Legislature(2021 - 2022)BUTROVICH 205
05/02/2022 01:30 PM Senate JUDICIARY
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| Audio | Topic |
|---|---|
| Start | |
| HB246 | |
| 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 | ||
| += | HB 246 | TELECONFERENCED | |
SB 124-MENTAL HEALTH FACILITIES & MEDS
1:58:16 PM
CHAIR HOLLAND reconvened the meeting and 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."
CHAIR HOLLAND noted that this was the second hearing in this
committee. The intention was to take public testimony, take
questions, and begin the amendment process.
1:58:55 PM
CHAIR HOLLAND opened public testimony on SB 124.
1:59:25 PM
ROBERT BARR, Deputy City Manager, City and Borough of Juneau,
Juneau, Alaska, spoke in support of SB 124. He stated that the
local police and fire departments report to him. He noted that
he had recently been engaged with several internal and external
organizations to create a Crisis Now response model in Juneau.
MR. BARR stated that he would provide general comments rather
than discuss the technical elements of SB 124. He suggested that
legislators might wonder whether the public could benefit from
the bill more than the status quo. He surmised that legislators'
primary concern with SB 124 relates to involuntary admission to
crisis stabilization centers or crisis residential centers
because SB 124, and its companion bill, would enable new types
of involuntary admissions under specific circumstances.
MR. BARR acknowledged the importance of the legislature being
very careful when implementing policies that affect an
individual's freedom. He stated that many people are insulated
from the harsh reality of mental, emotional, and behavioral
health crises. However, any police officer or trooper in the
state could provide plenty of anecdotal evidence about these
crises.
MR. BARR offered his belief that these crises break the systems
to have police officers and troopers dealing with most mental
health crises. Police do not have the time or training to handle
these cases, and the value police provide to communities suffers
when they must do so. As with most emergent community problems,
absent another option, the problems will fall to the police to
handle. Thus, the status quo is not a viable one.
2:01:15 PM
MR. BARR stated that SB 124 would grant additional powers and
responsibilities to public servants with the certifications,
training, and appropriate oversight to help people successfully
get through crises. He acknowledged that if he were a
legislator, he would ask whether he trusted the institutions in
place who would gain additional authority to do their jobs and
if the language was good. It will matter how legislation is
interpreted and executed.
MR. BARR said due to COVID-19, he had worked closely with the
Juneau Fire Department, the Juneau Police Department, the Juneau
Alliance for the Mentally Ill (JAMI), and the Alaska Mental
Health Trust Authority (AMHTA), as well as numerous
professionals at the Department of Health and Social Services
(DHSS) in the past two years. He reported being impressed with
their desire and ability to serve those in need. He offered his
belief police and troopers do excellent work and that it is a
lot to ask of them. In closing, he stated that if a family
member were in crisis, he would prefer to have medical personnel
respond to them rather than an officer. He would want these
medical professionals to have the tools to help his family
member achieve success. He offered his belief that this bill
would be a big step.
2:02:43 PM
CHAIR HOLLAND related his understanding that the execution would
be the final test. He asked whether he was speaking in favor of
SB 124.
MR. BARR answered that he was very much in favor of SB 124.
2:02:57 PM}
ALBERTA UNOK, President and CEO, Alaska Native Health Board,
Anchorage, Alaska, paraphrased prepared remarks in support of SB
124.
[Original punctuation provided.]
Thank you for introducing House Bill 172 and
Senate Bill 124, the "Crisis Now" legislation. The
Alaska Native Health Board (ANHB)1 fully supports the
passage of the House Judiciary Committee Substitute
for House Bill 172 which establishes the legal
framework for the operation of crisis stabilization
and crisis residential centers throughout Alaska. We
share your concern that crisis facilities, programs
and services need to be stood up across Alaska as soon
as possible, especially considering the behavioral
health impacts of the pandemic.
The behavioral health continuum of care in Alaska
is in dire need of investment and reform. The state
agencies and private sector groups who have worked on
establishing crisis services are to be commended.
Right now, the continuum of care mostly consists of
outpatient clinical services, a few hospital-based
facilities, and API.
Alaskans facing a psychiatric emergency often
cannot access care at API or hospital facilities
leading to long waits in emergency departments or
jails. Both of these locations are not staffed or
designed to provide needed services to individuals
experiencing a behavioral health emergency. These
crisis programs will help plug major gaps in that
continuum and give Alaskans the care they need in the
environment that best suits them.
2:04:57 PM
Several Tribal Health Organizations are planning
to develop programs and facilities that meet the
behavioral health care needs of the community which
includes crisis stabilization centers and crisis
residential center. Southcentral Foundation is
currently planning and designing a crisis
stabilization center on the Alaska Native Medical
Center campus which will be jointly managed with the
Alaska Native Tribal Health Consortium.
With these programs in development the legal
framework found in CSHB 172 is timely and passage
vital in order for these programs to operate
successfully. Providers standing up these services
will rely on the laws and policies that will be
enacted by the legislation to safely and effectively
operate crisis services. ANHB strongly urges the
passage of this law in this legislative session to
allow crisis services to meet the needs of all
recipients (voluntary and involuntary) by giving
providers the options needed to deliver care in the
best way possible.
Thank you for championing House Bill 172 and
Senate Bill 124. ANHB stands with you and partners to
urge all legislators to take the time to understand
the issues facing the behavioral health system and why
this is so important to accomplish this legislative
session. Alaskans depend on it, please act quickly to
pass this legislation into law.
2:07:19 PM
LISA GENTEMANN, representing self, Eagle River, Alaska, spoke in
opposition to SB 124 because of the potential for abuse of
power. She offered her view that the bill was unconstitutional.
She related a scenario that occurred at a military base outside
of Alaska to support her view.
MS. GENTEMANN stated that when a person is abruptly and
unexpectedly pulled from their daily routine, it will
destabilize them, not stabilize them. It may be terrifying to a
person detained against their will when they have committed no
crime. Further, the bill would allow medical personnel to force
patients to take psychotropic medications against their will.
However, these medications have many serious side effects. She
stated that when she worked as a dental hygienist, she always
had to have permission to treat a patient.
MS. GENTEMANN stated that once admitted, a patient loses many of
their constitutional rights. She said she firmly believes that
patient consent is necessary for successful medical treatment,
including mental health. She asked whether the many problems
reported at the Alaska Psychiatric Institute or other facilities
in Alaska were ever resolved.
2:10:25 PM
SHAYNE LACROIX, Commander, Palmer Police Department, Palmer,
Alaska, spoke in support of SB 124. He informed members that the
department had seen an increase in individuals experiencing
mental health and behavioral health crises in recent years. He
indicated that law enforcement officers have limited training to
interact with those experiencing mental health crises or to
provide the services they need. Typically, they are released to
resolve issues on their own or taken into custody and placed in
a pretrial facility or hospital. He offered his view that the
Crisis Now model would provide a facility with appropriate
services to help them overcome their crises, perhaps so they
will not need future interventions. He urged members to vote yes
on the bill.
2:12:03 PM
MICHAEL CARSON, Vice President & Recovery Specialist, My House
of Mat-Su; Chair, Mat-Su Opioid Task Force, Wasilla, Alaska,
stated that he fully supports the Crisis Now model in SB 124, in
particular the 23-hour stabilization center and the mobile
crisis team.
MR. CARSON shared Kelsey Green's story with her father's
permission. He said that Kelsey was trapped in heroin addiction.
When she was arrested, she was in poor health, weighing 100
pounds. She lost 20 pounds during five days spent in jail. Her
kidneys failed, her liver shut down, and she died at 24.
MR. CARSON offered his belief that if Kelsey had a chance to
stabilize, she might be alive today. He cautioned that he was
not inferring that she should not be held responsible for her
behavior. The possibilities for her life were endless if she
could have survived. He suggested that the crisis stabilization
center proposed in SB 124 could have saved her life. For
example, she could have worked as a peer-to-peer specialist or
in some other role in the recovery field.
2:14:39 PM
KATHLEEN WEDEMEYER, Deputy Director, Citizens Commission on
Human Rights, Northwest Chapter, Seattle, Washington, stated the
Citizens Commission on Human Rights is a mental health watchdog
group. SB 124 relates to improving crisis response to Alaskans.
It also pertains to the deprivation of liberties of Alaskan
citizens in the psychiatric system for Alaska. The commission is
against any increased detention for evaluation and any forced
treatment provisions of SB 124 that would affect the
constitutional rights of Alaska citizens. No one should be held
for more than 72 hours and up to 120 hours without judicial
review. She said, "This is not justice for all." She wondered
how many individuals already struggling would lose their jobs or
housing because they were detained for longer. She highlighted
the importance of having a uniform 72 hours for everyone to
facilitate recovery for those most in need.
2:16:15 PM
MS. WEDEMEYER stated that she had heard an argument in other
hearings that a clinician might not have time to do an adequate
evaluation over a weekend or holiday. She offered her view that
the facilities do not have adequate staff during weekends or
holidays. Alaskans who are detained longer must pay the price
for staff shortages. She offered her view that the timeframe
should be consistent, whether it begins on Tuesday or Friday.
MS. WEDEMEYER stated that the bill was amended to address minors
and notify parents/guardians upon admittance to facilities
before psychotropic drugs are administered. She noted that the
commission finds this a step forward in protecting vulnerable
youth and asks committee members not to dilute or remove these
protections.
2:17:18 PM
MS. WEDEMEYER speculated that to administer psychotropic drugs,
a patient would most likely be seized by several people,
wrestled to the ground, or held on a table or bed and forcibly
injected. She emphasized the need for safeguards for minors
facing this situation.
MS. WEDEMEYER acknowledged that people suffering from a mental
health crisis could harm themselves or others. Thus, the
legislature must work out a system to safeguard the public, but
the system must have safeguards for individuals.
2:18:13 PM
CHAIR HOLLAND asked if she was opposed to SB 124.
MS. WEDEMEYER responded that the commission is opposed to SB 124
unless amended. She noted that she sent amendments to the
committee members.
CHAIR HOLLAND acknowledged that he had received amendments,
including one that addressed the 72-hour confinement and other
points.
2:19:04 PM
SENATOR HUGHES asked her to identify her physical location and
affiliation for the record.
MS. WEDEMEYER stated she is in Seattle, but the Northwest
Chapter operates in Alaska and Montana. She stated that the
commission is an international group advocating for individuals
and is funded by individual donations.
2:20:22 PM
CHAIR HOLLAND found no further testimony, and closed public
testimony on SB 124.
2:20:56 PM
At ease
2:20:58 PM
CHAIR HOLLAND reconvened the meeting and invited Heather
Carpenter, Department of Health and Social Services (DHSS), and
Nancy Meade, Alaska Court System, to the table.
2:21:56 PM
CHAIR HOLLAND moved to adopt Amendment 1, work order 32-
GS1730\I.3.
32-GS1730\I.3
Dunmire
4/15/22
AMENDMENT 1
OFFERED IN THE SENATE BY SENATOR HOLLAND
TO: CSSB 124(HSS), Draft Version "I"
Page 5, line 18, following "cause":
Insert "serious"
Page 6, line 15, following "cause":
Insert "serious"
Page 7, line 11, following "cause":
Insert "serious"
Page 8, line 5, following "cause":
Insert "serious"
2:21:59 PM
SENATOR SHOWER objected for discussion purposes.
2:22:10 PM
HEATHER CARPENTER, Health Care Policy Advisor, Office of the
Commissioner, Department of Health and Social Services, Juneau,
Alaska, explained that Mr. Jim Gottstein asked for this
clarification in the previous committee. Amendment 1 would
insert the word "serious" before mental illness in several
places in the bill. She stated that Amendment 1 would further
align with a court ruling, and the department supports Amendment
1.
2:22:45 PM
At ease
2:23:09 PM
CHAIR HOLLAND reconvened the meeting.
2:23:15 PM
MS. CARPENTER stated that she misspoke. She stated that the word
"serious" goes before harm in several places in the bill. She
noted that the previous committee held a robust discussion on
this language.
2:23:31 PM
SENATOR MYERS asked whether there was a legal difference between
harm and serious harm.
2:24:13 PM
STEVEN BOOKMAN, Senior Assistant Attorney General, Human
Services Section, Civil Division, Department of Law, Anchorage,
Alaska, characterized Amendment 1 as a clean-up amendment. He
stated that he could talk for hours about the differences
between the terms, but it does not make a difference in this
statute. He elaborated that this statute was not intended to
address someone who harms someone in the mildest way possible.
It would not be the reason someone would seek an involuntary
commitment.
2:25:06 PM
SENATOR SHOWER removed his objection.
2:25:14 PM
CHAIR HOLLAND found no further objection, and Amendment 1 was
adopted.
2:25:22 PM`
CHAIR HOLLAND moved to adopt Amendment 2, work order 32-
GS1730\I.4.
32-GS1730\I.4
Dunmire
4/20/22
AMENDMENT 2
OFFERED IN THE SENATE BY SENATOR HOLLAND
TO: CSSB 124(HSS)
Page 1, line 2, following the first occurrence of
"facilities;":
Insert "relating to representation by an
attorney;"
Page 3, following line 30:
Insert a new bill section to read:
"* Sec. 11. AS 18.85.100(a) is amended to read:
(a) An indigent person who is under formal
charge of having committed a serious crime and the
crime has been the subject of an initial appearance or
subsequent proceeding, or is being detained under a
conviction of a serious crime, or is on probation or
parole, or is entitled to representation under the
Supreme Court Delinquency or Child in Need of Aid
Rules or at a review hearing under AS 47.12.105(d), or
is isolated, quarantined, or required to be tested
under an order issued under AS 18.15.355 - 18.15.395,
or is a respondent in a proceeding under AS 47.30
[AGAINST WHOM COMMITMENT PROCEEDINGS FOR MENTAL
ILLNESS HAVE BEEN INITIATED], is entitled
(1) to be represented, in connection with
the crime or proceeding, by an attorney to the same
extent as a person retaining an attorney is entitled;
and
(2) to be provided with the necessary
services and facilities of this representation,
including investigation and other preparation."
Renumber the following bill sections accordingly.
Page 5, line 25, following "application":
Insert "and appoint an attorney to represent the
respondent"
Page 6, line 17, following "application":
Insert "and appoint an attorney to represent the
respondent"
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"
Insert "Section 35"
2:25:30 PM
SENATOR SHOWER objected for discussion purposes.
MS. CARPENTER deferred to Ms. Meade.
2:25:41 PM
MS. MEADE explained that Amendment 2 specifies that the public
defender would provide an attorney in these proceedings. The
bill states that the court system shall appoint an attorney;
however, the public defender currently provides duties
concerning mental health commitments. Since testimony indicates
that this is different from a mental health commitment, she felt
it should be clarified that the public defender would provide an
attorney for these proceedings. She noted that if a statute says
an attorney should be appointed, but none of the agencies have
authorizing statutes, the court system must pay for it.
2:26:55 PM
SENATOR SHOWER asked, if someone had a mental health problem in
their family, whether this language would require them to use
the public defender or if the person could provide their own
attorney.
MS. MEADE answered that the court must ensure that the person
facing a mental health commitment has legal representation. If
the person is not indigent, the person will supply their own
lawyer. However, if the person is unable to communicate their
financial circumstance, the court would appoint the public
defender initially but would withdraw if the person had the
financial means. She stated that the public defender statute
only allows the agency to represent indigent persons.
2:28:09 PM
SENATOR SHOWER said he wanted to be sure that families could be
involved.
2:28:21 PM
SENATOR SHOWER removed his objection.
2:28:25 PM
CHAIR HOLLAND found no further objection, and Amendment 2 was
adopted.
2:28:35 PM
CHAIR HOLLAND moved to adopt Amendment 3, work order 32-
GS1730\I.5.
32-GS1730\I.5
Dunmire
4/22/22
AMENDMENT 3
OFFERED IN THE SENATE BY SENATOR HOLLAND
TO: CSSB 124(HSS)
Page 15, line 6:
Delete "and Social Services"
Insert ", the Department of Family and Community
Services,"
Page 15, line 23:
Delete "and Social Services"
Insert ", the Department of Family and Community
Services,"
Page 15, line 28:
Delete "and Social Services"
Insert ", the Department of Family and Community
Services"
Page 16, line 4:
Delete "and Social Services"
Page 16, line 10, following "Services":
Insert ", the Department of Health, or the Department
of Family and Community Services, as applicable,"
2:28:38 PM
SENATOR SHOWER objected for discussion purposes.
2:28:42 PM
MS. CARPENTER explained that Amendment 3 was a clean-up
amendment based on executive order (EO) 121, which will go into
effect on July 21, 2022. She stated that the bill lists the
Department of Health and Social Services (DHSS), but EO 121
splits DHSS into the Department of Health and the Department of
Family and Community Services, so this renames the appropriate
department.
2:29:17 PM
SENATOR SHOWER removed his objection.
CHAIR HOLLAND found no further objection, and Amendment 3 was
adopted.
2:29:40 PM
CHAIR HOLLAND moved to adopt Amendment 4, work order 32-
GS1730\I.11.
32-GS1730\I.11
Dunmire
4/29/22
AMENDMENT 4
OFFERED IN THE SENATE BY SENATOR HOLLAND
TO: CSSB 124(HSS)
Page 3, following line 30:
Insert a new bill section to read:
"* Sec. 11. AS 47.30.693 is amended to read:
Sec. 47.30.693. Notice to parent or guardian [OF
MINOR]. When a minor under 18 years of age is detained at
or admitted or committed to a treatment facility, the
facility shall inform the parent or guardian of the
location of the minor as soon as possible after the arrival
of the minor at the facility. When an adult for whom a
guardian has been appointed is detained at or admitted or
committed to a treatment facility and the facility is aware
of the appointment, the facility shall inform the guardian
of the location of the adult as soon as possible after the
arrival of the adult at the facility."
Renumber the following bill sections accordingly.
Page 4, lines 1 - 7:
Delete all material and insert:
"(c) When a crisis stabilization center, crisis
residential center, evaluation facility, or treatment
facility admits a minor respondent under this section, the
center or facility shall inform the parent or guardian of
the location of the minor as soon as possible after the
arrival of the minor at the facility. When a crisis
stabilization center, crisis residential center, evaluation
facility, or treatment facility admits an adult for whom a
guardian has been appointed and the center or facility is
aware of the appointment, the center or facility shall
inform the guardian of the location of the adult as soon as
possible after the arrival of the adult at the center or
facility."
Page 5, lines 4 - 8:
Delete all material and insert:
"(d) When a crisis stabilization center, crisis
residential center, evaluation facility, or treatment
facility admits a minor under this section, the center or
facility shall inform the parent or guardian that the minor
has been admitted as soon as possible after the arrival of
the minor at the facility. When a crisis stabilization
center, crisis residential center, evaluation facility, or
treatment facility admits an adult for whom a guardian has
been appointed and the center or facility is aware of the
appointment, the center or facility shall inform the
guardian that the adult has been admitted as soon as
possible."
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"
Insert "Section 35"
2:29:43 PM
SENATOR SHOWER objected for discussion purposes.
2:29:57 PM
MS. CARPENTER explained Amendment 4. She stated that the
language in Sections 11 and 13 was added in the Senate Health
and Social Services Committee (SHSS), [Version I], to address
someone entering a crisis stabilization center, crisis
residential center, evaluation facility or treatment facility.
The bill requires facilities to contact certain family members,
such as parents or guardians. Version I contained a few
provisions that were somewhat concerning to the department. She
stated that the previous language on page 4, line 4, had the
facilities immediately notifying family members, but it might
raise domestic violence concerns. For instance, if she were a
patient going into one of these facilities, it would not be the
person she put as her emergency contact. She said the department
felt those privacy concerns were very important. However, the
department thought it would be a good idea for these facilities
to communicate early with parents, guardians, or someone the
adult patient selected. She further explained that the
department thought it might work better to place this language
in a part of the statutes that relates to notifications to
parents and guardians. Amendment 4 would replace the language
currently found in Sections 11 and 13 and insert it in AS
47.30.693. It would expand the notification to parents of a
minor when admitted or committed to a treatment facility and
expand that to include other facilities.
2:31:51 PM
MS. CARPENTER stated that it would take the other material and
make it clearer. It would combine three concepts into one. The
language in Secs. 11 and 13 mirrors the process used in the
Division of Juvenile Justice facilities. Instead of immediate
notice, the facilities communicate with someone as soon as
possible if they can be located. She stated that in terms of
guardians, the court system keeps the records, so the facility
may not know if the person being admitted has a guardian. She
stated it could be a public guardian, such as someone from the
Office of Public Advocacy, or a private guardian.
2:32:50 PM
SENATOR SHOWER asked for more detail on parental rights, for
instance, if they had a runaway child picked up and placed in
one of the facilities. He asked whether they could take the
child and arrange for private care. However, he noted his
primary interest was the minor's rights.
2:33:41 PM
MS. CARPENTER responded that the facility must adhere to
criteria to hold someone in the new facilities, just as it is
today. She explained that an individual must exhibit signs of
mental illness or be gravely disabled and at risk of imminent
harm to be placed in these facilities. The facilities are not
meant to take runaway minors from their parents. Parents have
certain protections, including the right to their own counsel
for any hearings. The minor and the parent could have their own
attorneys. Thus, if the guardian ad litem believes the minor
should stay at the facility, but the parent disagrees, the minor
would have their own legal counsel.
2:34:51 PM
MR. BOOKMAN added that the minor would be appointed counsel by
the public defender, and if the parent could not afford an
attorney, the Office of Public Advocacy (OPA) would appoint one.
If the mother and father had differing views, OPA would appoint
an attorney for each parent. He highlighted that the bill offers
new places for people to go, but it retains existing rights. He
noted that the guardian ad litem falls under OPA, so if one was
appointed, the office has attorneys who could argue the case
before a judge.
2:35:57 PM
SENATOR SHOWER referred to the 72-hour rule. He related a
scenario in which a 12-year was left home with someone while the
parents were out of town. Suppose the minor ran away and was
picked up, perhaps screaming, so they ended up at a facility,
but the facility couldn't reach the parents. He wondered if the
minor would be held all weekend while medical staff continued to
try to locate the parents.
MS. CARPENTER answered that it would depend. She recapped that a
youth would be taken to one of the facilities because the youth
was exhibiting mental health behaviors and needed to be examined
by a mental health professional to see if they met the criteria
for a 72-hour commitment. If they do not meet the criteria at
any time, the youth cannot be held, and the patient will be
released. A safe discharge would be necessary for a minor, so
the facility would work with a parent or guardian.
MS. CARPENTER said if the youth met the criteria, the court
would schedule a hearing related to the 72-hour commitment. She
noted the committee would consider an amendment that could
change it, but the 72-hour period does not include Saturday,
Sunday, or legal holidays, which is also how it currently works.
Thus, no hearings would be heard on those days.
2:37:59 PM
SENATOR HUGHES expressed concern that the amendment pertains to
treatment facilities, which are the longer-term facilities such
as the Alaska Psychiatric Institute (API). She asked about the
24-hour outpatient crisis stabilization center and the 7-day
crisis residential center. She expressed an interest in reaching
out to the parent or guardian. She asked why the other
facilities had dropped off.
2:38:51 PM
MS. CARPENTER apologized for not fully explaining Amendment 4.
She stated that Sec. 11 relates to treatment centers. It deletes
but reinserts the language currently found in Sec. 11 on page 4,
lines 1-7, and in Sec. 13. It does exactly what Senator Hughes
related. She read subsection (c):
When a crisis stabilization center, crisis
residential center, evaluation facility, or treatment
facility admits a minor respondent under this section,
the center or facility shall inform the parent or
guardian of the location of the minor as soon as
possible after the arrival of the minor at the
facility. When a crisis stabilization center, crisis
residential center, evaluation facility, or treatment
facility admits an adult for whom a guardian has been
appointed and the center or facility is aware of the
appointment, the center or facility shall inform the
guardian of the location of the adult as soon as
possible after the arrival of the adult at the center
or facility.
2:40:19 PM
MS. MEADE stated that it might clarify that the first part of
the amendment would amend existing AS 47.30.693, which is for
voluntary admissions for treatment. She said this could be
viewed as a clean-up of existing law for voluntary admissions.
MS. MEADE indicated that AS 47.30.775 provides a robust statute
related to committing minors involuntarily, which outlines their
rights. As Mr. Bookman discussed, parents are notified and can
be appointed their own attorney. The statute begins with AS
47.30.700, and all the rights apply equally to the minor. The
parent can become a party to the case, which is unique and a
significant right, so there are many protections for minors that
have not been specifically discussed at this hearing.
2:41:35 PM
SENATOR HUGHES recalled Senator Begich and she expressed concern
in the previous committee of referral that abusive family
members or guardians should not be notified. She recalled it did
not need to be specified because those protections were in
place. She related her understanding that if a guardian became
an abuser, it might not be known at this point, but it may have
triggered the mental health crisis. However, someone would not
be appointed as a guardian if they have a history of abuse.
MS. CARPENTER, as a follow-up to the Senate Health and Social
Services Committee, stated that she is correct, which is why the
amendment removes the term, immediate family member. She
highlighted that the department believes this is the more
appropriate approach to protect an individual's rights and
rights to privacy. She emphasized that special consideration was
given to minors; that the parents need to know as soon as
possible. This language provides enough flexibility for
facilities if the parent or guardian is known. If frequent
crises occur, the facilities will know the guardian or parent,
which will improve notification. Further, it ties in with the
Division of Juvenile Justice statutes, which provides similar
laws.
2:43:36 PM
SENATOR SHOWER removed his objection.
2:43:43 PM
CHAIR HOLLAND found no further objection, and Amendment 4 was
adopted.
CHAIR HOLLAND said he would not offer Amendment 5, work order
32-GS1730\I.10.
2:44:20 PM
CHAIR HOLLAND moved to adopt Amendment 6, work order 32-
GS1730\I.12.
32-GS1730\I.12
Dunmire
4/28/22
AMENDMENT 6
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 "and":
Insert ", if available,"
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, if available, review the minor's
family history, diet, medication, and other possibly
relevant factors."
2:44:22 PM
SENATOR SHOWER objected for discussion purposes.
2:44:33 PM
MS. CARPENTER stated that Amendment 6 pertains to Sections 19
and 20. Section 19 relates to AS 47.30.836, which is non-crisis
medication. Amendment 6 would delete "guardian, or other family
member" and insert "or guardian." On page 11, line 21 it would
add "if available." It would also delete "triggers on page 11,
line 22. She reiterated that it would apply to non-crisis
situations to ensure that before psychotropic medication is
administered to a minor, the mental health professional would
consult with a parent or guardian. The department recommended
removing "other family member" because they generally do not
have standing with a minor patient.
MS. CARPENTER said "triggers" is removed on line 22 because it
is not defined in statute. The department held discussions with
two psychiatrists at API, who said that they consult with
parents when a minor is admitted in voluntary and involuntary
commitments. She stated that Sec. 19 was added in the Senate HSS
committee.
2:46:11 PM
MS. CARPENTER stated that the second half of Amendment 6 relates
to Sec. 21 on the bottom of page 11 and pertains to crisis
medication. The department requested a redraft of this section,
retaining the intent of working with a minor's parent prior to
administering psychotropic medication. She read:
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, if available, review the minor's
family history, diet, medication, and other possibly
relevant factors."
MS. CARPENTER explained that to the extent possible, the
department mirrors the language in both sections, but allowing
that for a true crisis, where there is immediate harm to the
patient or the provider, the providers could give crisis
medication in those scenarios. The psychiatrists relayed that
they would speak to the parents when the patients are brought
in. Still, they must be able to address a crisis and provide
crisis medications when that is the only safe option.
2:47:52 PM
SENATOR SHOWER said he understood administering the crisis
medication to prevent patient self-harm or to protect the
provider, but in non-crisis situations, it reads "and, if
available." He asked why it reads "and" instead of requiring it
in a non-crisis situation. He expressed concern about
contraindications. He said it seemed that the psychiatrist
wouldn't want to administer psychotropic medication until the
information was available.
MS. CARPENTER stated that the language "and, if available" is in
both sections. Thus, if the providers have the family history,
diet, medication, and other possibly relevant factors, they will
review it. However, if there isn't any way to obtain it, the
providers would not be held responsible.
SENATOR SHOWER acknowledged it would be important during a
crisis, but he has an issue with administering the drugs without
having the information. He expressed concern that patients might
experience more significant complications.
2:49:50 PM
SENATOR HUGHES stated that a single parent might not have access
to the other parent's family history. Amendment 6 requires the
consultation with a parent or guardian, and the family medical
history be reviewed. Still, if there is no known knowledge or
way to access it, and the consulted parent gives their
permission, she feels comfortable with it. The health care
professional also must understand the dangers of
contraindications. To uphold their oath, they would not
administer something that would create a bad result.
2:51:12 PM
SENATOR KIEHL related his understanding that Amendment 6 adds to
a list of restrictions in current law and that subsection (e)
provides another limitation when a facility can administer
psychotropic medications and not an expansion.
MS. CARPENTER agreed. She stated that it was important to
remember that this goes to hospitals actually administering the
medications, including API, Bartlett Regional Hospital,
Fairbanks Memorial Hospital, and Mat-Su Regional Medical Center,
which serve as the designated evaluation and treatment centers.
It relates more to non-crisis scheduled medication.
2:52:24 PM
SENATOR SHOWER indicated that the language seems to suggest that
it was forcing patients to be administered psychotropic drugs.
He paraphrased a portion of the bill related to psychotropic
drugs. He expressed concern that the medical professionals that
could not obtain the family history and other information would
administer the psychotropic medication anyway to a patient that
does not involve a crisis.
2:53:29 PM
MS. CARPENTER responded that the parent or guardian must consent
to the medication.
2:53:52 PM
SENATOR MYERS asked for the meaning of "triggers" since it was
not defined.
MS. CARPENTER said she was unsure, which was why the department
asked to have that term removed.
2:54:11 PM
SENATOR HUGHES indicated that the previous committee held more
discussions on psychotropic drugs. She referred to Amendment 6,
line 30, and stated that the phrase "to the extent time and
nature of the crisis permit" was added. She related a scenario
in which a young man, age 17, had a heart attack on the
basketball court and was rushed by ambulance to the emergency
room. The parents might not have been present, but the hospital
staff must administer lifesaving medication without parental
consent in order to save the minor's life. Further, a minor
might be doing something life-threatening. She stated that the
goal is to get parental consent, but if the child is about to
kill themselves, it's important to allow the health care
professional to save the child's life. She indicated that the
administration of these drugs would be limited to extreme
situations. She related a situation in which a young person was
beating their head against glass, and the glass was breaking,
and they bled profusely, but the parent was not available. She
emphasized the importance of allowing medical professionals to
calm children in those situations. She stated that the goal was
to contact the parent and obtain consent, but it is not always
possible to do so.
2:56:54 PM
CHAIR HOLLAND offered his view that the committee might need
further clarification on this issue.
CHAIR HOLLAND withdrew Amendment 6.
2:57:22 PM
CHAIR HOLLAND moved to adopt Amendment 7, work order 32-
GS1730\I.13.
32-GS1730\I.13
Dunmire
4/29/22
AMENDMENT 7
OFFERED IN THE SENATE BY SENATOR HOLLAND
TO: CSSB 124(HSS)
Page 13, lines 28 - 29:
Delete "state, municipal, or other local health
officer"
Insert "federally certified health care provider"
2:57:26 PM
SENATOR SHOWER objected for discussion purposes.
2:57:34 PM
MS. CARPENTER stated that Amendment 7 provides the definition of
a health officer. She explained that a prior committee
substitute that split out the definition of a peace officer in
Sec. 27 of the bill on page 13 was changed to a more common
meaning used in law enforcement. She indicated that they
reviewed the terms that were deleted and came up with the term
"health officer However, the department initially defined it
as "as a state, municipal, or other local health officer, public
health nurse, emergency medical technician, paramedic,
firefighter, or a person authorized by the court to carry out AS
47.30-660-47.30.915." Amendment 7 would delete "state,
municipal, or other local health officer" from the definition.
MS. CARPENTER related that the department consulted with
numerous individuals who work under these statutes. She
indicated that "state, municipal, or other local health officer"
was a term no longer used, so they deleted it. However, in
conversations with tribal partners, the department understood
the desire to have community health aides, or behavioral health
aides added. Amendment 7 would do that by inserting the language
"federally certified health care provider." She noted that their
tribal partners work through the authority of the Indian Health
Services. Thus, their providers are federally certified and not
licensed by the state.
MS CARPENTER stated that the health officers were the
individuals that would see some people in rural Alaska in
crisis. They could intervene and ask for that initial hold,
similar to how a Village Police Safety Officer (VPSO) would
operate. She characterized the health officers as the front-line
providers.
2:59:53 PM
SENATOR SHOWER removed his objection.
2:59:58 PM
CHAIR HOLLAND found no further objection, and Amendment 7 was
adopted.
3:00:26 PM
CHAIR HOLLAND held SB 124 in committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 246 SJUD CS (version W).pdf |
SJUD 5/2/2022 1:30:00 PM |
HB 246 |
| HB 246 SJUD Amendment W.1.pdf |
SJUD 5/2/2022 1:30:00 PM |
HB 246 |
| SB 124 SJUD Amendment #1 (I.3).pdf |
SJUD 4/27/2022 1:30:00 PM SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #2 (I.4).pdf |
SJUD 4/27/2022 1:30:00 PM SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #3 (I.5).pdf |
SJUD 4/27/2022 1:30:00 PM SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #4 (I.11).pdf |
SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #5 (I.10).pdf |
SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #6 (I.12).pdf |
SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 1:30:00 PM |
SB 124 |
| SB 124 SJUD Amendment #7 (I.13).pdf |
SJUD 5/2/2022 1:30:00 PM SJUD 5/4/2022 1:30:00 PM |
SB 124 |
| 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 Written Public Testimony - SJUD 5.2.22.pdf |
SJUD 5/2/2022 1:30:00 PM |
SB 124 |
| SB 124 - Testimony (Faith Myers).docx |
SJUD 5/2/2022 1:30:00 PM |
SB 124 |
| SB 124 - Letter of Support (Southcentral Foundation).pdf |
SJUD 5/2/2022 1:30:00 PM |
SB 124 |
| SB 124 Written Testimony (Jim Gottstein).pdf |
SJUD 5/2/2022 1:30:00 PM |
SB 124 |
| SB 124 - Testimony CCHR Seattle 5-2-22.pdf |
SJUD 5/2/2022 1:30:00 PM |
SB 124 |
| SB 124 - GCDSE Letter of Support.pdf |
SJUD 5/2/2022 1:30:00 PM |
SB 124 |