Legislature(2023 - 2024)BUTROVICH 205
04/23/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB17 | |
| HB371 | |
| SB231 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 17 | TELECONFERENCED | |
| += | HB 371 | TELECONFERENCED | |
| += | SB 231 | TELECONFERENCED | |
SB 231-MINORS & RESIDENT PSYCH TREATMENT CENTERS
3:47:57 PM3:47:59 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 231 "An Act relating to
residential psychiatric treatment centers; and providing for an
effective date."
3:48:41 PM
SENATOR MATT CLAMAN, District H, Alaska State Legislature,
Juneau, Alaska, provided an overview of SB 231 and stated that
the legislation seeks to enhance the rights of minors receiving
inpatient psychiatric care in Alaska. It includes provisions for
one hour of weekly communication with a parent or guardian,
semi-annual inspections by the department, and reporting on the
use of seclusion and restraint in these facilities.
CHAIR WILSON said the sponsor of SB 231 requested a committee
substitute.
3:49:33 PM
CHAIR WILSON solicited a motion.
3:49:36 PM
SENATOR KAUFMAN moved to adopt the committee substitute (CS) for
SB 231, work order 33-LS1196\S, as the working document.
3:49:47 PM
CHAIR WILSON objected for purposes of discussion.
3:49:53 PM
SENATOR CLAMAN stated the following concerning changes to SB
231, versions A, B, and S:
[Original punctuation provided.]
There are three versions of SB 231 in front of you
today. Version A, which we discussed in the first
hearing on March 26th, Version B and Version S.
Version B integrated the feedback that came from the
first hearing but included an unintended limitation on
the applicability of SB 231. We corrected that
limitation in Version S.
3:50:17 PM
SENATOR CLAMAN continued:
[Original punctuation provided.]
Version A of SB 231 only applied to minors receiving
treatment at facilities licensed as residential
psychiatric treatment centers. In discussion with the
Department and other stakeholders, we learned that
residential psychiatric treatment centers are only one
type of license for facilities that provide inpatient
mental health care to minors. Some facilities are
currently licensed as specialty hospitals or
psychiatric hospitals. We wanted to ensure that all
facilities providing in-patient mental health
evaluation or treatment to minors are included in SB
231, regardless of a facility's current or future type
of license.
Version B of SB 231 expanded the bills application to
"treatment facilities"defined in AS 47.30.915 as a
hospital, clinic, institution, center, or other health
care facility that has been designated by the
department for the treatment or rehabilitation of
mentally ill persons. Then we received feedback from
the Department of Health and the Department of Family
& Community Services that the definition for treatment
facility in AS 47.30.915 is used specifically in
designating psychiatric treatment facilities for
involuntary admission. Using this definition of
treatment facility could unintentionally limit the
scope of SB 231.
Version S of SB 231 creates a new definition in
statute, defining treatment facility as a hospital,
clinic, institution, center, or other healthcare
facility licensed to provide inpatient mental health
evaluation or treatment to minors.
Both Version B and Version S include clarifications on
a minor patient's rights to confidential communication
while at a treatment facility. First, the weekly, one-
hour requirement can be waived due to law or court
order or if it's considered therapeutically
unadvisable by an overseeing physician. Second, the
communication can be between a patient and their
parent, guardian, or another adult approved by an
overseeing physician. Third, communication can be via
video or telephone and the weekly, one-hour
requirement can be satisfied by cumulative sessions at
no more than four occasions.
3:52:36 PM
SENATOR CLAMAN continued:
[Original punctuation provided.]
Both Version B and Version S add a requirement that
the Department of Health annually publish a report on
their Internet website on the aggregate total uses of
seclusion and restraint at each treatment facility.
Finally, Version S differs from Version B in a
modification to the requirement for the Department of
Health to conduct unannounced inspections of treatment
facilities twice each year. In Version S, this
provision only applies to treatment facilities in
which a minor spends more than three nights in the
preceding year. This change prevents excessive
inspection of facilities that provide short-term,
inpatient psychiatric treatment for minors in a mental
health crisis, such as hospital emergency rooms.
In summary, Version S of SB 231 provides the most
clarified and inclusive application of the bill's
provisions. I encourage the Committee to adopt Version
S of SB 231 today.
SENATOR CLAMAN mentioned that the summary of changes for all
versions are in the committee's bill packet and at the
committee's request his staff could read them for the record.
3:53:43 PM
CHAIR WILSON asked if any committee member would like the
summary of changes read. Seeing no response, he asked for
comments from the departments present.
3:54:26 PM
TRACY DOMPELING, Director, Division of Behavioral Health,
Department of Health, Juneau, Alaska, stated that the department
supports the spirit of SB 231, emphasizing the importance of
ensuring minors in high-level inpatient care have rights and
receive appropriate, safe, and rehabilitative treatment. She
noted ongoing discussions within the Department of Health and
the Department of Family and Community Services to clarify the
new committee substitute (CS) and the types of facilities it
encompasses. She highlighted concerns about creating confusion
with an additional definition of treatment facilities in
statutes and the need for clarity on which facilities SB 231
aims to address. She referenced Senator Claman's discussion
about emergency rooms, noting that they are not licensed as
inpatient psychiatric treatment facilities, and stressed the
importance of identifying and monitoring higher-level care
facilities that engage in practices such as seclusion and
restraint.
3:56:28 PM
RENEE GAYHART, Director, Division of Health Care Services,
Department of Health, Juneau, Alaska, clarified that the term
"treatment facility" spans two statutes, and during licensing,
the focus is on licensing the facility itself rather than the
services provided. She emphasized that for higher levels [of
inpatient care], policies are crucial to ensuring the safety of
individuals in those facilities.
3:57:02 PM
CHAIR TOBIN said she is focusing on the definition of "facility"
that was added to the CS [version S], noting that it includes
hospitals. She asked if this means the Department of Health
would conduct inspections on a Department of Child and Family
Services facility, such as the Chilkat Unit of Alaska
Psychiatric Institute (API).
3:57:35 PM
MS. DOMPELING responded that her understanding was correct and
acknowledged that it raises the question of whether the
Department of Health would conduct surprise inspections at
another department's facility. She noted that such facilities,
like hospitals, already adhere to their own accreditation
standards.
SENATOR TOBIN responded that it is an interesting dynamic.
3:58:11 PM
CHAIR WILSON asked if Senator Claman had any opposition to
adjusting definitions.
3:58:29 PM
SENATOR CLAMAN replied that his office has been working on
creating a CS to provide a narrower definition without excluding
hospitals that provide inpatient psychiatric care to minors. He
addressed the department's comment about emergency rooms,
clarifying that under the current definition, even with the
three-day provision, emergency rooms still would not qualify
because they are not licensed to provide impatient mental health
evaluation and treatment. He expressed openness to refining the
definition further to include current facilities providing
psychiatric care to minors and those that may be licensed in the
future.
3:59:21 PM
CHAIR WILSON stated he is not concerned about one department
reviewing another department. For example, the Department of
Corrections' treatment programs could benefit from review by the
Division of Behavioral Health.
3:59:48 PM
CHAIR WILSON removed his objection; found no further objection
and CSSB 231, version S, was adopted as the committee's working
document.
4:00:56 PM
CHAIR WILSON held SB 231 in committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 17 Beveridge.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 17 |
| HB 17 LOS Lance.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 17 |
| HB 371 LOS Allmeroth.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 371 |
| SB 231 CS Work Draft 33-LS0496 v B.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB231 SHSS 3.26.24 response.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 AK Child and Family 4.4.24.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB231 Support Slaikeu.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Version S.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Summary of Changes Version A to Version S.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Summary of Changes Version A to Version B.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| SB 231 Summary of Changes Version B to Version S.pdf |
SHSS 4/23/2024 3:30:00 PM |
SB 231 |
| HB 17 Amdmt U.1.Tobin - Adopted UC 4.23.24.pdf |
SHSS 4/23/2024 3:30:00 PM |
HB 17 |