations  cover who                                                               
can serve in that role. He  said he believes that the person must                                                               
be a physician, but he would follow up with the committee.                                                                      
                                                                                                                                
2:23:37 PM                                                                                                                    
SENATOR  REINBOLD   offered  her   view  that   this  complements                                                               
Amendment  19  and  ensures  that  the  person  in  charge  is  a                                                               
physician. She  highlighted the importance of  having a physician                                                               
in charge since psychotropic medications could be administered.                                                                 
                                                                                                                                
2:24:35 PM                                                                                                                    
SENATOR HUGHES stated  that she knows someone who  is a physician                                                               
assistant who  specializes in mental  health. She said  she would                                                               
rather   have  that   person  making   the   decisions  than   an                                                               
obstetrician,  or  ear,  nose,   and  throat  (ENT)  doctor.  She                                                               
indicated that  she was uncomfortable limiting  it to physicians,                                                               
especially given  the shortage  of physicians  in the  state. She                                                               
emphasized that having those familiar  with mental health care in                                                               
charge would be better.                                                                                                         
                                                                                                                                
SENATOR REINBOLD  directed attention to  page 4, line  29, noting                                                               
that  this would  refer  to  the professional  in  charge at  the                                                               
center, not at a hospital.  She maintained her preference to have                                                               
a licensed physician in charge.                                                                                                 
                                                                                                                                
2:25:51 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  19, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 19                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
CHAIR WILSON  announced that Amendment 19  failed on a vote  of 1                                                               
yea, and 4 nays.                                                                                                                
                                                                                                                                
2:26:31 PM                                                                                                                    
SENATOR  BEGICH   expressed  hope  that  the   ambiguity  Senator                                                               
Reinbold highlighted would be addressed  in the next committee of                                                               
referral.                                                                                                                       
                                                                                                                                
2:26:38 PM                                                                                                                    
SENATOR COSTELLO  stated that farther  along in Section  13, Sec.                                                               
47.30.707(b)  says   that  if  a   respondent  is   unwilling  to                                                               
voluntarily go to the crisis  residential center, a mental health                                                               
professional may  submit an  ex parte  application to  the court.                                                               
Thus,  the statutes  provide additional  oversight. She  said she                                                               
understands   the   concerns   raised,  but   a   mental   health                                                               
professional will be involved in the action.                                                                                    
                                                                                                                                
2:27:37 PM                                                                                                                    
SENATOR  REINBOLD moved  to adopt  Amendment 20,  work order  32-                                                               
GS1730\B.11.                                                                                                                    
                                                                                                                                
                                                32-GS1730\B.11                                                                  
                                                      Dunmire                                                                   
                                                      3/15/22                                                                   
                                                                                                                                
                                                                                                                                
                          AMENDMENT 20                                                                                      
                                                                                                                                
                                                                                                                                
    OFFERED IN THE SENATE                BY SENATOR REINBOLD                                                                    
     TO:  CSSB 124(HSS), Draft Version "B"                                                                                      
                                                                                                                                
     Page 11, lines 9 - 10:                                                                                                     
          Delete "[LICENSED UNDER AS 47.32 OR] operated by                                                                      
     the federal government that performs evaluations"                                                                      
          Insert "licensed under AS 47.32 [OR OPERATED BY                                                                       
     THE FEDERAL GOVERNMENT]"                                                                                                   
                                                                                                                                
2:27:39 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
2:27:41 PM                                                                                                                    
SENATOR  REINBOLD explained  that  Amendment  20 would  reinstate                                                               
language that  removed a licensing  requirement in AS  47.32. The                                                               
intent is to ensure that licensure is required.                                                                                 
                                                                                                                                
2:28:35 PM                                                                                                                    
MS.  CARPENTER  stated  that this  refers  to  hospitals,  crisis                                                               
residential  centers, and  former evaluation  centers, which  are                                                               
required to  be licensed under  AS 47.32. The  department changed                                                               
this  definition  because  it  was too  broad.  It  included  all                                                               
facilities  licensed under  AS 47.32,  including assisted  living                                                               
homes,  childcare   facilities,  hospices,   free-standing  birth                                                               
centers,  and other  locations  that  would never  be  set up  to                                                               
perform  mental  health evaluations.  She  referred  to page  11,                                                               
lines [7-9],  which specifically indicates that  these facilities                                                               
have been  designated or  operated by  the department  to perform                                                               
the evaluations described in AS  47.30.660   47.30.915. She noted                                                               
that  this relates  to  the 72-hour  evaluations.  The reason  to                                                               
leave in the language "operated  by the federal government" would                                                               
include tribal facilities or military hospitals.                                                                                
                                                                                                                                
2:29:59 PM                                                                                                                    
SENATOR  REINBOLD  asked  whether   all  of  the  facilities  are                                                               
required to be licensed under AS 47.32.                                                                                         
                                                                                                                                
MS. CARPENTER answered yes, but  tribal facilities are licensed a                                                               
little  differently. She  added that  crisis residential  centers                                                               
would have to be licensed by the state.                                                                                         
                                                                                                                                
SENATOR REINBOLD offered her interpretation  that this carves out                                                               
an area  so tribal facilities  don't have  to be licensed  by the                                                               
state.                                                                                                                          
                                                                                                                                
MS.  CARPENTER  said  that  is  not  the  proper  interpretation,                                                               
because of  federal law  and the way  that tribes  are recognized                                                               
through the Indian Health Services.                                                                                             
                                                                                                                                
SENATOR   REINBOLD   offered   her  understanding   that   tribal                                                               
facilities  do not  have to  be licensed  by the  state under  AS                                                               
47.32.                                                                                                                          
                                                                                                                                
2:31:12 PM                                                                                                                    
CHAIR  WILSON related  his understanding  that tribal  facilities                                                               
are  licensed under  Indian Health  Services, a  separate federal                                                               
licensing  process.  Amendment 20  would  ensure  they could  not                                                               
qualify   to  provide   services  at   crisis  stabilization   or                                                               
residential centers.                                                                                                            
                                                                                                                                
2:31:38 PM                                                                                                                    
MS. CARPENTER agreed;  if Amendment 20 were to  pass, the state's                                                               
tribal  partners   would  not  be   able  to  operate   a  crisis                                                               
residential center that would serve as an evaluation center.                                                                    
                                                                                                                                
2:31:59 PM                                                                                                                    
SENATOR  REINBOLD asked  how many  tribal  facilities operate  in                                                               
Alaska.  She  indicated that  her  intent  was to  protect  state                                                               
sovereignty and state rights.                                                                                                   
                                                                                                                                
CHAIR WILSON stated that there are eight subregional hospitals                                                                  
and approximately 130 tribally-owned clinics in Alaska.                                                                         
                                                                                                                                
2:32:56 PM                                                                                                                    
SENATOR REINBOLD withdrew Amendment 20.                                                                                         
                                                                                                                                
2:33:11 PM                                                                                                                    
SENATOR REINBOLD moved to adopt Amendment 21, work order 32-                                                                    
GS1730\B.12.                                                                                                                    
                                                32-GS1730\B.12                                                                  
                                                      Dunmire                                                                   
                                                      3/15/22                                                                   
                                                                                                                                
                                                                                                                                
                          AMENDMENT 21                                                                                      
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 3, line 26:                                                                                                           
          Delete "health officer,"                                                                                          
                                                                                                                                
     Page 4, line 5:                                                                                                            
          Delete "or health officer"                                                                                        
                                                                                                                                
     Page 4, line 12:                                                                                                           
          Delete "health officer,"                                                                                          
                                                                                                                                
     Page 4, line 20:                                                                                                           
          Delete "or health officer"                                                                                            
                                                                                                                                
     Page 4, line 21:                                                                                                           
          Delete "or health officer"                                                                                            
                                                                                                                                
     Page 11, lines 22 - 24:                                                                                                    
          Delete all material.                                                                                                  
                                                                                                                                
     Renumber the following paragraph accordingly.                                                                              
                                                                                                                                
2:33:14 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
2:33:15 PM                                                                                                                    
SENATOR  REINBOLD  explained  that   Amendment  21  would  remove                                                               
"health officer." The  definition of "health officer"  is on page                                                               
11, lines 22-24.                                                                                                                
                                                                                                                                
     (23)  "health officer"  means  a  state, municipal,  or                                                                    
     other  local  health   officer,  public  health  nurse,                                                                    
     emergency  medical technician,  paramedic, firefighter,                                                                    
     or a  person authorized  by the court  to carry  out AS                                                                    
     47.30.660 - 47.30.915;                                                                                                     
                                                                                                                                
SENATOR REINBOLD said this definition seemed too broad.                                                                         
                                                                                                                                
2:34:16 PM                                                                                                                    
SENATOR  BEGICH stated  that the  definition of  "health officer"                                                               
was extensively discussed in earlier  meetings. He indicated that                                                               
the  record was  clear  that  a "health  officer"  was  a way  of                                                               
clarifying definitions  and cleaning up statutes.  He offered his                                                               
view that Amendment 21 was not necessary.                                                                                       
                                                                                                                                
2:34:51 PM                                                                                                                    
MS. CARPENTER agreed that the  definition of "health officer" was                                                               
updated  in Version  B, which  revised the  definition of  "peace                                                               
officer"  on page  11, lines  12-17  to provide  a more  standard                                                               
definition  found  in AS  01.10.060(a).  Section  21 deleted  the                                                               
officials  that  do  not  fall under  the  definition  of  "peace                                                               
officer"  and Section  22  added the  new  definition of  "health                                                               
officer,"   which   included    emergency   medical   technician,                                                               
paramedic,   firefighter,  to   address   individuals  who   were                                                               
operating  the  mobile  crisis teams  in  communities,  including                                                               
Anchorage and Fairbanks.                                                                                                        
                                                                                                                                
2:35:39 PM                                                                                                                    
SENATOR  REINBOLD referred  to Section  22,  AS 47.30.915,  which                                                               
defines "crisis residential  center, crisis stabilization center,                                                               
and health  officer." She characterized  the definitions  as very                                                               
broad.  She maintained  that the  definition of  "health officer"                                                               
was too broad.                                                                                                                  
                                                                                                                                
2:36:22 PM                                                                                                                    
SENATOR  HUGHES  asked Ms.  Carpenter  if  she said  intervention                                                               
teams  include  emergency  medical   service  providers  such  as                                                               
paramedics.                                                                                                                     
                                                                                                                                
MS. CARPENTER  answered that  is correct.  For example,  the fire                                                               
department operates the crisis mobile  team in Anchorage, and she                                                               
understands that paramedics are part  of the team. The department                                                               
gave  paramedics a  variance  to operate  to  allow for  Medicaid                                                               
reimbursements.                                                                                                                 
                                                                                                                                
2:37:11 PM                                                                                                                    
SENATOR COSTELLO  related her understanding that  the individuals                                                               
on  the  crisis mobile  team  would  identify  a person  who  was                                                               
"gravely disabled"  or "suffering from mental  illness and likely                                                               
to cause serious  harm to themselves or others."  This team would                                                               
take  the   person  into  custody,   take  them  to   the  crisis                                                               
stabilization center, fill  out the forms, and  be interviewed by                                                               
a mental health professional. She  asked whether that covered the                                                               
crisis mobile team's activities.                                                                                                
                                                                                                                                
MS. CARPENTER  agreed. She  directed attention  to Section  11 of                                                               
the bill, starting on page 3,  line 25, through page 4, lines 16.                                                               
It's the initial protective hold.                                                                                               
                                                                                                                                
2:38:13 PM                                                                                                                    
SENATOR COSTELLO  related her  understanding that  the definition                                                               
of "health officer   doesn't exist anywhere else  in statute. The                                                               
term "health  officer" was defined  to avoid having to  list each                                                               
professional every time the  individual profession was referenced                                                               
in the bill, making the  statutory language less wordy and easier                                                               
to understand.                                                                                                                  
                                                                                                                                
MS. CARPENTER agreed.                                                                                                           
                                                                                                                                
2:38:32 PM                                                                                                                    
SENATOR REINBOLD  maintained that  the term "health  officer" was                                                               
too broad, and reread the definition.                                                                                           
                                                                                                                                
2:39:20 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  21, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 21                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
CHAIR WILSON  announced that Amendment 21  failed on a vote  of 1                                                               
yea and 4 nays.                                                                                                                 
                                                                                                                                
2:39:44 PM                                                                                                                    
SENATOR  REINBOLD moved  to adopt  Amendment 22,  work order  32-                                                               
GS1730\B.13.                                                                                                                    
                                                                                                                                
                                                32-GS1730\B.13                                                                  
                                                      Dunmire                                                                   
                                                      3/15/22                                                                   
                                                                                                                                
                          AMENDMENT 22                                                                                      
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 3, lines 26 - 31:                                                                                                     
          Delete    "health     officer,    mental    health                                                                
     professional,  or physician  assistant licensed  by the                                                                
     State  Medical  Board to  practice  in  this state,  [A                                                                
     PSYCHIATRIST OR  PHYSICIAN WHO IS LICENSED  TO PRACTICE                                                                    
     IN THIS  STATE OR  EMPLOYED BY THE  FEDERAL GOVERNMENT,                                                                    
     OR A CLINICAL PSYCHOLOGIST  LICENSED BY THE STATE BOARD                                                                    
     OF    PSYCHOLOGIST    AND    PSYCHOLOGICAL    ASSOCIATE                                                                    
     EXAMINERS]"                                                                                                                
          Insert "a physician assistant licensed by the                                                                     
     State  Medical  Board  to practice  in  this  state,  a                                                                
     psychiatrist or  physician who is licensed  to practice                                                                    
     in this state [OR  EMPLOYED BY THE FEDERAL GOVERNMENT],                                                                    
     or a clinical psychologist  licensed by the state Board                                                                    
     of Psychologist and Psychological Associate Examiners"                                                                     
                                                                                                                                
     Page 4, lines 12 - 13:                                                                                                     
          Delete "health officer, [OR] mental health                                                                        
     professional, or physician assistant"                                                                                  
          Insert "psychiatrist or physician licensed to                                                                     
     practice in  the state, clinical  psychologist licensed                                                                
     by the  state Board  of Psychologist  and Psychological                                                                
     Associate Examiners, or  physician assistant [OR MENTAL                                                                
     HEALTH PROFESSIONAL]"                                                                                                      
                                                                                                                                
2:39:46 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
2:39:48 PM                                                                                                                    
SENATOR  REINBOLD  explained  that   Amendment  22  would  delete                                                               
"health  officer,   mental  health  professional,   or  physician                                                               
assistant"  and  replace  it with  a  psychiatrist  or  physician                                                               
licensed  to   practice  in  the  state,   clinical  psychologist                                                               
licensed by  the state Board  of Psychologists  and Psychological                                                               
Associate Examiners or physician assistant.                                                                                     
                                                                                                                                
SENATOR  REINBOLD  related  her understanding  that  some  issues                                                               
needed to  be addressed. She  expressed a willingness to  offer a                                                               
conceptual amendment  to Amendment  22 to address  tribal health.                                                               
It would  add in the  language on line  9 of Amendment  22, which                                                               
read, [OR EMPLOYED BY THE FEDERAL GOVERNMENT].                                                                                  
                                                                                                                                
2:40:54 PM                                                                                                                    
CHAIR WILSON  offered his view  that Amendment 22 was  similar to                                                               
Amendment 19 and Amendment 21.                                                                                                  
                                                                                                                                
2:41:10 PM                                                                                                                    
SENATOR COSTELLO asked  the record to reflect  that this language                                                               
refers to the  individual who would transport the  Alaskan to the                                                               
crisis  residential center  and not  someone at  the center.  She                                                               
highlighted that the "health officer"  would come in contact with                                                               
the individual, such as a  firefighter, not a physician assistant                                                               
licensed by  the state medical  board. She offered her  view that                                                               
the  physician  assistant  would  be at  the  crisis  residential                                                               
center. She  said she  was comfortable with  the language  in the                                                               
bill and would be a no vote on Amendment 22.                                                                                    
                                                                                                                                
2:42:30 PM                                                                                                                    
SENATOR REINBOLD explained Amendment  22 pertains to the language                                                               
on  page  3,   line  16,  Section  11.  AS   47.30.705  (a).  She                                                               
paraphrased the language, which read, in part:                                                                                  
                                                                                                                                
     A   peace  officer,   health  officer,   mental  health                                                                    
     professional,  or physician  assistant licensed  by the                                                                    
     State Medical Board to practice  in this state, who has                                                                    
     probable  cause to  believe that  a  person is  gravely                                                                    
     disabled or is suffering from a mental illness....                                                                         
                                                                                                                                
SENATOR REINBOLD offered  her view that people trained  to make a                                                               
medical  determination   in  this  area,  such   as  a  physician                                                               
assistant should play a role in these decisions.                                                                                
                                                                                                                                
2:43:44 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  22, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 22                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
CHAIR WILSON announced that Amendment 22  failed on a vote of one                                                               
yea, and 4 nays.                                                                                                                
                                                                                                                                
2:44:12 PM                                                                                                                    
SENATOR  REINBOLD  withdrew  Amendment  23.  She  explained  that                                                               
Amendment 23, was the same as Amendment 1.                                                                                      
                                                                                                                                
2:44:28 PM                                                                                                                    
SENATOR  REINBOLD  withdrew  Amendment  24.  She  explained  that                                                               
Amendment 24, was the same as Amendment 3.                                                                                      
                                                                                                                                
2:44:50 PM                                                                                                                    
SENATOR REINBOLD  remarked on  the issue  in Amendment  25, which                                                               
she  was   considering  withdrawing.   She  explained   that  the                                                               
committee discussed  the language  ", as a  result, is  likely to                                                               
cause harm to self or others or is gravely disabled, and,".                                                                     
                                                                                                                                
SENATOR  REINBOLD   stated  that   the  committee  held   a  long                                                               
discussion  about "serious"  and decided  not to  insert it.  She                                                               
said  that   Mr.  Jim   Gottstein  wrote   a  long   letter  [not                                                               
specifically identified] on  the reason it was  so important. She                                                               
said  she would  consider withdrawing  Amendment 25  if "serious"                                                               
could be  added in  Amendment 4  so it would  read "is  likely to                                                               
cause serious harm to self or others.                                                                                           
                                                                                                                                
2:45:48 PM                                                                                                                    
CHAIR  WILSON offered  his belief  that the  committee considered                                                               
adding "serious" as a conceptual amendment, and it failed.                                                                      
                                                                                                                                
SENATOR  REINBOLD said  she did  not believe  that the  committee                                                               
considered a conceptual  amendment. She offered her  view that it                                                               
was important  to add  the word "serious"  so the  language would                                                               
read, "is likely to cause serious harm to self or others".                                                                      
                                                                                                                                
2:46:23 PM                                                                                                                    
SENATOR BEGICH reminded members that  Amendment 25 was not before                                                               
the committee. He  offered his belief that  Mr. Bookman addressed                                                               
"serious"  and "harm."  He recalled  that a  conceptual amendment                                                               
was considered, and it failed.                                                                                                  
                                                                                                                                
2:47:14 PM                                                                                                                    
MR. BOOKMAN  stated that the  Alaska Supreme Court noted  that in                                                               
existing statutes, the definitions  for the phrases "serious harm                                                               
to others" and "harm to others" are the same.                                                                                   
                                                                                                                                
2:47:46 PM                                                                                                                    
SENATOR   REINBOLD   expressed   concern   that   someone   might                                                               
misinterpret the  language "causing  harm to  self or  others" or                                                               
not  give  that phrase  the  seriousness  it deserves.  She  said                                                               
people  might not  be  aware of  the court  case,  and since  the                                                               
legislature sets policy, she would like it defined.                                                                             
                                                                                                                                
2:48:28 PM                                                                                                                    
CHAIR  WILSON  offered  his  belief   that  was  accomplished  in                                                               
Amendment 4.  He recalled that  the discussion  characterized the                                                               
phrases as indistinguishable.                                                                                                   
                                                                                                                                
SENATOR  BEGICH   highlighted  that   the  committee   asked  the                                                               
Department of  Law to  confirm that  for the  record. He  said he                                                               
would  state it  again for  the record.  He stated  that when  he                                                               
reads "is likely to cause harm  to self or others," he interprets                                                               
it to mean serious harm because  that is how the courts interpret                                                               
it. He  indicated that  he was comfortable  with the  language in                                                               
the amendment that previously passed.  He offered his belief that                                                               
it  speaks to  the committee's  concern and  advocates for  those                                                               
suffering from psychotic episodes  that when speaking about harm,                                                               
it means serious harm.                                                                                                          
                                                                                                                                
2:49:34 PM                                                                                                                    
SENATOR  REINBOLD offered  her  view that  very  few people  will                                                               
listen to this  meeting. She said she did not  understand why the                                                               
committee would not add "serious" to make it clear.                                                                             
                                                                                                                                
2:50:06 PM                                                                                                                    
SENATOR HUGHES asked  whether the phrase  serious  harm  was used                                                               
anywhere else in statute.                                                                                                       
                                                                                                                                
MR. BOOKMAN  said he was  unsure. He  explained that he  does not                                                               
work in  the area  of criminal  law, and it  could be  defined in                                                               
criminal statutes.                                                                                                              
                                                                                                                                
2:50:46 PM                                                                                                                    
SENATOR  HUGHES  said she  understood  the  concern and  said  if                                                               
"serious harm" is used elsewhere, she  would seek to amend SB 124                                                               
in the Senate Judiciary Committee.                                                                                              
                                                                                                                                
2:51:27 PM                                                                                                                    
SENATOR  REINBOLD moved  to adopt  Amendment 25,  work order  32-                                                               
GS1730\B.16.                                                                                                                    
                                                                                                                                
                                                32-GS1730\B.16                                                                  
                                                      Dunmire                                                                   
                                                      3/15/22                                                                   
                                                                                                                                
                          AMENDMENT 25                                                                                      
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 5, line 25, following "and":                                                                                          
     Insert ", as a result, is  likely to cause harm to self                                                                    
     or others or is gravely disabled                                                                                           
                                                                                                                                
2:51:28 PM                                                                                                                    
CHAIR WILSON objected.                                                                                                          
                                                                                                                                
2:51:30 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  25, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 25                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
CHAIR WILSON announced that Amendment 25 failed on a vote of 1                                                                  
yea and 4 nays.                                                                                                                 
                                                                                                                                
2:51:53 PM                                                                                                                    
SENATOR REINBOLD moved to adopt Amendment 26, work order 32-                                                                    
GS1730\B.17.                                                                                                                    
                                                                                                                                
                                                32-GS1730\B.17                                                                  
                                                      Dunmire                                                                   
                                                      3/15/22                                                                   
                                                                                                                                
                                                                                                                                
                          AMENDMENT 26                                                                                      
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE             BY SENATOR REINBOLD                                                                      
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 1, line 3, following "situation;":                                                                                  
          Insert "relating to the administration of                                                                           
     psychotropic medication to minors;"                                                                                      
                                                                                                                                
     Page 10, following line 26:                                                                                                
     Insert a new bill section to read:                                                                                         
        "* Sec. 18. AS 47.30.836 is  amended by adding a new                                                                
     subsection to read:                                                                                                        
          (b)  Before administering psychotropic medication                                                                     
     to a minor patient under  this section, a mental health                                                                    
     professional shall consult with  a parent, guardian, or                                                                    
     other family  member of the  minor, evaluate  the minor                                                                    
     for  drug withdrawal  and medical  psychosis caused  by                                                                    
     currently  prescribed  drugs  or  self-medication,  and                                                                    
     review the  minor's family history,  diet, medications,                                                                    
     triggers, and other contributing factors."                                                                                 
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 11, following line 1:                                                                                                 
     Insert a new bill section to read:                                                                                         
        "* Sec. 20. AS 47.30.838 is  amended by adding a new                                                                
     subsection to read:                                                                                                        
          (e)  Before administering psychotropic medication                                                                     
     to a minor patient under  this section, a mental health                                                                    
     professional shall consult with  a parent, guardian, or                                                                    
     other family  member of the  minor, evaluate  the minor                                                                    
     for  drug withdrawal  and medical  psychosis caused  by                                                                    
     currently  prescribed  drugs  or  self-medication,  and                                                                    
     review  is likely  to  cause serious  harm  to self  or                                                                    
     others"."                                                                                                                  
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 13, lines 1 - 2:                                                                                                      
          Delete "secs. 1 - 27"                                                                                                 
          Insert "secs. 1 - 29"                                                                                                 
                                                                                                                                
     Page 13, lines 27 - 28:                                                                                                    
          Delete "sec. 23"                                                                                                      
          Insert "sec. 25"                                                                                                      
                                                                                                                                
     Page 13, line 29:                                                                                                          
          Delete "sec. 23"                                                                                                      
          Insert "sec. 25"                                                                                                      
                                                                                                                                
     Page 14, line 7:                                                                                                           
          Delete "Section 28"                                                                                                   
          Insert "Section 30"                                                                                                   
                                                                                                                                
2:51:55 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
2:51:58 PM                                                                                                                    
SENATOR  REINBOLD  explained that  Amendment  26  focuses on  the                                                               
administration  of psychotropic  medication to  minors. It  would                                                               
require that a mental health  professional consult with a parent,                                                               
guardian, or other family members  to evaluate the minor for drug                                                               
withdrawal and  medical psychosis caused by  currently prescribed                                                               
drugs or self-medication, and review  the minor's family history,                                                               
diet, medications, triggers, and  other contributing factors. She                                                               
stated  that  it  would  not   require  informed  consent  but  a                                                               
consultation.                                                                                                                   
                                                                                                                                
2:53:05 PM                                                                                                                    
SENATOR BEGICH recalled the committee  discussed the safety issue                                                               
and if the  parent, guardian, or other family  members would have                                                               
the patient's  best interests in  mind. He pointed out  that they                                                               
could have caused  the psychotic episode, or the  patient may not                                                               
have given permission.  He suggested that there  were issues with                                                               
the Health  Insurance Portability and Accountability  Act of 1996                                                               
(HIPAA) or related to abuse. He  stated that he would not support                                                               
Amendment 26.                                                                                                                   
                                                                                                                                
2:54:20 PM                                                                                                                    
SENATOR HUGHES commented that she  had offered to take the matter                                                               
of involving a family member or  guardian who may have abused the                                                               
minor  patient when  the bill  is heard  in the  Senate Judiciary                                                               
Committee.                                                                                                                      
                                                                                                                                
2:54:36 PM                                                                                                                    
SENATOR  COSTELLO  stated that  she  supports  the intention  but                                                               
noted it  was placed  in AS  47.30.836, relating  to psychotropic                                                               
medication  in  non-crisis  situations.   She  wondered  why  the                                                               
statutes  did  not contain  a  subsection  (a),  so it  may  need                                                               
redrafting. She offered her support for Amendment 26.                                                                           
                                                                                                                                
2:55:21 PM                                                                                                                    
SENATOR REINBOLD  maintained that  parents, guardians,  or family                                                               
members  of the  minor should  be consulted  because psychotropic                                                               
medications can have tremendous side effects.                                                                                   
                                                                                                                                
2:56:16 PM                                                                                                                    
A  roll  call vote  was  taken.  Senators Hughes,  Costello,  and                                                               
Reinbold voted in favor of the  motion to adopt Amendment 26, and                                                               
Senators  Begich   and  Wilson   voted  against   it.  Therefore,                                                               
Amendment 26 was adopted on a 3:2 vote.                                                                                         
                                                                                                                                
CHAIR WILSON  announced that Amendment  26 was adopted on  a vote                                                               
of 3 yeas and 2 nays.                                                                                                           
                                                                                                                                
2:56:39 PM                                                                                                                    
SENATOR  REINBOLD moved  to adopt  Amendment 27,  work order  32-                                                               
GS1730\B.18.                                                                                                                    
                                                32-GS1730\B.18                                                                  
                                                      Dunmire                                                                   
                                                      3/15/22                                                                   
                                                                                                                                
                                                                                                                                
                          AMENDMENT 27                                                                                      
                                                                                                                                
                                                                                                                                
    OFFERED IN THE SENATE               BY SENATOR REINBOLD                                                                     
         TO:  CSSB 124(HSS), Draft Version "B"                                                                                  
                                                                                                                                
                                                                                                                                
     Page 1, line 9:                                                                                                            
          Delete "believes in good faith"                                                                                       
          Insert "observes [BELIEVES IN GOOD FAITH]"                                                                        
                                                                                                                                
     Page 1, line 10, following "crisis":                                                                                       
          Insert "according to standards and measurements"                                                                  
                                                                                                                                
2:56:41 PM                                                                                                                    
CHAIR WILSON objected for discussion purposes.                                                                                  
                                                                                                                                
2:56:43 PM                                                                                                                    
SENATOR  REINBOLD  explained  that  Amendment  27  would  require                                                               
officers  to observe  rather than  believe in  good faith  that a                                                               
person is suffering  from an acute behavioral  health crisis. She                                                               
highlighted  that the  second  part of  the  amendment would  add                                                               
language   "according  to   standards   and  measurements."   She                                                               
expressed concern about false accusations.                                                                                      
                                                                                                                                
2:57:24 PM                                                                                                                    
CHAIR WILSON asked how a person would observe in good faith.                                                                    
                                                                                                                                
2:57:43 PM                                                                                                                    
MR. MORGAN  directed attention to  page 2, lines 5-13  to Section                                                               
1, of  Version B.  He noted  that subsection  (a) states,  "As an                                                               
alternative  to arrest...."  He  explained that  the officer  has                                                               
probable  cause  in these  cases  that  the subject  committed  a                                                               
crime. Thus, the  officer has already assessed  the situation and                                                               
decided they  could arrest or  cite them for a  criminal offense.                                                               
He said at  that point, the officer would believe  in good faith.                                                               
He related  that "good faith"  is a legal standard  that officers                                                               
are  held  accountable  to   in  many  adjudicative  proceedings,                                                               
including   search  warrant   applications  and   executions.  He                                                               
emphasized that  officers wouldn't  simply find someone  and make                                                               
observations.                                                                                                                   
                                                                                                                                
MR. MORGAN stated  that law enforcement officers had  a choice to                                                               
arrest  the  person  and  take   them  to  jail  based  on  their                                                               
observations and probable cause.                                                                                                
                                                                                                                                
2:58:59 PM                                                                                                                    
SENATOR  REINBOLD said  the arresting  officer  believes in  good                                                               
faith  that the  person  is suffering  from  an acute  behavioral                                                               
health crisis.  The officer could  arrest but  alternatively take                                                               
the person  to a crisis  stabilization center. She said  it gives                                                               
her more reason to support the bill.                                                                                            
                                                                                                                                
3:00:16 PM                                                                                                                    
MR. MORGAN noted  that he was reading from the  bill. He referred                                                               
to subsection (a) in Section  1, which begins, "As an alternative                                                               
to arrest,  a peace  officer may...."   He directed  attention to                                                               
paragraph  (1), "the  arresting  officer believes  in good  faith                                                               
...." The law enforcement officer  would have probable cause that                                                               
a crime  has occurred, and the  officer could make an  arrest. He                                                               
stated that some people are  good candidates for diversion into a                                                               
crisis stabilization center.                                                                                                    
                                                                                                                                
3:00:59 PM                                                                                                                    
SENATOR BEGICH  asked what standards and  measurements would mean                                                               
to law enforcement officers.                                                                                                    
                                                                                                                                
3:01:08 PM                                                                                                                    
MR. MORGAN answered  that there is no measurement  or standard in                                                               
law  enforcement. He  stated  that the  core  statement was  "the                                                               
arresting officer believes in good  faith. He characterized it as                                                               
a statement often repeated in  terms of why officers take action,                                                               
which is the  legal standard. He reiterated that  in these cases,                                                               
the officer already determined that  probable cause exists that a                                                               
crime  has  occurred  and  that   the  officer,  in  good  faith,                                                               
recognized that  this person was  experiencing a  mental episode.                                                               
It  would better  serve the  person to  be diverted  to a  crisis                                                               
stabilization center.  He offered his  view that the  language in                                                               
Amendment 27 was not consistent with police standards.                                                                          
                                                                                                                                
3:02:06 PM                                                                                                                    
SENATOR HUGHES  related her understanding that  "believes in good                                                               
faith" involved "observing." She  asked whether "believes in good                                                               
faith" would include observation.                                                                                               
                                                                                                                                
MR. MORGAN answered yes.                                                                                                        
                                                                                                                                
3:02:38 PM                                                                                                                    
SENATOR HUGHES  asked what  else "believes  in good  faith" would                                                               
include.                                                                                                                        
                                                                                                                                
3:02:52 PM                                                                                                                    
MR. MORGAN responded  that the good faith  standard is reasonable                                                               
for all  officers' actions. He  characterized it as  a reasonable                                                               
standard. Officers act in good  faith based on their training and                                                               
experience.   He   explained   that  law   enforcement   officers                                                               
automatically make observations  when determining probable cause.                                                               
He  emphasized  that determining  probable  cause  for an  arrest                                                               
requires observation.  He stated  that under  SB 124,  instead of                                                               
taking someone  who is  having a psychotic  episode to  jail, the                                                               
officer could take them to a crisis stabilization center.                                                                       
                                                                                                                                
SENATOR HUGHES thanked him for putting it on the record.                                                                        
                                                                                                                                
3:04:20 PM                                                                                                                    
SENATOR REINBOLD noted that the  bill doesn't say "probable cause                                                               
to  believe they  committed a  crime.  She  said when  someone is                                                               
arrested, the  offenders know the  charges and their  rights. She                                                               
read, "(a) As  an alternative to arrest, a peace  officer may, at                                                               
the  officer's   discretion,  deliver   a  person  to   a  crisis                                                               
stabilization  center,   a  crisis  residential  center,   or  an                                                               
evaluation facility  or decline to  arrest the person if  (1) the                                                               
officer believes in good faith  that the person is suffering from                                                               
an acute  behavioral health crisis;  and ...." She  asked whether                                                               
good faith was defined in statute or if it is a standard.                                                                       
                                                                                                                                
3:05:17 PM                                                                                                                    
MR. MORGAN  responded that  "good faith"  is a  criminal standard                                                               
applied  to  law  enforcement  when  the  courts  adjudicate  the                                                               
matter.  The court  determines  whether  law enforcement  actions                                                               
were reasonable and whether that officer acted in good faith.                                                                   
                                                                                                                                
3:05:49 PM                                                                                                                    
SENATOR REINBOLD  expressed concern  that if the  individuals are                                                               
not arrested  and are  taken to  crisis stabilization  centers or                                                               
crisis  residential centers,  they lose  many rights.  She stated                                                               
that  Amendment  27  would  help  ensure  protection  instead  of                                                               
relying on the officer's beliefs.                                                                                               
                                                                                                                                
3:06:31 PM                                                                                                                    
A roll  call vote was taken.  Senator Reinbold voted in  favor of                                                               
the motion  to adopt Amendment  27, and Senators  Begich, Hughes,                                                               
Costello, and  Wilson voted against  it. Therefore,  Amendment 27                                                               
failed on a 1:4 vote.                                                                                                           
                                                                                                                                
CHAIR WILSON  announced that Amendment 27  failed on a vote  of 1                                                               
yea and 4 nays.                                                                                                                 
                                                                                                                                
3:06:51 PM                                                                                                                    
CHAIR WILSON held SB 124 in committee.                                                                                          
                                                                                                                                
3:07:26 PM                                                                                                                    
There being no further business to come before the committee,                                                                   
Chair Wilson adjourned the Senate Health and Social Services                                                                    
Standing Committee meeting at 3:07 p.m.                                                                                         

Document Name Date/Time Subjects
SB 124 Amend. 1-39 3.17.22.pdf SHSS 3/17/2022 1:30:00 PM
SHSS 3/22/2022 1:30:00 PM
SHSS 3/29/2022 1:30:00 PM
SHSS 4/7/2022 1:30:00 PM
SB 124
SB 124 Ammendments Considered 15-27 3.29.pdf SHSS 3/29/2022 1:30:00 PM
SB 124