Legislature(2025 - 2026)BUTROVICH 205
03/04/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB89 | |
| Presentation(s): Mental Health Trust Authority | |
| SB90 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | SB 90 | TELECONFERENCED | |
| += | SB 89 | TELECONFERENCED | |
SB 90-MINOR MENTAL HEALTH: AGE OF CONSENT
4:08:54 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 90 "An Act relating to the
examination and treatment of minors; relating to consent for
behavioral and mental health treatment for minors 16 years of
age or older; and providing for an effective date."
4:09:09 PM
SENATOR CATHY GIESSEL, speaking as the sponsor of SB 90, stated
that she is an advanced practice registered nurse and board-
certified family nurse practitioner with several years of
experience in school-based clinics in both Anchorage and a rural
school district. She explained that her support for SB 90 comes
from direct experience working with youth and hearing their
mental health concerns during screenings. She emphasized that SB
90 is both data-driven and motivated by compassion, noting that
the average age of onset for mental health issues is 14 and
early detection improves outcomes. She highlighted that suicide
is the second leading cause of death nationally for individuals
aged 15 to 34, and Alaska leads the nation in teen suicide
rates, with 22 percent of high school students having considered
suicide in 2023 and 43 percent reporting sadness or
hopelessness.
4:10:53 PM
SENATOR GIESSEL stated that SB 90 addresses access to mental
health care by lowering the age of consent for behavioral health
services from 18 to 16. She clarified that under SB 90, teens
age 16 and older could receive up to five 90-minute sessions
without parental consent. After those sessions, parental consent
would be required unless contacting parents posed a risk to the
minor, and clinicians would be required to document efforts to
reach the parents. She noted that these parameters are further
detailed in the Sectional Analysis for SB 90.
SENATOR GIESSEL maintained that early mental health intervention
reduces the risk of substance abuse and crisis escalation and
helps teens engage more fully in treatment. She said SB 90 will
promote teen responsibility, increase self-esteem, and
ultimately strengthen families and communities by providing
proactive care. She concluded that supporting SB 90 is a step
toward addressing Alaska's youth mental health crisis.
4:13:49 PM
SENATOR GIESSEL referenced a 2017 presentation by Dr. Joshua
Sonkiss, a psychiatrist with Anchorage Community Mental Health
Services, which explained how the teen brain, particularly the
prefrontal cortex responsible for executive function, continues
developing during adolescence. She stated that equipping teens
with tools to manage stress and emotions can support brain
development and long-term mental health. She also pointed to a
behavioral health roadmap presented in April to the Committee,
which recommended increasing access to school-based Medicaid
services and youth use of prevention hotlines. She emphasized
that SB 90 encourages engagement of teens and their families and
builds overall family resilience while addressing Alaska's
suicide crisis.
4:17:23 PM
PAIGE BROWN, Staff, Senator Cathy Giessel, Alaska State
Legislature, Juneau, Alaska, provided the sectional analysis for
SB 90:
[Original punctuation provided.]
Senate Bill 90
Sectional Analysis (Version A)
"An Act relating to examination and treatment of
minors; relating to consent for behavioral health and
mental health treatment for minors 16 years of age of
older; and providing for an effective date."
Section 1. Amends AS 25.20.025: Examination and
Treatment of Minors.
This section adds youth who provide documentation
demonstrating they are an unaccompanied homeless minor
to the list of minors who can consent to medical
treatment.
This section would add behavioral and mental health
services to the list of services an unaccompanied
homeless minor, a minor living apart from their
parents or legal guardian, and a minor who is the
parent of a child, are able to consent to.
4:17:54 PM
MS. PAIGE continued reading the sectional analysis of SB 90:
[Original punctuation provided.]
Section 2. Adds new subsections to AS. 25.20.025: Examination
and Treatment of Minors.
This section adds new subsections relating to
documentation required by homeless unaccompanied
minors for the purposes of giving consent.
The documentation must state that the minor is:
1. 16 years of age or older
2. Does not have a fixed, regular, adequate
nighttime residence; and
3. Is not in the care and physical custody of a
parent or guardian,
And the document must be signed by:
1. A director or designee of a director of a
governmental or nonprofit entity that receives
funds to provide assistance to those who are
homeless;
2. A local educational agency liaison for homeless
youth, a local educational agency foster care
point of contact, or a licensed clinical social
worker employed by a school in the state;
3. An attorney that represents the minor; or
4. The minor and 2 adults with actual knowledge of
the minor's situation.
Section 3. Adds a new section to AS. 25.20: Parent and
Child.
This section would give a minor aged 16 years or older
the ability to consent to receive five 90-minute
sessions of outpatient behavioral or mental health
appointments, without obtaining the consent of the
minor's parent or guardian. It then outlines what
would happen in the case a minor needed continued
treatment.
Section 4. Amends AS. 47.10.084(c): Legal custody,
guardianship, and residual parental rights and
responsibilities.
This section adds the new section from section 3 to
the list of exceptions of a parent's residual rights
and responsibilities.
Section 5. Amends AS. 47.12.150(c): Legal custody,
guardianship, and residual parental rights and
responsibilities.
This section adds the new section from section 3 to
the list of exceptions of a parent's residual rights
and responsibilities. Section
6. Effective date.
This section provides for an effective date of January
1, 2026.
4:19:45 PM
SENATOR GIESSEL highlighted that in SB 90, page 3, line 1-3, the
bill states that a mental health provider may not prescribe
medication to a minor receiving behavioral or mental health
services.
4:20:52 PM
CHAIR DUNBAR commented that he was going to inquire about that
and thanked her for specifically mentioning the provision.
SENATOR GIESSEL responded that the language was included by
design. She also noted that Section 3, page 5, line 2, specifies
that treatment must meet the standard of care commonly accepted
among health professionals in Alaska, not random people.
CHAIR DUNBAR asked about the origin of the five-appointment
limit in SB 90. He acknowledged that selecting such numbers
often involves finding a rational standard but wondered if this
specific number was based on policies in other states or
developed independently.
4:21:16 PM
MS. BROWN stated that the five-session limit in SB 90 was based
on a statute in Idaho with a similar structure. She explained
that Idaho allows minors to access a limited number of sessions
without parental consent and stated her belief that Idaho also
sets the minimum age at 16.
4:21:35 PM
CHAIR DUNBAR acknowledged the general agreement on the
importance of youth accessing behavioral and mental health
services, particularly in reducing issues like suicidal
ideation. He questioned whether the primary challenge that SB 90
addresses is difficulty in reaching some parents or situations
where contacting parents could pose a danger to the child.
SENATOR GIESSEL deferred to Ms. Ireland who works in school-
based clinics. She said Ms. Ireland could give data related to
the difficulty in obtaining parental consent.
4:22:40 PM
CHAIR DUNBAR announced invited testimony on SB 90.
4:22:56 PM
JEN GRIFFIS, Vice President, Policy and Advocacy, Alaska
Children's Trust, Anchorage, Alaska, provided the following
invited testimony on SB 90:
Today I'm testifying in support of Senate Bill 90,
which would allow 16- and 17-year-olds the ability to
provide self-consent to receive up to five behavioral
health treatment sessions. Alaska Children's Trust
believes in a future where Alaska's children, youth,
and families have the knowledge, skills, supports, and
resources that they need to thrive. Achieving this
vision means ensuring that the next generation of
parents has access to the behavioral health support
they need so they can enter young adulthood as healthy
as possible. Senate Bill 90 creates a pathway for 16-
and 17-year-olds to receive behavioral health support
in situations where it might be challenging to obtain
parental consent. This legislation acknowledges the
wide variety of situations our Alaskan youth find
themselves in by carefully navigating the importance
of involving parents in the treatment process while
also affirming and empowering 16- and 17-year-olds
seeking behavioral health treatment.
According to Kids Count 2024, two out of every five
high school students in Alaska report feeling
persistently sad or hopeless for an extended period of
time during the previous year. This number has moved
steadily upwards since 2009, increasing almost 60
percent in the past decade. The option for youth to
consent to behavioral health treatment is a policy
choice implemented in states across the country.
Research demonstrates that allowing youth to self-
consent for behavioral health services can support
youth engagement in treatment and empower youth to
make informed decisions, leading to more effective
care and reducing risky behaviors. The policy changes
in Senate Bill 90 seek to increase youth access to
behavioral health services by balancing youth autonomy
with parental involvement, supporting Alaska's youth
as they seek treatment for their health and well-
being.
We encourage your support of Senate Bill 90, and thank
you for the opportunity to testify today.
4:25:40 PM
HEATHER IRELAND, Executive Director, Anchorage School-Based
Health Centers, Anchorage, Alaska, providing the following
invited testimony on SB 90:
For over 10 years, I have served as executive director
of Anchorage school-based health centers, a division
of Christian Health Associates. Thank you for the
opportunity to comment on the importance of Senate
Bill 90. If you want to make a difference for
adolescent mental health, you will pass this bill. I
was thrilled to see that Senate Bill 90 was being
brought forward, allowing 16- and 17-year-olds to
access behavioral health services, even if only for a
limited number of sessions, it has the potential to
make a huge difference in their lives. We are grateful
for the volunteer services Senator Giessel provided,
and she spoke eloquently and comprehensively about the
need for this bill.
Anchorage School-Based Health Centers (ASBHC) is a
nonprofit separate from the Anchorage School District
but operating medical clinics in middle and high
schools in Anchorage. We provide medical care to those
who cannot access it in the community. Parental
consent is required for students to receive the
medical care from advanced nurse practitioners and
doctors in our clinics, and like medical providers in
the community, we bill Medicaid, private insurance,
and Stride Care. But we also waive some fees for low-
income families, and primarily we receive a grant from
the municipality, as well as funding from the United
Way and private donors through Pick Click Give. So,
Anchorage school-based health centers have served
thousands of students since the inception in 2010.
4:27:23 PM
MS. IRELAND continued her invited testimony on SB 90:
Our providers screen for many types of risk, and we
have seen increasing numbers of students who exhibit
symptoms of depression, anxiety, and other mental
health challenges. Schools often concur with our
initial assessment that some youth are struggling, and
more often than not, students are willing to pursue
behavioral health treatment. Unfortunately, parental
consent is a huge barrier for youth to access the care
that they desperately need and want. Frequently, youth
are hesitant to ask their parents for treatment. My
observation has been that adults are reluctant to give
permission because of the stigma associated with
mental illness, which the younger generation has often
moved past. And it can also be logistically
challenging for adults to give consent, especially in
a school setting where families are not present. And
finally, of course, some adults don't want their
students discussing their personal life with a
healthcare professional, despite how desperately they
need the treatment.
Years ago, through my networking with school-based
health programs in other states, I learned that
Colorado lowered their age of consent to 12, and
previously it had been like 14 or 16. It was a
lightning bolt. This is a way we can actually help
kids. Sadly, after many years, Alaska has done nothing
to change the situation. By allowing 16- and 17-year-
olds to consent for their own care, youth can connect
with a clinician who can assess their safety and
broach the possibility of involving an adult in their
treatment. Early access to care prevents issues from
developing into a crisis, needing hospitalization, or
worse.
In 2018, a study out of Minnesota showed that school-
based mental health programs reduced self-reported
suicide by 15 percent. This is just one example of how
increasing access can make a difference.
Please pass Senate Bill 90, and please help youth who
are struggling.
4:29:34 PM
SENATOR TOBIN stated that she had a question regarding parental
reactions to behavioral health treatment for minors. She
expressed concern that some parents or guardians might deny
consent out of fear that they could be held liable for neglect
or harm. She asked Ms. Ireland whether she had any experience or
knowledge related to that situation.
4:30:00 PM
MS. IRELAND stated that clinicians and medical providers in her
program have made reports of harm in various situations
involving youth. She explained that these reports are typically
not made without the student's knowledge and often involve
communication with the student about the legal obligation to
report, and sometimes include the parent if they are not the
abuser. She emphasized that the Office of Children's Services is
responsible for assessing such reports and determining the
appropriate next steps. She noted that reports of harm can arise
during behavioral health treatment, medical visits, or through
conversations with mandated reporters such as teachers. She
stated her belief that SB 90 would not significantly increase
the occurrence of such reports.
4:31:36 PM
CHAIR DUNBAR acknowledged that Senator Hughes joined the meeting
at about 3:35 p.m.
4:32:00 PM
CHAIR DUNBAR opened public testimony on SB 90.
4:32:22 PM
ROGER BRANSON, representing self, Eagle River, Alaska, testified
in support of SB 90. He stated that he is a longtime mental
health advocate and described SB 90 as a critical tool to
empower youth to define their own self-care. He emphasized the
importance of involving individuals in their mental health
recovery and treatment planning.
4:33:03 PM
CHAIR DUNBAR paused public testimony to hear invited testimony
from Ms. Ringstad.
4:33:30 PM
ANN RINGSTAD, Executive Director, National Alliance on Mental
Illness Alaska, Anchorage, Alaska, provided the following
invited testimony for SB 90:
NAMI Alaska is one of 48 state organizations under the
umbrella of NAMI, the National Alliance on Mental
Illness, the nation's largest mental health advocacy
organization in the United States. Consider these
facts: one in six youth ages six to 17 experience a
mental health disorder each year in the United States;
50 percent of all mental illness develops by the time
a student reaches the age of 14, and 75 percent by the
time they reach the age of 25. Eight thousand Alaskans
ages 12 to 17 have depression. High school students
with depression are more than two times more likely to
drop out than their peers. Almost 63 percent of
Alaskans ages 12 to 17 who have depression did not
receive any care in the past year.
Behavioral health services are critical to support
these youth. Delayed treatment can be detrimental. The
earlier a mental health issue is detected, the better.
And one more important fact: Alaska's suicide rates
are sadly some of the highest in the nation. We rank
number three.
As the sponsor of the bill stated, SB 90 allows
minors, 16 of age and older, who provide documentation
they are living apart from their family and are
homeless, to seek help for their mental health
challenges. This would give them the ability to obtain
mental health services and give their own consent for
five 90-minute outpatient mental health sessions, with
parental notification to determine the next steps
unless parental consent would be detrimental to the
well-being of the youth. This would allow them to
receive timely services before their symptoms become
worse. Lowering the age of consent for behavioral
health care under these circumstances, from 18 to 16,
may prove to save lives.
Thank you for your consideration of these factors.
4:35:49 PM
CHAIR DUNBAR resumed public testimony on SB 90.
4:36:18 PM
STEVEN PEARCE, Director, Citizens Commission on Human Rights,
Seattle, Washington, testified in opposition to SB 90. He stated
that the Citizens Commission on Human Rights is a psychiatric
watchdog group and expressed concerns regarding SB 90. He
supported notifying parents when youth exhibit behavior that
affects school performance and taking action through protective
services if necessary but opposed turning schools into profit
centers for psychiatric diagnosis and treatment. He argued that
behavior is not a disease and claimed the theory of a chemical
imbalance in the brain lacks supporting evidence, criticizing
what he described as grooming individuals to believe behavior
equates to disease and that medication is the solution.
MR. PEARCE stated that if SB 90 is limited strictly to
counseling, that might be more acceptable, but he raised
concerns about violating informed consent. He emphasized that
informed consent is fundamental to treatment and argued that
limiting or removing parental involvement exceeds what is
necessary. He asserted that schools and counselors should make a
greater effort to reach parents and obtain authorization, and
failure to do so reflects a breakdown in communication. He cited
Tom Insel, former director of the National Institute of Mental
Health, who acknowledged that decades of mental health efforts
have not produced meaningful improvements, as evidenced by high
rates of suicide, disability, and poor mortality data.
4:39:05 PM
ED MARTIN, representing self, Kenai, Alaska, testified in
opposition to SB 90. He stated he is 70 years old and has
personal experience with mental health issues within his family.
He opposed SB 90, asserting that allowing 16-year-olds to enter
treatment without parental consent undermines parental rights.
He expressed concern over minors receiving seven and a half
hours of care without parental involvement and warned that such
a policy could be legally challenged. He questioned the bill's
fiscal impact and asked which nonprofits are involved and how
the services would be funded.
4:41:44 PM
CHAIR DUNBAR held public testimony open on SB 90.
4:41:50 PM
SENATOR HUGHES stated that she shared some of Mr. Martin's
concerns regarding SB 90. She said she supports seeking parental
consent upfront and limiting exceptions to extreme situations,
such as cases involving homeless youth. She noted that Idaho has
since revoked a similar law, raising its age of consent back to
18. She recalled prior concerns that insurers might not cover
services under this policy and requested and update.
4:43:45 PM
CHAIR DUNBAR stated he also had a question related to billing
for services and suggested the sponsor could address the
questions at the next hearing of SB 90.
4:43:56 PM
CHAIR DUNBAR held SB 90 in committee.