Legislature(2025 - 2026)DAVIS 106

02/27/2025 03:15 PM House HEALTH & SOCIAL SERVICES

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03:21:48 PM Start
03:22:32 PM HB36
03:59:43 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 36 FOSTER CHILDREN PSYCHIATRIC TREATMENT TELECONFERENCED
Moved HB 36 Out of Committee
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
          HB 36-FOSTER CHILDREN PSYCHIATRIC TREATMENT                                                                       
                                                                                                                                
3:22:32 PM                                                                                                                    
                                                                                                                                
CHAIR GENEVIEVE  MINA announced that  the only order  of business                                                             
would be,  HOUSE BILL NO. 36,  "An Act relating to  the placement                                                               
of  foster children  in psychiatric  hospitals;  relating to  the                                                               
care  of   children  in  state  custody   placed  in  residential                                                               
facilities outside  the state; and amending  Rule 12.1(b), Alaska                                                               
Child in Need of Aid Rules of Procedure."                                                                                       
                                                                                                                                
CHAIR MINA invited Representative Gray and staff to present an                                                                  
overview of HB 36.                                                                                                              
                                                                                                                                
3:23:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GRAY, as prime sponsor, presented HB 36.  He                                                                     
paraphrased the sponsor statement [included in the committee                                                                    
packet], which read as follows [original punctuation provided]:                                                                 
                                                                                                                                
     Due process  is a  basic constitutional right  of every                                                                    
     person in  Alaska: adults,  children, even  children in                                                                    
     the custody of the state.                                                                                                  
                                                                                                                                
     HB  36 would  require a  judicial hearing  within seven                                                                    
     days  of  admission  of  a foster  child  to  an  acute                                                                    
     psychiatric  hospital   with  the  possibility   of  an                                                                    
     additional  seven-day  extension.  HB  36  also  allows                                                                    
     parties  to  appear  remotely thus  reducing  cost  and                                                                    
     protecting expedient due process.                                                                                          
                                                                                                                                
     In 2015  an Alaska Superior court  deliberated the case                                                                    
     of  a foster  child  admitted to  an acute  psychiatric                                                                    
     hospital.  After the  child  had  been stabilized,  the                                                                    
     child  was   not  discharged  to  a   less  restrictive                                                                    
     environment,   but    instead   remained   hospitalized                                                                    
     unnecessarily  without any  judicial review  process in                                                                    
     statute.                                                                                                                   
                                                                                                                                
     The case,  Hooper Bay v. Lawton,  recognized an absence                                                                    
     of  statutory   guidance  regarding  children   in  the                                                                    
     custody of the state. The  findings in that case led to                                                                    
     an  injunction requiring  a court  hearing  to be  held                                                                    
     within  30   days  for   children  admitted   to  acute                                                                    
     psychiatric  facilities while  in  the  custody of  the                                                                    
     Office of Children's Services (OCS).                                                                                       
                                                                                                                                
     In  the 2024  Alaska  Supreme Court  case Kwinkagak  v.                                                                    
     State  the  court  found that  the  lack  of  statutory                                                                    
     guidance   evident  in   Hooper   Bay   had  not   been                                                                    
     ameliorated, and  that 30  days was  too long.  In this                                                                    
     case a  child was held  for 46 days without  a judicial                                                                    
     review.  The  Alaska  Supreme Court  concluded  in  its                                                                    
     decision:                                                                                                                  
                                                                                                                                
     "There is no doubt that  children in OCS custody are at                                                                    
     substantial risk of being  hospitalized for longer than                                                                    
     they need, or when they  do not need to be hospitalized                                                                    
     at   all."   And   further,   "Clarifying   the   legal                                                                    
     protections for a vulnerable  population of children in                                                                    
     state custody is of utmost importance."                                                                                    
                                                                                                                                
     House   Bill  36   provides  the   necessary  statutory                                                                    
     guidance asked for in the Kwinkagak decision.                                                                              
                                                                                                                                
     I appreciate your support.                                                                                                 
                                                                                                                                
3:27:41 PM                                                                                                                    
                                                                                                                                
KYLE JOHANSEN,  Staff, Representative  Andrew Gray,  Alaska State                                                               
Legislature,  on behalf  of Representative  Gray, prime  sponsor,                                                               
presented  the sectional  analysis  for HB  36  [included in  the                                                               
committee packet],  which read  as follows  [original punctuation                                                               
provided]:                                                                                                                      
                                                                                                                                
     Section 1                                                                                                                
     Non substantive statutory construction                                                                                     
                                                                                                                                
     Section 2                                                                                                                
     Defines  "acute psychiatric  hospital" as  suggested in                                                                    
     Kwinkagak v State of Alaska                                                                                                
     Defines "contemporaneous  two-way video  conference" to                                                                    
     expedite due process                                                                                                       
                                                                                                                              
     Section 3                                                                                                                
     New subsection                                                                                                             
     e)  Allows  the  State  to  place  child  in  an  acute                                                                    
     hospital if it's the least restrictive option, the                                                                         
     child  is gravely  disabled/mentally ill  and placement                                                                    
     would improve the condition of the                                                                                         
     child with  treatment or  deteriorate the  condition of                                                                    
     the child without treatment.                                                                                               
     f) Requires all  parties of the case to  be notified of                                                                    
     placement within 24 hours                                                                                                  
     g) Requires a court review  of placement within 7 days.                                                                    
     Gives the court the option                                                                                                 
     to extend the  court review up to 14  days if necessary                                                                    
     to secure attendance of case                                                                                               
     participants. Allows for  contemporaneous two-way video                                                                    
     conferencing.                                                                                                              
     h) Requires  case review  each 30 days  or by  a "good-                                                                    
     cause" request by the child or interested                                                                                  
     party.                                                                                                                     
                                                                                                                              
     Section 4                                                                                                                
       Adds "The number of children placed in residential                                                                       
     facilities providing care for children outside the                                                                         
          state' to the required annual report to the                                                                           
       Legislature on employee recruitment and retention,                                                                       
     including                                                                                                                  
     a five year plan, for the division.                                                                                        
                                                                                                                              
     Section 5                                                                                                                
     Amends Court Rule 12.1 (b) Alaska Child in Need of Aid                                                                     
     Rules of Procedure to mandate the court                                                                                    
      appointment of an attorney for a child who has been                                                                       
     placed in an acute psychiatric hospital.                                                                                   
                                                                                                                                
3:31:05 PM                                                                                                                    
                                                                                                                                
CHAIR MINA  asked the committee  for any questions  regarding the                                                               
Alaska Court System.                                                                                                            
                                                                                                                                
3:31:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   GRAY,   in   response   to   a   question   from                                                               
Representative Prax, explained that  a court rule change requires                                                               
a two-thirds vote  in both bodies.  He said  that if a two-thirds                                                               
vote is  not achieved in  both parties, then the  proposed change                                                               
of the bill would not pass, but  the rest of the bill would pass.                                                               
He clarified  that if part  of a bill fails  to pass with  a two-                                                               
third vote from  both bodies, then that part is  severed from the                                                               
bill automatically.                                                                                                             
                                                                                                                                
3:32:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked if seven  days is too long for foster                                                               
children to  wait for a  hearing on their hospitalization  and if                                                               
that time-period should be shortened to seventy-two hours.                                                                      
                                                                                                                                
REPRESENTATIVE GRAY  responded that seventy-two hours  may be too                                                               
short  of a  period  given the  number of  parties  that must  be                                                               
present for  a hearing  of this  kind.  He  explained that  HB 36                                                               
would  allow  parties   to  attend  a  hearing   virtually.    He                                                               
emphasized  that seven  days  is much  shorter  than the  current                                                               
thirty-day wait  foster children experience in  acute psychiatric                                                               
hospitals.                                                                                                                      
                                                                                                                                
3:34:00 PM                                                                                                                    
                                                                                                                                
CHAIR MINA  asked Ms.  Meade to  describe the  logistics required                                                               
for  a  court  hearing  regarding foster  children  in  an  acute                                                               
psychiatric  hospital  to  occur,  from an  Alaska  Court  System                                                               
perspective.                                                                                                                    
                                                                                                                                
3:34:19 PM                                                                                                                    
                                                                                                                                
NANCY MEADE,  General Counsel, Alaska Court  System (ACS), stated                                                               
that the Alaska Court System is  neutral on HB 36.  She explained                                                               
that,  according to  the [Alaska]  Supreme Court  and some  trial                                                               
courts,  a 72-hour  time frame  would be  impossible to  fulfill.                                                               
She said  that a seven-day  time frame would still  be difficult,                                                               
but  reasonable given  the interests  at stake.   She  said that,                                                               
according  to HB  36,  the Office  of  Children's Services  (OCS)                                                               
would need  to notify all  parties of the  Child in Need  of Aide                                                               
(CINA)  case within  24 hours  of their  hospitalization.   After                                                               
receiving  that  notice,  the  court would  need  to  schedule  a                                                               
hearing within  seven days of  the child's hospitalization.   She                                                               
confirmed that  a three-day requirement  is difficult due  to the                                                               
large number of parties required  to attend a hearing regarding a                                                               
child in need of  aide case.  This number may be  as large as ten                                                               
or twelve  parties.  She added  that the absence of  any of these                                                               
parties would cause  an absence of due process.   Ms. Meade added                                                               
that  seven days  strikes a  balance, as  the period  would allow                                                               
doctors  at a  facility the  time to  complete a  thorough enough                                                               
analysis  of  the  child  to provide  meaningful  evidence  at  a                                                               
hearing.                                                                                                                        
                                                                                                                                
3:37:49 PM                                                                                                                    
                                                                                                                                
CHAIR MINA announced the committee would hear invited testimony.                                                                
                                                                                                                                
3:38:06 PM                                                                                                                    
                                                                                                                                
AMANDA METIVIER,  Co-Founder, Facing  Foster Care,  described her                                                               
lived experience with  the foster care system as  a foster child,                                                               
foster parent, and social worker.   She explained that HB 36 came                                                               
after a request  by foster youth to ensure that  foster youth are                                                               
not forgotten  in acute care settings.   She said that  a hearing                                                               
within  seven days  would weed  out youth  who do  not need  this                                                               
level of care  and would begin the process of  identifying a more                                                               
appropriate  placement setting  in a  timely fashion.   She  said                                                               
that HB 36 would create a  sense of urgency and would enhance the                                                               
rights of youth  in the foster care system.   She emphasized that                                                               
shortening the requirement of a  hearing from the current 30 days                                                               
to  7 days  would  not be  burdensome as  ACS  often makes  early                                                               
hearings happen in CINA cases  where constitutional rights are at                                                               
stake.  She asked the committee for their support of HB 36.                                                                     
                                                                                                                                
3:42:12 PM                                                                                                                    
                                                                                                                                
SARAH LEWIS,  Project Coordinator, Facing Foster  Care, described                                                               
her personal experience with the  foster care system as a sister,                                                               
a caregiver, a  mother, and a peer of youth  who have been placed                                                               
in these hospitals.  She explained  that youth are placed in such                                                               
facilities  even   when  the  placement  is   unnecessary.    She                                                               
exemplified  this with  an  anecdote about  her  brother who  was                                                               
placed in an acute psychiatric  hospital due to false accusations                                                               
from  his foster  parents at  the time.   His  court hearing  was                                                               
scheduled  for  the  twenty-ninth  day  of  his  hospitalization,                                                               
during which  the judge  determined that  Ms. Lewis'  brother did                                                               
not  meet the  criteria  for placement  in  an acute  psychiatric                                                               
hospital and needed  to be released immediately.   Ms. Lewis also                                                               
shared  her  experience of  witnessing  another  sibling of  hers                                                               
being placed  in an  acute psychiatric  hospital.   She recounted                                                               
watching a nurse at this  facility taunt another patient with the                                                               
use of  "booty juice," which  Ms. Lewis  defined as the  "IM shot                                                               
that chemically sedates  a child."  Ms. Lewis  also explained how                                                               
heavily  medicated her  sister  was while  placed  at this  acute                                                               
psychiatric  hospital, describing  her  sister  "like a  zombie."                                                               
Ms. Lewis  said that she is  sharing her story now  to help those                                                               
who  do  not  have  a  voice   when  being  placed  in  an  acute                                                               
psychiatric hospital.   She said that  30 days is too  long for a                                                               
child to be in an  acute psychiatric hospital before they receive                                                               
a court hearing to determine if  the criteria are met for them to                                                               
be placed  in that  acute psychiatric  hospital.   She encouraged                                                               
the committee to support HB 36.                                                                                                 
                                                                                                                                
3:48:54 PM                                                                                                                    
                                                                                                                                
KXLO STONE,  Youth Leadership Board  Member, Facing  Foster Care,                                                               
described her personal experience with  the Foster Care System in                                                               
Alaska.  She explained that  the challenges her mother faced with                                                               
finding  stable   housing,  navigating  the  legal   system,  and                                                               
maintaining  relationships with  her children  with little  to no                                                               
support, prevented  her mother  from being  able to  advocate for                                                               
her  sister when  placed  in acute  psychiatric  hospitals.   Ms.                                                               
Stone said  that her  sister was  often hospitalized  "for normal                                                               
behavioral issues  for a child experiencing  the pain, confusion,                                                               
and instability of her situation."   She said that her sister was                                                               
often left in psychiatric facilities  for endless months, with no                                                               
visits,  no communication,  or updates  to the  family, and  that                                                               
these  hospitals were  used  in lieu  of  finding an  appropriate                                                               
placement for her  sister.  Ms. Stone asked the  committee to not                                                               
view the  placement of youth  in these facilities as  a one-size-                                                               
fits-all solution.   She said  that psychiatric  hospitals should                                                               
be  places where  youth  can  find a  path  forward to  recovery,                                                               
rather than  feeling trapped or punished  by their circumstances.                                                               
She emphasized  that the decision  to place  a child in  an acute                                                               
psychiatric hospital  should not be  taken lightly, and  that the                                                               
decision on  whether the youth  needs placement in  that facility                                                               
needs to  happen sooner  than later.   She explained  that foster                                                               
children, and  their communities,  need more  than a  system that                                                               
merely provides shelter,  but a system that  cares, supports, and                                                               
prioritizes  their  overall  well-being.     She  emphasized  the                                                               
vulnerability  of   foster  children   and  requested   that  the                                                               
committee advocate for this vulnerable population.                                                                              
                                                                                                                                
3:53:38 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:53 p.m. to 3:54 p.m.                                                                       
                                                                                                                                
3:54:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX asked where  foster children would be placed,                                                               
if not  in psychiatric hospitals,  when there is no  other foster                                                               
placement for the child.                                                                                                        
                                                                                                                                
REPRESENTATIVE GRAY  responded that if  there is not  a placement                                                               
for the  child outside  of the  facility, that  is a  problem for                                                               
OCS,  not the  facility itself.    He described  examples of  OCS                                                               
placing a  child in a hotel  room and hiring somebody  to monitor                                                               
the floor  of the hotel  where foster  children are staying.   He                                                               
explained that,  although not ideal,  this situation  would still                                                               
be a  less restrictive environment  than a hospital would  be for                                                               
the child,  and that a  hotel room costs  less per night  than an                                                               
acute  psychiatric hospital.   He  emphasized that  moving HB  36                                                               
should  not be  paused because  of  concerns that  there are  not                                                               
enough placement sites for foster  children in Alaska, given that                                                               
there  exist options  that could  be  utilized that  would be  in                                                               
better  interest  of  foster  children than  leaving  them  in  a                                                               
psychiatric facility.                                                                                                           
                                                                                                                                
3:57:07 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS said that building  out a continuum of care                                                               
is  necessary,  which  would  include  complex  care  residential                                                               
homes, outpatient  behavioral health services,  preventative care                                                               
for kids, and early intervention.                                                                                               
                                                                                                                                
3:57:29 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 3:57 p.m.                                                                                 
                                                                                                                                
3:57:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS moved  to report  HB 36  out of  committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.  There  being no objection, HB 36 was  reported out of the                                                               
House Health and Social Services Standing Committee.                                                                            
                                                                                                                                
3:57:58 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:57 p.m. to 3:58 p.m.                                                                       
                                                                                                                                
3:58:41 PM                                                                                                                    
                                                                                                                                
CHAIR MINA announced that HB 36 was reported from the House                                                                     
Health and Social Services Standing Committee.                                                                                  
                                                                                                                                
3:59:21 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 3:59 p.m.                                                                                 
                                                                                                                                
3:59:43 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 3:59 p.m.                                                                                                          
                                                                                                                                

Document Name Date/Time Subjects
HB 36 Bill Packet 02.25.25.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36 Fiscal Note Courts.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36 Fiscal Note DFCS.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36 Kwinkagak v. State.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36 Native Village of Hoooper Bay v. Christy Lawton.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36 N Version.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36 Sectional Analysis Version N.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36 Sponsor Statement Version N.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36-Court Case Excerpts-Version N.pdf HHSS 2/27/2025 3:15:00 PM
HB 36
HB 36-Document with links to relevant court cases Version N.pdf HHSS 2/27/2025 3:15:00 PM
HB 36