Legislature(2025 - 2026)GRUENBERG 120
03/04/2025 03:15 PM House STATE AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| Overview: (prison Fatalities and Mitigation Efforts) | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE STATE AFFAIRS STANDING COMMITTEE
March 4, 2025
3:18 p.m.
DRAFT
MEMBERS PRESENT
Representative Ashley Carrick, Chair
Representative Andi Story, Vice Chair
Representative Rebecca Himschoot
Representative Ky Holland
Representative Sarah Vance
Representative Kevin McCabe
Representative Elexie Moore
MEMBERS ABSENT
All members present
OTHER LEGISLATORS PRESENT
Representative Julie Coulombe
COMMITTEE CALENDAR
OVERVIEW: PRISON FATALITIES AND MITIGATION EFFORTS
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
TRAVIS WELCH, Director
Division of Health and Rehab Services
Department of Corrections
Anchorage, Alaska
POSITION STATEMENT: Co-offered the Prison Fatalities and
Mitigation Efforts overview.
ROBERT LAWRENCE, MD, Chief Medical Officer
Office of the Commissioner
Department of Health
Anchorage, Alaska
POSITION STATEMENT: Co-offered the Prison Fatalities and
Mitigation Efforts overview.
TIMOTHY BALLARD, MD, Chief Medical Officer
Division of Health and Rehab Services
Department of Corrections
Anchorage, Alaska
POSITION STATEMENT: Co-offered the Prison Fatalities and
Mitigation Efforts overview.
ADAM RUTHERFORD, Deputy Director
Division of Health and Rehab Services
Department of Corrections
Anchorage, Alaska
POSITION STATEMENT: Co-offered the Prison Fatalities and
Mitigation Efforts overview.
ACTION NARRATIVE
3:18:07 PM
CHAIR ASHLEY CARRICK called the House State Affairs Standing
Committee meeting to order at 3:18 p.m. Representatives
Himschoot, Holland, McCabe, Moore, Story, and Carrick were
present at the call to order. Representative Vance arrived as
the meeting was in progress. Also present was Representative
Coulombe.
^OVERVIEW: (Prison Fatalities and Mitigation Efforts)
OVERVIEW: (Prison Fatalities and Mitigation Efforts)
3:19:41 PM
CHAIR CARRICK announced that the only order of business would be
the Prison Fatalities and Mitigation Efforts overview.
3:22:45 PM
TRAVIS WELCH, Director, Division of Health and Rehab Services,
Department of Corrections (DOC), presented a PowerPoint, titled
"Prison Fatalities and Mitigation Efforts" [hard copy included
in the committee file]. He acknowledged the sensitivity of this
topic regarding deaths within correctional facilities. He
explained that DOC has a duty to provide essential care to those
in its custody. He said that the incarcerated population
experiences a higher concentration of the social challenges
Alaska faces, including high rates of heart disease, high
cholesterol, diabetes, substance use disorders, and mental
illness. He emphasized that in recent years, Alaska has had
some of the highest rates of drug overdose deaths, alcohol
poisoning, and suicides across the country. In response to a
series of committee questions, Mr. Welch said that the
population DOC serves often enters its facilities having
received less access to healthcare than the general population
in Alaska.
3:31:19 PM
ROBERT LAWRENCE, MD, Chief Medical Officer, Office of the
Commissioner, Department of Health (DOH), in response to a
question from the committee, said that many of the people DOC
serves come from families who depend on the individual in
custody. He emphasized that DOC offers a snapshot of the social
challenges affecting the entire Alaska community.
3:32:45 PM
MR. WELCH presented an overview of the in-custody deaths in DOC
between 2015 and 2024, with an average of 11 deaths per year.
In response to a series of committee questions, Mr. Welch
explained that "in-custody" refers to individuals under the care
of DOC, which could include those in a hospital. He named the
locations of DOC's infirmaries and explained that a greater
concentration of in-custody deaths occurs in those facilities.
He said that DOC tries to house individuals in the least
restrictive environment, which can include end-of-life releases
and communication with loved ones.
CHAIR CARRICK asked, noting 26 percent of deaths being by
suicide, if that number remained constant or increased.
3:39:44 PM
TIMOTHY BALLARD, MD, Chief Medical Officer, Division of Health
and Rehabilitation Services, Department of Corrections, in
response to a committee question, shared a breakdown of the
causes of in-custody deaths between 2015 and 2024, including
natural conditions, accidental deaths, and suicide. He said
that the rate of suicide has decreased in recent years.
3:42:58 PM
MR. WELCH provided statistics regarding the number of
incarcerated individuals living with a mental illness, a
substance use disorder, high blood pressure, and who use
tobacco. He highlighted that this is an aging population,
bringing its own medical complexities. He compared the
mortality rate of DOC to unified correctional systems in other
states.
3:45:26 PM
DR. BALLARD described the causes of death while in custody and
the recent trends in percentages of these different causes. He
then offered the demographics of in-custody deaths by race, age,
and gender. In response to a question from the committee, Dr.
Ballard said that the DOC website has an inmate demographics
page that shows trends in the population over the last 20 years.
3:49:54 PM
ADAM RUTHERFORD, Deputy Director, Division of Health and Rehab
Services, Department of Corrections, discussed some of the
challenges DOC faces in mitigating deaths.
3:51:08 PM
DR. LAWRENCE explained that prior to 2015, causes of deaths
within DOC fell into four major categories: sudden deaths that
occurred during the first 7 to 10 days within custody, often due
to withdrawals or unidentified problems when the individual
entered DOC; suicide; unanticipated natural causes; and
anticipated natural causes. He said that DOC responded to these
causes of death with three actions: employed and standardized
critical care guides; employed a pre-booking screen to identify
individuals at risk of sudden death during the intake period;
and revised the way it addresses medically managed withdrawals.
Dr. Lawrence emphasized that the ability to identify causes of
death, recognize what is coming through the DOC medical system,
and determine a mitigation strategy can have incredible power in
changing the outcomes for patients. He said that while the
average number of in-custody deaths has not varied much over
time, the causes of deaths have changed.
3:56:03 PM
MR. RUTHERFORD presented an overview on DOC's mitigation efforts
in response to mental health issues. He said that suicide is a
leading cause of death among the incarcerated population. He
said that DOC's mitigation efforts have focused on training for
both staff and those living within its facilities, which include
suicide prevention training, mental health first aide, and
scenario-based trainings. He emphasized DOC's goal of becoming
a "zero suicide agency" and said that this involves removing the
stigma surrounding suicide. Mr. Rutherford said that the
American Foundation for Suicide Prevention has identified four
areas of focus for preventing suicide: firearms, emergency
systems/departments, departments of correction, and healthcare
systems. He said that the National Commission of Correctional
Healthcare (NCCHC) identified three areas for improvement within
DOC for suicide prevention: better identification of folks that
are at risk, safely managing those who have been identified as
at-risk, and providing consistent training. Based on those
three principles, DOC evaluated its own suicide prevention
efforts. Mr. Rutherford said both identifying at-risk
individuals and offering meaningful programming to those in the
department's care are strengths of DOC. He said that DOC still
must improve its housing environments, communication, and
training.
4:03:22 PM
MR. RUTHERFORD described changes DOC has employed in response to
the review of its suicide prevention efforts; it implemented
larger windows in segregation environments, installed jump
barriers in areas of higher risk, increased the number of
medical bags throughout facilities, implemented evidence-based
screening tools for suicide, made NARCAN readily available to
DOC staff, and increased cameras. Mr. Rutherford emphasized the
importance of transparency from DOC, which includes having a
third-party medical examiner review cases of in-custody deaths
when they do occur. He explained that DOC's biggest mitigating
effort is investment in its staff. He shared a personal
anecdote where he witnessed an officer preventing a suicide in a
correctional facility.
4:11:39 PM
CHAIR CARRICK thanked Mr. Rutherford for focusing so much on the
mitigation efforts by DOC.
4:14:08 PM
MR. RUTHERFORD, in response to a question from Chair Carrick,
said that DOC often struggles to communicate with the loved ones
of an individual who died in custody. Barriers to this
communication include lacking a point of contact for the
deceased. He said that if there were a death within the system,
a chaplain would notify the family members of the death. He
said that this communication could also be challenging due to
DOC's requirement to respect the deceased's protected health
records.
4:16:32 PM
DR. LAWRENCE, in response to a question from Representative
Story, offered a personal anecdote regarding his experience
communicating with the designated family member of an
incarcerated patient, explaining that he communicated in the
same manner he would when caring for a patient in a hospital.
He said that communication becomes difficult when a family
member has not been designated as a point of contact prior to a
patient's death.
REPRESENTATIVE STORY followed up by questioning how DOC monitors
for suicidal ideation and detoxing. She indicated she would
like to know if, when a person dies of a medical issue in
custody, DOC reviews the healthcare that was provided to the
individual to see if anything was missed or could have been done
differently.
4:20:50 PM
ADJOURNMENT
There being no further business before the committee, the House
State Affairs Standing Committee meeting was adjourned at 4:20
p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 2025.03.04.HSTA.Presentation.DOC.pdf |
HSTA 3/4/2025 3:15:00 PM |