Legislature(2021 - 2022)BUTROVICH 205
05/04/2022 09:00 AM Senate JUDICIARY
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| Audio | Topic |
|---|---|
| Start | |
| SB124 | |
| 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
9:06:08 AM
CHAIR HOLLAND 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 this was the third hearing for the bill in this
committee. During the previous hearing, the committee 7
amendments and that process will continue today.
9:06:56 AM
SENATOR KIEHL moved to adopt Amendment 8, work order 32-
GS1730\I.14.
32-GS1730\I.14
Dunmire
5/2/22
AMENDMENT 8
OFFERED IN THE SENATE BY SENATOR KIEHL
TO: CSSB 124(HSS)
Page 15, line 18:
Delete "and"
Page 15, line 22, following "public":
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"
9:06:59 AM
CHAIR HOLLAND objected for discussion purposes.
9:07:02 AM
SENATOR KIEHL explained that Amendment 8 would charge the task
force established in the bill with identifying the methods for
collecting and reporting information on any patient complaints,
injuries, or traumatic events so the legislature can identify
and address any issues. He noted that the companion bill, HB
172, contains comparable language.
9:07:59 AM
SENATOR SHOWER asked for any other protections in the bill or
current statutes that protect patient privacy related to the
data collection.
9:08:34 AM
SENATOR KIEHL offered his belief that SB 124 does not change the
existing privacy laws, including the Health Insurance
Portability and Accountability Act of 1996 (HIPAA) or Alaska's
Personal Information Protection Act. He pointed out that
Amendment 8 or the bill would not require identifying data.
9:09:01 AM
SENATOR HUGHES offered her view that Amendment 8 addresses
something the previous committee discussed, providing
accountability regarding how these cases are handled.
9:09:34 AM
SENATOR MYERS suggested a potential Conceptual Amendment to 8.
He referred to differences between subparagraph (A), which would
record the number, type, and cause, and (C), which would record
the number and type of traumatic events but omits the cause. He
wondered if cause should be added.
SENATOR KIEHL responded that cause was included for patient
injuries because injuries are specific, identifiable incidents.
He suggested that isolation may have more to do with
institutional policies. However, he did not have any objection
to adding cause to subparagraph (C).
9:10:29 AM
SENATOR MYERS moved to adopt Conceptual Amendment 1 to Amendment
8, on line 10 after type add "and cause.
9:10:51 AM
SENATOR HUGHES suggested Conceptual Amendment 1 should also
delete the first and
SENATOR MYERS deferred to Legislative Legal Services to decide
if it was grammatically necessary.
9:11:02 AM
CHAIR HOLLAND objected for discussion purposes.
9:11:20 AM
CHAIR HOLLAND withdrew his objection; he heard no further
objection, and Conceptual Amendment 1 to Amendment 8 was
adopted.
CHAIR HOLLAND restated Conceptual Amendment 1 to Amendment 8. On
line 10 after number strike andand insert "," and after
type insert "and cause".
SENATOR MYERS agreed.
9:12:03 AM
CHAIR HOLLAND removed his objection; he found no further
objection, and Amendment 8, as amended, was adopted.
9:12:24 AM
SENATOR KIEHL moved to adopt Amendment 9, work order 32-
GS1730\I.9.
32-GS1730\I.9
Dunmire
4/27/22
AMENDMENT 9
OFFERED IN THE SENATE BY SENATOR KIEHL
TO: CSSB 124(HSS)
Page 6, lines 25 - 26:
Delete "Computation of the 72-hour period at a
crisis residential center before a hearing does not
include Saturdays, Sundays, and legal holidays."
Page 10, lines 25 - 26:
Delete "AS 47.30.708 or 47.30.715 [AS 47.30.715]"
Insert "AS 47.30.715"
9:12:26 AM
CHAIR HOLLAND objected for discussion purposes.
9:12:30 AM
SENATOR KIEHL stated his intention to explain Amendment 9 and to
withdraw it. However, he wanted to speak to it because the issue
would not go away. He indicated that Amendment 9 contains a
drafting mistake, but he might bring it back later in the
process.
SENATOR KIEHL explained that Amendment 9 pertains to how medical
facilities count the 72 hours when someone is being held who
does not want to be admitted to a psychiatric treatment
facility, whether it is a 7 or 30-day facility. He stated they
would be entitled to a court hearing under existing law with
lawyers within 72 hours. However, the current law does not count
weekends or holidays. He found holding someone for 6 days for a
30-day hold was proportionally acceptable. He expressed concern
that holding someone for 5 or 6 days before they had a hearing
before a judge would diminish their civil rights. He indicated
that the bill creates a new 7-day facility, which has the
potential to reap enormous benefits for people whose mental
health crisis is not so acute that it will take 30 days or
longer to address. He offered his view that there would be a
lower severity level for most 7-day holds.
SENATOR KIEHL characterized this as a balancing act because when
people need treatment but balk, things just get worse. He
cautioned against creating a process that is too tightly
structured. Since the court is closed on Friday, a patient
admitted on Thursday will not have a hearing until Tuesday if a
holiday occurs.
9:15:45 AM
SENATOR SHOWER asked if Amendment 9 could be amended now because
it gets to the heart of his concern. He stated that he supports
Amendment 9, and was concerned that by postponing action, the
committee might not have time to consider the language at a
later date.
9:16:23 AM
SENATOR KIEHL noted that he did not want to change the hearing
requirement for the 30-day holds, so the language for Amendment
9 will take some careful consideration.
9:16:47 AM
CHAIR HOLLAND withdrew his objection.
9:16:49 AM
SENATOR KIEHL withdrew Amendment 9 with the intention to bring
it back later in the process.
9:17:04 AM
SENATOR KIEHL moved to adopt Amendment 10, work order 32-
GS1730\I.15.
32-GS1730\I.15
Dunmire
5/2/22
AMENDMENT 10
OFFERED IN THE SENATE BY SENATOR KIEHL
TO: CSSB 124(HSS)
Page 8, lines 20 - 21:
Delete "AS 47.30.817 - 47.30.838, 47.30.840 -
47.30.850, and 47.30.855 - 47.30.865"
Insert "AS 47.30.817 - 47.30.865"
9:17:06 AM
CHAIR HOLLAND objected for discussion purposes.
9:17:09 AM
SENATOR KIEHL explained that Amendment 10 was a bit more than a
technical cleanup regarding a patient's rights at a crisis
residential center or hospital. He indicated that it would not
change the existing rights for patients, but the references to
those rights in the bill are different for adults and minors. He
offered his view that it would make the references uniform.
9:18:15 AM
SENATOR HUGHES asked if current law provides minors with fewer
rights.
SENATOR KIEHL responded that it was the opposite. He stated that
the goal was not to remove due process rights. However, if a
provision did not apply to a minor or adult, no harm would be
done.
9:18:50 AM
SENATOR HUGHES asked if the department had any concerns about
the process.
9:19:04 AM
HEATHER CARPENTER, Health Care Policy Advisor, Office of the
Commissioner, Department of Health and Social Services, Juneau,
Alaska, stated that the department worked with the sponsor of
Amendment 10. She explained that the bill inadvertently removed
one of the rights. She said Mr. Bookman agreed that it made
sense to expand it. The previous committee had already expanded
the citations related to minors. She said it would be fine if a
specific provision does not apply to a crisis stabilization
center or crisis residential center. However, it ensures the
full maximum protection of patient rights.
9:19:48 AM
SENATOR HUGHES stated her support for expanding patient rights.
9:20:02 AM
CHAIR HOLLAND removed his objection; he found no further
objection, and Amendment 10 was adopted.
9:20:18 AM
SENATOR KIEHL moved to adopt Amendment 11, work order 32-
GS1730\I.20.
32-GS1730\I.20
Dunmire
5/2/22
AMENDMENT 11
OFFERED IN THE SENATE BY SENATOR KIEHL
TO: CSSB 124(HSS)
Page 5, line 17, following "respondent":
Insert "has a mental illness and"
Page 5, line 24, following "the":
Insert "respondent has a mental illness and is
suffering an acute behavioral health crisis and, as a
result, is likely to cause harm to self or others or
is gravely disabled and the"
Page 5, line 25, following "center,":
Insert "and the respondent is not willing to
voluntarily go to a crisis residential center,"
Page 6, lines 5 - 7:
Delete "is mentally ill and that condition causes
the respondent to be gravely disabled or to present a
likelihood of serious harm to self or others"
Insert "has a mental illness and is suffering an
acute behavioral health crisis and, as a result, is
likely to cause harm to self or others or is gravely
disabled"
Page 6, line 14, following "respondent":
Insert "has a mental illness and"
9:20:20 AM
CHAIR HOLLAND objected for discussion purposes.
9:20:32 AM
SENATOR KIEHL explained that Amendment 11 would match what the
medical professionals need to assert to the judge, such that the
respondent is mentally ill, experiencing a crisis, and was
likely to cause self-harm or harm others. The judge needs to
find those things valid to hold someone. He stated that the
current language in SB 124 created a mismatch in SB 124, and
Amendment 11 comports the language.
9:21:13 AM
CHAIR HOLLAND removed his objection.
9:21:20 AM
CHAIR HOLLAND objected for discussion purposes to hear comments
from the department.
MS. CARPENTER stated that the department supports Amendment 11.
She noted that Senator Kiehl and his staff made a good catch.
The court system also brought a similar point to the
department's attention. She stated that Amendment 11 would
ensure that it was the same for crisis stabilization centers and
crisis residential centers.
9:21:55 AM
CHAIR HOLLAND removed his objection; he found no further
objection, and Amendment 11 was adopted.
9:22:12 AM
SENATOR HUGHES moved to adopt Amendment 12, work order 32-
GS1730\I.18.
32-GS1730\I.18
Dunmire
5/2/22
AMENDMENT 12
OFFERED IN THE SENATE BY SENATOR HUGHES
TO: CSSB 124(HSS)
Page 12, following line 23:
Insert a new bill section to read:
"* Sec. 24. AS 47.30.840(a) is amended to read:
(a) A person undergoing evaluation or treatment
under AS 47.30.660 - 47.30.915
(1) may not be photographed without the
person's consent and that of the person's guardian if
a minor, except that the person may be photographed
upon admission to a facility for identification and
for administrative purposes of the facility; all
photographs shall be confidential and may only be
released by the facility to the patient or the
patient's designee unless a court orders otherwise;
(2) at the time of admission to an
evaluation or treatment facility, shall have
reasonable precautions taken by the staff to inventory
and safeguard the patient's personal property; a copy
of the inventory signed by the staff member making it
shall be given to the patient and made available to
the patient's attorney and any other person authorized
by the patient to inspect the document;
(3) shall have access to an individual
storage space for the patient's private use while
undergoing evaluation or treatment;
(4) shall be permitted to wear personal
clothing, to keep and use personal possessions
including toilet articles if they are not considered
unsafe for the patient or other patients who might
have access to them, and to keep and be allowed to
spend a reasonable sum of the patient's own money for
the patient's needs and comfort;
(5) shall be allowed to have visitors at
reasonable times;
(6) shall have ready access to letter
writing materials, including stamps, and have the
right to send and receive unopened mail;
(7) shall have reasonable access to a
telephone, both to make and receive confidential
calls;
(8) has the right to be free of corporal
punishment;
(9) has the right to reasonable opportunity
for indoor and outdoor exercise and recreation;
(10) has the right, at any time, to have a
telephone conversation with or be visited by an
attorney;
(11) may not be retaliated against or
subjected to any adverse change of conditions or
treatment solely because of assertion of rights under
this section;
(12) who is a minor or an adult for whom a
guardian has been appointed may not be transferred
from an evaluation or treatment facility to a
different evaluation or treatment facility before the
facility makes a good faith attempt to notify the
parent or guardian of the person, as applicable, of
the proposed transfer."
Renumber the following bill sections accordingly.
Page 15, lines 5 - 6:
Delete "secs. 1 - 33"
Insert "secs. 1 - 34"
Page 16, lines 3 - 4:
Delete "sec. 29"
Insert "sec. 30"
Page 16, line 5:
Delete "sec. 29"
Insert "sec. 30"
Page 16, line 14:
Delete "Section 34"
9:22:15 AM
CHAIR HOLLAND objected for discussion purposes.
9:22:17 AM
SENATOR HUGHES explained Amendment 12. She noted that the
previous committee and this committee discussed patient rights
and ensuring the proper consent notification by a parent or
guardian happened. She recalled that a previous amendment
addressed patient notification upon arrival at one of these
facilities. Amendment 12 pertains to parental or guardian
notification when a patient is transferred to another facility.
9:23:05 AM
SENATOR HUGHES stated her intent to offer a Conceptual Amendment
to Amendment 12, on page 2, line 13, after from add crisis
stabilization center," which will ensure that the notifications
occur.
9:23:25 AM
SENATOR HUGHES moved Conceptual Amendment 1 to Amendment 12, on
page 2, line 13, after from, add "crisis stabilization
center,.
9:23:40 AM
CHAIR HOLLAND objected for discussion purposes.
SENATOR HUGHES stated that she had previously discussed this
concept with the department.
9:24:01 AM
SENATOR MYERS asked whether the crisis stabilization center was
a 7-day facility.
SENATOR HUGHES interjected that it referred to the less than 24-
hour facility.
9:24:36 AM
At ease
9:25:03 AM
CHAIR HOLLAND reconvened the meeting.
9:25:14 AM
CHAIR HOLLAND asked Ms. Carpenter if she had any comments
regarding Conceptual Amendment 1 to Amendment 12.
MS. CARPENTER said that Conceptual Amendment 1 to Amendment 12
does what the sponsor was hoping, which was to capture all three
types of facilities. She explained that the amendment did not
need to mention a crisis stabilization center since it is in the
definition of an evaluation facility in SB 124. She explained
that an evaluation facility or treatment facility would include
the Alaska Psychiatric Institute and the three hospitals in
Alaska that serve as designated evaluation facilities.
9:26:03 AM
CHAIR HOLLAND removed his objection to Conceptual Amendment 1 to
Amendment 12; he found no further objection, and Conceptual
Amendment 1 to Amendment 12 was adopted.
9:26:15 AM
MS. CARPENTER stated that the department was comfortable with
Amendment 12, as amended.
9:26:36 AM
CHAIR HOLLAND withdrew his objection to Amendment 12, as
amended; he found no further objection, and Amendment 12, as
amended, was adopted.
9:27:07 AM
CHAIR HOLLAND moved to adopt Amendment 13, work order 32-
GS1730\I.21.
32-GS1730\I.21
Dunmire
5/3/22
AMENDMENT 13
OFFERED IN THE SENATE BY SENATOR HOLLAND
TO: CSSB 124(HSS)
Page 11, lines 19 - 20:
Delete ", guardian, or other family member"
Insert "or guardian"
Page 11, line 21, following "review":
Insert "all available information regarding"
Page 11, line 22:
Delete "triggers,"
Page 11, line 30, through page 12, line 3:
Delete all material and insert:
"(e) Before determining whether a minor patient
should be given psychotropic medication under this
section, a mental health professional shall, to the
extent time and the nature of the crisis permit,
consult with a parent or guardian of the minor,
evaluate the minor for drug withdrawal and medical
psychosis caused by currently prescribed drugs or
self-medication, and review all available information
regarding the minor's family history, diet,
medications, and other possibly relevant factors."
9:27:11 AM
SENATOR SHOWER objected for discussion purposes.
9:27:19 AM
MS. CARPENTER stated that Amendment 13 relates to Secs. 19 and
21, on pages 11 and 12. She explained that Amendment 13 replaces
the amendment that the committee withdrew [Amendment 6, I.12] at
the last hearing. The main difference is found on lines 5 and 6.
She noted that Sec. 19 relates to non-crisis medication, and
Sec. 21 relates to crisis medication. Amendment 13 would delete
language in Sec. 19 that requires consulting with other family
members before administering psychotropic medication to a minor
patient. Instead, a mental health professional would consult
with a parent or guardian and review all available information
regarding the minor's family history, diet, medications, and
other possibly relevant factors. This was to address the
members' concerns to ensure that mental health professionals
were looking at all the available information. It would also
delete "triggers" on page 11, line 22. She stated that the
language on Amendment 13, page 1, lines 11-18 is the same
language the committee reviewed.
9:29:02 AM
SENATOR SHOWER expressed appreciation that the department
addressed this. He indicated he was not overly comfortable
because when a crisis is not time-sensitive, the department
should take the time to consider all information. Still, medical
professionals need to make judgment calls when the situation is
critical.
9:29:39 AM
SENATOR HUGHES referred to lines 16-17, which read prescribed
drugs or self-medication. She asked whether self-medication
would include someone under the influence of illegal drugs.
MS. CARPENTER answered yes.
9:30:10 AM
SENATOR SHOWER removed his objection
9:30:13 AM
CHAIR HOLLAND found no further objection, and Amendment 13 was
adopted.
9:30:54 AM
SENATOR KIEHL moved to adopt Conceptual Amendment 1 to SB 124.
9:30:56 AM
CHAIR HOLLAND objected for discussion purposes.
9:31:02 AM
SENATOR KIEHL explained Conceptual Amendment 1 to SB 124 would
ensure that the process when a patient moves from one level to
another at the facilities would have the same safeguards and
checks as every other. He stated that by including the language
"evaluation facility" in each section, the process of going from
a crisis stabilization center, evaluation facility, or hospital
would be the same as going from a crisis stabilization center to
a 7-day facility. Thus, transferring someone in the 23-hour
facility to a hospital would remain the same, with no
unintentional loopholes.
9:31:59 AM
MS. CARPENTER explained that the department, Department of Law
attorney, and the court system spent significant time with
Senator Kiehl and his staff and agree that this is the correct
solution to avoid a potential loophole that might arise in a
rare circumstance. For instance, if a patient comes into a 23-
hour crisis stabilization center because a bed at a crisis
residential center is unavailable or the situation is too acute,
medical professionals can elevate the patient to the next level
of care. The court must decide within the first 24 hours, but
the patient would still retain all their legal protections and
rights during the process.
9:33:14 AM
CHAIR HOLLAND removed his objection; he found no further
objection, and Conceptual Amendment 1 to SB 124 was adopted.
9:33:41 AM
MS. CARPENTER stated that the department, on behalf of the
governor, appreciated the committee's efforts to consider
improvements to the psychiatric crisis system.
9:34:06 AM
SENATOR SHOWER moved to report the committee substitute (CS) for
SB 124, work order 32-GS1730\I, as amended, from committee with
individual recommendations and attached fiscal note(s).
SENATOR HUGHES objected to ask a question. She noted that
Senator Kiehl withdrew an amendment to further work on the
language. She asked Senator Kiehl whether he would be working
with the Finance Committee on the amendment. She characterized
it as a good amendment.
SENATOR KIEHL answered yes; he said he would work with the
department, the Alaska Mental Health Trust, the court system,
and the Finance Committee on the amendment.
9:34:55 AM
SENATOR HUGHES removed her objection.
9:35:01 AM
CHAIR HOLLAND found no further objection, and CSSB 124(JUD) was
reported from the Senate Judiciary Standing Committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 124 SJUD Amendment #8 (I.14).pdf |
SEDC 5/2/2022 1:30:00 PM SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 9:00:00 AM SJUD 5/6/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #9 (I.9).pdf |
SEDC 5/2/2022 1:30:00 PM SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 9:00:00 AM SJUD 5/6/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #10 (I.15).pdf |
SEDC 5/2/2022 1:30:00 PM SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 9:00:00 AM SJUD 5/6/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #11 (I.20).pdf |
SEDC 5/2/2022 1:30:00 PM SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 9:00:00 AM SJUD 5/6/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #12 (I.18).pdf |
SJUD 5/4/2022 9:00:00 AM |
SB 124 |
| SB 124 SJUD Amendment #13 (I.21).pdf |
SJUD 5/4/2022 9:00:00 AM SJUD 5/6/2022 1:30:00 PM |
SB 124 |
| Conceptual Amendment 1 to SB 124.pdf |
SJUD 5/4/2022 9:00:00 AM |
SB 124 |