Legislature(2021 - 2022)ADAMS 519
04/22/2022 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB172 | |
| SB10 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 172 | TELECONFERENCED | |
| + | SB 10 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE BILL NO. 172
"An Act relating to admission to and detention at a
subacute mental health facility; establishing a
definition for 'subacute mental health facility';
establishing a definition for 'crisis residential
center'; relating to the definitions for 'crisis
stabilization center'; relating to the administration
of psychotropic medication in a crisis situation;
relating to licensed facilities; and providing for an
effective date."
1:35:54 PM
Co-Chair Merrick indicated that the bill was first heard in
committee on April 13, 2022.
HEATHER CARPENTER, HEALTH CARE POLICY ADVISOR, OFFICE OF
THE COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES,
relayed she was available for questions.
1:36:30 PM
Co-Chair Merrick OPENED public testimony.
1:37:02 PM
AT EASE
1:37:15 PM
RECONVENED
ED MERCER, CHIEF OF JUNEAU POLICE, JUNEAU (via
teleconference), supported the legislation. He
characterized the current mental health system as a
revolving door where people in a mental health crisis did
not receive proper help and were returned to the street.
Therefore, police officers spent a lot of time responding
to mental health crises. He related that if a call did not
involve criminal activity the only option was to transport
the individual to a hospital. If the situation did involve
criminal activity, the only option for an officer was to
put a mentally ill person in jail. An officer often
encountered the same people suffering from mental health
issues back out on the street and were forced to deescalate
situations. He indicated that the bill would allow officers
to transport the mentally ill individual to a crisis
stabilization center as an alternative to an arrest. He
believed that the bill would save officers time by
establishing a faster handoff to mental health officials
who would be better equipped to help the individuals. The
legislation would stop the revolving door approach by
granting people a 23 hour and 59 minutes cooling off
period and gave them access to providers trained to help.
He strongly supported the bill and believed it would be
good for the state and the Juneau community when dealing
with citizens suffering from mental illness.
1:40:36 PM
FAITH MYERS, MENTAL HEALTH ADVOCATES, ANCHORAGE (via
teleconference), spoke in support of the bill on the
condition that Representative Rasmussen added an amendment
to the bill requiring statistics on the mentally ill be
kept and shared with the legislature and the general
public. She provided a brief history of mental health in
Alaska. She shared that between 1904 and 1968, many Alaska
Natives were sent to a mental health facility out of state
called Morningside in Oregon and no records were kept or
shared with the state. She indicated that currently,
private psychiatric facilities write the patient grievance
procedures and the appeal process according to AS.
47.30.847. In addition, the patient advocate worked for the
hospital. She communicated that the way the state provided
psychiatric care needed much revision. She supported the
keeping and sharing of psychiatric statistics for patients'
treatment, care, injuries, traumatic events, and
complaints.
1:43:01 PM
LISA GENTEMANN, SELF, EAGLE RIVER (via teleconference),
testified against the bill. She believed the provisions
were open to abuse of power and the bill was
unconstitutional. She provided an example pertaining to her
daughter and son in law living in Fort Benning regarding a
Captain who was admitted to a mental hospital. She opined
that when a person was pulled out of their daily routine it
was destabilizing. She stated that the bill would allow
Alaskans to be detained against their will indefinitely.
She added that the bill would allow patients to be given
psychotropic medications against their will and once
admitted the patient lost all their constitutional rights.
She spoke to the numerous problems in mental health
facilities. She favored amending the bill to include
patient consent. She stated that counseling and medications
should not be forced on people. She asked the committee to
vote against the legislation.
1:45:58 PM
BRENDA MCFARLAND, CITY OF FAIRBANKS, FAIRBANKS (via
teleconference), spoke in favor of the bill. She relayed
that she was speaking on behalf of the City of Fairbanks.
She stressed that the bill was critical to the success of
the Crisis Now rollout taking place in Fairbanks. She
shared that she was a coordinator for the Crisis Now
program and the mobile crisis teams had been operating
since October 2021. She reported that the teams were
dispatched through an emergency dispatch center and
responded to people in crisis alongside or independent of
law enforcement and resolved 80 percent of the calls
onsite. The team also offered next day appointments at
Alaska Behavioral Health or Tanana Chiefs Conference. She
indicated that presently, people in crisis were calling and
asking for the Mobil Response Team. She emphasized that the
person in crisis still needed a place to go to calm down
and seek help. The Crisis Stabilization Center was a
necessary part of crisis response. She offered that
currently, the first responders were required to take the
person in crisis to the hospital Emergency Room (ER). She
shared that when the option was presented as the only
option it further escalated the situation. The bill ensured
people received appropriate healthcare quickly, provided
the patient a choice, kept patients out of costly hospital
stays, and minimized the impacts on first responders.
Co-Chair Merrick indicated that Representative Edgmon
joined the meeting.
1:48:15 PM
ARTHUR DELAUNE, SELF, FAIRBANKS (via teleconference),
shared that he was the father of a Native man diagnosed
with fetal alcohol spectrum disorder and co-occurring
mental health disorders including anxiety and depression.
His son had given him permission to testify. The testifier
wanted to personalize the issue and illuminate how mental
health patients were currently treated in facilities. He
shared the story of the way his son had been treated. He
detailed that his son had tried to commit suicide in the
past and was taken to the ER and placed in a padded cell
for many hours. His son was agitated and begged to leave.
His father agreed on the condition his son went to the
Crisis Counselor at the Fairbanks Mental Health Facility.
When they arrived at the facility, they were told they
could only place his son on a waiting list. There had been
a cumbersome paperwork process. There was a 14-day wait for
an intake and he experienced another intake 7 days later.
His son ultimately had to wait 34 days to speak to a
therapist. On day 35 his son had called and stated he
wanted to kill himself. He had been admitted to the
Fairbanks Memorial Hospital and 5 hours later admitted to
the behavioral health ward and did not see a doctor for 22
hours after check in. He provided further detail about the
story. He was referred back and forth between Fairbanks
Community Mental Health and Tanana Chiefs Conference and by
day 41 he had not received services. He emphasized that his
son had been caught between two mental health organizations
and a very broken mental health system. He stressed that
the services were absolutely needed and people in crisis
needed immediate help. He implored the committee to pass
the bill.
Representative Thompson thanked Mr. Delaune for sharing his
personal story.
1:53:27 PM
MIKE CARSON, CHAIR, MATSU OPIOID TASK FORCE, MAT-SU (via
teleconference), testified in support of the bill. He
shared a true story about a woman named Kelsey Green. He
had permission to share the story. The woman was addicted
to heroin and at one point arrested, taken to the Anchorage
Jail, and began to experience withdraw symptoms. She died
within 5 days in jail without receiving any stabilization
care or help. He believed that if Kelsey had been taken to
a crisis stabilization center, she would still be alive
today. He spoke to the endless possibilities that could
have taken place in her life if Kelsey had lived. He
supported stabilization centers. He thanked the committee
for hearing his testimony.
Co-Chair Merrick CLOSED public testimony.
1:56:00 PM
AT EASE
1:56:49 PM
RECONVENED
Co-Chair Merrick asked for a review of the fiscal notes.
SAMANTHA CHEROT, PUBLIC DEFENDER, ALASKA PUBLIC DEFENDER
AGENCY (via teleconference), reviewed the published fiscal
impact fiscal note (FN 9 (ADM) for the Department of
Administration (DOA), Public Defender Agency. She explained
that individuals who were held past 48 hours before a
petition was filed for up to seven days had a right to
council and a hearing. The fiscal note addressed the need
for one attorney in Anchorage, one paralegal in Palmer and
one paralegal in in Anchorage, and a law office assistant
in Fairbanks. She indicated that the narrative analysis on
the fiscal note described the basis for the need.
1:57:49 PM
Co-Chair Merrick moved to the next fiscal note.
Ms. Carpenter reviewed the published fiscal impact fiscal
note (FN 11 (DHS) from the Department of Health and Social
Services (DHSS), Designated Evaluation and Treatment. She
pointed to the Interagency Receipts (IA) fund source and
noted that the receipts were accepted via receipt authority
from Medicaid funding as designated on the departments
other fiscal note. She elaborated that the funding was
matched by a General Fund (GF) Mental Health (MH) fund
source. The fiscal note increased in the outyears because
DHSS anticipated that more facilities were expected to open
in the future. She furthered that GF would increase because
not all of the facilities were eligible for
Disproportionate Share Hospital (DSH) funds, which was how
the department currently matched funding for Designated
Evaluation and Treatment (DET) Centers. She indicated that
DSH funds were only available for hospitals and non-
tribally operated hospitals. She reiterated that DHSS
anticipated the growth of both the Designated Evaluation
and Stabilization (DES) and Designated Evaluation and
Treatment (DET) Centers to expand into each of the 9
behavioral health regions but only facilities that were
hospitals could receive DSH funds. The state was required
to pay for involuntary commitment. She listed the current
DET hospitals: Fairbanks Memorial Hospital, Bartlett
Regional Hospital, and Mat-Susitna Regional Medical Center.
She added that the fiscal note included additional costs
associated with implementing HB 172 for one full-time
employee in Anchorage and a Reimbursable Services Agreement
(RSA) to the Department of Law (DOL).
2:00:34 PM
Ms. Carpenter continued to review the published fiscal
impact Department of Health and Social Services fiscal note
(FN 6 (DHS) for Medicaid Services. She indicated that the
fiscal note accompanied the prior fiscal note and showed
the Medicaid Federal Receipts fund source and included the
Medicaid funding for the facilities that qualified for the
DSH funding.
NANCY MEADE, GENERAL COUNSEL, ALASKA COURT SYSTEM (via
teleconference), reviewed the published fiscal impact
fiscal note (FN 10 (CRT) for Judiciary, Trial Courts. She
communicated that the fiscal note covered the cost of two
Range 12 clerks for the added tasks of notifying guardians
during a crisis center admission as well as for involuntary
commitment proceedings. A good percentage of the
respondents had been previously appointed guardians to help
administer their affairs. In addition, the majority of
mental commitment proceedings, and most likely a majority
of the crisis center admissions were filed with the court
system during non-traditional work hours on weekends and
nights. She noted that the court system had a full-time
magistrate to cover the off hours but the new task of
researching the respondents' status as a protected person,
and notifying the guardian of the next hearing, cannot
reasonably be performed by that magistrate in light of his
or her many other obligations so the help was a necessity.
She determined that the court system could accomplish the
work during the daytime without additional help.
Representative Josephson perceived that the magistrates
would see an increased workload due to the bill. He asked
if there was concern over the matter. Ms. Meade was not
concerned about the issue. She explained that the
individuals in crisis typically ended up in court either
for a criminal arraignment or for an ex parte hearing for
an involuntary mental commitment. The bill would result in
nearly the same number of hearings, but the hearings would
be slightly different.
2:05:58 PM
Co-Chair Merrick moved to the last fiscal note.
KELLY HOWELL, SPECIAL ASSISTANT TO THE COMMISSIONER,
DEPARTMENT OF PUBLIC SAFETY (via teleconference), reviewed
the published zero fiscal note (FN 4 (DPS) from the
Department of Public Safety, Alaska State Trooper
Detachments. She commented that the bill added a new
subsection to AS 47.30.705 that required a peace officer to
prioritize transporting a mentally ill individual to a
crisis stabilization center if one existed in the
community. She did not anticipate an increase in cost and
believed that the department could implement and comply
with the changes with minimal fiscal impact.
Representative Edgmon remarked that fiscal notes were one
dimensional and did not reflect potential savings. He
thought the bill was one of the most critical pieces of
legislation during the current session. He noted that it
would save dollars and lives in the future.
HB 172 was HEARD and HELD in committee for further
consideration.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 10 v. D Sectional Analysis 2.28.2022.pdf |
HFIN 4/22/2022 1:30:00 PM |
SB 10 |
| SB 10 v. D Sponsor Statement 2.28.2022.pdf |
HFIN 4/22/2022 1:30:00 PM |
SB 10 |
| SB 10 v. D Supporting Document Essentail Workers and COVID Infection.pdf |
HFIN 4/22/2022 1:30:00 PM |
SB 10 |
| SB 10 v. D Supporting Document Union calls on state to treat Alaska grocery workers as first responders ADN.pdf |
HFIN 4/22/2022 1:30:00 PM |
SB 10 |
| SB 10 v. D Supporting Document Univ. of Alaska - Workforce Reports Summary.pdf |
HFIN 4/22/2022 1:30:00 PM |
SB 10 |
| HB 172 Public Testimony Rec'd by 042222.pdf |
HFIN 4/22/2022 1:30:00 PM |
HB 172 |
| HB172 GCDSE Letter of Support for April 2022_V1.0.pdf |
HFIN 4/22/2022 1:30:00 PM |
HB 172 |
| SB 10 Supporting Document 032722.pdf |
HFIN 4/22/2022 1:30:00 PM |
SB 10 |