Legislature(2023 - 2024)DAVIS 106
03/14/2023 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB89 | |
| HB80 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 89 | TELECONFERENCED | |
| *+ | HB 80 | TELECONFERENCED | |
| += | HB 60 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 14, 2023
3:01 p.m.
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Dan Saddler
Representative Jesse Sumner
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 89
"An Act relating to the day care assistance program and the
child care grant program; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 80
"An Act relating to competency to stand trial; relating to
commitment based on a finding of incompetency; relating to
administration of psychotropic medication; and relating to
victims' rights during certain civil commitment proceedings."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 89
SHORT TITLE: DAY CARE ASSIST./CHILD CARE GRANT PROGRAM
SPONSOR(s): REPRESENTATIVE(s) COULOMBE
02/27/23 (H) READ THE FIRST TIME - REFERRALS
02/27/23 (H) HSS, FIN
03/14/23 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 80
SHORT TITLE: INCOMPETENCY; CIVIL COMMITMENT
SPONSOR(s): REPRESENTATIVE(s) JOSEPHSON
02/22/23 (H) READ THE FIRST TIME - REFERRALS
02/22/23 (H) HSS, STA, JUD
03/14/23 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
REPRESENTATIVE JULIE COULOMBE
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, offered an introduction
to HB 89.
DANIEL ROBBINS, Staff
Representative Julie Coulombe
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: On behalf of the prime sponsor,
Representative Coulombe, gave a PowerPoint presentation and
sectional analysis on HB 89.
BLUE SHIBLER, Executive Director
Southeast Alaska Association of the Education of Young Children
Juneau, Alaska
POSITION STATEMENT: Provided invited testimony in support of HB
89.
JEN GRIFFIS, Public Policy Manager
thread
Anchorage, Alaska
POSITION STATEMENT: Provided invited testimony in support of HB
89.
HEATHER CARPENTER, Health Care Policy Advisor
Office of the Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
89.
REPRESENTATIVE ANDY JOSEPHSON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented HB 80.
ALEXANDER SCHROEDER, Staff
Representative Andy Josephson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: On behalf of Representative Josephson,
prime sponsor, offered a PowerPoint presentation, gave a
sectional analysis, and answered questions on HB 80.
ANGELA HARRIS, representing self
Anchorage, Alaska
POSITION STATEMENT: Provided invited testimony during the
hearing on HB 80.
NANCY MEADE, General Counsel
Administrative Staff
Office of the Administrative Director
Alaska Court System
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
80.
ACTION NARRATIVE
3:01:23 PM
CHAIR MIKE PRAX called the House Health and Social Services
Standing Committee meeting to order at 3:01 p.m.
Representatives Mina, Saddler, McCormick, Ruffridge, Sumner,
Fields, and Prax were present at the call to order.
HB 89-DAY CARE ASSIST./CHILD CARE GRANT PROGRAM
3:03:13 PM
CHAIR PRAX announced that the first order of business would be
HOUSE BILL NO. 89, "An Act relating to the day care assistance
program and the child care grant program; and providing for an
effective date."
3:03:40 PM
REPRESENTATIVE JULIE COULOMBE, Alaska State Legislature, as
prime sponsor, gave a brief introduction to HB 89. She stated
that there are two ways HB 89 would strengthen the child care
system. It would expand the number of families who can afford
child care by making subsidies more inclusive, and it would
align the subsidy level to reflect the actual cost of care.
After meeting with state departments and trade organizations,
she expressed the understanding that the hiring crisis is
contributing to the unavailability of daycare, but there are
many other factors, including the billing requirements on
daycare centers. The result of this is the cost of care is not
covered, and daycare centers are going out of business. She
added that the COVID-19 pandemic contributed to this. She
stated that while other solutions exist, HB 89 would address the
accessibility problem. The proposed legislation would do this
by increasing the number of families who could access the
vouchers and the number of vouchers available. Connected to
this, she said, there is a study which would investigate the
actual cost of care, not the current market's cost. She stated
that she would put forth an amendment to cover the cost of the
study.
3:07:18 PM
DANIEL ROBBINS, Staff, Representative Julie Coulombe, Alaska
State Legislature, on behalf of the prime sponsor,
Representative Coulombe, presented a PowerPoint on HB 89 [hard
copy included in the committee packet]. He began on slide 2 and
stated that the proposed legislation would address the lack of
affordable quality child care in the state, which has
contributed to the following: labor shortages, endangerment of
children, economic insecurity of families, and the decrease in
workforce participation. He pointed out the proposed
legislation would strengthen the child care sector by improving
access for families, which in turn would send parents back into
the workforce, as seen on slide 3. In reference to the next
slide, he said, HB 89 would align the subsidy level to reflect
the actual cost of care, which would strengthen the child care
system by expanding the number of families who could utilize
daycare vouchers. He pointed out on slide 5 that the child care
crisis is a result of low wages, labor shortages, and declining
numbers of child care providers. He continued that the decrease
in labor force participation equates to worker shortages, as
seen in the graph on slide 6. The graph relates that Alaska's
child care workforce decreased 20 percent between 2018 and 2020.
MR. ROBBINS pointed to slide 7 which related that child care
subsidies are inadequate and do not reflect the actual cost of
care. He explained that providers lose money when they offer
care to low-income families on subsidies; however, this does not
affect only low-income families. To compensate, providers raise
rates, affecting middle-class families who are ineligible for
subsidies. In turn, many middle-class families cannot afford
child care; therefore, a parent would need to stay home to care
for children. He moved to slide 8 which addressed the
eligibility for subsidies. He stated that the threshold to
receive subsidies for one earner is 85 percent of the state
median income, or $60,144. He noted that the federal poverty
line in Alaska for a two-person household is $24,640, which
means the current eligibility threshold is 244 percent of the
federal poverty line. He reasoned that this leaves most of the
middle class without affordable care, which results in severe
labor shortages across the state. The proposed legislation
would raise the eligibility threshold to 300 percent of the
federal poverty line, or $73,920. He stated that the level of
subsidy would be scaled by the Department of Health (DOH) based
on need. He stated that the result would be an expanded number
of families who could afford care, and this would allow more
Alaskans to reenter the workforce.
3:11:10 PM
MR. ROBBINS, continuing to slide 9, pointed out the subsidy for
child care is currently based on a market rate survey. He
stated that this underestimates the cost of care, which puts
providers at financial risk. He explained that because of
inadequate subsidies for low-income families, providers are
forced to raise rates, pricing some families out of child care.
He stated that the proposed legislation would align subsidy
rates with the actual cost of care, improving financial
stability for providers and affordability for middle-class
families. He expressed the opinion that a family with a
household income of $60,000 per year should not spend more than
$4,200 per year on child care costs. He compared this with
$6,600 per year now being spent. Referring to slide 11, he
pointed out that parents are moving to part time employment or
leaving work altogether. In other words, child care issues
affect parents' employment. He pointed out on slide 12 a case
study in Missouri where the state has introduced new programs
with tax credits which would go directly to employers and the
child care industry.
MR. ROBBINS moved to slide 13, pointing out the case study in
North Dakota which looks at a solution to the child care issue
by addressing affordability, availability, and quality. He said
North Dakota has already spent over $70 million on the program.
Recapping the solution in the proposed legislation, he said the
number of families who are eligible for child care subsidies
under the Child Care Assistance Program (CCAP) would be
expanded, making child care more affordable, which would help
parents return to the workforce.
3:14:19 PM
MR. ROBBINS proceeded to the sectional analysis on HB 89 [copy
included in the committee packet], which read as follows
[original punctuation provided]:
Section 1: Amends AS 47.25.001(a)[2] to increase the
maximum income threshold for state subsidies for child
care to 300% of federal poverty line for the state.
Section 2: Amends AS 47.25.071(c) to calculate the
true cost of providing child care in the state of
Alaska, and allows the grant program to fund
disbursements to beneficiaries at that amount.
Section 3: Adds a new section to make a conforming
change to the federal reporting provisions for the
child care assistance program.
Section 4: This is a conditional clause that gives the
United States Department of Health and Human Services
the authority to approve additional amendments to the
state plan for day care assistance or determine that
those amendments are not necessary.
Section 5: This is an effective date clause setting
the effective date on the day after the date the
United States Department of Health and Human Services
approves the corresponding amendment to the state plan
or determines that approval is not necessary.
3:16:14 PM
BLUE SHIBLER, Executive Director, Southeast Alaska Association
of the Education of Young Children (AEYC), expressed gratitude
for HB 89 and offered her support. She shared that AEYC is a
nonprofit organization which provides child care referral
services throughout Southeast Alaska. She shared that she is a
former owner of a child care center. She stated that throughout
her career she has engaged with families and watched parents
struggle to afford child care. The families who receive child
care assistance often cannot afford to pay the difference
between the subsidy and the actual tuition fee. She expressed
the belief that the proposed legislation would help close this
gap and allow more families access to quality child care in
Alaska. She expressed the concern that wages for child care
workers should also be addressed, otherwise the state is
expanding access to a system which is "about to crumble." In
addition to being the director of AEYC, she stated that she also
represents a coalition of healthcare providers and parents. She
stated that this group has recommended the funds from CCAP be
used directly for wage stipends. She expressed the opinion that
increasing access to child care for families should be done at
the same time as increasing pay for child care providers.
3:19:18 PM
JEN GRIFFIS, Public Policy Manager, thread, voiced support for
HB 89. She stated that thread is a statewide nonprofit which
provides professional development for child care providers,
supports programs, and helps connect parents to resources. She
stated that finding affordable child care is becoming more
difficult because early educators are leaving the workforce and
child care programs are closing. She expressed the opinion that
the unavailability of child care is having an impact on the
workforce and economy. She stated that historically the gap
between availability and need for child care in Alaska has been
around 25 percent. Various programs and communities have
reported declines in enrolment capacity to 40-60 percent, and
this is attributed to workforce shortages in child care. She
stated that federal stabilization funds provided during the
COVID-19 pandemic helped support child care providers, but the
third and final phase of funds have just been distributed. Data
on the impact of the second phase of funds has been gathered and
will be shared within the coming weeks. The preliminary
analysis of the data demonstrates that the $50 million in
stabilization funds, which went directly to child care providers
and programs, helped keep some businesses open.
MS. GRIFFIS continued that thread is advocating for direct
support to early educators and child care programs in the
upcoming fiscal year, but she argued that a more stable child
care sector would require a shift in current assistance program
policies. She stated that the proposed legislation would change
the eligibility for CCAP, allowing more families to participate,
and it would change how provider reimbursements are determined,
providing for a more stable child care system.
MS. GRIFFIS stated that while thread supports the intentions
behind HB 89, it has three recommendations to strengthen the
proposed legislation. The first suggested recommendation would
be to require the usage of the state's median income, as opposed
to the federal poverty limit, in any eligibility changes to the
CCAP. She said this consistency would help with program
continuity. Per thread's second recommendation, she said, the
cost-of-care language should be located in the portion of the
statute which impacts the entire assistance program, not just
the Child Care Grant Program. The final recommendation would be
to include cost-of-care language in the reimbursement
determination modeling, but it should not be the exclusive
measure. She indicated that other states use a multifactor
analysis, including cost of care and other relevant geographical
and market rate factors. She concluded that thread would
advocate for policies which reduce child care costs for parents
and increase support for child care providers.
3:24:42 PM
MS. GRIFFIS, in response to Representative Saddler, repeated
thread's second recommendation. In response to a follow-up
question, she stated that child care assistance is the
reimbursement given to child care providers who serve families
participating in CCAP, while the Child Care Grant Program
provides direct support to child care providers.
3:25:55 PM
MS. GRIFFIS, in response to Representative Mina, voiced that the
factors in a cost-of-care analysis can vary for different
states. She reiterated that factors could include the
geography, market rate, and actual cost of care. In response to
a follow-up question, she stated that the current market rates
would need to be considered in the context of the different
communities.
3:27:11 PM
REPRESENTATIVE SUMNER pointed out the hard cap of 300 percent of
the poverty line and questioned whether a phase out could be
used instead. He surmised that a hard cap could create a
situation where an incremental wage increase could have a
negative value for those needing assistance for child care.
3:28:14 PM
REPRESENTATIVE COULOMBE responded that [a phase out] was
discussed and considered. She stated that the proposed
legislation is a working document and expressed appreciation for
the input from testifiers. She deferred the question to DOH.
3:29:08 PM
HEATHER CARPENTER, Health Care Policy Advisor, Office of the
Commissioner, Department of Health, concerning HB 89, stated
that participants in public assistance programs could be
disincentivized to advance in the workplace by a "fiscal cliff."
She stated that the legislature would ultimately decide which
policy levers could be used to help families. She reminded the
committee that the programs under consideration are [the Child
Care Grant Program and CCAP]. She stated that the Child Care
Grant Program pays providers directly for costs to "keep their
doors open and hire staff," and CCAP is a subsidy paid by the
state to help families directly with monthly child care fees.
Because the federal government does not allow the fee to be
completely waived, every parent has a copay, and if wages go up,
the copay will increase. She suggested that raising the
eligibility standards to 300 percent of the federal poverty
level, as the legislation proposes, would help families.
Whether eligibility is based on the state median income or
federal poverty levels, the state would pay on both; however,
she advised "it would sure be easier if they were all on one."
Ms. Carpenter said other policy levers would include reducing
family copays and raising reimbursement rates paid directly to
providers. She explained that the rate is set currently by a
market survey, which is set by the federal government, and this
methodology has to be followed. She advised that the federal
government would have to give permission for this to be changed.
3:32:40 PM
REPRESENTATIVE RUFFRIDGE expressed the appreciation that the
proposed legislation is a working document. He referenced the
presentation and questioned the statement on slide 8 which
conveyed that DOH would scale the subsidy levels based on need.
He commented that DOH is doing this now through copays. He
questioned whether this would stay the same under HB 89.
MS. CARPENTER responded that the question partly addresses the
reason the fiscal note is indeterminate for the proposed
legislation. She said DOH is waiting for direction from the
legislature before reducing the current scale. She explained
that currently an individual earning up to 85 percent of the
state's median income has to pay a 9 percent copay. She
suggested that DOH could continue on this scale, or the proposed
legislation could make a change. She added that any change to
this would require a regulation change.
REPRESENTATIVE RUFFRIDGE referenced the proposed legislation's
current form and, for clarification, stated that as a person's
earnings nears the threshold of $64,144, the maximum copay would
be 9 percent, unless something is changed.
MS. CARPENTER responded that DOH would like guidance on this
issue.
3:35:14 PM
REPRESENTATIVE FIELDS offered his support for the proposed
legislation. He questioned whether language addressing the
wages [for care providers] should be added, as it would address
the stability of the workforce in addition to access [to child
care].
MS. CARPENTER responded that this would "get tricky." She
stated that the department would pay child care assistance to
private providers, but it could not direct how the money is
spent. The assumption is, if providers are paid more, they
would increase pay rates, but this is not a guarantee.
3:36:35 PM
REPRESENTATIVE SADDLER questioned the definitions of child care,
Head Start, and preschool. He also questioned the definition of
"high-quality child care."
3:37:27 PM
MS. GRIFFIS responded that to build kindergarten-readiness
skills for children under the age of five, the settings in
Alaska would be licensed child care programs, Head Start, and
pre-kindergarten. She stated that licensed child care falls
under DOH, while Head Start and pre-kindergarten fall under the
Department of Education and Early Development. These components
together form the system. In response to a follow-up question,
she explained that Head Start is a federally funded program.
She stated that she could provide specific information on the
program [after the hearing]. She stated that pre-kindergarten
in Alaska is publicly funded education through the school
districts. She continued that licensed child care is outside of
the other two settings. The licensing would be done through the
state, but the setting would have more flexibility. For
example, pre-kindergarten would occur during school hours for
half a day, with the summers off, and this does not always fit
with a family's schedule. She explained that, because needs are
different, thread advocates for a mixed delivery system to make
sure a variety of options are available.
REPRESENTATIVE SADDLER confirmed that [licensed] child care
would be characterized by flexibility in hours. He questioned
whether an educational element of child care exists.
MS. GRIFFIS responded that high-quality child care centers would
have elements of pre-kindergarten and Head Start. The
distinction for high-quality child care is the licensure,
regulations, and funding. She stated that high-quality child
care programs would have the same type of education and
structure as pre-kindergarten.
REPRESENTATIVE SADDLER expressed the understanding that "high
quality" does not imply a difference in quality; it simply is a
matter of how the center is regulated, funded, and licensed. He
questioned whether low-quality child care exists.
MS. GRIFFIS responded that unlicensed child care would be
considered low quality. In regard to affordability,
accessibility, and quality, she said the desire is to have
affordable access to high-quality child care. She offered to
follow up with more information on Alaska's Quality Recognition
and Improvement System (QRIS). She said the rating system has
five levels, with defined quality measures for each level, and
QRIS training, support, and assistance is available for
programs.
3:43:54 PM
REPRESENTATIVE FIELDS commented that some states pay for
quality. He voiced the opinion that the legislature could
support the department by making direct payments or
reimbursements to providers who achieve higher levels of
training and certification.
3:44:33 PM
REPRESENTATIVE RUFFRIDGE commented that the proposed legislation
addresses recalculating the actual cost of child care. He
expressed the assumption that this would entail a study and
questioned the timeframe for this type of study.
MS. CARPENTER responded that the department intends to do a
market rate survey alongside a cost-of-care survey, with an
added actuarial study. She stated that the department is
starting the procurement process in order to have information
for the next legislative session.
3:45:42 PM
MS. CARPENTER, in response to Chair Prax, offered to provide
details in writing on the studies. She added that some of the
COVID-19 relief money can be used for the studies. In response
to a follow-up question, she expressed the hope that the plan
would be before the committee by the end of the week.
3:47:10 PM
REPRESENTATIVE SADDLER, referencing the presentation, sited that
the number of child care workers has decreased by 20 percent
since 2018. He questioned whether this reduction corresponds to
the same rate of decline in the total workforce in the state.
MS. CARPENTER responded that the department does not have this
data. She stated that DOH has been working with the Department
of Labor and Workforce Development (DLWD) on demographics
concerning who could be served by the proposed legislation. She
stated that the answer would come best from DLWD.
3:48:20 PM
CHAIR PRAX announced that HB 89 was held over.
3:48:41 PM
The committee took an at-ease from 3:48 p.m. to 3:54 p.m.
HB 80-INCOMPETENCY; CIVIL COMMITMENT
[Contains discussion of SB 53.]
3:54:31 PM
CHAIR PRAX announced that the final order of business would be
HOUSE BILL NO. 80, "An Act relating to competency to stand
trial; relating to commitment based on a finding of
incompetency; relating to administration of psychotropic
medication; and relating to victims' rights during certain civil
commitment proceedings."
3:55:42 PM
REPRESENTATIVE ANDY JOSEPHSON, Alaska State Legislature, as
prime sponsor, introduced HB 80. He stated the proposed
legislation is concerned with criminal sentencing and competency
in Title 12 and the health section in Title 47 of the Alaska
statutes. He stated that the proposed legislation could have a
large effect on the Department of Family and Community Services
(DFCS). He shared that the bill had been conceived 13 months
ago after Angela Harris had been randomly stabbed and left
paralyzed. He stated that Ms. Harris has testified twice during
the hearing on [SB 53], which is sponsored by Senator Claman.
He continued that the proposed legislation would not address
crimes in regard to the human conditions of passion, motivation,
and jealousy; rather, it would address the type of criminality
unexplainable in motivation, with the perpetrator lacking the
sanity to stand trial. He explained that it was found in Ms.
Harris's case that Corey Ahkivgak, the perpetrator, had
extensive red flags and had committed multiple previous random
attacks, one being two months prior. He expressed the
understanding that mentally ill individuals, on the whole, are
not violent, and the proposed legislation would be targeting the
illness of psychosis. He expressed the opinion that the state
is doing an inadequate job of protecting the public in this
regard.
4:03:35 PM
REPRESENTATIVE JOSEPHSON explained the current court process
concerning a charged individual. If a mental evaluation is
needed, and the defendant is not rational, under the current law
for a felony, the court "shall" order a commitment up to 90
days, and for a misdemeanor it "may" order a commitment up to 90
days. He stated that during the commitment period the Alaska
Psychiatric Institute (API) would attempt to restore the person
to sanity. As an aside, he identified a series of reports which
relate that Alaska has been underfunding the effort to help
[mentally unstable] individuals. He cited that in its report,
the University of Nevada Las Vegas (UNLV) advised that the
implementation of recommendations would require significant
resource allocation. He suggested to the committee that the
financials be put aside, to first decide the fix and address the
cost, and then determine the state's investment.
REPRESENTATIVE JOSEPHSON, continuing the discussion of the
current law, expressed the understanding that individuals in
Alaska who have been committed for the 90-day period are not
receiving effective treatment. He explained that after the 90-
day period, the matter would come back to the courts if the
individual were not restored. He stated that the court has
discretion for a violent felony committed against another
person, and under the current law an individual can be held for
up to a year. He stated that research has found this to be "the
low end" in respect to the rest of the country, as some states
have no time limits on commitment. He stated that the proposed
legislation, along with [SB 53], would change this to a two-year
limit, giving a more reasonable window to restore an individual
to competency. He expressed the understanding that the proposed
two-year limit has raised questions about civil liberties,
resources, and further delay. He explained that, before the
court would extend the restoration timeframe, the following
would be addressed: whether the crime had involved force
against a person; whether releasing the individual would be
dangerous to other people; and the probability the individual
would regain competency within a reasonable period of time. If
an individual is not restored to competency, he said, the key
problem would be the next step.
4:09:27 PM
REPRESENTATIVE JOSEPHSON pointed out that a bill passed in 2008
requires incompetent individuals with a court dismissal to move
into Title 47, the civil commitment stage. He referred to AS
12.47.110, which read as follows:
(e) A defendant charged with a felony and found
to be incompetent to proceed under this section is
rebuttably presumed to be mentally ill and to present
a likelihood of serious harm to self or others in
proceedings under AS 47.30.700 - 47.30.915. In
evaluating whether a defendant is likely to cause
serious harm, the court may consider as recent
behavior the conduct with which the defendant was
originally charged.
REPRESENTATIVE JOSEPHSON argued that the problem with this law
is it does not say what to do next. He explained that the case
would be dismissed if a person is declared unfit for trial. To
stand trial, a person would have to understand the charge and be
capable of helping with his/her own defense. Not being able to
do this would violate the person's due process rights. He
stated that a gap in the law is created because "there is no one
that steps up to the plate after the case is dismissed." He
said under Title 47 anyone can file a petition to commit another
person, but no state agencies are obligated to file the
petition. He explained that the proposed legislation would
appoint the Department of Law (DOL) to report to DFCS when an
individual's case is dismissed, and a three-day window would be
given for the petition to be filed. He advised that a "buck
stops here moment" should exist. He expressed the opinion that
the current law is both overinclusive and underinclusive. He
continued that, under the current law, when a person is deemed
incompetent but not a threat to the public, the judge still
could send the individual to be restored. He stated that this
would be considered overinclusive. He stated that the law is
underinclusive because a judge is not required to commit a
person for some of the "red flag" misdemeanors.
4:14:15 PM
REPRESENTATIVE JOSEPHSON offered a comparison of [SB 53] and HB
80 and stated the current versions line up. He suggested that
[SB 53] is tougher on involuntary commitment and expressed
concern about its efforts regarding out-patient restoration.
Instead, he suggested that a system needs to seamlessly retain
the individual. He stated that the current law contains mixed
issues. The law says these proceedings will be "stayed" during
the effort to restore competency. He surmised that this means
the individual cannot meet bail; however, he explained there is
a constitutional right to bail, so the issue becomes mixed. He
voiced the opinion that a chain of custody should exist until
the individual has been treated and can be released.
4:16:26 PM
REPRESENTATIVE JOSEPHSON, in summary, stated that HB 80 would:
extend the period a person is held for treatment from one year
to two years; require DFCS to be informed of the need to file a
petition; allow the victim to have the right to track the
criminal case and the civil commitment proceedings; codify Sell
v. United States 539 U.S. 166 (2003); change the statute of
limitations from 5 years to 10 years for certain cases; allow
telephonic examinations to determine competency; and make better
distinctions between less severe cases and violent cases.
4:19:43 PM
REPRESENTATIVE SADDLER questioned whether competency to stand
trial would equate to sanity.
REPRESENTATIVE JOSEPHSON responded in the negative. He stated
that he has incorrectly interchanged some terms. He clarified
that if someone is not sane, he/she may be insane; however, "not
guilty by reason of insanity" is seldom used. He stated that
"competency" would mean someone who could help with his/her
trial.
REPRESENTATIVE SADDLER confirmed that "competence" would be a
person's ability to meaningfully participate in his/her own
defense. He suggested that "restoration to sanity" would
presume that a level of sanity could be restored. He questioned
the establishment of a baseline and whether an individual would
be restored to "competency" or "sanity."
REPRESENTATIVE JOSEPHSON expressed the opinion that the
individual would be restored to competency.
4:22:22 PM
ALEXANDER SCHROEDER, Staff, Representative Andy Josephson,
Alaska State Legislature, on behalf of Representative Josephson,
prime sponsor of HB 80, in response to Representative Saddler's
question, explained that someone could pursue a plea of "not
guilty by reason of insanity" and still be competent for trial.
He further explained that one deals with the moment of the
crime, while the other deals with the moment of participating in
the trial.
4:22:52 PM
REPRESENTATIVE FIELDS thanked the sponsor for introducing the
proposed legislation. Concerning a psychotic person who cannot
be restored to competency to stand trial, he questioned the
process of supervising these people, so the public is not
endangered. He questioned whether the proposed legislation
would address this.
REPRESENTATIVE JOSEPHSON responded that the proposed legislation
would require DOL to notify DFCS when a person who was not
restored to competency is released. He reiterated that a
petition would need to be filed within three days to retain the
person. In response to a follow-up question, he stated there is
a mechanism in the proposed legislation which would detain the
individual at API, and this process would be seamless. He
expressed uncertainty concerning the state's current handling of
individuals who cannot be restored. He added that 9 years ago a
UNLV report indicated API had 10 beds but needed 35 beds. He
continued that UNLV issued another report which estimated the
capital costs for API to address this.
REPRESENTATIVE FIELDS offered the opinion that the state should
be able to administer psychotropic drugs involuntarily to
dangerous people. He questioned whether people would be
monitored after they are medicated and released.
REPRESENTATIVE JOSEPHSON stated that probation officers would do
this type of thing concerning Title 12, not Title 47. He stated
that many people are brought to competency, so there is a
winnowing out. He expressed uncertainty concerning whether the
state would currently follow up on a released individual who has
been medicated.
4:27:11 PM
REPRESENTATIVE SUMNER, per the proposed legislation, questioned
the purpose of having DFCS file the civil commitment instead of
DOL. He expressed concern over DFCS's 60-percent turnover rate
and questioned whether, from a personnel stance, DFCS would
"drop the ball."
REPRESENTATIVE JOSEPHSON responded that agency turnover is
unknown, as DOL had significant turnover last year. He stated
that DOL participates in the dismissal cases in the courtroom,
and the files with the evaluations would be at API, [which is a
part of DFCS.] When an individual is not restored and he/she is
an imminent threat to public safety, he said, DFCS would contact
the Civil Division of DOL to ask for a petition to commit.
4:29:05 PM
REPRESENTATIVE RUFFRIDGE expressed concern about using the word
"seamless" when describing a government process. In reference
to the process of deeming a person incompetent after two years,
he questioned how this would become a civil issue. He expressed
the opinion that the process crosses a boundary, as the
criminality which had occurred was not addressed.
REPRESENTATIVE JOSEPHSON responded that it has become a civil
issue because "there's no other place to go," and the case can
be brought back in the future if the person is restored to
competency. He continued that the tool exists now to civilly
commit people under Title 47. He asserted that the proposed
legislation would assign an agency to be responsible for this
instead of "letting it languish and we watch the next event
happen."
REPRESENTATIVE RUFFRIDGE expressed the opinion that under a
civil commitment an individual would end up in a less structured
environment. He expressed the understanding that guilt cannot
be assigned to an individual who cannot stand trial and
suggested that at the end of two years the individual would
become "not guilty by reason of insanity." He reasoned that
there should be a place for these individuals - a third option
which would be a more secure commitment - not 30 years inside of
API's general population.
REPRESENTATIVE JOSEPHSON responded that the use of "not guilty
by reason of insanity" is unfavored in Alaska. He explained
that when a criminal case is dismissed, API becomes involved.
At this point, the person would be considered simply "not
guilty." From here the case is dismissed without prejudice, and
the person is simply allowed to go. He referred to the initial
involuntary commitment procedures in AS 47.37.100. He stated
that, per these procedures, a screening investigation would be
done of the individual by a local mental health professional.
Within 48 hours after the screening the judge may issue an order
indicating the person is believed to be mentally ill. This
would require the individual to be gravely disabled or present a
likelihood of serious harm to self or others. He explained that
this is the present system; however, the question of
responsibility is unanswered.
4:34:31 PM
ANGELA HARRIS, representing self, began her invited testimony by
recounting the story of her attack. She shared that she had
been stabbed on February 13, 2022, while returning books to the
library. She shared that she and her family have lived in
Alaska since 2005, and she is a mother of four children. She
stated that the assailant, Corey Ahkivgak, severed her spine
with a knife. While she was in surgery he had been captured by
the police. She stated that since the stabbing, she is
paralyzed, her home had to be modified, her parents had to
relocate, and her spouse had to quit his job. After attending
physical therapy for approximately nine months, she is no longer
in recovery. She shared that she sees a counselor to treat the
PTSD [post-traumatic stress disorder] from her assault.
MS. HARRIS stated that Mr. Ahkivgak has a history of assaulting
women, which began in 2018 when he violently attacked his mother
with a frying pan. She stated that in December 2021, he
attacked two different women. After being declared incompetent
and not restorable, he had been released back into the public on
January 6, 2022. She stated that he stabbed her 38 days after
this release, and once again he has been declared incompetent
and not restorable, which means he may be released after his
next commitment proceedings. She argued that the state needs to
improve the mental health system, particularly in reference to
violent offenders. She pointed out the loopholes in the current
laws, adding that the victims should not be left to pursue civil
commitment. She maintained that Mr. Ahkivgak has more resources
at his disposal than she does as a victim, and her assault is an
example of why better health care facilities and laws are
needed. She stated that API serves the entire state, yet it
operates on a very limited capacity, with only 10 beds
designated for restoration. She reasoned that the moment an
offender commits a violent act to a fellow citizen, his/her
rights should be weighed against the victim's rights to safety.
MS. HARRIS stated that the proposed legislation is forcing a
necessary conversation about how the state deals with competency
restoration. She argued that the current wait time for a bed is
inexcusable, especially when violent offenders can be let off
without appropriate restoration treatment. She continued that
the proposed legislation would address one of her primary
concerns - closing the loophole. She explained that HB 80 would
do this by allowing a civil commitment to be filed when a person
has had all charges dropped because he/she is incompetent and
not restorable. She stated that Mr. Ahkivgak should not have
been released to the public, and an involuntary commitment
petition should have been filed. She stated that HB 80 would
address this duty.
4:40:36 PM
REPRESENTATIVE FIELDS thanked the testifier. He compared the
timeframe of her attack with the time it would take for the
number of committee referrals for the proposed legislation. He
expressed concern that the legislation would not reach the floor
in the current year and offered the hope the situation could be
addressed more quickly, as families are at risk every day. He
expressed the understanding that Ms. Harris's perpetrator would
be available for release within the next few months. Deferring
to DOL, he questioned the justice system's current options
concerning the release of manifestly dangerous people.
4:42:01 PM
NANCY MEADE, General Counsel, Administrative Staff, Office of
the Administrative Director, Alaska Court System, explained, if
a person is found incompetent after a number of attempts at
restoration, the current statute requires a criminal case to be
dismissed. This dismissal would include an unlikelihood of
restoration because of a mental condition or an inability to get
into API for restoration. She stated that this statute says the
case "shall" be dismissed, ending the criminal case. In this
situation the proposed legislation would require involuntary
civil commitment proceedings to be filed in three days for an
evaluation. She suggested that serial commitments could result
from the evaluation, as health professionals could file a
petition for a 30-day commitment, a 90-day commitment, and then
a 180-day commitment. If someone is deemed mentally ill and
likely to cause harm to self or others, subsequent 180-day
commitments can be filed. She stated that some individuals are
held under serial 180-day commitments, but this is rare.
4:43:40 PM
REPRESENTATIVE RUFFRIDGE thanked Ms. Harris for the testimony
and expressed the opinion that an apology is owed. He
maintained that a significant breakdown of the process had
happened, and the state should be making progress in order to
make communities safe. He expressed the understanding that
there is not a process for individuals in the state who have
committed a crime but cannot be restored to competency because
of significant mental health issues. In regard to restoring
competency, he questioned whether an individual would be free if
he/she is not restorable.
MS. MEADE responded in the affirmative. She stated that there
is not a place under the current statute for individuals who
fall into this category. The criminal case would get dismissed,
and under current law this would be "the end of it." She stated
that with the proposed legislation at least a civil process
would begin, but an institution for criminally incompetent,
dangerous individuals does not exist. She expressed the
understanding that API can try to restore individuals and hold
them under commitments, but it is not an institution for
criminally incompetent defendants.
REPRESENTATIVE RUFFRIDGE, with a follow-up question, asked
whether all criminally incompetent people, who are not going
through restoration, would be free in public.
MS. MEADE responded that this is not exactly correct. She
stated that individuals found incompetent would remain in jail,
not on bail, during the pretrial phase; however, once they meet
the bail conditions, they could be out. She said if individuals
are violent, there would be conditions to keep them, and some
would be at API. In response to a follow-up question, she
stated that [Mr. Ahkivgak's] restoration process was completed,
and the case was dismissed because he was not restorable. She
stated that someone in this situation could be under a civil
commitment, but another person would need to file the petition.
She stated that the proposed legislation would require that this
be filed.
REPRESENTATIVE RUFFRIDGE questioned whether, under the proposed
legislation, API would be the only place for an individual to be
civilly committed.
MS. MEADE responded that the court system would be able to grant
a petition for a three-day evaluation, and the evaluation could
happen in a number of facilities; however, with a question on
subsequent petitions, she would have to defer to DFCS.
4:49:35 PM
REPRESENTATIVE MINA thanked Ms. Harris for her testimony. She
acknowledged the need to change the "problematic" system. She
voiced the understanding that, under the current statute, once
the clock starts, the individual has one year in the restoration
process. She expressed the assumption that the one year would
include an individual's time on API's waitlist. Once the
individual is in the competency process, she questioned the
average number of days a case would take.
4:51:35 PM
REPRESENTATIVE JOSEPHSON responded that a four-year-old report
by Agnew Beck Consulting, titled "Forensic Psychiatric Hospital
Feasibility Study," found that then the average length of stay
at API had been 75 days, and the 10 beds available had served
around 50 individuals a year. He stated that people had waited
as long as 150 days for a bed. With the initial 75 days, this
would total 225 days. He said, "We are pushing the outer limits
that the law will go." For example, if the crime is a
misdemeanor for a year sentencing, the estimated 225 days could
go towards the sentencing.
4:53:30 PM
REPRESENTATIVE MINA requested a follow up from API with an
updated number.
4:54:26 PM
MR. SCHROEDER presented a PowerPoint on HB 80, titled "An Act
Related to Competency to Stand Trial" [hard copy included in the
committee packet]. He highlighted four key U.S. Supreme Court
cases seen on slide 2, which have historically impacted the area
of law concerning HB 80. He stated that Dusky v. United States
362 U.S. 402 (1960) laid out that a defendant's ability to
assist in his/her legal defense is a due process right. He
stated Jackson v. Indiana 406 U.S. 715 (1972) determined a
defendant who is incompetent to stand trial cannot be held for
competency restoration for an unlimited amount of time. He
added that an exact timeframe had not been determined, and
states vary on this point. He described Alaska as being on the
shorter end of this; however, the state does have flexibility to
change the timeframe. He continued that O'Connor v. Donaldson
422 U.S. 563 (1975) sets down the civil commitment criteria,
which is different than competency criteria. If an individual
is to be involuntarily committed, a civil commitment would
require the person has to be a danger to self or others, or
gravely disabled. He stated that Sell v. United States 539 U.S.
166 (2003) set down the criteria for involuntarily medicating an
individual for the purposes of bringing the individual to
competency to stand trial. He added that this would not be for
treatment or civil commitment, but for exceptional cases where
there is grave danger to the public.
4:58:20 PM
MR. SCHROEDER, referencing the need for the proposed
legislation, moved to slide 5 and recapped the assault on Ms.
Harris. He moved to slide 7 which covered Mr. Ahkivgak's
assaults on two other victims two months prior to the assault on
Ms. Harris. After these two assaults, Mr. Ahkivgak was deemed
incompetent to stand trial, unrestorable, and released. He
pointed out that his erratic behavior is random but predictable,
as it can be traced back to 2009. From researching court
records, he displayed highlights listed on slide 8 from Mr.
Ahkivgak's file. He pointed out that in 2009 Mr. Ahkivgak's
competency had been an issue; however, he had been found to be
competent. Reviewing the incidents on the slide, he stated that
in 2010 Mr. Ahkivgak threatened his mother, and in 2013 he
erratically waived a large hunting knife at a transit center.
After this incident he was found not competent and subsequently
restored. He voiced that competency is fluid, depending on the
individual's state of mind at the time of the crime. He listed
several other examples of Mr. Ahkivgak's erratic behavior,
including Ms. Harris's 2021 assault.
5:01:54 PM
MR. SCHROEDER indicated that slide 9 shows two cases from 2022
where competency issues were raised. The cases involved two
different individuals, both committing violent crimes. He
stated that he is pointing out these instances to reinforce that
the problem is recent, ongoing, and constant in the state. He
moved to slide 10 which addresses Clayton Charlie, the
individual who stabbed and killed Michael Greco, the zookeeper
in Anchorage. He said, since the crime, Mr. Charlie has
received treatment out of state, been declared competent,
returned to Alaska, and been convicted of murder. Moving to
slide 11, he pointed out Mr. Charlie's extensive court file,
which included the diagnosis of paranoid schizophrenia. The
list of Mr. Charlie's assaults includes the threat of murder
against his own family. Mr. Charlie's competency had been
raised multiple times and restored. He pointed out that in
2018, after the murder of Mr. Greco, Mr. Charlie's stepfather
had been quoted in the case file as saying, "Michael Greco's
murder illustrates grave shortcomings in the mental health care
and judicial system's dealing with Clayton's mental illness ....
I have long realized and voiced that I thought someone would die
as a result of his psychosis ...." The case file shows that he
had assaulted someone at API. At that time Mr. Charlie was
charged with assault, found incompetent to stand trial, and
released.
5:04:53 PM
MR. SCHROEDER, moving to slide 12, pointed out the various
recent clippings from news articles concerning the problems at
API. On slide 13 he pointed out that API's average wait time is
almost six months. He noted that [for a misdemeanor charge] the
maximum time someone can spend in restoration is six months. In
other words, he said, restoration could be ordered, but if the
individual could not get into API within a reasonable amount of
time, restoration would be dropped. He stated that slide 14
highlights the seriousness of the issue in the country. In
light of the U.S. Supreme Court cases, he said, the problem is
not unique to Alaska. Lawsuits across the country have been
brought up by advocacy organizations over the wait times, with
the most notable cases being in the State of Washington, as it
has paid out over $86 million from lawsuits.
MR. SCHROEDER continued to the sectional analysis reviewed in
slides 15 to 24. He stated that HB 80 would reduce the
evaluation wait times by expanding evaluation options. The bill
would refine who can do a forensic evaluation, as Section 1 and
Section 2 synchronize the language by adding the adjective
"qualified" in front of "psychologist". He stated that
"qualified" is already listed in front of "psychiatrist", and
these terms would be defined in Section 7. He stated that this
portion of the bill is directly from House Bill 304 [heard
during the Thirty-First Alaska State Legislature]. Referring to
[Section 4] of the bill, he stated that it is specified that
previously conducted evaluations can be used concerning
[misdemeanor cases], and this would speed up the process. He
stated that [Section 5] would allow telephonic evaluations. He
argued that because Alaska is a large state with very few
forensic psychologists, telephonic evaluations would reach more
people. He reasoned that this could possibly allow
psychologists from out of state to do evaluations. He noted
that other sections in the statute allow for teleconferencing.
5:08:56 PM
MR. SCHROEDER moved to slide 19, which addressed Section 4 of
the proposed legislation. In this section dismissal rates would
be reduced by moving from one year to two years for restoration.
He added that this timeframe is still much shorter than most of
the country. He stated that a qualification has been added
which would prevent a person from being in restoration longer
than the sentencing for the crime committed. Additionally, he
said, a two-year restoration period would reflect the type of
crime committed. He continued that the current exception in the
statute of limitations would be removed. He stated that the
force against the person as a barrier to further restoration was
removed; instead, different sets of criteria for restoration
would be included. He continued that in [Section 5] of the
proposed legislation a felony requirement for restoration would
shift to a different set of laws. He expressed the opinion that
some felonies do not deserve to require restoration, while some
misdemeanors do. He stated that Section 6 puts existing case
law and practice into statute by codifying Sell v. United
States.
5:11:28 PM
MR. SCHROEDER, moving to slide 5, stated that HB 80 would create
a seamless process by requiring DFCS to file a civil commitment
upon the dismissal of charges. He added that the legislation
would create a three-day window to allow this to take place. He
continued that [Sections 8, 9, and 10] would give victims access
to commitment proceedings. He shared that Ms. Harris has
requested this provision because she does not know if [Mr.
Ahkivgak] is currently "on the street" or not. In conclusion,
he stated that HB 80 would protect the public and effectively
bring defendants to competency or commitment. He stated that
wait times for defendants to receive treatment would be reduced
as much as possible, with restoration required only for those
with alarming charges, as individuals should not serve time
longer than for the crime they committed.
5:13:18 PM
CHAIR PRAX questioned, "Which is the group that's going to file
all the lawsuits once this bill is passed?"
5:13:37 PM
REPRESENTATIVE JOSEPHSON responded that the group may be the
Disability Law Center. He stated that HB 80 would direct [a
state agency] to commit "dangerous" people, but it would not
delineate the process like SB 53. He suggested this should be
left to the psychologist and expressed the opinion that, because
of this, the Disability Law Center would "like" HB 80 more than
SB 53.
CHAIR PRAX commented that the proposed legislation is difficult,
and the civil rights side would need to be considered ahead of
time.
REPRESENTATIVE JOSEPHSON commented that the current law allows
anyone to petition to have another person civilly committed. He
stated that the proposed legislation would appoint the person
who would oversee the process. He expressed the opinion that
this is not a huge step from the current law.
5:15:23 PM
CHAIR PRAX announced that HB 80 was held over.
5:16:05 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:16 p.m.