Legislature(2011 - 2012)BUTROVICH 205

02/15/2012 01:30 PM HEALTH & SOCIAL SERVICES

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Heard & Held
Moved CSSB 134(HSS) Out of Committee
Bills Previously Heard/Scheduled
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                       February 15, 2012                                                                                        
                           1:33 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Senator Bettye Davis, Chair                                                                                                     
Senator Dennis Egan                                                                                                             
Senator Johnny Ellis                                                                                                            
Senator Kevin Meyer                                                                                                             
Senator Fred Dyson                                                                                                              
MEMBERS ABSENT                                                                                                                
All members present                                                                                                             
COMMITTEE CALENDAR                                                                                                            
SENATE BILL NO. 134                                                                                                             
"An Act relating to child support awards; and repealing Rule                                                                    
90.3, Alaska Rules of Civil Procedure."                                                                                         
     - MOVED CSSB 134(HSS) OUT OF COMMITTEE                                                                                     
SENATE BILL NO. 55                                                                                                              
"An Act relating to mental health patient rights, notifications,                                                                
and grievance procedures."                                                                                                      
     - HEARD & HELD                                                                                                             
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: SB 134                                                                                                                  
SHORT TITLE: CHILD SUPPORT AWARDS                                                                                               
SPONSOR(s): SENATOR(s) KOOKESH                                                                                                  
01/17/12       (S)       PREFILE RELEASED 1/6/12                                                                                
01/17/12       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/17/12       (S)       HSS, JUD                                                                                               
02/06/12       (S)       HSS AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
02/06/12       (S)       Heard & Held                                                                                           
02/06/12       (S)       MINUTE(HSS)                                                                                            
02/15/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
BILL: SB  55                                                                                                                  
SHORT TITLE: MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES                                                                          
SPONSOR(s): SENATOR(s) DAVIS                                                                                                    
01/19/11       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/19/11       (S)       HSS, FIN                                                                                               
02/15/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
WITNESS REGISTER                                                                                                              
KIMBERLY CLARK, Staff                                                                                                           
Senator Albert Kookesh                                                                                                          
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Explained changes to SB 134 on behalf of the                                                              
JOHN MALLONEE, Director                                                                                                         
Child Support Services Division                                                                                                 
Department of Revenue (DOR)                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered questions related to SB 134.                                                                     
THOMAS OBERMEYER, Staff                                                                                                         
Senator Bettye Davis                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Introduced SB 55 on behalf of the sponsor.                                                                
JEAN MISCHEL, Legislative Counsel                                                                                               
Division of Legal and Research Services                                                                                         
Legal Affairs Agency                                                                                                            
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Explained the changes in version T of SB 55.                                                              
KATE BURKHART, Executive Director                                                                                               
Alaska Mental Health Board                                                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions regarding SB 55.                                                                       
JIM GOTTSTEIN                                                                                                                   
Law Project on Psychiatric Rights                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Commented on SB 55.                                                                                       
FAITH MEYER, Mental Health Advocate                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 55.                                                                            
DORRANCE COLLINS, Mental Health Advocate                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 55.                                                                            
ACTION NARRATIVE                                                                                                              
1:33:15 PM                                                                                                                    
CHAIR BETTYE DAVIS  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,  Meyer,  Egan, Dyson,  and  Chair                                                               
Davis. Senator Ellis arrived during the course of the meeting.                                                                  
                  SB 134-CHILD SUPPORT AWARDS                                                                               
1:34:02 PM                                                                                                                    
CHAIR DAVIS announced  that the first order of  business would be                                                               
SB 134.                                                                                                                         
SENATOR EGAN moved  to adopt the proposed CS for  SB 134, labeled                                                               
27-LS0671\B, as the working document before the committee.                                                                      
CHAIR DAVIS objected for discussion purposes.                                                                                   
KIMBERLY  CLARK, staff,  Senator  Albert  Kookesh, explained  the                                                               
changes  to version  B on  behalf of  the sponsor.  She said  the                                                               
first change is  on page 1, line 2; the  words "and providing for                                                               
an effective date" were added.                                                                                                  
The second  change is  on page  15, line  4; the  following words                                                               
were added:  "for the purpose  of establishing a  monthly support                                                               
obligation  for monthly  health care  expenses, a  tribunal shall                                                               
apply a reviewable presumption that  the cost of health insurance                                                               
is  reasonable  under this  section  if  the cost  of  purchasing                                                               
health insurance does not exceed  five percent of the responsible                                                               
parent's net income."                                                                                                           
The third change is on page  16, line 2; the following words were                                                               
removed:  "if   a  party  has   made  a  reasonable   demand  for                                                               
documentation  under  the subsection,  a  tribunal  may modify  a                                                               
child support arrears retroactively."                                                                                           
The  fourth change  is on  page 16,  line 29;  the words  "and AS                                                               
25.28.050(b)" were removed.                                                                                                     
CHAIR DAVIS asked if anything was added in that section.                                                                        
MS. CLARK said no.                                                                                                              
She continued to explain that another  change is on page 18, line                                                               
1; the section  was changed to AS 25.28.095, which  is the review                                                               
of the  guidelines. The  following words  were added:  "The child                                                               
support services agency established  in AS 25.27.010 shall notify                                                               
the  legislative   committees  with  jurisdiction   over  matters                                                               
involving  child support  awards  of the  need  for a  compliance                                                               
review of the  guidelines established in this  chapter every four                                                               
years  as provided  in federal  law. The  compliance review  must                                                               
include  a  determination  of  whether  the  application  of  the                                                               
guidelines   consistently   results   in   a   determination   of                                                               
appropriate child support awards in the state."                                                                                 
On page  18, line 8,  the section  number was corrected.  On page                                                               
19, lines 22-23, Section 6  was added as follows: "The uncodified                                                               
law of the State of Alaska is  amended by adding a new section to                                                               
read:  TRANSITION;  CHILD  SUPPORT  SERVICES  AGENCY.  The  child                                                               
support services  agency established in AS  25.27.010 may proceed                                                               
to adopt regulations  necessary to implement the  changes made by                                                               
AS 25.28, enacted by sec. 1  of this Act, but the regulations may                                                               
not take  effect before the effective  date of Section 1  of this                                                               
Section 7  was added on  line 28. It  states that, "Section  6 of                                                               
this Act takes effect immediately under AS 01.10.070(c)."                                                                       
Section 8  was added on line  29. It states, "Except  as provided                                                               
in Section 7 of this Act, this Act takes effect July 1, 2013."                                                                  
JOHN  MALLONEE,   Director,  Child  Support   Services  Division,                                                               
Department  of   Revenue  (DOR),  noted  the   changes  addressed                                                               
concerns from the last meeting.                                                                                                 
CHAIR DAVIS  said she would  provide a  copy of the  document for                                                               
Mr. Mallonee.                                                                                                                   
1:40:35 PM                                                                                                                    
SENATOR  MEYER asked  if there  was  a Department  of Health  and                                                               
Social Services (DHSS) fiscal note.                                                                                             
MR.  MALLONEE  replied   that  there  was  a   fiscal  note  from                                                               
Department of Revenue for about $6.7 million.                                                                                   
CHAIR DAVIS  stated that it was  her intention to move  the bill.                                                               
She asked where it would be heard next.                                                                                         
MS. CLARK  said it would  be heard  next in the  Senate Judiciary                                                               
Standing Committee.                                                                                                             
1:42:08 PM                                                                                                                    
CHAIR DAVIS  understood that  all concerns  were included  in the                                                               
new CS. She noted the bill has two more committee hearings.                                                                     
SENATOR EGAN moved  to report the CS for SB  134, version B, from                                                               
committee  with  individual   recommendations  and  the  attached                                                               
fiscal notes.                                                                                                                   
CHAIR DAVIS  announced that without objection,  CSSB 134(STA) was                                                               
reported from committee.                                                                                                        
        SB  55-MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES                                                                    
1:45:19 PM                                                                                                                    
CHAIR DAVIS  announced that  the next  bill before  the committee                                                               
would  SB  55, an  Act  relating  to  a mental  health  patient's                                                               
rights, notifications, and grievance procedures.                                                                                
SENATOR EGAN  moved to adopt the  proposed CS for SB  55, labeled                                                               
27-LS0082\T, as the working document before the committee.                                                                      
CHAIR DAVIS objected for discussion purposes.                                                                                   
THOMAS OBERMEYER,  staff, Senator Bettye Davis,  introduced SB 55                                                               
on  behalf of  the sponsor.  He read  from the  following sponsor                                                               
     SB 55 amends the  one-paragraph mental health grievance                                                                    
     procedure  provided  under   AS  47.30.847.  This  bill                                                                    
     governs  due process  and grievance  procedures in  all                                                                    
     state  and private  mental  health hospitals,  clinics,                                                                    
     and units  which receive public funds.  Prompted by the                                                                    
     8,000-10,000  admissions  to mental  health  facilities                                                                    
     and  units   in  Alaska  each  year   where  there  are                                                                    
     relatively  few  formal  grievances  filed,  this  bill                                                                    
     requires adequate  notice, forms,  advocate assistance,                                                                    
     rapid   written  administrative   response,  right   to                                                                    
     appeal,  and telephonic  access  to  a state  monitored                                                                    
     call center to lodge a complaint immediately.                                                                              
     Mental health  patients are  among the  most vulnerable                                                                    
     in Alaska.  Among the thousands of  individuals civilly                                                                    
     committed or  brought into locked  hospital psychiatric                                                                    
     units for  forced evaluations each  year, some are   in                                                                    
     handcuffs,   shackles   or   strapped  to   a   gurney,                                                                    
     involuntarily  medicated without  consent of  family or                                                                    
     legal representative,  or court  ordered to  receive or                                                                    
     continue psychiatric  treatment in public,  private, or                                                                    
     non-profit psychiatric  clinics. There are  hundreds of                                                                    
     patient assaults  and staff  injuries each  year. There                                                                    
     are  also thousands  of  children  who are  voluntarily                                                                    
     committed  each  year  usually in  private  facilities.                                                                    
     Although  sometimes  treated with  psychotropic  drugs,                                                                    
     children are considered better  protected by the state,                                                                    
     family  members,  legal representatives,  and  attorney                                                                    
     Current statutes  and regulations do little  to protect                                                                    
     psychiatric patients  civilly committed 30 to  60 days,                                                                    
     individuals  detained for  forced  evaluation  up to  7                                                                    
     days,  or  individuals  detained  in a  jail  or  in  a                                                                    
     psychiatric  emergency  room   or  private  unit  while                                                                    
     waiting  for space  in a  psychiatric hospital.   State                                                                    
     and  federal   courts  have  consistently   ruled  that                                                                    
     individuals  who have  not committed  a  crime and  are                                                                    
     locked  up  for  psychiatric evaluation  and  treatment                                                                    
     should not  be treated like criminals  and their rights                                                                    
     are to  remain intact to the  greatest extent possible.                                                                    
     Ironically, prisoners  in Alaska's  correctional system                                                                    
     are  afforded  a   much  more  comprehensive  grievance                                                                    
     procedure  with  due  process  rights  and  protections                                                                    
     under the law than mental health patients.                                                                                 
     Upon  admission to  a mental  health facility  patients                                                                    
     often  experience  an  immediate loss  of  liberty  and                                                                    
     freedom, arbitrary  exercise of  authority, and  may be                                                                    
     institutionally traumatized in  the process. Because of                                                                    
     the  exceptional   circumstances  under   which  mental                                                                    
     health patients  are admitted and treated,  due process                                                                    
     requires  special  safeguards in  transparent,  readily                                                                    
     available   grievance   procedures   and   more   state                                                                    
     oversight.  This bill  will reduce  unnecessary patient                                                                    
     trauma,  assaults, unintentional  injury or  death, and                                                                    
     attendant  liability  and   litigation  experienced  in                                                                    
     other states before statutory reform.                                                                                      
     New grievance  procedures under  SB 5  require detailed                                                                    
     complaint forms, three  levels of administrative review                                                                    
     requiring  written   answers  by   within  5   days  by                                                                    
     supervisory and executive staff  at levels one and two,                                                                    
     including  response  to  urgent  grievances  within  24                                                                    
     hours.  A level  three final  administrative appeal  to                                                                    
     the commissioner must be answered  within 14 days after                                                                    
     filing or by default  is denied. A commissioner's final                                                                    
     decision may  be appealed to  Superior Court  within 30                                                                    
     days. A grievance  may be filed at any  time, but there                                                                    
     is  a  statutory limitation  of  one  year after  being                                                                    
     discharged from  the facility  or unit.  All grievances                                                                    
     filed  shall become  part  of  the patient's  permanent                                                                    
     record. Mental  health facilities  and units  must file                                                                    
     periodic reports  of the number and  type of grievances                                                                    
     and resolutions, including  litigation. The bill allows                                                                    
     for a  personal representative  to act in  the interest                                                                    
     of the  patient in  the grievance  process, as  well as                                                                    
     providing a  patient advocate  appointed in  the mental                                                                    
     health facility or unit.                                                                                                   
     Although it  is counterintuitive  that more  verbal and                                                                    
     written  complaints are  not reported  to the  state or                                                                    
     documented  each year,  including an  estimated 250  at                                                                    
     the  Alaska Psychiatric  Institute which  may treat  an                                                                    
     estimated  1200   to  1500  patients  per   year,  many                                                                    
     facilities  in  this  rapidly growing  area  of  mental                                                                    
     health are  privately held and not  presently compelled                                                                    
     to report  to the state Division  of Behavioral Health.                                                                    
     Private  hospitals  presently  may only  report  mental                                                                    
     health  complaints  to  the Joint  Commission  for  the                                                                    
     Accreditation  of Hospital  Organizations (JCAHO),  not                                                                    
     the  state.  Furthermore,  JCAHO  reportedly  may  only                                                                    
     review grievance procedures  in participating hospitals                                                                    
     every  2-3 years.  Also, many  grievances  in the  past                                                                    
     have been  handled verbally without creating  a patient                                                                    
     record and  in-patient stays are often  very short from                                                                    
     a couple of  days up to a  week or two.   Passage of SB                                                                    
     55  will  improve  mental health  treatment,  grievance                                                                    
     reporting, and state oversight.                                                                                            
MR. OBERMEYER related that Wilda Laughlin from the Department of                                                                
Health and Social Services (DHSS) and Kate Burkhart from the                                                                    
Mental Health Board have concerns.                                                                                              
CHAIR DAVIS requested a summary of all changed in version T.                                                                    
1:53:32 PM                                                                                                                    
JEAN  MISCHEL,   Legislative  Counsel,  Division  of   Legal  and                                                               
Research Services,  Legal Affairs  Agency, explained  the changes                                                               
in version T of SB 55. She related  that page 2, line 22, to page                                                               
3, line 5, contains several  additional patient rights for people                                                               
undergoing evaluation  or treatment in a  mental health facility.                                                               
She noted  the patient grievance  procedure has been  modified in                                                               
Version T to  exclude the hearing officer  and the administrative                                                               
hearing  office.  On page  5,  changes  were made  regarding  the                                                               
grievance process. Page  6 clarifies the urgent  level of review.                                                               
On page 8, the definition of the facility was changed.                                                                          
2:00:48 PM                                                                                                                    
KATE BURKHART,  Executive Director,  Alaska Mental  Health Board,                                                               
said  she  was speaking  on  behalf  of  the  board and  she  had                                                               
provided  written comments  in members'  packets. She  said today                                                               
she would discuss  the scope of the bill, how  the bill fits into                                                               
the  accepted  administrative  law  tenants,  and  the  issue  of                                                               
emergency grievance.                                                                                                            
MS. BURKHART thanked the sponsor and  noted that SB 55 has come a                                                               
long way in  meeting the sponsor's intent to improve  access to a                                                               
grievance procedure  for vulnerable  Alaskans. She  addressed the                                                               
scope  of  the  bill.  She  said  she  hopes  that  the  improved                                                               
definition  of   "facility"  limits  the   scope  of  SB   55  to                                                               
"designated  evaluation and  treatment facilities,"  or hospitals                                                               
with  mental  health  units  to   which  a  person  is  committed                                                               
involuntarily under  Title 47. However,  there are  references in                                                               
the  CS that  could apply  SB 55  to community  behavioral health                                                               
centers and  providers of voluntary  mental health  services. She                                                               
related  the   differences  between  voluntary   and  involuntary                                                               
treatment services. She suggested  clearly defining the treatment                                                               
setting in the bill and limiting it to hospital settings.                                                                       
MS.  BURKHART  opined  if  SB  55  were  to  apply  to  community                                                               
behavioral health  providers, it would create  a conflict related                                                               
to patient  grievances. Anyone who  receives Medicaid  dollars is                                                               
required  to  comply  with  federal  grievance  regulations.  The                                                               
Division of Behavior  Health also has a layer  of requirements. A                                                               
grievance process  can be  included in  the bill  as long  as all                                                               
layers are taken into consideration.                                                                                            
MS.  BURKHART noted  that the  definition of  "grievance" in  the                                                               
bill no longer conflicts with federal regulations.                                                                              
2:06:29 PM                                                                                                                    
MS.  BURKHART addressed  how SB  55 fits  in with  administrative                                                               
procedures.  Other than  the  Alaska  Psychiatric Institute,  the                                                               
providers  of involuntary  mental  health  services are  private,                                                               
non-profit hospitals.  They are  not administrative  agencies and                                                               
receipt of state funds does  not convert them into administrative                                                               
agencies. She  explained that level three  reviews, which require                                                               
the commissioner  to make a  determination, do not  work because,                                                               
under administrative law, hospitals do  not have to submit to the                                                               
commissioner's determination.                                                                                                   
MS. BURKHART voiced  concern about the shifting of  the burden of                                                               
proof in the  CS. As written now, the hospital  has the burden of                                                               
proof to  prove something  did not  happen. Usually,  the patient                                                               
has  to prove  that something  happened. Vulnerable  patients are                                                               
not  always able  to  do so  and the  bill  provides for  patient                                                               
advocates. She opined  that shifting the burden  of proof creates                                                               
an  environment where  the mental  health provider  has to  prove                                                               
that  something  did  not  happen,  which  is  not  fair  to  the                                                               
provider. She suggested the patient have representation.                                                                        
MS. BURKHART  addressed emergency  grievances that  were included                                                               
in the  CS due to  concern that  the department was  not tracking                                                               
violent offenses against patients.  All incidents are reported to                                                               
the department  and tracked. She  emphasized that  crimes against                                                               
disabled people are often marginalized.  She stressed that crimes                                                               
are not grievances and should be reported to law enforcement.                                                                   
2:10:28 PM                                                                                                                    
SENATOR DYSON asked if Chair Davis would address those concerns.                                                                
CHAIR DAVIS  said she would  look at  them, but not  address them                                                               
SENATOR DYSON asked if the bill would pass from committee today.                                                                
CHAIR DAVIS stated her intention to not move the bill today.                                                                    
SENATOR DYSON reserved  his questions for the new  version of the                                                               
SENATOR DYSON asked what  size small community-based institutions                                                               
MS. BURKHART explained that it depends on the community.                                                                        
SENATOR  DYSON  noted  he  has seen  an  abuse  of  overmedicated                                                               
2:13:15 PM                                                                                                                    
MS.  BURKHART  agreed that  there  were  people who  believed  in                                                               
medication as the answer; however,  some people do not believe in                                                               
medication. She said she believed  that the answer lies somewhere                                                               
in between.                                                                                                                     
SENATOR DYSON asked  if Ms. Burkhart thought there  was a problem                                                               
with overmedication and if there were remedies.                                                                                 
MS. BURKHART  suggested in a  community setting the remedy  is to                                                               
work with a treatment team. In  a hospital setting, the remedy is                                                               
through  the  court   system.  She  said  she   did  not  believe                                                               
overmedication was pervasive.                                                                                                   
SENATOR DYSON  asked if anything  needs to be changed  in statute                                                               
to assist overmedicated patients.                                                                                               
MS.  BURKHART   suggested  increasing   the  number   of  patient                                                               
advocates. She opined  that in a hospital,  a grievance procedure                                                               
with a patient advocate is the way to go.                                                                                       
SENATOR DYSON said he thought he heard "no."                                                                                    
2:16:07 PM                                                                                                                    
JIM GOTTSTEIN,  Law Project on  Psychiatric Rights,  commented on                                                               
SB  55.  He  related  his experience  with  court  appeals  being                                                               
detrimental to  patients due to  high costs if the  person loses.                                                               
He suggested  on page 5,  line 23, adding  "if such an  appeal is                                                               
filed, no attorney fee award  against the grievant may be ordered                                                               
by  the court."  He  stressd  it was  important  to  beef up  the                                                               
grievance procedures  and put them  in regulation. He  said there                                                               
are not  adequate remedies for  overmedication and  suggested the                                                               
system needs to have non-medication alternatives.                                                                               
2:20:34 PM                                                                                                                    
FAITH MEYER, Mental  Health Advocate, testified in  support of SB                                                               
55.  She  agreed that  grievance  procedures  should be  improved                                                               
because  they are  inadequate.  She related  that  no patient  in                                                               
2005-2006 was  allowed to  file a  grievance. She  concluded that                                                               
current  statute was  poorly  written and  does  not include  due                                                               
process or an appeal process.                                                                                                   
2:24:32 PM                                                                                                                    
DORRANCE COLLINS,  Mental Health  Advocate, testified  in support                                                               
of SB 55.  He discussed the lack of grievance  procedure rules to                                                               
protect  patient  rights.  He  recalled   the  history  of  API's                                                               
restrictions  of  patient's  rights.   He  made  suggestions  for                                                               
wording changes in the bill.                                                                                                    
CHAIR DAVIS asked if Mr. Collins was working off of version T.                                                                  
MR. COLLLINS said he was. He noted that he has provided written                                                                 
CHAIR DAVIS noted that the committee would continue to work on                                                                  
SB 55.                                                                                                                          
SENATOR DYSON thanked the sponsor.                                                                                              
2:30:02 PM                                                                                                                    
There being no further business to come before the committee,                                                                   
Chair Davis adjourned the Senate Standing Health and Social                                                                     
Services Committee at 2:30 p.m.                                                                                                 

Document Name Date/Time Subjects
SB 127 Bill.pdf SHSS 2/15/2012 1:30:00 PM
SB 127
SB 127 Sponsor Statement.pdf SHSS 2/15/2012 1:30:00 PM
SB 127
Fiscal Note.pdf SHSS 2/15/2012 1:30:00 PM
SB 55 Bill.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Sectional Summary T.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB055 Fiscal Note.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Supporting Documents - API Dashboard.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Supporting Documents -Advocates Myers Collins.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Supporting Documents.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Opposing Document - DHSS BH 10-10-2011.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Opposing Document -North Star Behavior Health 2-14-2011.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Sponsor Statement.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 1SB055 Opposing Document - North Star 8-24-2011.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 - Opposing Documents- AMHB -AK Grievance Crosswalk 2009.pdf SHSS 2/15/2012 1:30:00 PM
SB 55
SB 55 Opposing Documents-Comments-Burkhart AMHB 2-15-2012.pdf SHSS 2/15/2012 1:30:00 PM
HB 2
SB 55
Suicide_Prevention_Lunch_Learn Press Release.pdf SHSS 2/15/2012 1:30:00 PM
NCSL Luncheon Suicide Prevention-AK- Feb 2012-PowerPoint.ppt SHSS 2/15/2012 1:30:00 PM