Legislature(2025 - 2026)DAVIS 106
04/03/2025 03:15 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB52 | |
| HB144 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 52 | TELECONFERENCED | |
| *+ | HB 144 | TELECONFERENCED | |
| *+ | HB 151 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 52-MINORS & PSYCHIATRIC HOSPITALS
3:21:01 PM
CHAIR MINA announced that the first order of business would be
HOUSE BILL NO. 52, "An Act relating to the rights of minors
undergoing evaluation or inpatient treatment at psychiatric
hospitals; relating to the use of seclusion or restraint of
minors at psychiatric hospitals; relating to a report published
by the Department of Health; relating to inspections by the
Department of Health of certain psychiatric hospitals; and
providing for an effective date." [Before the committee,
adopted as a working document on 3/25/25, was the proposed
committee substitute (CS) for HB 52, Version 34-LS0399\N,
Radford, 3/24/25 ("Version N").]
3:21:25 PM
REPRESENTATIVE MAXINE DIBERT, Alaska State Legislature, as prime
sponsor, provided a brief recap of HB 52, Version N. She
explained that Version N would include three straightforward
reforms: expand rights of parents to communicate with their
children receiving care; require unannounced thorough
inspections by state public health officials twice annually; and
ensure that facilities are transparent about their use of
physical and chemical restraints and seclusion.
3:25:00 PM
MATTIE HULL, Staff, Representative Maxine Dibert, on behalf of
Representative Dibert, prime sponsor, answered questions
regarding HB 52, Version N, from the previous hearing on the
bill. He said that Version N would not be duplicative, but
expansive, of current patients' rights while in psychiatric
treatment facilities. He said that 35 students would be
interviewed from two different facilities twice a year. He
added that inspections under HB 52, Version N, would be
unannounced to ensure the authenticity of their results.
3:28:41 PM
REPRESENTATIVE GRAY asked about medications that are being used
as both restraints and medications and how that would affect the
need for substance use to be reported.
MR. HULL responded that chemical restraints are drugs used on a
patient for discipline or convenience but not required to treat
medical systems. He added that he would be willing to clarify
this distinction through an amendment to Version N.
REPRESENTATIVE GRAY expressed a concern that Version N would
allow facilities to do something and not report it, such as
overprescribing a drug that a child already takes.
3:32:23 PM
KIM SWISHER, Deputy Director, Office of Children's Services
(OCS), Department of Family and Community Service (DFCS),
responded that she may not be the best to answer the question
from Representative Gray.
3:32:48 PM
ROBERT NAVE, Division Operations Manager, Division of Health
Care Services (DHCS), Department of Health (DOH), responded that
there should be a record of all drug administration at the
facility.
3:33:28 PM
REPRESENTATIVE RUFFRIDGE asked what current inspections of these
facilities look like and if unannounced inspections, under HB
52, Version N, would replace current inspections.
MR. HULL responded that all hospital inspections are
unannounced, according to Medicaid standards. However,
hospitals are allowed to contract out private agencies to
conduct these inspections. He does not know the frequency of
current inspections.
MR. NAVE added that the unannounced inspections under the
proposed legislation would be in addition to current inspections
of the facilities.
REPRESENTATIVE RUFFRIDGE asked again if current inspections are
unannounced.
MR. NAVE responded that that is correct.
REPRESENTATIVE RUFFRIDGE asked when the last time the
psychiatric facilities underwent inspections.
MR. NAVE responded that he does not have the last date of the
inspections.
REPRESENTATIVE RUFFRIDGE asked about the frequency of current
inspections.
MR. HULL responded that the inspections occur at least annually.
REPRESENTATIVE RUFFRIDGE asked about the safety of interviewers
if they are required to conduct interviews alone.
MR. HULL responded that he would work to clear up that concern.
3:37:50 PM
REPRESENTATIVE FIELDS said that the mistreatment of children in
hospitals has cost the state much more money than it would cost
to keep these vulnerable patients safe.
3:38:55 PM
REPRESENTATIVE SCHWANKE asked about who would approve
communication between patients and their families.
MR. HULL responded that treatment plans are not always overseen
by a physician but by other high-level staff, who could approve
of this communication.
REPRESENTATIVE SCHWANKE asked for clearer language regarding who
can approve communications.
CHAIR MINA explained that the original language of the bill
seemed too restrictive.
3:41:33 PM
MR. NAVE said that less restrictive language would include
mental health clinicians, psychiatrists, and other healthcare
professionals.
REPRESENTATIVE SCHWANKE expressed concern regarding a broad
range of individuals being allowed to approve or deny
communications.
3:42:38 PM
CHAIR MINA asked if Version N would have more restrictive rights
for minors, limiting length of video calls with families.
MR. HULL responded that the proposed legislation would not set a
maximum number of communications per week but would set a
minimum of one hour per week.
3:44:38 PM
REPRESENTATIVE GRAY asked what the facility is responsible for
if a patient does not want to spend one hour in communication
with their family.
REPRESENTATIVE DIBERT responded that she is not sure how that
situation would look and she would have to investigate that
question more deeply.
3:47:07 PM
MS. SWISHER responded that currently, if a youth does not want
to speak with their family, then the facility does not force it.
3:47:41 PM
REPRESENTATIVE GRAY emphasized that he does not want a facility
to be able to say communication did not happen because the child
did not want to, whether the child truly said that or not.
3:48:43 PM
REPRESENTATIVE RUFFRIDGE emphasized that HB 52, Version N, would
give the right, not the requirement, of a child to have
communication with their guardian. He suggested also giving
parents and guardians the right to communicate with their
children in psychiatric facilities.
MR. HULL responded that the rights of parents are also very
important and he would like to encourage parents to reach out to
their children in psychiatric facilities.
3:50:57 PM
REPRESENTATIVE GRAY emphasized cases of nonverbal children, who
may not be able to ask for the opportunity to communicate with
their guardian.
3:51:57 PM
CHAIR MINA returned to her question regarding restrictions that
HB 52 would place on the rights to communicate that currently
exist under psychiatric rights law.
MR. HULL responded that the language Chair Mina referred to is
present in both current statute on psychiatric rights and HB 52,
Version N.
CHAIR MINA asked if providers currently have the ability to
restrict the number of calls made by a psychiatric patient.
3:53:49 PM
MR. NAVE responded that facilities can put some limits on access
to communication.
3:54:21 PM
REPRESENTATIVE FIELDS agreed that language regarding limits on
communication should be amended.
3:54:33 PM
REPRESENTATIVE GRAY said that he disagrees and said that
children in psychiatric hospitals should not have unlimited
access to phone calls.
3:55:17 PM
CHAIR MINA said that if facilities can already restrict access
to communication, the proposed legislation would not need to
further restrict access.
3:56:00 PM
REPRESENTATIVE FIELDS said that existing language in Version N
could be misconstrued and further limit access to communication.
3:56:33 PM
MR. HULL said that Version N of HB 52 would set a floor, not a
maximum, of communication.
3:57:18 PM
SETH GREEN, MD, Behavioral Health Clinical Supervisor, Aleutian
Pribilof Islands Association, advised that cutting off
communication and connections to home increases loneliness for
children in psychiatric facilities. He said that having access
to communication increases the long-term benefits of psychiatric
treatment. He added that he supports unannounced and unexpected
inspections of psychiatric facilities. He emphasized that
reducing the use of restraint is essential for positive outcomes
of psychiatric treatment.
4:01:03 PM
REPRESENTATIVE PRAX asked if the Aleutian Pribilof Islands
Association provides residential or out-patient care.
DR. GREEN responded that they only provide out-patient care.
4:02:05 PM
REPRESENTATIVE PRAX asked if psychiatric facilities are
currently inspected annually with their license renewals.
MR. NAVE responded that that is correct.
REPRESENTATIVE PRAX asked if that inspection is announced or
unannounced.
MR. NAVE said that it is an unannounced inspection.
REPRESENTATIVE PRAX asked if, under HB 52, Version N, there
would be three unannounced inspections per year.
MR. NAVE responded that is correct.
REPRESENTATIVE PRAX asked if the accrediting agency also
performs inspections and, if so, whether they are unannounced,
as well.
MR. NAVE responded that those inspections are also unannounced.
REPRESENTATIVE PRAX asked if DOH reviews the results of the
accrediting agency's inspections.
MR. NAVE responded that DOH does review the findings.
4:04:28 PM
REPRESENTATIVE GRAY described his experience with unannounced
inspections at the hospital he worked at. He explained that
although inspections were unannounced, they occurred within a
predictable timeline, allowing the hospital to prepare in
advance for the inspection. He asked whether the proposed
legislation should include random unannounced inspections to
prevent this ability to prepare.
MR. NAVE responded that the additional inspections under Version
N would fall outside of the predictable timeline that currently
exists.
4:06:30 PM
CHAIR MINA asked if there are any gaps in data collection
currently being missed that would be included under the reports
required under HB 52, Version N.
MR. HULL responded that the inspections would only inspect the
in-state populations, even though the majority of Alaska
children in psychiatric hospitals are sent to out-of-state
facilities.
4:08:08 PM
MS. SWISHER responded that current reporting captures youth at
both in-state and out-of-state facilities. She said she is
unaware of any gaps in current data reporting.
CHAIR MINA asked if the annual report, under Version N, would
reference the children in out-of-state facilities.
MS. SWISHER responded that the annual report would encompass the
reporting that already exists, regarding both children at in-
state and out-of-state facilities.
CHAIR MINA asked if there is an existing report in DFCS related
to children that are sent out of state.
MS. SWISHER responded that there is an existing quarterly
report.
4:10:18 PM
REPRESENTATIVE GRAY asked what would prevent the state from
doing unannounced visits to out-of-state facilities where Alaska
children are residing.
MR. HULL responded that he is not entirely sure but could help
to find that information.
MS. SWISHER responded that OCS occasionally does perform
unannounced visits to out-of-state facilities, and she is not
sure of any non-budgetary restrictions.
REPRESENTATIVE GRAY asked if Ms. Swisher goes to Utah.
MS. SWISHER responded that OCS does transfer children to out-of-
state facilities when necessary.
4:13:01 PM
REPRESENTATIVE SCHWANKE asked what the benefit would be from
posting annual reports of facilities online.
MR. HULL responded that HB 52 would ensure transparency as well
as the anonymity of the patients.
REPRESENTATIVE SCHWANKE expressed concern regarding publishing
the full report online.
4:15:38 PM
MR. HULL responded that psychiatric facilities have increasingly
used medications improperly and that the state needs to protect
children from this abuse. He said that full transparency is
essential in this endeavor.
4:17:09 PM
REPRESENTATIVE RUFFRIDGE asked who is responsible for the
deficiencies found in these facilities. He asked about
accreditation agencies' responsibility.
MR. HULL responded that he would love to see more federal
oversight of these facilities. He said that many states are
increasing protections for the children in their psychiatric
facilities.
MR. NAVE responded there are multiple layers of oversight and
jurisdiction over these facilities. He said that each layer has
different jurisdiction and different focuses.
4:21:03 PM
REPRESENTATIVE PRAX said that he is concerned about over-
reporting.
MR. NAVE responded that the State of Alaska has a very broad
definition of restraint, which he does not want to further
restrict. He said that he would rather see more than less
reporting.
REPRESENTATIVE PRAX asked if there are any Health Insurance
Portability and Accountability Act (HIPAA) restrictions to be
concerned about when reporting.
MR. NAVE responded that any reports published online would be
de-identified.
REPRESENTATIVE PRAX asked if there is a problem with reporting
to the state if a child is not in the custody of the state.
MR. NAVE answered that that would not be a HIPAA violation.
4:24:47 PM
REPRESENTATIVE GRAY named some of the main drugs used as
restraints in psychiatric facilities and expressed his concerns
regarding the more addictive substances. He said he wants to
know if addictive substances are being used as restraints when
there are other options for restraint.
REPRESENTATIVE SCHWANKE responded that she does not question the
need for the report, especially to families and to the
legislature. She said she wonders if publishing the report
online would create more problems and questions for DOH.
4:27:45 PM
REPRESENTATIVE PRAX considered whether the House Health and
Social Services Standing Committee should be required to read
the report.
[HB 52, Version N, was held over.]