Legislature(2021 - 2022)ADAMS 519
04/28/2022 09:00 AM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB172 | |
| HB170 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 413 | TELECONFERENCED | |
| + | HB 350 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 172 | TELECONFERENCED | |
| += | HB 170 | 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."
9:32:47 AM
Co-Chair Merrick invited Ms. Heather Carpenter to make
opening remarks.
HEATHER CARPENTER, HEALTH CARE POLICY ADVISOR, OFFICE OF
THE COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES,
thanked the committee for continued consideration of the
bill and made herself available for questions.
9:33:36 AM
Co-Chair Merrick MOVED to ADOPT Amendment 1, 32-GH1730\N.3
(Dunmire, 4/21/22) (copy on file):
Page 13, line 10, through page 14, line 1:
Delete all material and insert:
"* Sec. 26. AS 47.32.010(b), as repealed and reenacted
by sec. 79 of Executive Order 121, is amended to read:
(b) This [THE FOLLOWING ENTITIES ARE SUBJECT TO
THIS] chapter and regulations adopted under this
chapter by the Department of Health apply to the
following entities:
(1) ambulatory surgical centers;
(2) assisted living homes;
(3) child care facilities;
(4) freestanding birth centers;
(5) home health agencies;
(6) hospices, or agencies providing hospice
services or operating hospice programs;
(7) hospitals;
(8) intermediate care facilities for
individuals with an intellectual disability
or related condition;
(9) maternity homes;
(10) nursing facilities;
(11) residential child care facilities;
(12) residential psychiatric treatment
centers;
(13) rural health clinics;
(14) subacute mental health facilities
[CRISIS STABILIZATION CENTERS]."
Page 14, line 16:
Delete "and Social Services"
Insert ", the Department of Family and Community
Services,"
Page 14, line 30:
Delete "and Social Services"
Insert ", the Department of Family and Community
Services,"
Page 15, line 4:
Delete "and Social Services"
Insert ", the Department of Family and Community
Services"
Page 15, line 11:
Delete "and Social Services"
Page 15, line 17:
Delete "and Social Services"
Insert "or the Department of Family and Community
Services, as applicable,"
Vice-Chair Ortiz OBJECTED for discussion.
Co-Chair Merrick reviewed the amendment. She explained that
it addressed some needed changes to the bill to prepare for
the impending split of the Department of Health and Social
Services (DHSS).
Vice-Chair Ortiz WITHDREW the OBJECTION.
There being NO further OBJECTION, Amendment 1 was ADOPTED.
9:34:12 AM
Co-Chair Merrick MOVED to ADOPT Amendment 2, 32-GH1730\N.4
(Dunmire, 4/21/22) (copy on file):
Page 4, lines 13 - 14:
Delete "[FOR EMERGENCY EVALUATION]"
Insert "for emergency evaluation"
Page 8, line 11:
Delete "47.30.815"
Insert "47.30.865"
Vice-Chair Ortiz OBJECTED for discussion.
Co-Chair Merrick reviewed the amendment. She explained that
it incorporated technical changes made in the Senate
version of the bill.
Representative Wool was curious why the language "for
emergency evaluation" was proposed to be deleted as well as
inserted in the same section in the same lines. He thought
it seemed redundant.
Ms. Carpenter responded that the words "for emergency
evaluation" had been previously deleted. The amendment
would replace the words back into the text.
Co-Chair Merrick indicated Representative Edgmon had joined
the meeting.
9:35:01 AM
Representative Josephson asked if the amendment would make
the bill mirror the Senate version.
Ms. Carpenter responded in the affirmative and thought the
changes proposed by the Senate were beneficial to the bill
and technical in nature.
Vice-Chair Ortiz WITHDREW the OBJECTION.
There being NO further OBJECTION, Amendment 2 was ADOPTED.
Co-Chair Merrick MOVED to ADOPT Amendment 3, 32-GH1730\N.2
(Dunmire, 4/19/22) (copy on file):
Page 1, line 2, following "facilities;":
Insert "relating to representation by an
attorney;"
Page 3, following line 30:
Insert a new bill section to read:
"* Sec. 11. AS 18.85.100(a) is amended to read:
(a) An indigent person who is under formal
charge of having committed a serious crime
and the crime has been the subject of an
initial appearance or subsequent proceeding,
or is being detained under a conviction of a
serious crime, or is on probation or parole,
or is entitled to representation under the
Supreme Court Delinquency or Child in Need
of Aid Rules or at a review hearing under
AS 47.12.105(d), or is isolated,
quarantined, or required to be tested under
an order issued under AS 18.15.355 -
18.15.395, or is a respondent in a
proceeding under AS 47.30 [AGAINST WHOM
COMMITMENT PROCEEDINGS FOR MENTAL ILLNESS
HAVE BEEN INITIATED,] is entitled
(1) to be represented, in connection
with the crime or proceeding, by an
attorney to the same extent as a person
retaining an attorney is entitled; and
(2) to be provided with the necessary
services and facilities of this
representation, including investigation
and other preparation."
Renumber the following bill sections accordingly.
Page 14, lines 15 - 16:
Delete "secs. 1 - 30"
Insert "secs. 1 - 31"
Page 15, lines 10 - 11:
Delete "sec. 26"
Insert "sec. 27"
Page 15, line 12:
Delete "sec. 26"
Insert "sec. 27"
Page 15, line 21:
Delete "Section 31"
Insert "Section 32"
Vice-Chair Ortiz OBJECTED for discussion.
Co-Chair Merrick reviewed the amendment. She explained that
the amendment was at the request of the court system to
clarify the role of the public defender. She noted that Ms.
Nancy Meade was available for questions about the
amendment.
9:35:50 AM
Representative Josephson invited Ms. Meade to give her
sense of the amendment.
NANCY MEADE, GENERAL COUNSEL, ALASKA COURT SYSTEM, provided
further detail regarding the amendment. She relayed that
Amendment 3 would ensure that when there was a mental
health crisis situation and an individual was held
involuntarily in a crisis center, the attorney appointed by
the court for the individual would be from the public
defender's office. There needed to be a statute stating who
the appointed attorney would be, and if it was not dictated
in statute, the court system would need to pay for the
attorney. She wanted to offer clarity that the legal duty
was that of the public defender.
Vice-Chair Ortiz WITHDREW the OBJECTION.
There being NO further OBJECTION, Amendment 3 was ADOPTED.
9:37:16 AM
Representative Rasmussen MOVED to ADOPT Amendment 4, 32-
GH1730\N.5 (Dunmire, 4/21/22) (copy on file):
Page 14, line 26:
Delete "and"
Page 14, line 29, following "matters":
Insert "; and
(4) identify methods for collecting and
making available to the legislature and the
general public statistics recording
(A) the number, type, and cause of
patient injuries;
(B) the number, type, and resolution of
patient complaints; and
(C) the number and type of traumatic
events experienced by a patient; in
this subparagraph, "traumatic event"
means being placed in isolation or
physical restraint of any kind"
Co-Chair Merrick OBJECTED for discussion.
Representative Rasmussen reviewed the amendment. The
amendment would require that statistics of psychiatric
patient complaints, injuries, and traumatic events be
obtained and shared with the legislature and the public.
Vice-Chair Ortiz asked for more detail regarding the impact
of the amendment and how it would alter the bill.
Representative Rasmussen replied that it would make data
more available and the process more transparent.
Co-Chair Merrick asked Ms. Carpenter to comment.
Ms. Carpenter replied that it directed the department on
the statistics that needed to be collected and their public
distribution. The amendment fit naturally in the bill. She
thought it made sense for the amendment to describe the
process in more specific terms.
9:39:40 AM
Representative Wool asked if the practice was done with any
other patient group in custody in the state. He thought
some of the terms seemed too broad, such as "traumatic
event."
Ms. Carpenter answered that she thought "traumatic event"
was appropriate and pointed out that the amendment included
a definition of the term. Hospitals were accustomed to
reporting on events such as infections and mental health
crises and there were already many statistics captured
across the board. A consultant would likely be hired to
help with public outreach. She shared that meetings would
be publicly noticed and tools would be put on a website for
the public.
Representative Wool asked if statistics regarding mental
health holds would be publicly available, such as Alaska
Psychiatric Institute (API) holds.
Ms. Carpenter would not be able to speak to the statistics
related to the Department of Corrections, but API
statistics were reported monthly to the court system. The
statistics that were required to be reported were different
for each hospital, which was the reason the amendment would
allow transparency in the process to ensure that reporting
efforts would not be duplicated.
9:43:41 AM
Representative Wool suggested that API was a state-run
facility. People could be committed and held against their
will in an API facility. He thought the reporting
requirements would be the same at API.
Ms. Carpenter responded that Representative Wool was
correct that the amendment included entities such as API
and Fairbanks Memorial Hospital. It would capture all
providers of psychiatric care.
Representative Carpenter read the amendment. He thought it
did not specifically require the reporting of the
information to the legislature. He wondered if the
amendment would have the intended affect by making
statistics available.
9:46:03 AM
AT EASE
9:47:20 AM
RECONVENED
Ms. Carpenter responded to Representative Carpenter's
question. She pointed to page 14, lines 15 through 18 of
the bill and explained language would be added to require
that statistics be reported to the Senate Secretary and the
Chief Clerk. Methods would then have to be identified to
determine how to report the statistics to the legislature
and general public.
Co-Chair Merrick asked if Mr. Steve Williams had any
comments.
9:48:16 AM
STEVE WILLIAMS, CHIEF EXECUTIVE OFFICER, ALASKA MENTAL
HEALTH TRUST AUTHORITY, agreed with Ms. Carpenter's
assessment. He emphasized that the amendment would ensure
that the rights of patients and patient advocates would be
recognized. The Alaska Mental Health Trust Authority
(AMHTA) welcomed the addition to the bill.
Representative Carpenter was curious about the opinion of
Legislative Legal Services.
9:50:02 AM
AT EASE
9:52:57 AM
RECONVENED
Co-Chair Merrick indicated Mr. Andrew Dunmire was available
online for questions.
Representative Carpenter thought the language in the bill
never directly stated that data must be reported to the
legislature and wondered if reporting would be required
based on the existing language.
ANDREW DUNMIRE, ATTORNEY, LEGISLATIVE LEGAL SERVICES (via
teleconference), thought Representative Carpenter was
correct that the Department of Health and AMHTA would be
required to submit a report that identified how to collect
the statistics and relay them to the legislature and
public. However, there was no obligation to report the data
to the legislature in the language of the bill.
9:55:26 AM
Representative Carpenter asked if the intent of the
amendment was to have the statistics provided to the
legislature or ensure that statistics were collected by
AMHTA.
Representative Rasmussen indicated that the intent of the
amendment was to identify and report. She was open to a
conceptual amendment.
9:55:56 AM
AT EASE
10:00:11 AM
RECONVENED
Representative Carpenter did not have an objection to the
amendment. He thought the intent of the amendment was to
make information available to the legislature but was not
sure it was what the administration was requesting. He
acknowledged there was no technical problem with the
amendment.
10:00:58 AM
Representative Josephson asked who would own and operate
the subacute and mental health crisis facilities.
Ms. Carpenter asked whether Representative Josephson wanted
to know who owned the statutes or the actual facilities.
Representative Josephson responded, "The latter."
Ms. Carpenter responded that the individual operators of
the subacute and mental health facilities also owned the
facilities. She provided some examples of facilities and
the ownership, such as Bartlett Regional Hospital being
owned by the City and Borough of Juneau (CBJ). She
explained that the facilities would operate under the
licensures stood up by the Department of Health.
Co-Chair Merrick clarified that Amendment 4 was currently
being discussed.
Representative Josephson asked what part of the amendment
compelled the reporting of statistics. He thought it was in
section 29 on page 14.
Ms. Carpenter indicated that was not what section 29 did.
The section created a method to authorize the department to
get the statistics and report them publicly and to the
legislature. Potential improvements could be made based on
the statistics.
Representative Josephson responded that it did not change
his outlook on the bill.
Representative Edgmon referred to page 14 of the bill and
relayed his understanding of it. The reporting would be
inclusive of the information listed on page 14. He thought
the reports would act as a learning tool and a catalyst for
improvements. He asked if his interpretation was correct.
Ms. Carpenter responded, "Yes, it is." She added that it
was important to understand how new facilities would fit
into the current system and what changes still needed to
happen. The involuntary commitment statutes were outdated.
10:05:16 AM
Representative Edgmon thought Ms. Carpenter's response was
sufficient. He wondered if the bill was consistent with the
bill sponsor's intent.
Ms. Carpenter replied that the department had worked with
the trust on the language of the bill. Many outside
entities were consulted on the bill, such as medical
providers and disability law centers. Providers appreciated
the novel approach to the issue and being included in the
conversation.
Representative Carpenter believed the report was based on
system improvement, not actionable information or data. He
no longer objected to Amendment 4.
Representative Rasmussen thought it was a fair starting
point for evaluation. The legislature was already being
provided with data.
10:07:19 AM
Representative Wool read line 28 on page 14 of the bill. He
thought it was similar language as that in the amendment.
He thought it was acceptable if it simply aimed to assess
methods. He wondered about the immediacy of reporting and
hoped that people would not be able to identify a person in
crisis based on public information.
Ms. Carpenter responded that his concerns with privacy
would be evaluated as part of the process. She assured him
that data privacy would be taken seriously and data
collection would be compliant with HIPAA [Health Insurance
Portability and Accountability Act]. She thought the
ability to see what other providers were doing would be a
good tool for the provider community.
Co-Chair Merrick WITHDREW the OBJECTION.
There being NO further OBJECTION, Amendment 4 was ADOPTED.
Vice-Chair Ortiz MOVED to report CSHB 172(FIN) out of
committee with individual recommendations and the
accompanying fiscal notes.
There being NO OBJECTION, it was so ordered.
CSHB 172(FIN) was REPORTED out of committee with five "do
pass" recommendations and five "no recommendation"
recommendations and with a previously published zero fiscal
note: FN4 (DPS); and with four previously published fiscal
impact notes: FN5 (AJS), FN6 (DHS), FN7 (DHS), and FN8
(ADM).
10:10:51 AM
AT EASE
10:13:18 AM
RECONVENED
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 350 Sectional.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 350 |
| HB 350 Sponsor Statement.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 350 |
| HB 350 Supporting Docs.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 350 |
| HB 350 ASD Bond Debt vs Facility Backlog for HB 350 070121.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 350 |
| HB 350 Sectional.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 350 |
| HB 170 Amendment 10 LeBon.Wool W.14 042822.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 170 |
| HB 170 Conceptual Amendment 1 to Amendment 2 Wool 042822.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 170 |
| HB 170 - AIDEA Response Letter to HF Committee 042822.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 170 |
| HB 226 Additional Documents- DOL Presentations 4.29.22.pdf |
HFIN 4/28/2022 9:00:00 AM |
HB 226 |