Legislature(1995 - 1996)
04/09/1996 01:45 PM FIN
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
HOUSE BILL 493 "An Act relating to involuntary commitment for alcoholism or drug abuse." REPRESENTATIVE IVAN IVAN testified in support of HB 493, noting that he introduced the bill as a solution to assist with the public inebriate problem faced by many communities throughout the State. Under current statute, AS 47.37.190, provisions allow for the involuntary commitment of alcoholics. Those provisions allow for 30 day commitments followed by a recommitment length of 90 days. Current law has been found to be unwieldy, expensive and treatment options are not readily available. According to a community survey report by the City and Borough of Juneau (CBJ), communities use the commitment policy sparingly, if they use it at all. The report also emphasized that the current commitment process is not working. Representative Ivan continued, under HB 493, the involuntary commitment process would be similar to those found in the involuntary mental health commitments. Drug abusers were not included in the definitions of incapacitation or intoxication. According to the Division of Alcoholism and Drug Abuse, many public inebriates are ingesting not only alcohol but drugs. The bill would change the definition of intoxicated persons to include drugs which are defined under the controlled substances statutes in Title 11. DR. GILBERT SANDERS, (TESTIFIED VIA TELECONFERENCE), PSYCHOLOGIST, DIRECTOR, CHEMICAL DEPENDENCY UNIT, MT. EDGECUMBE HOSPITAL, SITKA, voiced concern with the legislation. Particularly in reference to language proposed on Page 2, Lines 5 & 6, "physician". He suggested that psychologists should have the same authority as the physicians. He requested Committee members make that change. 5 He added, language in the bill references the individuals "health and safety". He recommended that reference clearly include the mental health as well as the physical health. He stressed that the problem of drug abuse is clearly a mental health disorder. (Tape Change, HFC 96-105, Side 2). DONALD DAPCEVICH, EXECUTIVE DIRECTOR, GOVERNOR'S ADVISORY BOARD ON ALCOHOLISM & DRUG ABUSE, OFFICE OF THE COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, noted that the Board was an advocate for the individuals who are subject to the provisions of the legislation and for services statewide with regard to substance abuse. He stated that the Board strongly supports the legislation. The current situation has created an unworkable law placing pressure on municipalities, courts, police and the medical facilities around the State. He stressed that current law is confusing. Mr. Dapcevich thought that the legislation could provide better treatment options. He pointed out that the "hope" is that the legislation could educate communities of the "clinical" rather than "social" definitions of those subject to the statute. Mr. Dapcevich spoke to the civil rights of involuntarily committing someone against their will. Current statute allows for involuntary commitment. The changes would create a longer time span for recommitment when the initial phase had been completed and more time is considered to be needed. He referenced the cost/benefit analysis. [Copy on file]. Mr. Dapcevich suggested that a cost savings could exist, pointing out that marginal costs differ from real costs. Mr. Dapcevich reiterated that over a long term "real cost savings" would exist. Representative Mulder asked Mr. Dapcevich if the definition on Page 7, Section #14, was adequate. Mr. Dapcevich stated that it was. Often times people get caught up in the definition of "intoxification" using is synonymously as it applies to motor vehicle accidents, whereas, in a law of involuntary commitment, very different issues are regarded for incapacitation. The statute as proposed is correct. Mr. Dapcevich interjected that he disagreed with Dr. Sanders request to add "mental health" issues to involuntary commitment. He pointed out that there exists a mental health commitment law for issues dealing with mental health 6 concerns. Mr. Dapcevich added, the fiscal note which had been submitted was too high. The Board supports reducing it. In response to Representative Martin's statement, Mr. Dapcevich explained that times are changing, people are realizing that involuntary commitment is not an evil process. Representative Martin asked if there has been discussion with the Native people throughout Alaska. Mr. Dapcevich stated that there has been constructive dialogue with the Alaska Federation of Natives (AFN). Representative Martin questioned how the proposed program would differ from the many alcohol programs that have preceded it. Mr. Dapcevich replied that for the referenced population, all treatment programs are effective on some level. Long term treatment is the only treatment that is effective for late stage chronic alcoholics or addicts. Representative Martin pointed out that HB 493 and HCR 26 address the same concern. Representative Brown inquired the rate of success of late stage alcoholics going through a treatment program. Mr. Dapcevich advised that the rate of success is measured in the cost benefit analysis. To measure long term sobriety, it would be far less effective. He added that most studies find a 12% - 15% recovery, a "good" rate of recovery for the late stage alcoholic. Representative Brown asked why the Board felt that it should be easier to commit someone with the proposed condition than the already existing standard used to commit someone with mental illness. Mr. Dapcevich replied, it was the intent to make the legislation consistent with the mental health commitment. Representative Brown asked if the municipalities would be involved in providing the treatment facilities. Mr. Dapcevich responded that all facilities currently used are joint State and municipality funded. Representative Brown questioned the fiscal impact to the municipalities. Mr. Dapcevich suggested that eventually there would be a fiscal savings to the municipalities. ELMER LINDSTROM, SPECIAL ASSISTANT, OFFICE OF THE COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES (DHSS), explained the fiscal note for the Department. The funds associated with the FY98 portion of the request would cover legal training and treatment programs for the municipalities. The out-year projections include an expected need for additional residential treatment beds. No treatment impact is expected for FY97. 7 Representative Kohring asked why Juneau had been chosen as the pilot city for the program. BARBARA CRAVER, ASSISTANT CITY ATTORNEY, CITY AND BOROUGH OF JUNEAU (CBJ), JUNEAU, responded that Juneau was not the pilot program, but rather, Juneau has been using this system since the local treatment facility has been in operation. There will be no changes to the Juneau facility with passage of the legislation, although, it is anticipated that the bill would provide clinically based definitions which will make everything at that operation run more smoothly. Mr. Lindstrom reiterated, the Juneau facility was not a pilot program, instead a program that has been using the recommendations now put forth. Representative Brown asked the difference in Section #7, being incapacitated by alcohol and being at risk for serious illness. Ms. Craver stated that language had been added because involuntary commitments require serious harm of some kind. She continued, incapacitation is being redefined in the definition section, Section #14. CBJ does support the new definition and standard. Representative Brown asked if all heavy drinkers would be at risk of fitting into the category. She suggested that the definition of who was eligible for involuntary commitment was too broad. SHANNON O'FALLON, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW, noted that the legislation was attempting to make the standard similar to the mental health commitment statute, AS 47.30.700. Under the mental health commitment statute, the person must be suffering from a mental illness and be of a danger to themselves and/or others, and/or gravely disabled. Representative Mulder referenced the Alaska Court System fiscal note and questioned the long term impact. (Tape Change, HFC 96-106, Side 1). ARTHUR SNOWDEN, ADMINISTRATIVE DIRECTOR, ALASKA COURT SYSTEM, stated that he would check with the administrative director for the Court System. He explained, when a bill is initiated under the context of addressing a person incapacitated due to alcohol or drugs and taken into possession by a police officer, the Court System assumes that most of these persons would be indigent. Thus, they will need an attorney and the Court System will be responsible for that cost. He remarked that the communities will stand by the statute. Mr. Snowden thought that the Court System fiscal note was correct, although volunteered to further research that information. 8 Representative Martin MOVED to report CS HB 493 (JUD) out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS HB 493 (JUD) was reported out of Committee with a "no recommendation" and with fiscal notes by the Department of Administration dated 3/19/96, the Alaska Court System dated 3/19/96, the Department of Health and Social Services dated 3/19/96 and a zero fiscal note by the Department of Public Safety dated 3/19/96.