05/15/1999 09:00 PM House FIN

CS FOR SENATE BILL NO. 97(FIN) am                                                                                               
                                                                                                                                
"An Act relating to mental health services and                                                                                  
programs; relating to liability for payment for mental                                                                          
health evaluation and treatment services; and providing                                                                         
for an effective date."                                                                                                         
                                                                                                                                
LORNA RAMBERT, SENATOR P. KELLY testified on behalf of the                                                                      
sponsor in support of SB 97. She read the sponsor statement:                                                                    
                                                                                                                                
DHSS reimburses private community hospitals (Designated                                                                         
Evaluation and Treatment Facilities) throughout Alaska                                                                          
to provide emergency mental health inpatient evaluation                                                                         
and treatment services. Hospitals provide these                                                                                 
services to individuals who are at risk of harming                                                                              
themselves or others. or who are so severely impaired                                                                           
by mental health symptoms that they are unable to care                                                                          
for themselves. Often these individuals are                                                                                     
experiencing severe psychiatric symptoms, such as                                                                               
depressive or psychotic symptoms, and need intensive                                                                            
inpatient mental health services.                                                                                               
Senate Bill 97 seeks to clarify the state's                                                                                     
responsibility for payment for services and the                                                                                 
responsibility of the state to determine the ability of                                                                         
patients to pay for those services. The proposed                                                                                
legislation clarifies client eligibility for these                                                                              
services. Additionally, it establishes                                                                                          
procedures for determining eligibility, processing                                                                              
applications, and paying claims. SB 97 creates an                                                                               
entitlement for eligible clients, thus allowing payment                                                                         
for serving those individuals whose mental illness                                                                              
increases their danger to themselves or others. The                                                                             
following are criteria for eligibility:                                                                                         
                                                                                                                                
* A patient is determined to be "suffering from a                                                                               
mental illness, and as a result is likely to cause                                                                              
serious harm to themselves or others, or is                                                                                     
gravely disabled." and;                                                                                                         
                                                                                                                                
* The patient's gross monthly household income falls                                                                            
below 185% of the federal poverty guideline.                                                                                    
                                                                                                                                
SB 97 amends current statutes defining the state's                                                                              
responsibility for payment for inpatient psychiatric                                                                            
service for those patients needing intensive services.                                                                          
Historically the Department of Health and Social                                                                                
Services (DHSS) has reimbursed hospitals for only those                                                                         
patients who are committed by the courts for evaluation                                                                         
and treatment services. This legislation would require                                                                          
the department to reimburse hospitals for individuals                                                                           
who meet the commitment criteria, but who voluntarily                                                                           
admit themselves into the hospital. These individuals                                                                           
are therefore, not court ordered into care, but could                                                                           
be held under court order if they attempted to leave                                                                            
the hospital.                                                                                                                   
                                                                                                                                
GINA MACDONALD, DEPARTMENT OF HEALTH AND SOCIAL SERVICES                                                                        
offered to answer questions.  She noted that the Department                                                                     
does support the bill. She noted that the API 2000 project                                                                      
will reduce the number of beds at the Alaska Psychiatric                                                                        
Institute from 79 to 54. The legislation would provide a                                                                        
clear structure to direct how private hospitals would be                                                                        
paid to perform some emergency mental health functions.                                                                         
                                                                                                                                
In response to a question by Representative Austerman, Ms.                                                                      
MacDonald explained that federal funds would be used through                                                                    
FY 2001.                                                                                                                        
                                                                                                                                
PAT CLASBY, ALASKA STATE HOSPITAL AND NURSING HOME                                                                              
ASSOCIATION stated that the Association supports the                                                                            
legislation.  Most hospitals in the state provide some type                                                                     
of emergency mental health evaluation services. Several                                                                         
hospitals also provide treatment services beyond 72 hours.                                                                      
The hospitals around the state have been working with the                                                                       
state as Alaska Psychiatric Institute is downsized. She                                                                         
emphasized that there needs to be a clear understand of when                                                                    
patients are the state's responsibility. Hospitals would be                                                                     
concerned if the services were developed and became an                                                                          
unfunded mandate.                                                                                                               
                                                                                                                                
Representative Kohring MOVED to report CSSB 97 FIN) am out                                                                      
of Committee with individual recommendations.                                                                                   
                                                                                                                                
There being NO OBJECTIONS, it was so ordered.                                                                                   
                                                                                                                                
CSSB 97(FIN) am was REPORTED out of Committee with a "do                                                                        
pass" recommendation and with a published fiscal note by the                                                                    
Department of Health and Social Services dated4/21/99.