Legislature(2023 - 2024)DAVIS 106

04/30/2024 03:00 PM House HEALTH & SOCIAL SERVICES

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Audio Topic
03:09:00 PM Start
03:10:43 PM Confirmation Hearing(s):|| Board of Social Work Examiners
03:18:46 PM SB240
05:11:44 PM HB363
05:58:28 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor’s Appointees: Board of TELECONFERENCED
Social Work Examiners - Anne Wells
-- Public Testimony --
+= HB 363 FOSTER CHILDREN PSYCHIATRIC TREATMENT TELECONFERENCED
Moved CSHB 363(HSS) Out of Committee
-- Public Testimony --
+ SB 240 SCHOOL MEDICAL ASSIST;TREATMENT OF MINORS TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 30, 2024                                                                                         
                           3:09 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Mike Prax, Chair                                                                                                 
Representative Justin Ruffridge, Vice Chair                                                                                     
Representative CJ McCormick                                                                                                     
Representative Dan Saddler                                                                                                      
Representative Jesse Sumner                                                                                                     
Representative Zack Fields                                                                                                      
Representative Genevieve Mina                                                                                                   
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARING(S):                                                                                                        
                                                                                                                                
Board of Social Work Examiners                                                                                                
                                                                                                                                
     Anne Well - Fairbanks                                                                                                      
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
CS FOR SENATE BILL NO. 240(HSS)                                                                                                 
"An Act  allowing minors 16 years  of age or older  to consent to                                                               
behavioral health and mental  health services; authorizing school                                                               
personnel  to  recommend a  behavioral  health  or mental  health                                                               
professional to  a child 16 years  of age or older;  and relating                                                               
to  medical assistance  coverage  for rehabilitative,  mandatory,                                                               
and optional services furnished or  paid for by a school district                                                               
on behalf of certain children."                                                                                                 
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 363                                                                                                              
"An  Act  relating  to  the   placement  of  foster  children  in                                                               
psychiatric hospitals."                                                                                                         
                                                                                                                                
     - MOVED CSHB 363(HSS) OUT OF COMMITTEE                                                                                     
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 240                                                                                                                  
SHORT TITLE: SCHOOL DISTRICT MEDICAL ASSISTANCE                                                                                 
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
02/19/24       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/19/24       (S)       HSS                                                                                                    
02/27/24       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
02/27/24       (S)       Heard & Held                                                                                           
02/27/24       (S)       MINUTE(HSS)                                                                                            
03/12/24       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
03/12/24       (S)       Heard & Held                                                                                           
03/12/24       (S)       MINUTE(HSS)                                                                                            
04/04/24       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
04/04/24       (S)       Moved CSSB 240(HSS) Out of Committee                                                                   
04/04/24       (S)       MINUTE(HSS)                                                                                            
04/08/24       (S)       HSS RPT CS 2DP 1NR 1AM   NEW TITLE                                                                     
04/08/24       (S)       AM: WILSON                                                                                             
04/08/24       (S)       DP: GIESSEL, DUNBAR                                                                                    
04/08/24       (S)       NR: KAUFMAN                                                                                            
04/22/24       (S)       HSS CS ADOPTED Y13 N7                                                                                  
04/24/24       (S)       TRANSMITTED TO (H)                                                                                     
04/24/24       (S)       VERSION: CSSB 240(HSS)                                                                                 
04/26/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
04/26/24       (H)       HSS                                                                                                    
04/30/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
BILL: HB 363                                                                                                                  
SHORT TITLE: FOSTER CHILDREN PSYCHIATRIC TREATMENT                                                                              
SPONSOR(s): GRAY                                                                                                                
                                                                                                                                
02/20/24       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/20/24       (H)       HSS                                                                                                    
03/14/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
03/14/24       (H)       Heard & Held                                                                                           
03/14/24       (H)       MINUTE(HSS)                                                                                            
04/30/24       (H)       HSS AT 3:00 PM DAVIS 106                                                                               
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ANNE WELLS, Appointee                                                                                                           
Board of Social Work Examiners                                                                                                  
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Social Work Examiners.                                                                                                          
                                                                                                                                
EMILY RICCI                                                                                                                     
Deputy Commissioner, Department of Health                                                                                       
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Introduced SB  240 on  behalf of  the bill                                                             
sponsor, Senate Rules by request of the governor.                                                                               
                                                                                                                                
SENATOR CATHY GIESSEL                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  On behalf  of the bill sponsor, Senate Rules                                                             
by  request  of  the   governor,  offered  information,  answered                                                               
questions, and recommended an amendment  during the hearing on SB
240.                                                                                                                            
                                                                                                                                
STEVEN PEARCE, Director                                                                                                         
Citizens Commission on Human Rights                                                                                             
Seattle, Washington                                                                                                             
POSITION STATEMENT:  Testified in opposition to SB 240.                                                                       
                                                                                                                                
HEATHER IRELAND, Executive Director                                                                                             
Anchorage School Based Centers                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of SB 240.                                                                          
                                                                                                                                
LAURA RUSSELL, Assistant Attorney General                                                                                       
Human Services Section                                                                                                          
Civil Division (Anchorage)                                                                                                      
Department of Law                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:   Answered  committee  questions during  the                                                             
hearing on SB 240.                                                                                                              
                                                                                                                                
SHARON FISHEL                                                                                                                   
School Health and Safety                                                                                                        
Innovation and Education Excellence                                                                                             
Department of Education                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Answered  committee  questions during  the                                                             
hearing on SB 240.                                                                                                              
                                                                                                                                
MATT DAVIDSON, Legislative Liaison                                                                                              
Department of Family & Community Services                                                                                       
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Answered  committee  questions during  the                                                             
hearing on SB 240.                                                                                                              
                                                                                                                                
KXLO STONE                                                                                                                      
Facing Foster Care in Alaska, Statewide Rep. on Youth Board                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 363.                                                                          
                                                                                                                                
BARBARA MALCHICK                                                                                                                
Facing Foster Care in Alaska                                                                                                    
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 363.                                                                          
                                                                                                                                
REPRESENTATIVE ANDREW GRAY                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, answered committee                                                                     
questions on HB 363.                                                                                                            
                                                                                                                                
KIM SWISHER, Deputy Director                                                                                                    
Office of Children's Services, Department of Family & Community                                                                 
Services                                                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered committee questions on HB 363.                                                                  
                                                                                                                                
ANA KARINA THOMPSON                                                                                                             
Licensing Specialist, Department of Health                                                                                      
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered committee questions on HB 363.                                                                  
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:09:00 PM                                                                                                                    
                                                                                                                                
CHAIR  MIKE PRAX  called  the House  Health  and Social  Services                                                             
Standing   Committee    meeting   to    order   at    3:09   p.m.                                                               
Representatives   Mina,  Saddler,   Sumner,  Fields,   Ruffridge,                                                               
McCormick, and Prax were present at the call to order.                                                                          
                                                                                                                                
^CONFIRMATION HEARING(S):                                                                                                       
^Board of Social Work Examiners                                                                                                 
                    CONFIRMATION HEARING(S)                                                                                 
                 BOARD OF SOCIAL WORK EXAMINERS                                                                             
                                                                                                                                
3:10:43 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX announced that the first order of business would be a                                                                
confirmation hearing for the governor's appointee to the Board                                                                  
of Social Work Examiners.                                                                                                       
                                                                                                                                
3:10:57 PM                                                                                                                    
                                                                                                                                
ANNE WELLS, Appointee, Board of  Social Work Examiners, began her                                                               
testimony by  giving her background  and history in the  field of                                                               
social work  and spoke  to her experiences  during her  tenure on                                                               
the board.                                                                                                                      
                                                                                                                                
3:12:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked what the Steven A. Cohen Clinic was.                                                                
                                                                                                                                
MS.  WELLS  answered  that  the  Steven A.  Cohen  Clinic  is  an                                                               
outpatient  mental  health  clinic facility  that  serves  anyone                                                               
affiliated with a military member, active duty or veteran.                                                                      
                                                                                                                                
3:13:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA  asked Ms. Wells  what the  biggest challenge                                                               
the board has faced during her membership on it.                                                                                
                                                                                                                                
MS. WELLS  responded that  both the  challenge of  retaining good                                                               
social  workers in  their  field  of work  and  the challenge  of                                                               
changing  certain  regulations   surrounding  social  workers  in                                                               
Alaska have been the biggest issues facing the board.                                                                           
                                                                                                                                
3:15:03 PM                                                                                                                    
                                                                                                                                
CHAIR  PRAX asked  Ms. Wells  whether she  was familiar  with the                                                               
Anchorage Veterans Court.                                                                                                       
                                                                                                                                
MS. WELLS  said that  she wasn't aware  of the  court's existence                                                               
and said  that she would look  into the prospects that  the court                                                               
presents the board.                                                                                                             
                                                                                                                                
3:15:50 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  opened public testimony  on the  confirmation hearing                                                               
for Anne  Wells to  the Board  of Social  Work Examiners.   After                                                               
ascertaining  that there  was no  one who  wished to  testify, he                                                               
closed public testimony.                                                                                                        
                                                                                                                                
3:16:34 PM                                                                                                                    
                                                                                                                                
CHAIR  PRAX stated  that  the House  Health  and Social  Services                                                               
Standing  Committee  has  reviewed   the  qualifications  of  the                                                               
governor's appointees  and recommends that the  following name be                                                               
forwarded  to a  joint session  for consideration:   Anne  Wells,                                                               
Board of Social Work Examiners.   He said that signing the report                                                               
regarding  appointments  to  boards  and commissions  in  no  way                                                               
reflects an  individual member's  approval or disapproval  of the                                                               
appointee, and  the nomination  is merely  forwarded to  the full                                                               
legislature for confirmation or rejection.                                                                                      
                                                                                                                                
3:17:11 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:17 p.m. to 3:18 p.m.                                                                       
                                                                                                                                
           SB 240-SCHOOL DISTRICT MEDICAL ASSISTANCE                                                                        
                                                                                                                                
3:18:46 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX announced that the next  order of business would be CS                                                               
FOR SENATE  BILL NO. 240(HSS),  "An Act allowing minors  16 years                                                               
of  age or  older  to  consent to  behavioral  health and  mental                                                               
health  services; authorizing  school  personnel  to recommend  a                                                               
behavioral health  or mental  health professional  to a  child 16                                                               
years  of  age  or  older; and  relating  to  medical  assistance                                                               
coverage  for rehabilitative,  mandatory,  and optional  services                                                               
furnished or paid  for by a school district on  behalf of certain                                                               
children."                                                                                                                      
                                                                                                                                
3:19:32 PM                                                                                                                    
                                                                                                                                
EMILY  RICCI,  Deputy  Commissioner,  Department  of  Health,  on                                                               
behalf  of the  bill  sponsor,  Senate Rules  by  request of  the                                                               
governor,  introduced SB  240 to  the committee.   She  explained                                                               
that Section  5 of CSSB  240(HSS) is  identical to HB  343, which                                                               
the  House Health  and Social  Services Standing  Committee heard                                                               
earlier in the  current legislative session.  She  said that CSSB
240(HSS) would remove the existing  requirement that Medicaid may                                                               
only  reimburse  schools for  services  that  are covered  in  an                                                               
eligible  student's individualized  education  plan  (IEP).   She                                                               
emphasized that  the intent  of CSSB 240(HSS)  was to  expand the                                                               
number  of services  for which  a school  might be  able to  seek                                                               
Medicaid reimbursement.                                                                                                         
                                                                                                                                
3:20:46 PM                                                                                                                    
                                                                                                                                
SENATOR  CATHY GIESSEL,  Alaska State  Legislature, on  behalf of                                                               
the  bill  sponsor, Senate  Rules  by  request of  the  governor,                                                               
shared  her experience  working  as a  nurse practitioner  within                                                               
high  schools and  middle schools  in Anchorage.   She  explained                                                               
that  one of  her most  pertinent tasks  in those  schools is  to                                                               
screen the  students for mental  health conditions  like anxiety,                                                               
depression, or  suicidal ideation  and said that  she is  able to                                                               
refer that student for behavioral  health support if any of those                                                               
screening  tools indicate  a positive  diagnosis.   She clarified                                                               
that  she was  describing background  information as  a means  to                                                               
explain  the  amendment  she  was   about  to  recommend  to  the                                                               
committee  and emphasized  that  mental health  needs have  risen                                                               
since  she had  started providing  care in  the Anchorage  School                                                               
District (ASD)  nine years ago.   She provided  specific examples                                                               
of  personal  situations that  might  affect  a student's  mental                                                               
health and said  that often, parental consent is  a major barrier                                                               
to proper treatment of a  student's mental health condition.  She                                                               
emphasized that one out of  five students in Alaska have reported                                                               
a  suicide  attempt and  explained  that  the amendment  she  was                                                               
recommending to  the committee was  the result of  her experience                                                               
working  as a  clinician in  the district.   She  read through  a                                                               
series of  proposals that  could be made  with the  amendment and                                                               
described  their necessity.    She shared  a  series of  prepared                                                               
statements  by  various  mental health  entities  in  Alaska  and                                                               
emphasized  that the  amendment  to CSSB  240(HSS) would  empower                                                               
both children  and parents to improve  Alaska's collective mental                                                               
health.                                                                                                                         
                                                                                                                                
3:41:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked how age  16 was chosen instead of age                                                               
14 or lower.                                                                                                                    
                                                                                                                                
SENATOR GIESSEL  answered that  16 was a  more palatable  age for                                                               
practitioners in Alaska.                                                                                                        
                                                                                                                                
3:42:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  asked why 16-year-old  Alaskans shouldn't                                                               
be allowed to be prescribed their own mental health medication.                                                                 
                                                                                                                                
SENATOR GIESSEL replied that it  is her philosophical belief as a                                                               
clinician that  children are  being medicated  too much  and said                                                               
that counseling is extremely effective.                                                                                         
                                                                                                                                
REPRESENTATIVE   SADDLER   asked   which  was   more   effective:                                                               
counseling or mental health medication.                                                                                         
                                                                                                                                
SENATOR  GIESSEL answered  that  there is  no comparison  between                                                               
counseling and mental health medication.                                                                                        
                                                                                                                                
3:47:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA commented  her affirmation  of the  value of                                                               
counseling,  especially for  people  who are  not experiencing  a                                                               
crisis  and asked  what percentage  of at-home  abusers are,  for                                                               
example, parents, caregivers, and foster parents.                                                                               
                                                                                                                                
SENATOR GIESSEL said that she does not have that information.                                                                   
                                                                                                                                
3:48:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  asked where  schools are going  to find                                                               
mental health  professionals to employ, given  a declining public                                                               
school budget and a lack of qualified professionals in Alaska.                                                                  
                                                                                                                                
SENATOR  GIESSEL  answered  that  schools in  Alaska  would  hire                                                               
clinicians and pass the cost off  to Medicaid.  She said that the                                                               
primary intention of SB 240 was  to increase the amount of social                                                               
workers in public schools without any extra cost to the schools.                                                                
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  asked  how CSSB  240(HSS)  would  help                                                               
rural students in Alaska experiencing mental health problems.                                                                   
                                                                                                                                
SENATOR   GIESSEL    replied   that   the   state    would   work                                                               
collaboratively   with  tribal   health   entities  and   provide                                                               
telehealth services to students in need of them.                                                                                
                                                                                                                                
3:55:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  asked  whether   there  is  evidence  to                                                               
support that  behavioral health intervention  lowers the  rate of                                                               
suicide.                                                                                                                        
                                                                                                                                
SENATOR  GIESSEL answered  that  there  is no  way  to track  the                                                               
number  of  suicides  prevented  and  explained  that  behavioral                                                               
health  treatment is  meant  as an  intervention  to stop  mental                                                               
health issues before they develop into suicidal ideation.                                                                       
                                                                                                                                
3:59:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  commented   on  Representative  Saddler's                                                               
question by  referencing a meta-analysis found  through an online                                                               
search  engine and  other  studies that  find  that talk  therapy                                                               
reduces the risk of suicide.                                                                                                    
                                                                                                                                
4:00:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  said that he has  reservations with the                                                               
age of consent being 16 with  regard to a child's agency in their                                                               
own  medical  decisions and  asked  what  the barrier  to  proper                                                               
children's mental health treatment in Alaska is.                                                                                
                                                                                                                                
SENATOR GIESSEL answered  that the main barrier  to proper mental                                                               
health treatment  of a child  is often the parents'  inaction and                                                               
the  child's reluctance  to receive  any treatment  at all.   She                                                               
explained  that there  are many  adverse  consequences that  come                                                               
from  a child  who might  not  have access  to behavioral  health                                                               
services and said that the goal  of CSSB 240(HSS) is to prevent a                                                               
child from "going over the waterfall" of mental health.                                                                         
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE recalled  that  he had  things that  he                                                               
didn't  want to  share with  his parents  and shared  his concern                                                               
that a  barrier might still  exist in  CSSB 240(HSS) for  kids to                                                               
trust the process of mental health treatment.                                                                                   
                                                                                                                                
4:07:37 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:07 p.m. to 4:09 p.m.                                                                       
                                                                                                                                
4:09:03 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX opened public testimony on SB 240.                                                                                   
                                                                                                                                
4:09:24 PM                                                                                                                    
                                                                                                                                
STEVEN  PEARCE, Director,  Citizens Commission  on Human  Rights,                                                               
testified in opposition  to SB 240.  He  explained his background                                                               
in mental  health advocacy and  psychiatric care.  He  shared his                                                               
belief that it  would be dangerous to allow students  aged 16 and                                                               
older to make their own psychiatric decisions.                                                                                  
                                                                                                                                
4:13:15 PM                                                                                                                    
                                                                                                                                
HEATHER  IRELAND,  Executive  Director,  Anchorage  School  Based                                                               
Centers,  testified in  support of  SB 240.   She  said that  the                                                               
bill's  provision to  allow for  students  aged 16  and older  to                                                               
consent for  their own  psychiatric care  is important  and urged                                                               
the committee's support of the proposed legislation.                                                                            
                                                                                                                                
4:15:25 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:15 p.m. to 4:16 p.m.                                                                       
                                                                                                                                
4:16:19 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX,  after ascertaining  that there was  no one  else who                                                               
wished to testify, closed public testimony on SB 240.                                                                           
                                                                                                                                
4:16:59 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX moved  to adopt Amendment 1 to  CSSB 240(HSS), labeled                                                               
33-GS2369/B.1, Bergerud, 4/30/24, which read as follows:                                                                        
                                                                                                                                
     Page 1, lines 1 - 3:                                                                                                       
          Delete "allowing minors 16 years of age or older                                                                    
     to  consent  to  behavioral health  and  mental  health                                                                  
     services; authorizing  school personnel to  recommend a                                                                  
     behavioral health  or mental  health professional  to a                                                                  
     child 16 years of age or older; and"                                                                                     
                                                                                                                                
     Page 1, line 7, through page 3, line 17:                                                                                   
          Delete all material.                                                                                                  
                                                                                                                                
     Page 3, line 18:                                                                                                           
          Delete "Sec. 5"                                                                                                     
          Insert "Section 1"                                                                                                  
                                                                                                                                
REPRESENTATIVE FIELDS objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE   FIELDS  explained   that   there  are   multiple                                                               
circumstances where  it might  not make sense  or be  feasible to                                                               
get consent  from a minor's parents  to get care.   He noted that                                                               
the  current  language  in CSSB  240(HSS)  directs  a  healthcare                                                               
provider that  is providing  services for  someone aged  16-18 to                                                               
contact   the  minor's   parents  regardless   of  the   proposed                                                               
amendment.                                                                                                                      
                                                                                                                                
4:21:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  asked  whether  parental  consent  was                                                               
required for the billing of Medicaid services.                                                                                  
                                                                                                                                
MS.  RICCI  answered  that  SB   240  does  not  address  federal                                                               
requirements  related to  the Family  Educational Rights  Privacy                                                               
Act (FERPA).                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  asked  whether a  clinician  providing                                                               
services to 16-  and 17-year-old students would be  allowed to be                                                               
reimbursed by Medicaid if Amendment 1 were not adopted.                                                                         
                                                                                                                                
MS. RICCI replied  that the school district would not  be able to                                                               
bill Medicaid for any confidential services provided.                                                                           
                                                                                                                                
4:24:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SUMNER  asked  who  would pay  for  the  services                                                               
provided if Medicaid does not reimburse the service.                                                                            
                                                                                                                                
MS. RICCI  explained that it  would depend  on how the  school is                                                               
providing the service and said that  it would most likely fall on                                                               
the district.                                                                                                                   
                                                                                                                                
4:25:49 PM                                                                                                                    
                                                                                                                                
CHAIR  PRAX  asked whether  a  school  might  end up  with  legal                                                               
liability if a  parent does not consent to  the services provided                                                               
to a student.                                                                                                                   
                                                                                                                                
LAURA  RUSSELL,   Assistant  Attorney  General,   Human  Services                                                               
Section, Civil Division (Anchorage),  Department of Law, answered                                                               
that  there are  a variety  of structures  related to  behavioral                                                               
health services  and explained  that it  would be  conjecture for                                                               
her  to speculate  on  which entity  might  absorb the  financial                                                               
liability of the services that a student has received.                                                                          
                                                                                                                                
CHAIR PRAX asked who would be liable  to the parent if a child is                                                               
not eligible for Medicaid and the school is a legal provider.                                                                   
                                                                                                                                
MS.  RUSSELL explained  that the  statute  addressed in  sections                                                               
three and four of CSSB  240(HSS) provide five exceptions in which                                                               
a student is exempt from obtaining parental consent.                                                                            
                                                                                                                                
4:29:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  directed the committee  members' attention                                                               
to language  on page 3,  line 15  of CSSB 240(HSS)  and explained                                                               
that   the  parental   consent  language   would  be   maintained                                                               
regardless of whether or not the proposed amendment is adopted.                                                                 
                                                                                                                                
REPRESENTATIVE  SADDLER asked  who would  be responsible  for the                                                               
cost of mental health treatment  outside of Medicaid services and                                                               
asked whether CSSB  240(HSS) would address only  children who are                                                               
covered by Medicaid.                                                                                                            
                                                                                                                                
MS. RICCI  replied that she didn't  want to speculate on  how the                                                               
services  might  be paid  for  and  explained that  the  proposed                                                               
amendment is not limited to children covered by Medicaid.                                                                       
                                                                                                                                
REPRESENTATIVE SADDLER asked why  the proposed legislation should                                                               
be passed if  there is an uncertainty  as to who is  meant to pay                                                               
for the services outlined by the law.                                                                                           
                                                                                                                                
MS.  RICCI explained  that  who  might pay  for  the services  is                                                               
greatly dependent  on the child, school  district, and behavioral                                                               
health provider  and said that  it would ultimately come  down to                                                               
whatever  contract agreement  was reached  between the  clinician                                                               
and the school district.                                                                                                        
                                                                                                                                
4:34:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE asked  whether counseling  services are                                                               
currently funded by public education funding.                                                                                   
                                                                                                                                
SHARON  FISHEL,   School  Health   and  Safety,   Innovation  and                                                               
Education  Excellence,  Department  of Education,  answered  that                                                               
there  is  no  other  funding   available  beside  public  school                                                               
funding.                                                                                                                        
                                                                                                                                
4:35:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SADDLER  asked   how   many  behavioral   health                                                               
professionals  are working  within the  public school  system and                                                               
what it means  for a mental health professional to  work within a                                                               
school system.                                                                                                                  
                                                                                                                                
MS. FISHEL  answered by  giving a number  of examples  related to                                                               
statistics surrounding mental health services in public schools.                                                                
                                                                                                                                
4:38:34 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  asked whether there  could be liability for  a mental                                                               
health  clinician not  responding to  a known  problem of  mental                                                               
health just because  the student's parents didn't  consent to the                                                               
treatment.                                                                                                                      
                                                                                                                                
MS.  RUSSEL answered  that CSSB  240(HSS) and  Amendment 1  would                                                               
neither mandate provisions of services  nor create an affirmative                                                               
duty  to   provide  services,  rather   the  two   would  provide                                                               
permissive language to  allow a school to provide  services if it                                                               
so pleases.                                                                                                                     
                                                                                                                                
CHAIR  PRAX asked  whether  a mental  health  clinician would  be                                                               
required to  report a  parent that doesn't  allow their  child to                                                               
seek  mental  health  treatment   to  the  Office  of  Children's                                                               
Services (OCS).                                                                                                                 
                                                                                                                                
MS.  RUSSEL  explained  that the  proposed  legislation  and  the                                                               
proposed   amendment  would   not  change   existing  obligations                                                               
surrounding mandatory reporting.                                                                                                
                                                                                                                                
4:43:57 PM                                                                                                                    
                                                                                                                                
MS.  RICCI noted  that  page three,  lines 6  through  8 of  CSSB
240(HSS)  are addressed  by the  proposed  amendment and  require                                                               
that a clinician note in  a student's file any concerns regarding                                                               
their mental health.                                                                                                            
                                                                                                                                
REPRESENTATIVE  SADDLER  pointed  to  page 2,  line  29  of  CSSB
240(HSS)  and shared  his concern  that the  proposed legislation                                                               
would allow for Alaskans aged 16 and 17 to give consent.                                                                        
                                                                                                                                
MS.  RICCI replied  that Section  5 of  the proposed  legislation                                                               
would ensure that the extent of  the consent a 16- or 17-year-old                                                               
would be  allowed to give  would encompass only their  own mental                                                               
health treatment.                                                                                                               
                                                                                                                                
4:46:02 PM                                                                                                                    
                                                                                                                                
MS. RUSSEL affirmed that Ms. Ricci's answer was correct.                                                                        
                                                                                                                                
4:46:51 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  asked whether the  proposed amendment would  create a                                                               
greater risk of someone being reported to OCS.                                                                                  
                                                                                                                                
MATT  DAVIDSON,  Legislative  Liaison,  Department  of  Family  &                                                               
Community Services  (DFCS), answered that the  proposed amendment                                                               
would not change anything related to the duty to report to OCS.                                                                 
                                                                                                                                
4:48:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  questioned  where   the  line  is  drawn                                                               
between a parent's responsibility to  care for their children and                                                               
the state's obligation to step in and help students.                                                                            
                                                                                                                                
REPRESENTATIVE MCCORMICK  opined that young people  are perfectly                                                               
capable of  recognizing mental health  issues that they  might be                                                               
facing.                                                                                                                         
                                                                                                                                
4:52:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA  expressed  her intention  to  vote  against                                                               
Amendment  1 and  shared  her  belief that  lowering  the age  of                                                               
consent  for behavioral  health services  is  a good  idea.   She                                                               
shared her concern  for a scenario in which a  child might not be                                                               
able to  get access to care  because of a barrier  created by the                                                               
proposed amendment.                                                                                                             
                                                                                                                                
4:54:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  shared his  support for Amendment  1 to                                                               
CSSB 240(HSS)  and said that  he thinks that while  CSSB 240(HSS)                                                               
is  not the  answer  to  how to  help  young people  experiencing                                                               
mental health issues, it is a good place to start.                                                                              
                                                                                                                                
REPRESENTATIVE  MCCORMICK proffered  that the  idea that  parents                                                               
should be  involved [in a  minor's decisions regarding  their own                                                               
mental  health   treatment  and  services]  comes   from  a  very                                                               
privileged perspective.                                                                                                         
                                                                                                                                
5:00:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  said that  if the proposed  amendment were                                                               
to be passed,  the legislature would effectively  be denying care                                                               
to children who are living in circumstances of neglect or abuse.                                                                
                                                                                                                                
5:00:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SADDLER  shared   his  understanding   that  the                                                               
proposed amendment would not make informed consent mandatory.                                                                   
                                                                                                                                
REPRESENTATIVE  FIELDS   corrected  his  previous   statement  on                                                               
Amendment 1 and said that it  would not be mandatory for a school                                                               
report.                                                                                                                         
                                                                                                                                
5:01:57 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 5:01 p.m. to 5:07 p.m.                                                                       
                                                                                                                                
5:07:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  moved to  table  Amendment  1 to  CSSB
240(HSS).                                                                                                                       
                                                                                                                                
REPRESENTATIVE  PRAX asked  Representative Sumner  if he  had any                                                               
objection to Amendment 1.                                                                                                       
                                                                                                                                
REPRESENTATIVE SUMNER [objected to  the motion to table Amendment                                                               
1].                                                                                                                             
                                                                                                                                
5:08:41 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 5:08 p.m.                                                                                 
                                                                                                                                
5:08:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SUMNER removed  his  objection to  the motion  to                                                               
table  Amendment 1  to CSSB  240(HSS).   There  being no  further                                                               
objection, Amendment 1 was tabled.                                                                                              
                                                                                                                                
5:09:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCCORMICK  asked Chair Prax  if there could  be an                                                               
extension of the amendment deadline.                                                                                            
                                                                                                                                
CHAIR PRAX  said that he would  be okay with an  extension of the                                                               
amendment deadline.                                                                                                             
                                                                                                                                
5:09:47 PM                                                                                                                    
                                                                                                                                
The committee  took two  consecutive at-eases  from 5:09  p.m. to                                                               
5:11 p.m.                                                                                                                       
                                                                                                                                
[CSSB 240(HSS), with Amendment 1 tabled, was held over.]                                                                        
                                                                                                                                
5:10:39 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 5:10 p.m. to 5:11 p.m.                                                                       
                                                                                                                                
          HB 363-FOSTER CHILDREN PSYCHIATRIC TREATMENT                                                                      
                                                                                                                                
5:11:44 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  announced that  the next order  of business  would be                                                               
HOUSE BILL NO.  363, "An Act relating to the  placement of foster                                                               
children in psychiatric hospitals."                                                                                             
                                                                                                                                
5:12:40 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX opened public testimony on HB 363.                                                                                   
                                                                                                                                
KXLO   STONE,   Facing   Foster   Care   in   Alaska,   Statewide                                                               
Representative on  Youth Board, testified  in support of  HB 363.                                                               
She explained her background in  foster care and her own personal                                                               
experiences with the  Alaska foster care system.   She emphasized                                                               
the  adverse  living  conditions  of foster  care  facilities  in                                                               
Alaska and  explained how it  negatively affects  foster children                                                               
in  Alaska.   She  highlighted  the  importance of  the  proposed                                                               
bill's provision for  a 5-day limit on a hearing  from the Office                                                               
of Children's Services (OCS.)                                                                                                   
                                                                                                                                
5:15:18 PM                                                                                                                    
                                                                                                                                
BARBARA  MALCHICK, Facing  Foster  Care in  Alaska, testified  in                                                               
support  of HB  363.   She described  the process  that a  foster                                                               
child is put  through upon their admittance  into Alaska's foster                                                               
care system  and emphasized the negative  impact that months-long                                                               
hearing  delays  have on  foster  children.   She  explained  the                                                               
changes that  HB 363  would make  on the  current structure  of a                                                               
foster  child's   hearing  process  and  offered   the  committee                                                               
comparison to other countries' foster child hearing processes.                                                                  
                                                                                                                                
5:20:30 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX,  after ascertaining  that there was  no one  else who                                                               
wished to testify, closed public testimony on HB 363.                                                                           
                                                                                                                                
5:20:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE ANDREW  GRAY, Alaska  State Legislature,  as prime                                                               
sponsor of  HB 363, asked  for the will  of the committee  on its                                                               
decision to move HB 363 out of committee.                                                                                       
                                                                                                                                
5:21:00 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 5:21 p.m.                                                                                 
                                                                                                                                
5:21:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  moved to adopt  Amendment 1 to  HB 363,                                                               
labeled,33-LS1049/S.1, Bergerud, 4/30/24 which read as follows:                                                                 
                                                                                                                                
     Page 2, lines 24 - 25:                                                                                                     
          Delete "48 hours"                                                                                                     
          Insert "five days"                                                                                                    
                                                                                                                                
     Page 2, lines 28 - 29:                                                                                                     
          Delete "48-hour period"                                                                                               
          Insert "five-day period"                                                                                              
                                                                                                                                
     Page 2, line 31:                                                                                                           
          Delete "48-hour period"                                                                                               
          Insert "five-day period"                                                                                              
                                                                                                                                
     Page 3, line 1:                                                                                                            
          Delete "48 hours, the 48-hour period"                                                                                 
          Insert "five days, the five-day period"                                                                               
                                                                                                                                
     Page 3, lines 2 - 4:                                                                                                       
          Delete "The court may grant one request to                                                                            
      continue the hearing for up to two business days if                                                                       
       necessary to secure the attendance of the child, a                                                                       
     party, or a material witness."                                                                                             
                                                                                                                                
     Page 3, line 9:                                                                                                            
          Delete "based on"                                                                                                     
          Insert "after considering"                                                                                            
                                                                                                                                
     Page 3, line 10, following "professional,":                                                                                
          Insert "or upon the written report of a mental                                                                        
     health professional if the child and all parties agree                                                                     
     the report may be relied on,"                                                                                              
                                                                                                                                
     Page 3, line 14, following "untreated.":                                                                                   
          Insert "If the court does not make the necessary                                                                      
       findings, the court shall order the department to                                                                        
     transfer the child to another appropriate setting that                                                                     
     is in the best interests of the child."                                                                                    
                                                                                                                                
REPRESENTATIVE MCCORMICK objected.                                                                                              
                                                                                                                                
5:22:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GRAY informed Representative McCormick, "This is                                                                 
a friendly amendment at the request of the sponsor."                                                                            
                                                                                                                                
5:22:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER moved to adopt Conceptual Amendment 1 to                                                                  
Amendment 1, to delete lines 5-9 on page 2 [as numbered on                                                                      
Amendment 1].                                                                                                                   
                                                                                                                                
REPRESENTATIVE FIELDS objected.                                                                                                 
                                                                                                                                
5:23:03 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 5:23 p.m.                                                                                 
                                                                                                                                
5:23:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked  the bill sponsor for  his opinion on                                                               
the proposed Conceptual Amendment 1 to Amendment 1.                                                                             
                                                                                                                                
REPRESENTATIVE  GRAY said  that he  understood the  reason behind                                                               
the proposed amendment and explained  that Conceptual Amendment 1                                                               
to  Amendment 1  would strike  important bill  language regarding                                                               
placement and housing of foster children.   He said that he would                                                               
not oppose the proposed conceptual amendment.                                                                                   
                                                                                                                                
REPRESENTATIVE FIELDS withdrew his objection.                                                                                   
                                                                                                                                
5:25:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS   commented  that  he  has   a  subsequent                                                               
amendment  that  is designed  to  address  the lack  of  suitable                                                               
facilities.                                                                                                                     
                                                                                                                                
REPRESENTATIVE RUFFRIDGE shared his  concern that the legislation                                                               
might  put  an undue  stress  on  the  Alaska foster  care  court                                                               
system.                                                                                                                         
                                                                                                                                
5:27:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA  asked  whether   OCS  could  speak  to  the                                                               
possibility of  a foster child  being left  to wait in  the court                                                               
system.                                                                                                                         
                                                                                                                                
5:29:46 PM                                                                                                                    
                                                                                                                                
KIM  SWISHER, Deputy  Director,  Office  of Children's  Services,                                                               
Department  of Family  & Community  Services,  answered that  OCS                                                               
sometimes experiences  an inappropriate  level of  care placement                                                               
for  a  child  and  explained  how  OCS  works  with  psychiatric                                                               
hospitals to deliver the proper care for a foster child.                                                                        
                                                                                                                                
5:31:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  commented  that   he  would  vote  no  on                                                               
Conceptual Amendment 1 to Amendment 1.                                                                                          
                                                                                                                                
A roll call  vote was taken.   Representatives Ruffridge, Sumner,                                                               
and Prax voted in favor of  Conceptual Amendment 1 to Amendment 1                                                               
to HB 363.  Representatives Fields, Mina, and McCormick voted                                                                   
against it.  Therefore, Conceptual Amendment 1 to Amendment 1                                                                   
failed by a vote of 3-3.                                                                                                        
                                                                                                                                
5:33:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE [moved to withdraw] Amendment 1.                                                                       
[There being no objection, Amendment 1 was withdrawn.]                                                                          
                                                                                                                                
5:33:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS moved to adopt Amendment 2 to HB 363,                                                                     
labeled 33-LS1049/S.2, Bergerud, 4/30/24, which read as follows:                                                                
                                                                                                                                
     Page 1, line 1, following "hospitals;":                                                                                  
          Insert "relating to the care of children in state                                                                   
     custody  placed in  residential facilities  outside the                                                                  
     state;"                                                                                                                  
                                                                                                                                
     Page 3, following line 18:                                                                                                 
     Insert a new bill section to read:                                                                                         
        "* Sec. 4. AS 47.14.112(d) is amended to read:                                                                      
          (d)  The division of the department with                                                                              
     responsibility  over  the  custody  of  children  shall                                                                    
     prepare  and  make  available  to  the  legislature  an                                                                    
     annual  report on  employee recruitment  and retention,                                                                    
     including  a  five-year  plan, for  the  division.  Not                                                                    
     later  than November 15  of each  year, the  department                                                                    
     shall deliver  the report to  the senate  secretary and                                                                    
     the  chief clerk  of the  house of  representatives and                                                                    
     notify the  legislature that  the report  is available.                                                                    
     The report  prepared under this subsection  is separate                                                                    
     from  the annual  report  to  the legislature  required                                                                    
     under AS 18.05.020  and must include, for  the previous                                                                    
     12 months,                                                                                                                 
               (1)  the number of frontline social workers                                                                      
     employed by  the division, the annual  average turnover                                                                    
     rate of  the workers, and  the average caseload  of the                                                                    
     workers on January 1 and July 1 of that year;                                                                              
               (2)  the number of children removed from                                                                         
     their homes;                                                                                                               
               (3)  the achievement of success measured by                                                                      
     the following:                                                                                                             
               (A)  rate of family reunification;                                                                               
               (B)  average length of time children spent                                                                       
     in custody of the department;                                                                                              
               (C)  rate of placement with an adult family                                                                      
     member or family friend;                                                                                                   
               (D)  number of children placed in a                                                                              
     permanent  living   arrangement  with  a   guardian  or                                                                    
     biological or adoptive parent;                                                                                             
               (E)  number of children released from the                                                                        
     custody of the department;                                                                                                 
               (4)  if the department has met or exceeded                                                                       
     the caseload  standards under this chapter  and, if the                                                                    
     standards  were  exceeded,  the  number  of  caseworker                                                                    
     positions in the division that  could be eliminated and                                                                    
     the  amount  of funding  that  could  be reduced  while                                                                    
     continuing  to  meet  but   not  routinely  exceed  the                                                                    
     caseload standards;                                                                                                        
               (5)  the performance of the department on                                                                        
     federal benchmarks  focused on the  safety, well-being,                                                                    
     and  permanent placements  of foster  children compared                                                                    
     with the previous five years;                                                                                          
               (6)  the number of children placed in                                                                        
     residential  facilities  providing  care  for  children                                                                
     outside the state."                                                                                                    
                                                                                                                              
     Renumber the following bill section accordingly.                                                                           
                                                                                                                                
REPRESENTATIVE RUFFRIDGE objected for the purpose of discussion.                                                                
                                                                                                                                
REPRESENTATIVE FIELDS explained that the proposed amendment                                                                     
would track the statistics surrounding foster care services                                                                     
provided to children in Alaska's foster care system.                                                                            
                                                                                                                                
5:35:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE removed his objection.  There being no                                                                 
further objection, Amendment 2 was adopted.                                                                                     
                                                                                                                                
5:35:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS moved to adopt Amendment 3 to HB 363,                                                                     
labeled 33-LS1049/S.3, Bergerud, 4/30/24, which read as follows:                                                                
                                                                                                                                
     Page 1, line 1, following "Act":                                                                                         
          Insert "establishing the Family First Prevention                                                                    
     Services Team;"                                                                                                          
                                                                                                                                
     Page 1, following line 3:                                                                                                  
     Insert a new bill section to read:                                                                                         
        "* Section  1. AS 44.30.020 is  amended by  adding a                                                                
     new subsection to read:                                                                                                    
          (c)  The Department of Family and Community                                                                           
     Services  shall establish  the Family  First Prevention                                                                    
     Services  Team,  consisting  of  department  employees,                                                                    
     that shall be responsible  for ongoing plan submission,                                                                    
     assessment,   communication   with   agency   partners,                                                                    
     evaluation, and reporting  requirements under P.L. 115-                                                                    
     123 (Family First Prevention Services Act)."                                                                               
                                                                                                                                
     Page 1, line 4:                                                                                                            
          Delete "Section 1"                                                                                                  
          Insert "Sec. 2"                                                                                                     
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 4, following line 16:                                                                                                 
     Insert a new bill section to read:                                                                                         
        "*  Sec.  6. The  uncodified  law  of the  State  of                                                                
     Alaska is amended by adding a new section to read:                                                                         
          CHILD WELFARE PREVENTION PROGRAM SCAN AND FAMILY                                                                      
     FIRST  PREVENTION  SERVICES  PLAN SUBMISSION.  (a)  The                                                                    
     Department  of  Family  and  Community  Services  shall                                                                    
     contract with a third-party  review agency to conduct a                                                                    
     comprehensive  scan  of  all child  welfare  prevention                                                                    
     programs in  the state identified by  the United States                                                                    
     Department  of Health  and  Human Services,  Children's                                                                    
     Bureau.  The  scan  must   include  evaluation  of  any                                                                    
     curriculum  used by  the program,  staff qualifications                                                                    
     and workloads, targeted  population identification, and                                                                    
     methods  of outreach,  data collection,  organizational                                                                    
     management  and evaluation,  and reporting  procedures.                                                                    
     The scan  must be  completed not later  than January 1,                                                                    
     2025.                                                                                                                      
          (b)  Not later than July 1, 2025, the Family                                                                          
     First   Prevention   Services   Team   established   in                                                                    
     AS 44.30.020(c),  added by  sec. 1  of this  Act, shall                                                                    
     submit to  the United  States Department of  Health and                                                                    
     Human  Services,  Children's  Bureau,  a  Family  First                                                                    
     Prevention  Services  Title  IV-E Prevention  Plan  for                                                                    
     approval."                                                                                                                 
                                                                                                                                
REPRESENTATIVE RUFFRIDGE object for the purpose of discussion.                                                                  
                                                                                                                                
REPRESENTATIVE FIELDS explained that  Amendment 3 would establish                                                               
a team  based around  the concept of  "family first"  foster care                                                               
prevention services.   He said that the  proposed amendment would                                                               
involve only one  department instead of two  and highlighted that                                                               
the  solution  was suggested  by  a  report, titled  "Reimagining                                                               
Child Services in Alaska."                                                                                                      
                                                                                                                                
5:39:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER  asked whether  OCS would have  the funding                                                               
to achieve the proposed amendment's goals.                                                                                      
                                                                                                                                
REPRESENTATIVE FIELDS  explained that  OCS is already  working on                                                               
ensuring  funding  for  a  team   like  the  one  proposed  under                                                               
Amendment 3.                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER  asked what the "family  first" title means                                                               
in reference to  the foster care prevention  plan under Amendment                                                               
3.                                                                                                                              
                                                                                                                                
REPRESENTATIVE FIELDS  answered that  the term  refers to  a team                                                               
that would keep kids safe and healthy in their foster homes.                                                                    
                                                                                                                                
5:41:24 PM                                                                                                                    
                                                                                                                                
MS.  SWISHER explained  that Amendment  3 would  be vital  in the                                                               
establishment of a safer foster care  system in Alaska.  She said                                                               
that  there are  currently only  three practices  in Alaska  that                                                               
independently verify  the safety  of foster homes  and emphasized                                                               
that the services have been proven to be effective .                                                                            
                                                                                                                                
5:44:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SUMNER shared  his understanding  that the  money                                                               
would be spent to create a plan  for the teams, not on the actual                                                               
establishment of the teams.                                                                                                     
                                                                                                                                
MS. SWISHER confirmed  that Representative Sumner's understanding                                                               
was correct and  said that OCS would not be  opposed to reviewing                                                               
the propositions resulting from Amendment 3 in the future.                                                                      
                                                                                                                                
REPRESENTATIVE  FIELDS [moved  to withdraw]  Amendment 3.  [There                                                               
being no objection, Amendment 3 was withdrawn.]                                                                                 
                                                                                                                                
5:45:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS moved  to  adopt Amendment  4  to HB  363,                                                               
labeled 33-LS1049/S.4, Bergerud, 4/30/24, which read as follows:                                                                
                                                                                                                                
     Page 1, line 1, following "Act":                                                                                         
          Insert  "establishing a  revolving  loan fund  for                                                                  
     the construction of  residential psychiatric facilities                                                                  
     for   minors  in   the  Alaska   Mental  Health   Trust                                                                  
     Authority;"                                                                                                              
                                                                                                                                
     Page 1, following line 3:                                                                                                  
     Insert a new bill section to read:                                                                                         
        "* Section  1. AS 44.25 is  amended by adding  a new                                                                
     section to read:                                                                                                           
          Sec.   44.25.293.  Psychiatric   treatment  center                                                                  
     revolving  loan  fund.  (a) The  psychiatric  treatment                                                                  
     center   revolving  loan   fund  is   created  in   the                                                                    
     authority. The authority shall  administer the fund and                                                                    
     shall use the fund to  award loans to in-state entities                                                                    
     for  the  establishment  and expansion  of  residential                                                                    
     psychiatric treatment  facilities for minors.  The fund                                                                    
     consists of  money appropriated to the  fund, including                                                                    
     loan payments and interest earned on the fund.                                                                             
          (b)   A loan  awarded under  this section  may not                                                                    
     exceed                                                                                                                     
               (1)  $500,000 if the loan is for the                                                                             
     construction of a new facility; or                                                                                         
               (2)  $50,000 if the loan is for an existing                                                                      
     facility that is establishing  or expanding services to                                                                    
     minors.                                                                                                                    
          (c)   The  authority may  not award  a loan  under                                                                    
     this section to  an entity that has  an existing unpaid                                                                    
     loan   under   this   section  or   to   a   for-profit                                                                    
     corporation.                                                                                                               
          (d)  An entity is  eligible each calendar year for                                                                    
     not  more than  two  loans made  under  (b)(1) of  this                                                                    
     section and not more than  five loans made under (b)(2)                                                                    
     of this section.                                                                                                           
          (e)   In  awarding loans  under this  section, the                                                                    
     authority  shall prioritize  loans  for a  construction                                                                    
     project   in  a   region   in   which  no   residential                                                                    
     psychiatric  treatment facility  for  minors exists.  A                                                                    
     facility that provides treatment  to adults is eligible                                                                    
     to receive a loan under  this section if the facility's                                                                    
     primary  mission  is  to provide  psychiatric  care  to                                                                    
     minors and  the facility  submits documentation  to the                                                                    
     authority  showing that  residents who  are minors  are                                                                    
     physically  separated in  the  facility from  residents                                                                    
     who are adults.                                                                                                            
          (f)    The terms  of  a  loan awarded  under  this                                                                    
     section  must require  the  loan to  be  repaid over  a                                                                    
     period of  not less than  five years and not  more than                                                                    
     10  years. The  authority  shall  provide for  interest                                                                    
     rates  for loans  awarded under  this section  that are                                                                    
     less than the current market  rate as determined by the                                                                    
     authority.                                                                                                                 
          (g)  In this section,                                                                                                 
               (1)  "adult" means an individual who is 18                                                                       
     years of age or older;                                                                                                     
               (2)  "minor" means an individual under 18                                                                        
     years of age."                                                                                                             
                                                                                                                                
     Page 1, line 4:                                                                                                            
          Delete "Section 1"                                                                                                  
          Insert "Sec. 2"                                                                                                     
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
REPRESENTATIVE  FIELDS  explained  that  the  proposed  amendment                                                               
would establish  a revolving  loan fund  for the  construction of                                                               
residential psychiatric facilities for  minors in Alaska. He said                                                               
that intention  of Amendment 4  was to  create a place  where the                                                               
State  could  both  make investments  and  expand  the  treatment                                                               
capacity of the State.                                                                                                          
                                                                                                                                
REPRESENTATIVE  SUMNER  opined  that the  500,000  dollar  figure                                                               
proposed by  Amendment 4  was not enough  to build  a psychiatric                                                               
facility.                                                                                                                       
                                                                                                                                
5:47:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE   said  that   he  was   supportive  of                                                               
Amendment 4  when he saw  "Alaska Mental Health  Trust Authority"                                                               
(AMHTA) but  was disappointed when  he learned that  the proposed                                                               
fund would come from the General Fund of the Permanent Fund.                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS said  that he would be  supportive of funds                                                               
coming from AMHTA.                                                                                                              
                                                                                                                                
5:49:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  PRAX   shared  his  concern  that   the  proposed                                                               
amendment would create a new fiscal note for HB 363.                                                                            
                                                                                                                                
5:50:09 PM                                                                                                                    
                                                                                                                                
MS.   SWISHER  recommended   the  question   be  answered   by  a                                                               
representative  from the  Department  of Health  (DOH) but  added                                                               
that she is unsure of the necessity of the proposed amendment.                                                                  
                                                                                                                                
5:50:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE said  that he  probably wouldn't  be in                                                               
support of the proposed amendment.                                                                                              
                                                                                                                                
5:51:07 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MINA commented  that she likes the  ideas that the                                                               
proposed amendment puts forward.                                                                                                
                                                                                                                                
5:51:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER  asked whether the proposed  revolving loan                                                               
funds proposed under Amendment 4  would be restricted to use only                                                               
on construction.                                                                                                                
                                                                                                                                
5:52:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  answered that the revolving  loan fund was                                                               
initially created with  the idea of construction  in mind, though                                                               
it could be used for different applications in the future.                                                                      
                                                                                                                                
5:52:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SUMNER  asked Representative Gray for  his opinion                                                               
on Amendment 4.                                                                                                                 
                                                                                                                                
5:52:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GRAY  replied that  he would support  whatever the                                                               
will of the committee is.                                                                                                       
                                                                                                                                
REPRESENTATIVE SUMNER  shared his  understanding that there  is a                                                               
high likelihood  of a  fiscal note being  created if  Amendment 4                                                               
were adopted.                                                                                                                   
                                                                                                                                
5:53:53 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX opined  that it would likely create a  new fiscal note                                                               
for HB 363.                                                                                                                     
                                                                                                                                
REPRESENTATIVE FIELDS said that the  creation of a fiscal note is                                                               
a  subjective speculation  to make  and takes  into account  many                                                               
logistical considerations.                                                                                                      
                                                                                                                                
5:55:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SUMNER  offered   his  understanding   that  the                                                               
presumption  of the  committee was  that a  fiscal note  would be                                                               
added  to a  piece of  legislation if  said legislation  required                                                               
funding.                                                                                                                        
                                                                                                                                
5:56:04 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX sought confirmation that  Amendment 4 would generate a                                                               
fiscal note for HB 363.                                                                                                         
                                                                                                                                
ANA KARINA THOMPSON, Licensing  Specialist, Department of Health,                                                               
answered  that the  proposed amendment  would  likely generate  a                                                               
fiscal note.                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  [moved to  withdraw] Amendment 4.   [There                                                               
being no objection, Amendment 4 was withdrawn.]                                                                                 
                                                                                                                                
5:57:12 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  asked whether  it was  the will  of the  committee to                                                               
move HB 363 out of committee.                                                                                                   
                                                                                                                                
REPRESENTATIVE RUFFRIDGE moved to report  HB 363, as amended, out                                                               
of   committee   with    individual   recommendations   and   the                                                               
accompanying  fiscal  notes.   There  being  no  objection,  CSHB
363(HSS)  was  reported  out  of  the  House  Health  and  Social                                                               
Services Standing Committee.                                                                                                    
                                                                                                                                
5:58:28 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 5:58 p.m.                                                                                                          

Document Name Date/Time Subjects
Anne Wells Social Work Resume_Redacted.pdf HHSS 4/30/2024 3:00:00 PM
Governor's Appointee
Anne Wells Social Work App_Redacted.pdf HHSS 4/30/2024 3:00:00 PM
Governor's Appointee
SB 240 Fiscal Note DOH-MAA.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB 240 Fiscal Note DOH-MS.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB 240 Fiscal Note EED-SSA.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB 240 Letter of Support - ACT.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB 240 Sectional Analysis Version B.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB 240 Sponsor Statement Version A.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB 240 Trust LOS 2.26.24.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB 240 Version B.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
SB240 Summary Version A.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
HB 363 Amendment S.1 #1.pdf HHSS 4/30/2024 3:00:00 PM
HB 363
SB 240 Amendment B.1 #1.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
HB 363 Kwinghagak v. OCS Court Case.pdf HHSS 4/30/2024 3:00:00 PM
HB 363
HB 363 Amendment S.2 #2.pdf HHSS 4/30/2024 3:00:00 PM
HB 363
HB 363 Amendment S.3 #3.pdf HHSS 4/30/2024 3:00:00 PM
HB 363
HB 363 Amendment S.4 #4.pdf HHSS 4/30/2024 3:00:00 PM
HB 363
HB 363 Roque Support.pdf HHSS 4/30/2024 3:00:00 PM
HB 363
SB 240 ANC School Testimony.pdf HHSS 4/30/2024 3:00:00 PM
SB 240
HB 346 Sponsor Follow Up.pdf HHSS 4/30/2024 3:00:00 PM
HB 346