Legislature(2001 - 2002)
05/06/2001 01:45 PM Senate JUD
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 115-EMERGENCY COMMITMENT ORDERS AND TREATMENT
SENATOR DONNY OLSON, cross sponsor for HB 115, testified that the
problems associated with alcohol abuse in Alaska are well
documented and this bill would make it possible for mid-level
practitioners, advanced nurse practitioners and physician
assistants (PA) in particular, to have the opportunity to commit
those who chronically abuse the use of alcohol to a treatment
facility.
When an intoxicated individual must be transported great
distances to reach a hospital for examination by a physician
before they can be admitted to a treatment program, enough time
may have passed that the alcohol in their blood stream may have
metabolized to the point that they do not look or act drunk and
their blood alcohol level may be within acceptable limits. When
this happens, individuals who may be in need of treatment might
be turned away. HB 115 allows the first responders to admit
intoxicated individuals to treatment programs.
CHAIRMAN TAYLOR said he had received some criticism of the bill
stemming from the concern that mid level practitioners may not
have the training, experience and background to make the
necessary diagnosis for commitment.
Number 304
SENATOR OLSON responded that the concern is valid for those just
out of training but he personally knows of many mid lever
practitioners, both physician assistants and nurse practitioners,
who are as capable as and show better judgment than rookie
medical doctors. Because physician assistants have collaborative
agreements with medical doctors and any questionable decisions
reflect on that doctor, such agreements would not be formed if
the doctor did not have confidence in that health care provider.
CHAIRMAN TAYLOR then asked whether the bill had been modified in
other committees.
SENATOR OLSON responded that the original bill allowed additional
types of health care providers to make commitment decisions.
CHAIRMAN TAYLOR asked whether emergency medical technicians (EMT)
were included originally.
SENATOR OLSON acknowledged that EMTs and marriage counselors were
originally included and now the bill is limited to physician
assistants and nurse practitioners.
SENATOR THERRIAULT asked if a judge makes the final decision
after the written application for admission is made.
SENATOR OLSON said that was correct. Even a physician needs
judicial agreement in cases of involuntary commitment. As a past
member of the medical board, he knows that physician assistants
who have recently finished school are not sent to rural Alaska
immediately. Physician assistants are better trained than in
previous years and are well controlled.
Number 609
ANGELA TILLERY testified via teleconference from Anchorage that
she is opposed to involuntary commitment for any reason. Her
beliefs are based on two separate cases that she went on to
explain.
CHAIRMAN TAYLOR told the witness this bill is for involuntary
commitment for intoxicated individuals and her case models were
not applicable to the legislation.
MS. TILLERY said she understood that but she is opposed to
involuntary commitment for any reason. The court or family should
make the decision.
CHAIRMAN TAYLOR reminded her that the courts make the final
decision in any case.
KATHLEEN WEDERMEYER, first stated that there should be more
opportunity for public testimony. She thought the bill was still
worded too generally. It allows PAs and nurse practitioners to
sign off on commitment forms in urban areas where there is no
shortage of medical doctors who could make the decision. Although
supposedly intended for use in rural areas, this is stated
nowhere in the bill.
Next she questioned whether there would be a judge available in a
village that didn't even have a doctor. In her opinion, an
advanced nurse practitioner or physician assistant should never
have the authority to sign 30 day commitment forms.
CHAIRMAN TAYLOR replied that commitments are not made without a
court hearing.
MS. WEDERMEYER responded that that is only for 30 day
commitments. For 48 hour to 10 day commitments there is no
hearing. Short term commitment papers are "rubber stamped"; a
judge's signature is obtained via fax or over the telephone.
TOM SWANSON testified against HB 115 for the same reasons as
those stated above. He wanted the steps for involuntary
commitment outlined and asked whether the individual had any
rights at all once they were committed.
CHAIRMAN TAYLOR said his concerns are addressed in current Alaska
law. The conditions for commitment are carefully thought out and
have met constitutional challenge. This legislation simply
changes who may sign the initial application.
SENATOR THERRIAULT asked whether the court is involved in any
commitment.
CHAIRMAN TAYLOR explained that the court is not involved on an
emergency basis.
SENATOR OLSON disagreed with the accuracy of some of the previous
testimony. He said that there are 72 hour holds that may be
placed but a judge must agree. In his rural medical experience,
there was not enough time to deal with intoxicated individuals
when they were in an intoxicated state in addition to other
emergencies.
CHAIRMAN TAYLOR called for further testimony and received no
response. He asked for the pleasure of the committee.
SENATOR COWDERY moved SCS CSHB 115 (HES) from committee with
individual recommendations.
There being no objection, SCS CSHB 115 (HES) moved from committee
with individual recommendations.
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