Legislature(2021 - 2022)DAVIS 106
03/15/2022 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB172 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 172 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 15, 2022
3:10 p.m.
MEMBERS PRESENT
Representative Liz Snyder, Co-Chair
Representative Tiffany Zulkosky, Co-Chair
Representative Ivy Spohnholz
Representative Zack Fields
Representative Ken McCarty
Representative Mike Prax
Representative Christopher Kurka
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 172
"An Act relating to admission to and detention at a subacute
mental health facility; establishing a definition for 'subacute
mental health facility'; establishing a definition for 'crisis
residential center'; relating to the definitions for 'crisis
stabilization center'; relating to the administration of
psychotropic medication in a crisis situation; relating to
licensed facilities; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 172
SHORT TITLE: MENTAL HEALTH FACILITIES & MEDS
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
04/12/21 (H) READ THE FIRST TIME - REFERRALS
04/12/21 (H) JUD, HSS, FIN
05/14/21 (H) JUD AT 1:00 PM GRUENBERG 120
05/14/21 (H) Heard & Held
05/14/21 (H) MINUTE(JUD)
05/15/21 (H) JUD AT 1:00 PM GRUENBERG 120
05/15/21 (H) -- MEETING CANCELED --
02/14/22 (H) JUD AT 1:00 PM GRUENBERG 120
02/14/22 (H) -- MEETING CANCELED --
02/16/22 (H) JUD AT 1:30 PM GRUENBERG 120
02/16/22 (H) Heard & Held
02/16/22 (H) MINUTE(JUD)
02/21/22 (H) JUD AT 1:00 PM GRUENBERG 120
02/21/22 (H) Heard & Held
02/21/22 (H) MINUTE(JUD)
02/23/22 (H) JUD AT 1:30 PM GRUENBERG 120
02/23/22 (H) Heard & Held
02/23/22 (H) MINUTE(JUD)
02/25/22 (H) JUD AT 1:30 PM GRUENBERG 120
02/25/22 (H) Moved CSHB 172(JUD) Out of Committee
02/25/22 (H) MINUTE(JUD)
02/28/22 (H) JUD RPT CS(JUD) NEW TITLE 3DP 1DNP 1NR
1AM
02/28/22 (H) DP: DRUMMOND, SNYDER, CLAMAN
02/28/22 (H) DNP: EASTMAN
02/28/22 (H) NR: KREISS-TOMKINS
02/28/22 (H) AM: VANCE
03/08/22 (H) HSS AT 3:00 PM DAVIS 106
03/08/22 (H) Heard & Held
03/08/22 (H) MINUTE(HSS)
03/15/22 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
HEATHER CARPENTER, Health Care Policy Advisor
Office of the Commissioner
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
172.
NANCY MEADE, General Counsel
Administrative Staff
Office of the Administrative Director
Alaska Court System
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
172.
STEVEN BOOKMAN, Senior Assistant Attorney General
Human Services Section
Civil Division (Anchorage)
Department of Law
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
172.
STEVE WILLIAMS, Chief Executive Officer
Alaska Mental Health Trust Authority
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
172.
ACTION NARRATIVE
3:10:07 PM
CO-CHAIR LIZ SNYDER called the House Health and Social Services
Standing Committee meeting to order at 3:10 p.m.
Representatives Kurka, Prax, Spohnholz, Zulkosky, Fields, and
Snyder were present at the call to order. Representative
McCarty arrived as the meeting was in progress.
HB 172-MENTAL HEALTH FACILITIES & MEDS
3:11:03 PM
CO-CHAIR SNYDER announced that the only order of business would
be HOUSE BILL NO. 172, "An Act relating to admission to and
detention at a subacute mental health facility; establishing a
definition for 'subacute mental health facility'; establishing a
definition for 'crisis residential center'; relating to the
definitions for 'crisis stabilization center'; relating to the
administration of psychotropic medication in a crisis situation;
relating to licensed facilities; and providing for an effective
date."
3:13:45 PM
CO-CHAIR SNYDER turned to questions from the committee.
3:13:49 PM
CO-CHAIR ZULKOSKY asked about the recommendations from Gottstein
with the law project on civil rights.
3:14:48 PM
HEATHER CARPENTER, Health Care Policy Advisor, Office of the
Commissioner, Department of Health and Social Services (DHSS)
explained that the trust held a meeting on March 7, including
Gottstein. Ms. Carpenter said she agreed with his 5 edits in
concept and went on to explain the details of the edits.
REPRESENTATIVE ZULKOSKY asked if it was possible for the
department to submit the edits to the co-chairs' offices.
MS. CARPENTER replied, "Absolutely."
3:17:12 PM
REPRESENTATIVE FIELDS thanked Ms. Carpenter for her work with
Mr. Gottstein.
3:17:24 PM
REPRESENTATIVE PRAX directed attention to Section 3, on page 2,
and asked the difference between "deliverance", "arrest", and
"involuntarily commit".
MS. CARPENTER offered her understanding that Sections 1 through
10 are conforming edits to the 2020 law, "The Alternative to
Arrest." She explained that the person in crisis would be taken
to an evaluation center, and she deferred to the public safety
for a more in-depth answer.
REPRESENTATIVE PRAX asked whether it would be accurate to say
delivery to a mental health or crisis center wouldn't show up on
Court View.
MS. CARPENTER directed the question to Nancy Meade.
3:20:48 PM
NANCY MEADE, General Counsel, Administrative Staff, Office of
the Administrative Director, Alaska Court System, confirmed
Representative Prax was correct that a delivery to a mental
health or crisis center would not show on Court View.
3:21:20 PM
REPRESENTATIVE FIELDS asked Ms. Carpenter if his understanding
is correct that if the bill passed, it would expand some
facilities, and he asked what the funding streams would look
like.
MS. CARPENTER explained what the facilities would look like and
explained the concept of "No wrong door." She went on to
explain what would happen if the crisis was not resolved at that
stage.
REPRESENTATIVE FIELDS asked what centers would be included in
the program.
MS. CARPENTER answered non-profit providers. She said she does
have a list of which providers have been approved and offered to
provide it to the committee.
REPRESENTATIVE FIELDS asked how this would change the workforce.
MS. CARPENTER talked about the work DHSS is doing to identify
the changes and outlined various ways the department is working
on workforce development.
3:25:11 PM
REPRESENTATIVE KURKA asked about wording on page 6, mentioned
the 72-hour hold, and asked what the rational is for excluding
weekends and holidays.
MS. CARPENTER explained that the department aligned the wording
with how it is done today under AS 47.30.
3:27:07 PM
STEVEN BOOKMAN, Senior Assistant Attorney General, Human
Services Section, Civil Division (Anchorage), Department of Law,
echoed Ms. Carpenter that the idea behind the wording was to
keep the timing in line with previous law. He explained that it
can be difficult to provide the correct care without
observation. He mentioned the high standard to involuntarily
commit someone and pointed to Ms. Meade to give more specifics
regarding court system availability.
3:29:05 PM
MS. MEADE explained that the courts are staffed 24 hours.
REPRESENTATIVE KURKA voiced his concern that convenience is what
determines how long someone is held. He asked how it balances
with the rights of the individual.
MS. MEADE replied that the court issues an expert within 24
hours and within that order the court sets a subsequent hearing
date.
3:32:38 PM
REPRESENTATIVE SPOHNHOLZ asked Ms. Carpenter if there has been
any discussion on capital funding for the facilities outlined in
the bill.
MS. CARPENTER explained that the department has not been able to
have detailed conversations about capital costs.
3:34:33 PM
STEVE WILLIAMS, Chief Executive Officer, Alaska Mental Health
Trust Authority, Department of Revenue (DOR), stated his belief
that Ms. Carpenter covered it well, and he mentioned that DOR is
looking at costs involved in starting and maintaining the
facilities. He mentioned that the department is working with a
similar program in Arizona, as well as local providers.
REPRESENTATIVE SPOHNHOLZ cited a similar program in Georgia that
was able to address 90 percent of mental health crises via call
centers, and she asked about efforts to fund call centers.
MR. WILLIAMS responded that revenue questions were being
explored.
REPRESENTATIVE SPOHNHOLZ opined that the governor should use the
extra revenue from oil windfall to fund these projects.
3:38:13 PM
REPRESENTATIVE FIELDS voiced his agreement with Representative
Spohnholz. He asked how the language would protect the public
from "menacing" people with mental illness.
MS. CARPENTER pointed to Mr. Bookman for more details around the
criminal process.
REPRESENTATIVE FIELDS clarified that he is talking about "people
who are disturbed" who have yet to commit a crime.
MS. CARPENTER confirmed that the bill is aimed at that issue and
explained that the "mobile crisis teams" would be the first
response, and then if that has not resolved the issue, they
would be taken to a crisis center.
REPRESENTATIVE FIELDS asked if it's fair to say in the judgement
of the providers, that they would be able to involuntarily
commit someone they deem a threat to themselves or others.
MS. CARP explained they would have the power to do that and
emphasized that this is not about criminal proceedings.
3:42:06 PM
REPRESENTATIVE ZULKOSKY asked who, within the existing
continuum, would be able to provide crisis stabilization
centers, and who would be available to do this work.
MS. CARPENTER explained that it depends on the community, and
she gave examples. She repeated that DHSS hopes to have all the
services within the 1015 waiver.
MR. WILLIAMS talked about the conversations held with "all
sorts" of mental health providers. He said the department is
considering how the framework can be applied to specific
communities.
REPRESENTATIVE ZULKOSKY asked if the respective organizations
would apply through the department.
MS. CARPENTER explained the layers of procedure that providers
must follow and noted that the providers would have to apply for
approval through the department; she emphasized the department's
role in communicating between the providers.
CO-CHAIR SNYDER asked what the time frame would be to open doors
of crisis centers today if the money to do so were available.
MS. CARPENTER explained that it was provider specific, and she
was unsure of an exact timeline. She expressed her hesitancy to
speak for providers.
CO-CHAIR SNYDER commented that best-case scenario would probably
be in months, if not years.
MS. CARPENTER confirmed that in a best-case scenario it would
take months, and she emphasized that a year is not that long in
"the provider world."
3:53:46 PM
REPRESENTATIVE KURKA asked what protocols for obtaining parental
consent exist in the bill or in existing regulation.
MS. CARPENTER answered that the rights of respondents are
outlined in the bill. She also pointed out that there is
existing statute regarding the rights of minors in this
scenario.
REPRESENTATIVE KURKA pointed out that in the Matanuska-Susitna
("Mat-Su") Valley there is a need for developable land, and he
asked whether the Alaska Mental Health Trust Authority would get
any funding from "the land trust."
3:56:20 PM
MR. WILLIAMS explained that "the trust" is actively engaged in
investigating much of what is being discussed.
REPRESENTATIVE KURKA asked if Mr. Williams viewed the trust as
an advisory group.
MR. WILLIAMS said that the trust is advisory as well as a
funding source.
3:59:10 PM
REPRESENTATIVE SPOHNHOLZ asked whether DOR has used those
resources previously for capital grants.
MR. WILLIAMS confirmed that the trust does provide funding for
capital grants.
REPRESENTATIVE SPOHNHOLZ commented that while this discussion
has been focused on Title 47 holds, people who have experienced
mental health holds are not criminals. She pointed to the many
reasons that someone could have a psychiatric crisis.
4:02:56 PM
REPRESENTATIVE PRAX, returning to the issue of the 72-hour hold,
asked how dependents of those in 72-hour hold are addressed.
MS. CARPENTER explained, in the example of a single parent, it
would likely involve child services. She offered to follow up
in writing.
REPRESENTATIVE PRAX said that would be fine.
4:05:04 PM
REPRESENTATIVE MCCARTY asked what has been done to provide an
electronic health record for continuity of care.
MS. CARPENTER explained that electronic health records take a
variety of different avenues. She reminded the committee that
the program will be part of the Alaska Health Information
Exchange (Alaska HIE).
REPRESENTATIVE MCCARTY stated that the heartbeat of Arizona's
system is the communication. He voiced his dislike of the
Alaska Automated Information Management System (AKAIMS). He
emphasized the importance of good communication in crisis care.
MS. CARPENTER agreed that it is important to think about how the
health information exchange will be connected. She talked about
how other areas in electronic health records could be improved,
and she mentioned the Alaska Tribal Health System.
REPRESENTATIVE MCCARTY mentioned his 12-year work in health
communication. He said, "We do have the technology," and he
asked what the legislature can do to make sure all factors are
working.
MS. CARPENTER said she will take [the question] back to the
department, and she emphasized the focus on ensuring connections
are made so that an individual's record follows as the
individual "flows through the system."
4:14:03 PM
REPRESENTATIVE KURKA stated he understands the benefit of
sharing data and asked how that is balanced with the patient's
right to privacy.
MS. CARPENTER explained it would be covered by the Health
Insurance Portability and Accountability Act (HIPAA).
REPRESENTATIVE KURKA talked about the birth of his second born.
He asked how someone in a mental health crisis provides informed
consent.
MS. CARPENTER deferred to Mr. Bookman to address the question.
4:16:12 PM
MR. BOOKMAN explained that providers can exchange information
for treatment purposes.
REPRESENTATIVE KURKA expressed his desire to read HIPAA.
4:17:40 PM
REPRESENTATIVE PRAX mentioned concerns over involuntary
medications and asked whether HB 172 would change law regarding
involuntary medications.
MS. CARPENTER explained that the current bill would make no
changes to the current administration of crisis medications.
She also spoke to Mr. Gottstein's concerns and mentioned that
she had worked with him to make edits.
4:20:37 PM
REPRESENTATIVE KURKA asked for clarification as to where the
changes were reflected.
MS. CARPENTER explained that those changes were not in the
current draft.
4:21:36 PM
The committee took a brief at-ease.
4:21:41 PM
REPRESENTATIVE MCCARTY addressed Representative Kurka's question
regarding confidentiality and HIPAA. He explained what is
involved in an involuntary hold and what is outlined in HIPAA.
He talked about his experience in Kodiak.
CO-CHAIR SNYDER pointed to Mr. Bookman for further information.
4:27:59 PM
MR. BOOKMAN confirmed and pointed to the rights of the patient.
4:29:02 PM
CO-CHAIR SNYDER reminded the committee about the amendment
deadline.
[HB 172 was held over.]
4:30:08 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:30 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB172 - Amendments to HHSS 3.17.2022.pdf |
HHSS 3/15/2022 3:00:00 PM |
HB 172 |
| HB172- Follow-up to HHSS 3.17.2022.pdf |
HHSS 3/15/2022 3:00:00 PM |
HB 172 |