Legislature(2021 - 2022)BUTROVICH 205
03/22/2022 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB124 | |
| Presentation(s): the State of Alaska's Health | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 124 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
SB 124-MENTAL HEALTH FACILITIES & MEDS
1:34:17 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 124
"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."
He noted that the committee started the amendment process last
Thursday and stopped on Amendment 13.
1:35:16 PM
At ease
1:35:32 PM
CHAIR WILSON reconvened the meeting.
CHAIR WILSON acknowledged that Senator Begich had joined the
meeting.
1:35:40 PM
SENATOR HUGHES moved that the committee rescind its action [to
adopt] Amendment 10.1 to SB 124.
1:35:46 PM
CHAIR WILSON objected for discussion purposes.
1:35:50 PM
At ease
1:36:25 PM
CHAIR WILSON reconvened the meeting.
1:36:27 PM
SENATOR HUGHES explained that she held discussions with the
department. The amendment applied to voluntary commitments but
must also apply to involuntary ones. She said she serves on the
next committee of referral, the Senate Judiciary Committee, and
would address her concerns in that committee as the amendment
does not meet the intended objective.
1:36:55 PM
CHAIR WILSON withdrew his objection; he found no further
objection, and the action [to adopt] Amendment 10.1 was
rescinded.
1:37:14 PM
SENATOR REINBOLD moved to adopt Amendment 13, work order 32-
GS1730\B.2.
32-GS1730\B.2
Dunmire
3/14/22
AMENDMENT 13
OFFERED IN THE SENATE BY SENATOR REINBOLD
TO: CSSB 124(HSS), Draft Version "B"
Page 3, following line 24:
Insert a new bill section to read:
"* Sec. 11. AS 47.30.700 is amended by adding a new
subsection to read:
(c) When a crisis stabilization center, crisis
residential center, evaluation facility, or treatment
facility admits a respondent under this section, the
crisis stabilization center, crisis residential
center, evaluation facility, or treatment facility
shall, unless the petition was filed by an immediate
family member of the respondent, immediately notify
the respondent's immediate family, or, if the
respondent is a minor, a parent or guardian of the
minor, that the respondent has been admitted."
Renumber the following bill sections accordingly.
Page 4, line 17:
Delete "a new subsection"
Insert "new subsections"
Page 4, following line 21:
Insert a new subsection to read:
"(d) When a crisis stabilization center, crisis
residential center, evaluation facility, or treatment
facility admits a person under this section, the
crisis stabilization center, crisis residential
center, evaluation facility, or treatment facility
shall immediately notify the person's immediate
family, or, if the person is a minor, a parent or
guardian of the person, that the person has been
admitted."
Page 13, lines 1 - 2:
Delete "secs. 1 - 27"
Insert "secs. 1 - 28"
Page 13, lines 27 - 28:
Delete "sec. 23"
Insert "sec. 24"
Page 13, line 29:
Delete "sec. 23"
Insert "sec. 24"
Page 14, line 7:
Delete "Section 28"
Insert "Section 29"
1:37:17 PM
CHAIR WILSON objected for purposes of discussion.
1:37:25 PM
At ease
1:39:38 PM
CHAIR WILSON reconvened the meeting.
1:39:39 PM
SENATOR REINBOLD stated that Amendment 13 would require
immediate notification of a family member when an individual is
admitted to a crisis stabilization center, crisis residential
center, evaluation facility, or treatment facility.
1:40:05 PM
SENATOR BEGICH said he understood the intent, but his concern
was to ensure that the contact with family was safe, and that
might not happen if Amendment 13 were to pass,. He suggested
that the amendment could be considered in the Senate Judiciary
Committee. He maintained his objection.
1:41:15 PM
SENATOR COSTELLO wondered if adding the language or guardian
on lines 8 and 22, after "family" would address his concern.
1:41:54 PM
SENATOR HUGHES stated that she would work on the language in the
Senate Judiciary Committee to ensure that parents and guardians
were notified and that Senator Begichs safety concern was also
addressed.
SENATOR REINBOLD said her concern was for immediate family
members who did not know where the person was being admitted.
She suggested the committee conceptually amend Amendment 13
today and the next committee of referral could address how to
avoid notifying family members in abusive situations.
1:44:39 PM
SENATOR BEGICH said he had contemplated Senator Costello's
suggestion, which he understood would add respondents
immediate family or guardian." He offered to withdraw his
objection if she agreed to offer the amendment.
SENATOR COSTELLO offered to make a conceptual amendment.
1:45:00 PM
CHAIR WILSON asked Ms. Meade to comment on Amendment 13.
1:45:36 PM
NANCY MEADE, General Counsel, Office of the Administrative
Director, Alaska Court System, Anchorage, Alaska, stated that
she reviewed Amendment 13 and did not find any technical issues.
1:45:54 PM
SENATOR COSTELLO moved Conceptual Amendment 1 to Amendment 13.
Page 1, line 8:
Insert "or guardian" following "family"
Page 1 line 22:
Insert "or guardian" following "family"
SENATOR COSTELLO stated that it would read "immediate family or
guardian" in both instances.
1:46:31 PM
CHAIR WILSON objected for purposes of discussion.
1:46:36 PM
CHAIR WILSON offered his view that Conceptual Amendment 1 to
Amendment 13 would not address the issue of notifying an
immediate family member that the admitted person would not want
notified. He related the notification could be a brother,
sister, grandmother, mother, or another family member.
SENATOR BEGICH agreed. He felt comfortable that Senator Hughes
would work on language in the next committee of referral.
CHAIR WILSON remarked that generally, he did not prefer to have
another committee address an unfinished amendment. He asked the
will of the committee.
1:47:43 PM
SENATOR REINBOLD asked if this relates to the full amendment.
CHAIR WILSON answered that Conceptual Amendment 1 to Amendment
13 was before the committee.
1:48:02 PM
CHAIR WILSON stated the committee would take a roll call vote on
Conceptual Amendment 1 to Amendment 13.
1:48:04 PM
SENATOR HUGHES stated she understood that Chair Wilson was
uncomfortable that the issue was unfinished. She committed to
work on the issue in the next committee of referral. She offered
support for Conceptual Amendment 1 to ensure that notification
to the immediate family occurs.
1:48:30 PM
At ease
1:49:01 PM
CHAIR WILSON reconvened the meeting and asked for a roll call
vote.
1:49:13 PM
A roll call vote was taken. Senators Begich, Hughes, Costello,
and Reinbold voted in favor of adopting Conceptual Amendment 1
to Amendment 13, and Senator Wilson voted against it. Therefore,
Conceptual Amendment 1 to Amendment 13 was adopted on a 4:1
vote.
CHAIR WILSON announced that Conceptual Amendment 1 to Amendment
13 was adopted on a vote of 4 yeas and 1 nay.
1:49:43 PM
SENATOR REINBOLD opined that parental consent should be required
for admission to the crisis care facilities, not just
notification. She said it was easier to modify and adjust the
notification language once it is in the bill. She urged members
to vote yes.
1:50:24 PM
CHAIR WILSON stated that some patients do not always want family
members informed of their medical conditions, especially when
they are not minors. He offered his belief that this was a
significant concern.
1:50:48 PM
SENATOR HUGHES offered to address this issue and Senator
Begich's concern that a family member could be abusing the
person. She offered to review both of those issues in the Senate
Judiciary Committee.
1:51:10 PM
SENATOR BEGICH commented that he would have opposed Amendment 13
if Senator Hughes hadnt indicated she would work on these
issues in the Senate Judiciary Committee.
1:51:28 PM
CHAIR WILSON removed his objection; he found no further
objection, and Amendment 13, as amended, was adopted.
1:51:43 PM
SENATOR REINBOLD moved to adopt Amendment 14, work order 32-
GS1730\B.4.
32-GS1730\B.4
Dunmire/Foote
3/14/22
AMENDMENT 14
OFFERED IN THE SENATE BY SENATOR REINBOLD
TO: CSSB 124(HSS), Draft Version "B"
Page 7, line 30, following "if":
Insert "the respondent is"
Page 8, line 1:
Delete all material and insert:
"(2) if the respondent is a minor,
(A) the minor has the rights identified
in AS 47.30.700 - 47.30.815;
(B) psychotropic medication may not be
administered to the minor unless a parent or
legal guardian has given permission to the crisis
stabilization center or crisis residential center
to administer the psychotropic medication; and
(C) a parent or legal guardian has the
right to be fully informed of possible side
effects of a proposed psychotropic medication."
1:51:46 PM
CHAIR WILSON objected for discussion purposes.
1:51:48 PM
SENATOR REINBOLD explained that Amendment 14 would ensure that
parental or guardian permission is required before administering
psychotropic drugs to a minor in a crisis care facility. She
stated her belief that informed consent is a critical right.
1:53:04 PM
SENATOR HUGHES said she was unsure whether Senator Reinbold was
present during a prior discussion about the need for medical
personnel to give medication during life-threatening situations,
such as a person experiencing a heart attack. In those
instances, medical personnel might not have time to get a
parent, guardian, or other family member's permission before
administering drugs or providing procedures. She noted that
minor athletes could have heart attacks. She related a scenario
where a minor was endangering their life or others when admitted
to crisis stabilization centers. She asked Senator Reinbold if
she was suggesting that the center would have to get permission
from a parent or legal guardian before saving the child's life.
SENATOR REINBOLD recalled a discussion about the language in
Amendment 3. She recognized that the court system stated that
"serious" did not need to be added, but a psychiatrist she spoke
to disagreed because it required a higher standard. She offered
his view that the committee should revisit the amendment. She
offered her belief that a parent or guardian should be involved
when psychotropic drugs are administered because of the risk of
side effects. She said she would want a parent or guardian
involved when administering psychotropic drugs during a life-
threatening situation.
1:55:39 PM
SENATOR HUGHES agreed that some psychotropic drugs were not
administered in life-threatening situations. For instance, she
understood that lithium was used for routine behavioral health,
which a crisis stabilization center would prescribe. She offered
her view that consent could be required unless the minor's life
was endangered. She asked whether the sponsor would be willing
to consider an exception for emergency situations in which the
minor's life was at risk.
1:57:04 PM
SENATOR REINBOLD said she was open to having an exception for
life endangerment.
1:57:32 PM
At ease
1:58:10 PM
CHAIR WILSON reconvened the meeting.
1:58:11 PM
SENATOR BEGICH asked whether these rights were already covered
in law.
1:58:49 PM
STEVEN BOOKMAN, Senior Assistant Attorney General, Human
Services Section, Civil Division, Department of Law, Anchorage,
Alaska, agreed that law addresses this in AS 25.20.025,
Examination and treatment of minors. It essentially says that
parents make decisions about minors. It lists instances in which
a parent cannot be contacted or, if contacted, is unwilling to
grant or withhold consent that a minor can consent to treatment.
He stated that the concerns voiced earlier about crisis
medication, where the alternative was to tie someone down, and
non-crisis medication intended to improve a general condition,
was an important distinction. He offered his view that this was
addressed in the existing statute.
1:59:49 PM
SENATOR BEGICH stated his belief that it was covered.
1:59:58 PM
CHAIR WILSON agreed.
2:00:11 PM
SENATOR REINBOLD commented that was what she had thought. She
stated that the bill amends AS 47, not AS 25 and that these are
new residential centers. She said she was told that AS 25 would
not apply to them. She stated that Amendment 14 would make it
clear that the rights in Article 10 apply to the minors in these
new facilities.
2:00:55 PM
SENATOR HUGHES asked whether Legislative Legal Services said AS
25 would not apply.
SENATOR REINBOLD answered that her information came from a
patient advocacy group concerned about the new subacute
facilities. She stated that Amendment 14 would ensure that
Article 10 rights also apply to minors.
CHAIR WILSON stated that Mr. Bookman clarified that AS 25 does
apply. He noted that the court administrator nodded her
agreement that Title 25 would apply to SB 124.
2:02:06 PM
SENATOR HUGHES asked for assurance that AS 25 would separate the
life-threatening situations from medication given to soothe the
patient, such that consent from a parent or guardian would not
be necessary.
2:02:40 PM
MR. BOOKMAN answered that he believed it would do so. He stated
that AS 25.20.025 covers medical treatment generally. He
indicated that regarding crisis medication, the intent of SB 124
is to incorporate the standard currently used in evaluation
centers. Under AS 47.30.838, a crisis medication may be used
only if there's a crisis or an impending crisis requiring
immediate use of the medication to preserve life or prevent
significant physical harm. He offered his belief that a mood
stabilizer or something that is soothing would not be permitted
because that medication would not be necessary to prevent an
impending or actual crisis. The crisis medication would need to
have an immediate effect. It would not be permissible under AS
47.30.838.
2:04:08 PM
SENATOR HUGHES stated that it made sense that AS 25 would apply
to situations where a child is rushed to an emergency room for
treatment. Although she supports the concept of Amendment 14,
she does not support the amendment. She offered to follow up
with Legislative Legal Services for assurances that AS 25 does
apply and that parental consent would be required in non-
emergency situations. If not, she offered to raise the issue in
the Senate Judiciary Committee.
2:05:03 PM
SENATOR REINBOLD asked whether parental and minor rights in AS
47.37.815 apply to the new facilities.
MR. BOOKMAN answered yes. He explained that the minor would have
rights as any patient would. He clarified that the new crisis
stabilization centers, and crisis residential centers would not
have the ability to involuntarily prescribe non-crisis
medication. It is not an issue for minors because the only way a
minor at one of these centers could receive long-term medication
would be with the parent or guardian's permission. He explained
that the existing statute would allow for a limited exception if
the parents were unavailable and the minor was mature enough to
consent.
2:06:38 PM
SENATOR REINBOLD offered her view that Amendment 14 was critical
because psychotropic medication can cause nightmares, increased
saliva, swelling of the face, lips, tongue, or throat, thoughts
of suicide, or other harmful side effects. She offered her
support for informed consent, parental involvement, and an
advocate or legal guardian.
2:07:42 PM
CHAIR WILSON maintained his objection.
2:07:45 PM
A roll call vote was taken. Senator Reinbold voted in favor of
Amendment 14, and Senators Hughes, Costello, Begich, and Wilson
voted against it. Therefore, Amendment 14 failed on a 1:4 vote.
2:08:05 PM
CHAIR WILSON announced that Amendment 14 failed on a vote of 1
yea and 4 nays.
2:08:18 PM
CHAIR WILSON held SB 124 in committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 124 Testimony 3.21.22.pdf |
SHSS 3/22/2022 1:30:00 PM |
SB 124 |
| SB 124 Amendments Considered 1-12 3.17.22.pdf |
SHSS 3/17/2022 1:30:00 PM SHSS 3/22/2022 1:30:00 PM |
SB 124 |
| SB 124 Amend. 1-39 3.17.22.pdf |
SHSS 3/17/2022 1:30:00 PM SHSS 3/22/2022 1:30:00 PM SHSS 3/29/2022 1:30:00 PM SHSS 4/7/2022 1:30:00 PM |
SB 124 |
| SB 124 CS Work Draft V. B.pdf |
SHSS 3/8/2022 1:30:00 PM SHSS 3/17/2022 1:30:00 PM SHSS 3/22/2022 1:30:00 PM |
SB 124 |
| SHSS- State of Health Presentation 3.22.22 .pdf |
SHSS 3/22/2022 1:30:00 PM |
|
| SB 124 Testimony 3.22.22.pdf |
SHSS 3/22/2022 1:30:00 PM |
SB 124 |
| SB 124 Ammend. Consider 13&14 3.22.22.pdf |
SHSS 3/22/2022 1:30:00 PM |
SB 124 |
| StateHealthImprovementPlan.HealthyAlaskans2030_Final.Revised-_02012022.pdf |
SHSS 3/22/2022 1:30:00 PM |