Legislature(2001 - 2002)

03/22/2001 03:05 PM House HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
HB 115-EMERGENCY COMMITMENT ORDERS                                                                                            
CHAIR DYSON announced  that the first order of  business would be                                                               
HOUSE BILL  NO. 115,  "An Act allowing  a physician  assistant or                                                               
advanced  nurse practitioner  to certify  the need  for emergency                                                               
treatment as a result of intoxication."                                                                                         
Number 0128                                                                                                                     
REPRESENTATIVE WILSON moved to adopt CSHB 115, version 22-                                                                      
LS0059\F,  Ford,  2/15/01, as  the  working  document before  the                                                               
committee.   There being no  objection, Version F was  before the                                                               
REPRESENTATIVE MARY KAPSNER,  Alaska State Legislature, testified                                                               
as sponsor  of HB 115.   She informed the committee  that she had                                                               
three  amendments  to offer  the  committee.   Amendment  1,  22-                                                               
LS0059\F.3, Ford, 3/22/01, read as follows:                                                                                     
     Page 2, line 3:                                                                                                            
          Delete "master"                                                                                                   
          Insert "clinical"                                                                                                 
REPRESENTATIVE COGHILL asked Representative  Kapsner to provide a                                                               
comparison of  what a master  social worker is versus  a clinical                                                               
social worker.                                                                                                                  
REPRESENTATIVE KAPSNER answered that the  two are the same.  This                                                               
[amendment] merely cleans up the language.                                                                                      
REPRESENTATIVE  CISSNA related  her understanding  that there  is                                                               
different training, licensure, and coursework.                                                                                  
ANNE  HENRY, Special  Projects  Coordinator,  Division of  Mental                                                               
Health  &  Developmental  Disabilities, Department  of  Health  &                                                               
Social  Services,  explained  that  a  licensed  clinical  social                                                               
worker means that  the individual has a master's  degree plus two                                                               
years of experience in order to receive the clinical license.                                                                   
Number 0284                                                                                                                     
REPRESENTATIVE COGHILL  moved that the committee  adopt Amendment                                                               
1.  There being no objection, Amendment 1 was adopted.                                                                          
CHAIR  DYSON referred  to  his  amendment labeled  22-LS0059\F.2,                                                               
Ford, 3/22/01.   He explained  that this amendment would  allow a                                                               
person  to be  considered for  an involuntary  commitment if  the                                                               
person is a  danger to his or her own  unborn child, specifically                                                               
in cases of  fetal alcohol syndrome (FAS).  He  noted the need to                                                               
change the  "on an" language  throughout the amendment  to "their                                                       
own".   The  amendment  with the  aforementioned  change read  as                                                           
     Page 1, line 5, following "intoxication;":                                                                               
          Insert   "relating   to    commitment   based   on                                                                  
     intoxication or alcohol or drug abuse;"                                                                                  
     Page 2, following line 5:                                                                                                  
          Insert a new bill section to read:                                                                                    
        "* Sec. 2.  AS 47.37.180(a) is amended to read:                                                                     
          (a)  An intoxicated person who (1) has                                                                                
     threatened,   attempted   to  inflict,   or   inflicted                                                                    
     physical harm on another or  their own unborn child, or                                                                
     is likely to inflict physical  harm on another or their                                                                
     own  unborn   child,  unless   committed,  or   (2)  is                                                                
     incapacitated by alcohol or drugs,  may be committed to                                                                    
     an  approved public  treatment  facility for  emergency                                                                    
     treatment.   A  refusal to  undergo treatment  does not                                                                    
     constitute evidence of lack of  judgment as to the need                                                                    
     for treatment."                                                                                                            
     Renumber the following bill sections accordingly.                                                                          
     Page 2, line 27, following "another":                                                                                      
          Insert " or their own unborn child"                                                                               
     Page 2, line 28, following "another":                                                                                      
     Insert " or their own unborn child"                                                                                    
The committee took a brief at-ease from 3:12 p.m. to 3:14 p.m.                                                                  
Number 0540                                                                                                                     
DIANA WEBBER, Director, Yukon Koyukuk  Mental Health Galena, said                                                               
that HB 115 is  an excellent bill.  She then  turned to the issue                                                               
of  delivering  mental health  services  in  rural Alaska.    She                                                               
informed  the  committee  that  some of  the  highest  levels  of                                                               
alcohol abuse and fetal alcohol syndrome  exist in her area.  She                                                               
emphasized that  community mental health centers  in rural Alaska                                                               
face  great difficulty  in  obtaining  licensed master's  [level]                                                               
clinical providers.   Therefore, Ms. Webber  suggested broadening                                                               
the  list of  providers to  include  the same  level of  master's                                                               
providers  that  Medicaid approves  to  bill  for clinical  work,                                                               
which  would include  some  unlicensed master's-level  providers,                                                               
such as  master's in counseling  psychology.  She  explained that                                                               
it  is  very  difficult  for master's-level  providers  in  rural                                                               
Alaska to get licensed because  they don't have the same face-to-                                                               
face access  to psychologists, psychiatrists, and  social workers                                                               
who could supervise them.                                                                                                       
CHAIR DYSON  suggested to Ms.  Webber that she discuss  that with                                                               
Representative  Kapsner   after  the   meeting  and   perhaps  an                                                               
amendment could be made in the  Senate.  Chair Dyson said he felt                                                               
it was  too late  in the  process to  do this  now.   Chair Dyson                                                               
requested  that  Ms. Webber  speak  to  why this  legislation  is                                                               
valuable and how difficult it is to do involuntary commitments.                                                                 
MS.  WEBBER explained  that currently,  in her  area, involuntary                                                               
commitments  can  only  be  authorized by  a  psychologist  or  a                                                               
psychiatrist,  which her  area does  not have.   Therefore,  such                                                               
folks have  to be  convinced to  go to Fairbanks  in order  to be                                                               
committed.   Ms. Webber clarified  that the current law  does not                                                               
serve areas that  are underserved by medical  professionals.  Ms.                                                               
Webber  emphasized, "I  wholeheartedly  endorse adding  master's-                                                               
level  clinicians, in  some form  or other,  to be  able to  make                                                               
those clinical decisions regarding commitment.   It would be very                                                               
helpful to us."                                                                                                                 
Number 0772                                                                                                                     
CHAIR  DYSON  requested  that  Mr.   Ford,  the  drafter  of  the                                                               
legislation, inform the committee  of his reasoning for inserting                                                               
"relating to commitment based on  intoxication or alcohol or drug                                                             
abuse;" on page 1, line 5.                                                                                                    
MIKE  FORD, Attorney,  Legislative  Counsel,  Legal and  Research                                                               
Services  Division, Legislative  Affairs  Agency, explained  that                                                               
the problem  was that the  title wasn't  broad enough.   He said,                                                               
"We  included a  reference  to allow  including  the language  on                                                               
lines 6 through 12 [of the amendment labeled F.2]."                                                                             
CHAIR DYSON  said the  decision to broaden  the title  to include                                                               
Section  2  [of  the  amendment labeled  F.2]  is  Representative                                                               
Kapsner's decision.                                                                                                             
REPRESENTATIVE KAPSNER said that although  this is a worthy idea,                                                               
she felt  her bill was  becoming a "Christmas tree."   Initially,                                                               
the bill was introduced to  allow mid-level practitioners to sign                                                               
the  commitment papers  for involuntary  commitment.   Then  [the                                                               
title] was  broaden to include  mental health  professionals, and                                                               
now  it is  being  linked with  FAS.   Therefore,  Representative                                                               
Kapsner expressed  the need  to maintain  the original  intent of                                                               
the legislation.   Perhaps  [what is  proposed in  amendment F.2]                                                               
can be  done at a  later time,  in another bill.   Representative                                                               
Kapsner also  expressed concern  with the  possibility of  HB 115                                                               
dying with the inclusion of Chair Dyson's amendment [F.2].                                                                      
CHAIR DYSON clarified that the  committee has before it CSHB 115,                                                               
Version F, as amended by Amendment 1.                                                                                           
REPRESENTATIVE KAPSNER  informed the  committee that she  had one                                                               
other  minor amendment.   At  the prior  hearing on  HB 115,  the                                                               
committee had added  the language "medical examiners"  on page 3,                                                               
line 4.   She related  her understanding that a  medical examiner                                                               
is  a   person  who  examines   people  after  they   have  died.                                                               
Therefore,   she  suggested   changing  "medical   examiners"  to                                                               
"medical providers" on page 3, line 4.                                                                                          
REPRESENTATIVE  WILSON   moved  that  the  committee   adopt  the                                                               
following amendment:                                                                                                            
     Page 3, line 4:                                                                                                            
          Delete "examiners"                                                                                                    
          Insert "providers"                                                                                                    
[No objection was stated.]                                                                                                      
Number 1042                                                                                                                     
REPRESENTATIVE  COGHILL moved  to  report CSHB  115, version  22-                                                               
LS0059\F,  Ford,  2/15/01,  as  amended  out  of  committee  with                                                               
individual  recommendations  and  the  accompanying  zero  fiscal                                                               
note.  There being no  objection, CSHB 115(HES) was reported from                                                               
the  House   Health,  Education  and  Social   Services  Standing                                                               

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