Legislature(1995 - 1996)

04/09/1996 01:45 PM FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
  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.                                                        

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