Legislature(2025 - 2026)BUTROVICH 205
03/04/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| SB89 | |
| Presentation(s): Mental Health Trust Authority | |
| SB90 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | SB 90 | TELECONFERENCED | |
| += | SB 89 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 4, 2025
3:31 p.m.
MEMBERS PRESENT
Senator Forrest Dunbar, Chair
Senator Cathy Giessel, Vice Chair
Senator Matt Claman
Senator Löki Tobin
Senator Shelley Hughes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 89
"An Act relating to physician assistants; relating to
collaborative agreements between physicians and physician
assistants; relating to the practice of medicine; relating to
health care providers; and relating to provisions regarding
physician assistants in contracts between certain health care
providers and health care insurers."
- MOVED SB 89 OUT OF COMMITTEE
PRESENTATION(S): MENTAL HEALTH TRUST AUTHORITY
- HEARD
SENATE BILL NO. 90
"An Act relating to the examination and treatment of minors;
relating to consent for behavioral and mental health treatment
for minors 16 years of age or older; and providing for an
effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 90
SHORT TITLE: MINOR MENTAL HEALTH: AGE OF CONSENT
SPONSOR(s): SENATOR(s) GIESSEL
02/10/25 (S) READ THE FIRST TIME - REFERRALS
02/10/25 (S) HSS, FIN
03/04/25 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 89
SHORT TITLE: PHYSICIAN ASSISTANT SCOPE OF PRACTICE
SPONSOR(s): SENATOR(s) TOBIN
02/07/25 (S) READ THE FIRST TIME - REFERRALS
02/07/25 (S) HSS, L&C
02/18/25 (S) HSS AT 3:30 PM BUTROVICH 205
02/18/25 (S) Heard & Held
02/18/25 (S) MINUTE(HSS)
02/27/25 (S) HSS AT 3:30 PM BUTROVICH 205
02/27/25 (S) Heard & Held
02/27/25 (S) MINUTE(HSS)
03/04/35 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
MARY WILSON, Chief Executive Officer (CEO)
Alaska Mental Health Trust Authority
Anchorage, Alaska
POSITION STATEMENT: Co-presented Mental Health Trust Authority.
KATIE BALDWIN JOHNSON, Chief Operating Officer (COO)
Alaska Mental Health Trust Authority
Anchorage, Alaska
POSITION STATEMENT: Co-presented Mental Health Trust Authority.
PAIGE BROWN, Staff
Senator Cathy Giessel
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided the sectional analysis for SB 90.
JEN GRIFFIS, Vice President
Policy and Advocacy
Alaska Children's Trust
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 90.
HEATHER IRELAND, Executive Director
Anchorage School-Based Health Centers
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 90.
ROGER BRANSON, representing self
Eagle River, Alaska
POSITION STATEMENT: Testified in support of SB 90.
ANN RINGSTAD, Executive Director
National Alliance on Mental Illness Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 90.
STEVEN PEARCE, Director
Citizens Commission on Human Rights
Seattle, Washington
POSITION STATEMENT: Testified in opposition to SB 90.
ED MARTIN, representing self
Kenai, Alaska
POSITION STATEMENT: Testified in opposition to SB 90.
ACTION NARRATIVE
3:31:55 PM
CHAIR DUNBAR called the Senate Health and Social Services
Standing Committee meeting to order at 3:31 p.m. Present at the
call to order were Senators Claman, Tobin, Giessel, and Chair
Dunbar. Senator Hughes arrived thereafter.
SB 89-PHYSICIAN ASSISTANT SCOPE OF PRACTICE
3:32:53 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 89
"An Act relating to physician assistants; relating to
collaborative agreements between physicians and physician
assistants; relating to the practice of medicine; relating to
health care providers; and relating to provisions regarding
physician assistants in contracts between certain health care
providers and health care insurers."
3:33:05 PM
CHAIR DUNBAR stated he received no amendments for SB 89 and the
sponsor had no closing comments.
3:33:40 PM
CHAIR DUNBAR solicited the will of the committee.
3:33:44 PM
SENATOR GIESSEL moved to report SB 89, work order 34-LS0063\N,
from committee with individual recommendations and attached
fiscal note(s).
3:33:58 PM
CHAIR DUNBAR found no objection and SB 89 was reported from the
Senate Health and Social Services Standing Committee.
3:34:09 PM
At ease.
[SENATOR HUGHES arrived at the meeting at 3:35 p.m.]
3:36:46 PM
CHAIR DUNBAR reconvened the meeting and solicited a motion.
3:36:49 PM
SENATOR CLAMAN moved to reconsider SB 89.
3:36:57 PM
CHAIR DUNBAR found no objection and SB 89 was before the
committee on reconsideration.
3:37:06 PM
SENATOR GIESSEL moved to report SB 89, work order 34-LS0063\N,
from committee on reconsideration with individual
recommendations and attached fiscal note(s).
3:37:14 PM
CHAIR DUNBAR found no objection and SB 89 was reported from
Senate Health and Social Services Standing Committee on
reconsideration.
3:37:24 PM
At ease.
^PRESENTATION(S): MENTAL HEALTH TRUST AUTHORITY
PRESENTATION(S): MENTAL HEALTH TRUST AUTHORITY
3:38:04 PM
CHAIR DUNBAR reconvened the meeting and announced the
presentation Mental Health Trust Authority.
3:38:29 PM
MARY WILSON, Chief Executive Officer (CEO), Alaska Mental Health
Trust Authority, Anchorage, Alaska, co-presented Mental Health
Trust Authority. She moved to slide 2 and introduced herself as
the new CEO of the Trust, four weeks into the role. She shared
that she grew up in Alaska, graduated from Dimond High School,
and completed her undergraduate and medical education through
the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI)
program. Her background includes pediatric training in
California, a fellowship at UCLA, a master's in public health,
and leadership experience with the Permanente Medical Group
focused on prevention and outcomes. She said she returned to
Alaska three years ago and saw this role as a strong fit for her
experience and desire to contribute.
3:40:31 PM
MS. WILSON emphasized the importance of addressing both crisis
care and its underlying causes and outcomes. She compared it to
heart attack treatment where immediate care is critical, but
prevention and follow-up matter for long-term health. She stated
the Trust focuses on both the acute event and broader factors
before and after. This approach applies across all populations
the Trust serves.
3:41:15 PM
MS. WILSON moved to slide 3, Trustees. She listed the Trust
Governance Board members: Brent Fisher, Agnes Moran, Rhonda
Boyles, Corey Feig, Kevin Feinman, John Morrison, and Eva
Halterman. She noted that the Trust is overseen by this board,
to whom she reports as CEO.
3:41:38 PM
MS. WILSON moved to slide 4, Trust Beneficiaries, and stated
that Trust beneficiaries include Alaskans with mental illness,
intellectual and developmental disabilities, Alzheimer's
disease, traumatic brain injuries, and substance use disorders,
often with overlapping conditions. The Trust prioritizes youth
and adults whose behavioral health condition or developmental
disability places them at the risk of institutionalization and
that without proper community support their conditions might
escalate. Prevention, when evidence-based, is also part of the
Trust's mandate. She emphasized the board and staff's commitment
to improving beneficiaries' life and health outcomes.
3:42:44 PM
MS. WILSON moved to slide 5, Our Role. She explained that the
Trust is a state corporation managing the Alaska Mental Health
Trust, a perpetual trust aimed at improving beneficiaries'
lives. She highlighted the Trust's unique status as an
independent state corporation that uses land and financial
assets to support a comprehensive system of mental health and
disability services. The Trust works through grant making and
system improvement, and partners closely with state agencies,
including the Departments of Health and Family and Community
Services, on efforts like the Comprehensive Integrated Mental
Health Program Plan (COMP Plan). She noted the Trust prioritizes
funding for system improvement, innovation and strategic
initiatives.
3:43:52 PM
CHAIR DUNBAR asked for clarification on the relationship between
the Trust and the Department of Natural Resources (DNR)
regarding Trust land management. He noted a common misconception
that the Trust solely manages its land, when DNR's Trust Land
Office is actually involved. He requested an explanation of how
decisions are made and whether the Trust board approves major
actions while DNR handles daily operations.
3:44:41 PM
MS. WILSON clarified that the Trust Land Office (TLO) reports to
both the board of trustees and her as CEO. While the Department
of Natural Resources (DNR) may assist with activities like
assessing land for timber or mining, DNR does not manage Trust
land. The board of trustees oversees all major land decisions,
including approving capital investments and analysis presented
by TLO.
3:45:33 PM
CHAIR DUNBAR asked for confirmation that the Trust Land Office
budget appears under the Department of Natural Resources (DNR),
not within the Mental Health Trust Authority's budget.
MS. WILSON responded that the Trust covers the operational costs
and capital investments of TLO. She noted the TLO contracts and
aligns closely with DNR. She offered to follow up with more
detail on funding flow, but that was her current understanding
after four weeks in the role of CEO.
3:46:29 PM
MS. WILSON moved to slide 6, About the Trust. She summarized the
Trust's origins, beginning before statehood when Alaskans with
mental illness were sent to long-term institutions in Oregon. In
1956, Congress transferred mental health service responsibility
to Alaska with a million-acre land grant. She said that the
Alaska Supreme Court determined that the state had breached its
fiduciary responsibility in the 1984 Weiss v. State of Alaska
lawsuit. In the final landmark settlement in 1994 the Alaska
Mental Health Trust authority as now known, was established. The
new trust authority had its lands reconstituted back to a
million acres, received a cash payment of $200 million. This
became the part of the trust called corpus and is managed by the
Alaska Permanent Fund Corporation, with an independent board of
trustees established to oversee the organization.
MS. WILSON clarified that the Weiss settlement affirms the state
must fund basic mental health services, while the Trust supports
strategy, innovation, and select programs, representing only a
small portion of overall mental health funding.
3:48:45 PM
MS. WILSON moved to slide 7, FY 26: Trust Focus Areas, and
shared the established focus areas and priorities of the Trust:
[Original punctuation provided.]
FY26: Trust Focus Areas
The Trust develops its budget and engages in
grantmaking, advocacy, and system improvement efforts
around the following areas:
Established Focus Areas
• Disability Justice
• Mental Health & Addiction Intervention -Includes
Behavioral Health Crisis Response
• Beneficiary Employment & Engagement
• Housing and Home & Community Based Services
Additional Priorities
• Workforce Development
• Early Childhood Intervention & Prevention
MS. WILSON noted her appreciation for the Trust's inclusion of
early childhood intervention and prevention, aligning with her
background as a pediatrician. She explained that while focus
areas remain consistent, strategic emphasis shifts based on
state needs, partner input, and data analysis. These focus areas
guide grant funding and support a proactive, not reactive,
approach. She added that all focus areas align with the state's
Comprehensive Integrated Mental Health Program (COMP). Funding
is directed across beneficiary groups and lifespan from
childhood to adulthood. Behavioral health cuts across all
priority and focus areas, including prevention, negative
circumstances that lead to life instability and progression of
disabilities, improving social determinants of health, improving
access to critical services, treatments and supports, and
reintegration after institutionalization or incarceration.
3:50:28 PM
MS. WILSON moved to slide 8, Trust Grantmaking FY 26, a pie
graph showing Authority Grants in the amount of $19,119,300 and
Mental Health Trust Authority Authorized Receipt (MHTAAR) Grants
in the amount of $10,196.8. Authority Grants are designated
grants to community providers, nonprofits, local governments,
and Tribal organizations and include $1.9 million in mini
grants. MHTAAR Grants are designated grants to state agencies
and require receipt authority. The graph shows that a large
percentage of what the Trust gives goes to state agencies.
3:51:03 PM
KATIE BALDWIN JOHNSON, Chief Operating Officer (COO), Alaska
Mental Health Trust Authority, Anchorage, Alaska, co-presented
Mental Health Trust Authority. She moved to slide 9, a pie
chart, and provided examples of how the Trust partners with
various entities on behavioral health initiatives:
[Original punctuation provided.]
MHTAAR Grants, FY26
Total: $10,196.8 (53 MHTAAR Projects)
• Department of Health ($4,413.9)
• UAA ($1,870.0)
• AHFC ($1,485.0)
• Department of Corrections ($1,041.7)
• Department of Family and Community Services ($587.0)
• Department of Administration ($355.9)
• Alaska Court System ($158.3)
• Department of Public Safety ($130.0)
• Department of Education and Early Development
($130.0)
• Department of Labor and Workforce Development
($25.0)
MS. JOHNSON explained that Authority Grants go directly to
beneficiary-serving organizations and are used alongside state
department efforts to support program development, financial
modeling, technical assistance, capital needs, and startup
costs. One example is the 1115 Behavioral Health Waiver, where
the Trust uses grant funds to support planning and
implementation efforts that expand the continuum of care.
MS. JOHNSON highlighted that in 2024, trustees authorized
approximately $1 million in Authority Grants to agencies
providing direct behavioral health services, with a focus on
expanding treatment access. Funded projects included
transitional housing for 32 women completing treatment in
Anchorage, expanded opioid treatment on the Kenai Peninsula,
enhanced case management for high emergency room utilizers, and
improved mental health interventions for at-risk youth and
families. She also noted efforts to support recruitment and
retention in the behavioral health workforce.
3:53:48 PM
MS. JOHNSON briefly discussed the use of Mental Health Trust
Authorized Receipts (MHTAAR) to enhance the capacity of state
departments. She cited FY26 budget examples: $750,000 from the
Trust, matched with $750,000 in general funds, to support the
statewide crisis call center, and a $400,000 MHTAAR increment to
the Department of Family and Community Services to support
complex care work, a shared priority with the Department of
Health. She said these examples reflect how the Trust aligns its
funding with mutual state priorities.
3:56:12 PM
SENATOR TOBIN asked about the intersection between the Trust and
Indian Health Services (IHS), specifically how the Trust
supports IHS behavioral and mental health efforts in Alaska.
MS. JOHNSON replied that the Tribal Health System is a valued
partner of the Trust, with regular engagement to identify gaps,
priorities, and needs. She noted that tribal partners contribute
to the Trust's budget planning process and often lead healthcare
innovation in Alaska. She highlighted partnerships with
Southcentral Foundation in Anchorage and efforts in Nome and
Kotzebue to improve local crisis response. Tribal input helps
shape trustee recommendations.
3:57:54 PM
SENATOR TOBIN opined that sometimes it is unclear who is
responsible for whom regarding trust beneficiaries and
additional dollars. She asked whether, at the forming of the
Mental Health Trust, the court stipulated only looking at
specific populations, or if everyone was to benefit through
collaborative work.
3:58:23 PM
MS. WILSON explained that the Trust's mandate, as outlined in
the settlement agreement, defines its role as part of a broader
system and allows for collaboration without strictly limiting
who qualifies as a beneficiary. She noted that focus areas can
evolve over time, such as a growing emphasis on early childhood
prevention. Strategic direction is informed by data and emerging
best practices, such as Adverse Childhood Experiences (ACE)
scores, which help identify trauma and predict long-term
outcomes, which weren't available in the past.
3:59:58 PM
MS. WILSON moved to slide 10, a map of Alaska with an embedded
video that emphasized the need for crisis centers as
alternatives to hospitals or jails for individuals experiencing
behavioral health emergencies, particularly in rural areas like
Kotzebue. It highlighted the importance of having trained
responders rather than uniformed law enforcement, which can
escalate situations. The Crisis Now model offers same-day
behavioral health assessments, reduces unnecessary
hospitalizations, and saves Medicaid costs, helping 90 percent
of 3,600 callers remain in their communities last year. The
model supports collaboration among law enforcement, emergency
rooms, crisis providers, and call lines, with services refined
through feedback. A coordinated, community-based approach is
essential to meeting Alaska's behavioral health needs.
4:04:33 PM
MS. WILSON moved to slide 11.
4:04:40 PM
CHAIR DUNBAR reflected on the launch of the 2019 crisis
initiative, recalling the Anchorage Assembly's efforts to
establish a Crisis Team (CT), including multiple veto overrides
to secure funding. He expressed appreciation that the work is
continuing and asked for more details about the current crisis
call center. He noted that in the past, accessing the Mobile
Crisis Team (MCT) in Anchorage was difficult and shared a
personal experience highlighting gaps in the system. He asked
for an update on the crisis call center and where the program is
centered.
4:05:44 PM
MS. JOHNSON explained that the current crisis call center is
operated by Careline in Fairbanks, with a satellite office in
the Mat-Su Valley. She emphasized the call center's central role
in the behavioral health crisis continuum, offering immediate
support and responding to thousands of calls annually. In
Anchorage, she noted ongoing efforts to coordinate dispatch of
the Mobile Crisis Team, co-responder police-social work units,
and the HOPE outreach team. She added that the Division of
Behavioral Health is actively planning the future of the call
center system, including potential statewide expansion and
integration with local crisis response efforts.
4:07:32 PM
CHAIR DUNBAR thanked the presenters for their time.
4:08:11 PM
At ease.
SB 90-MINOR MENTAL HEALTH: AGE OF CONSENT
4:08:54 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 90 "An Act relating to the
examination and treatment of minors; relating to consent for
behavioral and mental health treatment for minors 16 years of
age or older; and providing for an effective date."
4:09:09 PM
SENATOR CATHY GIESSEL, speaking as the sponsor of SB 90, stated
that she is an advanced practice registered nurse and board-
certified family nurse practitioner with several years of
experience in school-based clinics in both Anchorage and a rural
school district. She explained that her support for SB 90 comes
from direct experience working with youth and hearing their
mental health concerns during screenings. She emphasized that SB
90 is both data-driven and motivated by compassion, noting that
the average age of onset for mental health issues is 14 and
early detection improves outcomes. She highlighted that suicide
is the second leading cause of death nationally for individuals
aged 15 to 34, and Alaska leads the nation in teen suicide
rates, with 22 percent of high school students having considered
suicide in 2023 and 43 percent reporting sadness or
hopelessness.
4:10:53 PM
SENATOR GIESSEL stated that SB 90 addresses access to mental
health care by lowering the age of consent for behavioral health
services from 18 to 16. She clarified that under SB 90, teens
age 16 and older could receive up to five 90-minute sessions
without parental consent. After those sessions, parental consent
would be required unless contacting parents posed a risk to the
minor, and clinicians would be required to document efforts to
reach the parents. She noted that these parameters are further
detailed in the Sectional Analysis for SB 90.
SENATOR GIESSEL maintained that early mental health intervention
reduces the risk of substance abuse and crisis escalation and
helps teens engage more fully in treatment. She said SB 90 will
promote teen responsibility, increase self-esteem, and
ultimately strengthen families and communities by providing
proactive care. She concluded that supporting SB 90 is a step
toward addressing Alaska's youth mental health crisis.
4:13:49 PM
SENATOR GIESSEL referenced a 2017 presentation by Dr. Joshua
Sonkiss, a psychiatrist with Anchorage Community Mental Health
Services, which explained how the teen brain, particularly the
prefrontal cortex responsible for executive function, continues
developing during adolescence. She stated that equipping teens
with tools to manage stress and emotions can support brain
development and long-term mental health. She also pointed to a
behavioral health roadmap presented in April to the Committee,
which recommended increasing access to school-based Medicaid
services and youth use of prevention hotlines. She emphasized
that SB 90 encourages engagement of teens and their families and
builds overall family resilience while addressing Alaska's
suicide crisis.
4:17:23 PM
PAIGE BROWN, Staff, Senator Cathy Giessel, Alaska State
Legislature, Juneau, Alaska, provided the sectional analysis for
SB 90:
[Original punctuation provided.]
Senate Bill 90
Sectional Analysis (Version A)
"An Act relating to examination and treatment of
minors; relating to consent for behavioral health and
mental health treatment for minors 16 years of age of
older; and providing for an effective date."
Section 1. Amends AS 25.20.025: Examination and
Treatment of Minors.
This section adds youth who provide documentation
demonstrating they are an unaccompanied homeless minor
to the list of minors who can consent to medical
treatment.
This section would add behavioral and mental health
services to the list of services an unaccompanied
homeless minor, a minor living apart from their
parents or legal guardian, and a minor who is the
parent of a child, are able to consent to.
4:17:54 PM
MS. PAIGE continued reading the sectional analysis of SB 90:
[Original punctuation provided.]
Section 2. Adds new subsections to AS. 25.20.025: Examination
and Treatment of Minors.
This section adds new subsections relating to
documentation required by homeless unaccompanied
minors for the purposes of giving consent.
The documentation must state that the minor is:
1. 16 years of age or older
2. Does not have a fixed, regular, adequate
nighttime residence; and
3. Is not in the care and physical custody of a
parent or guardian,
And the document must be signed by:
1. A director or designee of a director of a
governmental or nonprofit entity that receives
funds to provide assistance to those who are
homeless;
2. A local educational agency liaison for homeless
youth, a local educational agency foster care
point of contact, or a licensed clinical social
worker employed by a school in the state;
3. An attorney that represents the minor; or
4. The minor and 2 adults with actual knowledge of
the minor's situation.
Section 3. Adds a new section to AS. 25.20: Parent and
Child.
This section would give a minor aged 16 years or older
the ability to consent to receive five 90-minute
sessions of outpatient behavioral or mental health
appointments, without obtaining the consent of the
minor's parent or guardian. It then outlines what
would happen in the case a minor needed continued
treatment.
Section 4. Amends AS. 47.10.084(c): Legal custody,
guardianship, and residual parental rights and
responsibilities.
This section adds the new section from section 3 to
the list of exceptions of a parent's residual rights
and responsibilities.
Section 5. Amends AS. 47.12.150(c): Legal custody,
guardianship, and residual parental rights and
responsibilities.
This section adds the new section from section 3 to
the list of exceptions of a parent's residual rights
and responsibilities. Section
6. Effective date.
This section provides for an effective date of January
1, 2026.
4:19:45 PM
SENATOR GIESSEL highlighted that in SB 90, page 3, line 1-3, the
bill states that a mental health provider may not prescribe
medication to a minor receiving behavioral or mental health
services.
4:20:52 PM
CHAIR DUNBAR commented that he was going to inquire about that
and thanked her for specifically mentioning the provision.
SENATOR GIESSEL responded that the language was included by
design. She also noted that Section 3, page 5, line 2, specifies
that treatment must meet the standard of care commonly accepted
among health professionals in Alaska, not random people.
CHAIR DUNBAR asked about the origin of the five-appointment
limit in SB 90. He acknowledged that selecting such numbers
often involves finding a rational standard but wondered if this
specific number was based on policies in other states or
developed independently.
4:21:16 PM
MS. BROWN stated that the five-session limit in SB 90 was based
on a statute in Idaho with a similar structure. She explained
that Idaho allows minors to access a limited number of sessions
without parental consent and stated her belief that Idaho also
sets the minimum age at 16.
4:21:35 PM
CHAIR DUNBAR acknowledged the general agreement on the
importance of youth accessing behavioral and mental health
services, particularly in reducing issues like suicidal
ideation. He questioned whether the primary challenge that SB 90
addresses is difficulty in reaching some parents or situations
where contacting parents could pose a danger to the child.
SENATOR GIESSEL deferred to Ms. Ireland who works in school-
based clinics. She said Ms. Ireland could give data related to
the difficulty in obtaining parental consent.
4:22:40 PM
CHAIR DUNBAR announced invited testimony on SB 90.
4:22:56 PM
JEN GRIFFIS, Vice President, Policy and Advocacy, Alaska
Children's Trust, Anchorage, Alaska, provided the following
invited testimony on SB 90:
Today I'm testifying in support of Senate Bill 90,
which would allow 16- and 17-year-olds the ability to
provide self-consent to receive up to five behavioral
health treatment sessions. Alaska Children's Trust
believes in a future where Alaska's children, youth,
and families have the knowledge, skills, supports, and
resources that they need to thrive. Achieving this
vision means ensuring that the next generation of
parents has access to the behavioral health support
they need so they can enter young adulthood as healthy
as possible. Senate Bill 90 creates a pathway for 16-
and 17-year-olds to receive behavioral health support
in situations where it might be challenging to obtain
parental consent. This legislation acknowledges the
wide variety of situations our Alaskan youth find
themselves in by carefully navigating the importance
of involving parents in the treatment process while
also affirming and empowering 16- and 17-year-olds
seeking behavioral health treatment.
According to Kids Count 2024, two out of every five
high school students in Alaska report feeling
persistently sad or hopeless for an extended period of
time during the previous year. This number has moved
steadily upwards since 2009, increasing almost 60
percent in the past decade. The option for youth to
consent to behavioral health treatment is a policy
choice implemented in states across the country.
Research demonstrates that allowing youth to self-
consent for behavioral health services can support
youth engagement in treatment and empower youth to
make informed decisions, leading to more effective
care and reducing risky behaviors. The policy changes
in Senate Bill 90 seek to increase youth access to
behavioral health services by balancing youth autonomy
with parental involvement, supporting Alaska's youth
as they seek treatment for their health and well-
being.
We encourage your support of Senate Bill 90, and thank
you for the opportunity to testify today.
4:25:40 PM
HEATHER IRELAND, Executive Director, Anchorage School-Based
Health Centers, Anchorage, Alaska, providing the following
invited testimony on SB 90:
For over 10 years, I have served as executive director
of Anchorage school-based health centers, a division
of Christian Health Associates. Thank you for the
opportunity to comment on the importance of Senate
Bill 90. If you want to make a difference for
adolescent mental health, you will pass this bill. I
was thrilled to see that Senate Bill 90 was being
brought forward, allowing 16- and 17-year-olds to
access behavioral health services, even if only for a
limited number of sessions, it has the potential to
make a huge difference in their lives. We are grateful
for the volunteer services Senator Giessel provided,
and she spoke eloquently and comprehensively about the
need for this bill.
Anchorage School-Based Health Centers (ASBHC) is a
nonprofit separate from the Anchorage School District
but operating medical clinics in middle and high
schools in Anchorage. We provide medical care to those
who cannot access it in the community. Parental
consent is required for students to receive the
medical care from advanced nurse practitioners and
doctors in our clinics, and like medical providers in
the community, we bill Medicaid, private insurance,
and Stride Care. But we also waive some fees for low-
income families, and primarily we receive a grant from
the municipality, as well as funding from the United
Way and private donors through Pick Click Give. So,
Anchorage school-based health centers have served
thousands of students since the inception in 2010.
4:27:23 PM
MS. IRELAND continued her invited testimony on SB 90:
Our providers screen for many types of risk, and we
have seen increasing numbers of students who exhibit
symptoms of depression, anxiety, and other mental
health challenges. Schools often concur with our
initial assessment that some youth are struggling, and
more often than not, students are willing to pursue
behavioral health treatment. Unfortunately, parental
consent is a huge barrier for youth to access the care
that they desperately need and want. Frequently, youth
are hesitant to ask their parents for treatment. My
observation has been that adults are reluctant to give
permission because of the stigma associated with
mental illness, which the younger generation has often
moved past. And it can also be logistically
challenging for adults to give consent, especially in
a school setting where families are not present. And
finally, of course, some adults don't want their
students discussing their personal life with a
healthcare professional, despite how desperately they
need the treatment.
Years ago, through my networking with school-based
health programs in other states, I learned that
Colorado lowered their age of consent to 12, and
previously it had been like 14 or 16. It was a
lightning bolt. This is a way we can actually help
kids. Sadly, after many years, Alaska has done nothing
to change the situation. By allowing 16- and 17-year-
olds to consent for their own care, youth can connect
with a clinician who can assess their safety and
broach the possibility of involving an adult in their
treatment. Early access to care prevents issues from
developing into a crisis, needing hospitalization, or
worse.
In 2018, a study out of Minnesota showed that school-
based mental health programs reduced self-reported
suicide by 15 percent. This is just one example of how
increasing access can make a difference.
Please pass Senate Bill 90, and please help youth who
are struggling.
4:29:34 PM
SENATOR TOBIN stated that she had a question regarding parental
reactions to behavioral health treatment for minors. She
expressed concern that some parents or guardians might deny
consent out of fear that they could be held liable for neglect
or harm. She asked Ms. Ireland whether she had any experience or
knowledge related to that situation.
4:30:00 PM
MS. IRELAND stated that clinicians and medical providers in her
program have made reports of harm in various situations
involving youth. She explained that these reports are typically
not made without the student's knowledge and often involve
communication with the student about the legal obligation to
report, and sometimes include the parent if they are not the
abuser. She emphasized that the Office of Children's Services is
responsible for assessing such reports and determining the
appropriate next steps. She noted that reports of harm can arise
during behavioral health treatment, medical visits, or through
conversations with mandated reporters such as teachers. She
stated her belief that SB 90 would not significantly increase
the occurrence of such reports.
4:31:36 PM
CHAIR DUNBAR acknowledged that Senator Hughes joined the meeting
at about 3:35 p.m.
4:32:00 PM
CHAIR DUNBAR opened public testimony on SB 90.
4:32:22 PM
ROGER BRANSON, representing self, Eagle River, Alaska, testified
in support of SB 90. He stated that he is a longtime mental
health advocate and described SB 90 as a critical tool to
empower youth to define their own self-care. He emphasized the
importance of involving individuals in their mental health
recovery and treatment planning.
4:33:03 PM
CHAIR DUNBAR paused public testimony to hear invited testimony
from Ms. Ringstad.
4:33:30 PM
ANN RINGSTAD, Executive Director, National Alliance on Mental
Illness Alaska, Anchorage, Alaska, provided the following
invited testimony for SB 90:
NAMI Alaska is one of 48 state organizations under the
umbrella of NAMI, the National Alliance on Mental
Illness, the nation's largest mental health advocacy
organization in the United States. Consider these
facts: one in six youth ages six to 17 experience a
mental health disorder each year in the United States;
50 percent of all mental illness develops by the time
a student reaches the age of 14, and 75 percent by the
time they reach the age of 25. Eight thousand Alaskans
ages 12 to 17 have depression. High school students
with depression are more than two times more likely to
drop out than their peers. Almost 63 percent of
Alaskans ages 12 to 17 who have depression did not
receive any care in the past year.
Behavioral health services are critical to support
these youth. Delayed treatment can be detrimental. The
earlier a mental health issue is detected, the better.
And one more important fact: Alaska's suicide rates
are sadly some of the highest in the nation. We rank
number three.
As the sponsor of the bill stated, SB 90 allows
minors, 16 of age and older, who provide documentation
they are living apart from their family and are
homeless, to seek help for their mental health
challenges. This would give them the ability to obtain
mental health services and give their own consent for
five 90-minute outpatient mental health sessions, with
parental notification to determine the next steps
unless parental consent would be detrimental to the
well-being of the youth. This would allow them to
receive timely services before their symptoms become
worse. Lowering the age of consent for behavioral
health care under these circumstances, from 18 to 16,
may prove to save lives.
Thank you for your consideration of these factors.
4:35:49 PM
CHAIR DUNBAR resumed public testimony on SB 90.
4:36:18 PM
STEVEN PEARCE, Director, Citizens Commission on Human Rights,
Seattle, Washington, testified in opposition to SB 90. He stated
that the Citizens Commission on Human Rights is a psychiatric
watchdog group and expressed concerns regarding SB 90. He
supported notifying parents when youth exhibit behavior that
affects school performance and taking action through protective
services if necessary but opposed turning schools into profit
centers for psychiatric diagnosis and treatment. He argued that
behavior is not a disease and claimed the theory of a chemical
imbalance in the brain lacks supporting evidence, criticizing
what he described as grooming individuals to believe behavior
equates to disease and that medication is the solution.
MR. PEARCE stated that if SB 90 is limited strictly to
counseling, that might be more acceptable, but he raised
concerns about violating informed consent. He emphasized that
informed consent is fundamental to treatment and argued that
limiting or removing parental involvement exceeds what is
necessary. He asserted that schools and counselors should make a
greater effort to reach parents and obtain authorization, and
failure to do so reflects a breakdown in communication. He cited
Tom Insel, former director of the National Institute of Mental
Health, who acknowledged that decades of mental health efforts
have not produced meaningful improvements, as evidenced by high
rates of suicide, disability, and poor mortality data.
4:39:05 PM
ED MARTIN, representing self, Kenai, Alaska, testified in
opposition to SB 90. He stated he is 70 years old and has
personal experience with mental health issues within his family.
He opposed SB 90, asserting that allowing 16-year-olds to enter
treatment without parental consent undermines parental rights.
He expressed concern over minors receiving seven and a half
hours of care without parental involvement and warned that such
a policy could be legally challenged. He questioned the bill's
fiscal impact and asked which nonprofits are involved and how
the services would be funded.
4:41:44 PM
CHAIR DUNBAR held public testimony open on SB 90.
4:41:50 PM
SENATOR HUGHES stated that she shared some of Mr. Martin's
concerns regarding SB 90. She said she supports seeking parental
consent upfront and limiting exceptions to extreme situations,
such as cases involving homeless youth. She noted that Idaho has
since revoked a similar law, raising its age of consent back to
18. She recalled prior concerns that insurers might not cover
services under this policy and requested and update.
4:43:45 PM
CHAIR DUNBAR stated he also had a question related to billing
for services and suggested the sponsor could address the
questions at the next hearing of SB 90.
4:43:56 PM
CHAIR DUNBAR held SB 90 in committee.
4:44:24 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Health and Social Services
Standing Committee meeting at 4:44 p.m.