02/25/2022 01:30 PM House JUDICIARY

             HB 172-MENTAL HEALTH FACILITIES & MEDS                                                                         
                                                                                                                                
1:34:30 PM                                                                                                                    
                                                                                                                                
CHAIR CLAMAN announced that the  first order of business would be                                                               
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."  [Before  the committee, adopted as a  working document on                                                               
2/16/22  and  amended  on 2/23/22,  was  the  proposed  committee                                                               
substitute (CS)  for HB 172, Version  32-GH1730\W, Foote, 2/16/22                                                               
("Version W").]                                                                                                                 
                                                                                                                                
CHAIR CLAMAN  explained that the offered  amendment would address                                                               
previously expressed  concerns from  the committee  pertaining to                                                               
grievance procedures.   He stated that the  timeline proposed for                                                               
the Department  of Health  and Social  Services (DHSS)  to report                                                               
grievance procedures  to the legislature  would be one  year from                                                               
the effective date of the bill.   This would allow the department                                                               
to  confer with  stakeholders  and licensing  organizations.   He                                                               
stated  that Legislative  Legal Services  has permission  to make                                                               
any   technical   and   conforming  changes   to   the   proposed                                                               
legislation.                                                                                                                    
                                                                                                                                
1:36:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SNYDER moved to adopt Amendment 5 to HB 172,                                                                     
Version W, as amended, labeled 32-GH1730\W.20 Foote 2/24/22,                                                                    
which read as follows:                                                                                                          
                                                                                                                                
     Page 12, following line 31:                                                                                                
          Insert a new bill section to read:                                                                                    
        "*  Sec. 26.  The  uncodified law  of  the State  of                                                                
     Alaska is amended by adding a new section to read:                                                                         
          REPORT TO THE LEGISLATURE. (a) One year after the                                                                     
     effective date  of this Act,  the Department  of Health                                                                    
     and Social Services and the  Alaska Mental Health Trust                                                                    
     Authority  shall submit  a joint  report to  the senate                                                                    
     secretary   and   chief   clerk   of   the   house   of                                                                    
     representatives  and notify  the  legislature that  the                                                                    
     report is available. The report must                                                                                       
               (1)  include an assessment of the current                                                                        
     state, federal,  and accrediting body  requirements for                                                                    
     psychiatric    patient   rights,    including   patient                                                                    
     grievance  and  appeal  policies  and  procedures;  the                                                                    
     assessment must address the  adequacy of these policies                                                                    
     and  procedures and  the practical  challenges patients                                                                    
     face in availing themselves of these rights;                                                                               
               (2)  identify and recommend any additional                                                                       
     changes  to  state   statutes,  regulations,  or  other                                                                    
     requirements   that  could   enhance  patient   rights,                                                                    
     particularly    involving    involuntary    admissions,                                                                    
     involuntary medications,  and the practical  ability of                                                                    
     patients to avail themselves of their rights; and                                                                          
               (3)  assess and recommend any needed changes                                                                     
     to current processes for  data collection and reporting                                                                    
     of patient  grievances and appeals, patient  reports of                                                                    
     harm  and  restraint,  and   the  resolution  of  these                                                                    
     matters.                                                                                                                   
          (b)  The process used by the Department of Health                                                                     
     and Social Services and the  Alaska Mental Health Trust                                                                    
     Authority    to    develop     the    assessment    and                                                                    
     recommendations under (a) of  this section must include                                                                    
     convening  a diverse  stakeholder  group that  includes                                                                    
     members  representing patients  with lived  experience,                                                                    
     patient  advocates,   the  Disability  Law   Center  of                                                                    
     Alaska,   providers   of  psychiatric   services,   the                                                                    
     ombudsman,   the  Alaska   Mental  Health   Board,  the                                                                    
     Department  of  Health  and Social  Services,  and  the                                                                    
     Alaska   Mental  Health   Trust   Authority.  A   draft                                                                    
     assessment  and   any  recommendations  must   be  made                                                                    
     available for public comment, and  any comments must be                                                                    
       given due consideration before the production and                                                                        
     transmittal of the final report."                                                                                          
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 13, line 14:                                                                                                          
          Delete "Section 27"                                                                                                   
          Insert "Section 28"                                                                                                   
                                                                                                                                
CHAIR CLAMAN objected.                                                                                                          
                                                                                                                                
1:36:26 PM                                                                                                                    
                                                                                                                                
HEATHER CARPENTER,  Senior Policy  Advisor, Department  of Health                                                               
and Social Services,  spoke to Amendment 5.  She  stated that the                                                               
amendment  was  drafted  following   concerns  expressed  by  the                                                               
committee.  She  stated that the amendment refers  to a "report".                                                               
She explained  that the  report could be  described as  an action                                                               
plan.  She  stated that stakeholders, including  DHSS, the Alaska                                                               
Mental   Health   Trust   Authority,   individuals   with   lived                                                               
experience,  patient  advocates,  the Disability  Law  Center  of                                                               
Alaska,   and   the   Alaska  State   Ombudsman   would   provide                                                               
transparency, bring  forth concerns,  and conduct a  full review.                                                               
She stated that this would  require a public process, including a                                                               
comment period and a report to be issued to the legislature.                                                                    
                                                                                                                                
REPRESENTATIVE  EASTMAN stated  that the  proposed amendment  did                                                               
not include on-site  visits and was associated  with oversight of                                                               
accrediting  bodies.     He  expressed   the  opinion   that  the                                                               
legislature should take steps to ensure on-site visits.                                                                         
                                                                                                                                
1:39:28 PM                                                                                                                    
                                                                                                                                
CHAIR  CLAMAN withdrew  his objection.   There  being no  further                                                               
objection, Amendment 5 was adopted.                                                                                             
                                                                                                                                
REPRESENTATIVE DRUMMOND  expressed her  belief that HB  172 would                                                               
benefit Alaskans.                                                                                                               
                                                                                                                                
REPRESENTATIVE  VANCE expressed  the recognition  of the  need to                                                               
keep [those  suffering with  a mental  illness] out  of emergency                                                               
rooms  and   jails.    She   expressed  concerns   regarding  the                                                               
involuntary administration of psychotropic medications.                                                                         
                                                                                                                                
REPRESENTATIVE EASTMAN expressed  the intent to vote  to keep the                                                               
bill  in   committee.    He  expressed   concerns  regarding  the                                                               
involuntary administration of medications.                                                                                      
                                                                                                                                
CHAIR CLAMAN noted  that the passage of Version  W would maintain                                                               
the status-quo on  the rights of patients  and the administration                                                               
of  psychotropic medications.   He  stated that  a bill  had been                                                               
passed in a previous legislature  which addressed the matter.  He                                                               
stated that the  Citizen's Commission on Human  Rights of Alaska,                                                               
Montana,  and Washington  has provided  a letter,  dated May  12,                                                               
2021;  however,  the  letter  did  not  take  into  consideration                                                               
Version W.   He noted  that the  lawsuit with the  Disability Law                                                               
Center, relating  to access to  psychiatric treatment, is  in the                                                               
process  of being  settled.   He  noted that  the Disability  Law                                                               
Center  has been  involved  in testimony  and  has expressed  its                                                               
support for the proposed legislation.                                                                                           
                                                                                                                                
1:45:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SNYDER moved  to  report HB  172,  Version W,  as                                                               
amended,  out of  committee with  individual recommendations  and                                                               
the accompanying fiscal notes.                                                                                                  
                                                                                                                                
1:45:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN objected.                                                                                                
                                                                                                                                
A roll  call vote was  taken.  Representatives  Drummond, Snyder,                                                               
Kreiss-Tomkins,  and Claman  voted  in favor  of  moving HB  172,                                                               
Version  W,   as  amended,  out  of   committee  with  individual                                                               
recommendations    and    the    accompanying    fiscal    notes.                                                               
Representatives Vance  and Eastman voted against  it.  Therefore,                                                               
CSHB 172(JUD)  was reported out  of the House  Judiciary Standing                                                               
Committee by a vote of 4-2.