Legislature(2021 - 2022)BUTROVICH 205
05/04/2021 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
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| Start | |
| SB124 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 124 | TELECONFERENCED | |
| += | SB 38 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
May 4, 2021
1:49 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator Shelley Hughes, Vice Chair
Senator Tom Begich
Senator Mia Costello
Senator Lora Reinbold
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 124
"An Act relating to admission to and detention at a subacute
mental health facility; establishing a definition for 'subacute
mental health facility'; establishing a definition for 'crisis
residential center'; relating to the definitions for 'crisis
stabilization center'; relating to the administration of
psychotropic medication in a crisis situation; relating to
licensed facilities; and providing for an effective date."
- HEARD & HELD
SENATE BILL NO. 38
"An Act relating to the practice of naturopathy; establishing
the Naturopathy Advisory Board; relating to the licensure of
naturopaths; relating to disciplinary sanctions for naturopaths;
relating to the Department of Commerce, Community, and Economic
Development; and providing for an effective date."
- BILL HEARING CANCELED AND RESCHULED TO 5/6/21
PREVIOUS COMMITTEE ACTION
BILL: SB 124
SHORT TITLE: MENTAL HEALTH FACILITIES & MEDS
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
04/12/21 (S) READ THE FIRST TIME - REFERRALS
04/12/21 (S) HSS, FIN
04/27/21 (S) HSS AT 1:30 PM BUTROVICH 205
04/27/21 (S) Heard & Held
04/27/21 (S) MINUTE(HSS)
04/29/21 (S) HSS AT 1:30 PM BUTROVICH 205
04/29/21 (S) -- MEETING CANCELED --
05/04/21 (S) HSS AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
MARK REGAN, Attorney
Disability Law Center of Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 124.
FRANCESCA ALLEGREZZA, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to SB 124.
MAJOR DAVID HANSON, Deputy Director
Central Office
Division of Alaska State Troopers
Department of Public Safety
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 124.
KATHLEEN WEDEMEYER, Citizens Commission on Human Rights
Northwest Chapter
Seattle, Washington
POSITION STATEMENT: Testified about concerns with SB 124.
ANN RINGSTAD, Executive Director
National Alliance on Mental Illness Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 124.
SARAH KOOGLE, Director of Adult Services
Alaska Behavioral Health
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of SB 124.
ROGER BRANSON, representing self
Eagle River, Alaska
POSITION STATEMENT: Testified in support of SB 124.
BEVERLY SCHOONOVER, Executive Director
Advisory Board on Alcoholism and Drug Abuse and
Alaska Mental Health Board
Division of Behavioral Health
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified in support of SB 124.
CHRISTINE ROBBINS, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in opposition to SB 124.
ANDREA MCLEOD, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to SB 124.
LISA GENTEMANN, representing self
Eagle River, Alaska
POSITION STATEMENT: Testified in opposition to SB 124.
KRISTIANA FITZWATER, representing self
Palmer, Alaska
POSITION STATEMENT: Testified in opposition to SB 124.
HEATHER CARPENTER, Health Care Policy Advisor
Office of the Commissioner
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 124.
ALBERT WALL, Deputy Commissioner
Office of the Commissioner
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 124.
STEVEN BOOKMAN, Senior Assistant Attorney General
Human Services Section
Civil Division
Department of Law
Anchorage, Alaska
POSITION STATEMENT: Answered questions on SB 124.
NANCY MEADE, General Counsel
Administrative Staff
Office of the Administrative Director
Alaska Court System
Juneau, Alaska
POSITION STATEMENT: Answered questions on SB 124.
ACTION NARRATIVE
1:49:28 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 1:49 p.m. Present at the
call to order were Senators Hughes, Costello, Reinbold, and
Chair Wilson. Senator Begich arrived during the course of the
meeting.
SB 124-MENTAL HEALTH FACILITIES & MEDS
1:49:58 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 124
"An Act relating to admission to and detention at a subacute
mental health facility; establishing a definition for 'subacute
mental health facility'; establishing a definition for 'crisis
residential center'; relating to the definitions for 'crisis
stabilization center'; relating to the administration of
psychotropic medication in a crisis situation; relating to
licensed facilities; and providing for an effective date."
CHAIR WILSON stated his intent to take public testimony for SB
124, sponsored by the Senate Rules Committee by the request of
the governor. He noted that the committee had heard an overview
of the bill on April 27.
1:51:01 PM
CHAIR WILSON opened public testimony on SB 124.
1:51:12 PM
MARK REGAN, Attorney, Disability Law Center of Alaska,
Anchorage, Alaska, stated that SB 124 makes it easier for people
in crisis to get short-term mental health treatment. The
Disability Law Center of Alaska endorses SB 124 with minor
language adjustments regarding the appointment of attorneys,
evaluations performed by residential centers, readmission, and
staffing capacity. SB 124 replaces an outdated system. He urged
the legislature to moderately revise and pass SB 124.
SENATOR REINBOLD asked if SB 124 is based on a Disability Law
Center lawsuit against Alaska.
MR. REGAN replied that SB 124 is an idea independent of the
Disability Law Center of Alaska's lawsuit. It will help solve
the problems raised by the settled case and is an improvement
that would be before members regardless of the suit. It makes it
possible for people to get through the process cleaner, simpler,
and faster.
1:55:01 PM
FRANCESCA ALLEGREZZA, representing self, Anchorage, Alaska,
stated she does not support unconstitutional SB 124. She
questioned how a person is determined to be mentally ill and
feared that having an opposing view could lead to a
determination of being mentally ill. She considers SB 124
government overreach and a precursor to red flag laws and
reeducation camps.
MAJOR DAVID HANSON, Deputy Director, Central Office, Division of
Alaska State Troopers, Department of Public Safety, Anchorage,
Alaska, stated the Department of Public Safety (DPS) supports
subacute mental health facilities for people experiencing mental
health crises. DPS views law enforcement's response to mental
health calls as a serious priority. Troopers often respond to
incidents where people are experiencing suicidal ideations,
manic episodes, delusions, depression, or states of distortion
due to the ingestion of drugs or alcohol. Trooper investigations
sometimes reveal no crime, but the subject needs immediate
assistance; such an occurrence is when a crisis stabilization
center can offer an alternative to inappropriate placement in
jails, full-scale medical services, or being left to suffer.
1:59:21 PM
SENATOR REINBOLD asked that a scene be described in which a
state trooper, without mental health training, needs to detain a
person experiencing a mental health crisis. She opined that
mental health certification for peace officers should be
included in SB 124.
1:59:58 PM
MAJOR HANSON replied that troopers receive mental health crisis
training at the academy, which covers a variety of illnesses.
They cannot diagnose an individual on scene, and they respond to
identify problems and investigate crimes. He stated peace
officers would be able to take individuals to a subacute care
facility for aide.
SENATOR REINBOLD reiterated that she wanted a clear description
of a person experiencing a mental health crisis. She asked if a
person would be reported as mentally ill if they did not want to
be vaccinated or expressed a political opinion. She wondered if
clear and convincing evidence would be approved over probable
cause, as probable cause is an opinion.
MAJOR HANSON replied that law enforcement would not act on a
person solely expressing an opinion.
Through training and collaboration with stakeholders, the
centers described in SB 124 would be the best place to take a
mentally ill person who is perceived to be a harm to themselves
or others.
2:03:16 PM
SENATOR REINBOLD replied that she wanted a description of the
situation. She also asked if reporting individuals would be
based on clear and convincing evidence and not probable cause.
MAJOR HANSON stated his belief that all troopers have
encountered individuals experiencing mental health episodes,
such as a delusional person screaming in their driveway and
frightening others. Troopers do not diagnose people. Their job
is to stabilize a situation, get needed help, and keep people
safe. They are to assist and resolve problems. He stated
troopers are never in a position where they can, at the moment,
say something is one hundred percent true. Troopers respond to
rapidly evolving situations and must use the tools, facilities,
and services available at the time. To suggest that troopers use
a clear and convincing standard goes beyond being reasonable in
many situations.
2:06:31 PM
KATHLEEN WEDEMEYER, Citizens Commission on Human Rights
Northwest Chapter, Seattle, Washington, stated the Citizens
Commission on Human Rights is a mental health watchdog group. SB
124 rethinks the psychiatric system for Alaska. The commission
is against any increased detention for evaluation and any forced
treatment provisions of SB 124 that would affect the
constitutional rights of Alaska citizens. No one should be held
for more than 72 hours without judicial review. Additionally, a
psychiatrist must be the gatekeeper of detention beyond 24
hours. One of the many issues with SB 124 is that individuals
may be subject to unjustifiable confinement and subsequent
consequences of being labeled mentally ill.
MS. WEDEMEYER said a key element of SB 124 should be the
enactment of health outcome measurements. When establishing
systems that promote treatment, governments and courts should
consider the lack of accountability that has been built into
treatment systems that utilize involuntary commitment and
community treatment laws. They should also consider the
importance of information when seeking to create health in the
people forced into treatment. The public is told about treatment
failures but not about recommended treatment that fails to
produce the outcome psychiatry and advocates promoted.
In public mental health, tracking system outcomes are favored
over mental health outcomes. Service utilization, engagement in
services, demographics, and ethnic information are system
outcomes. There is almost a complete lack of tracking for actual
health outcomes.
2:08:45 PM
MS. WEDEMEYER opined that the envisioned system must be
accountable to the citizens via the government that funds it.
Tracking patient health outcomes should be an essential part of
SB 124 and not be ignored because of imaginative closure
violations. On the web pages of advocates for SB 124, such as
Crisis Now, NAMI, and hospitals, there is minimal information
about the toxic nature of psychiatric drugs and the long list of
dangerous side effects.
There must be a system to address individuals experiencing
emotional crises and represent harm to themselves or others. The
legislature must work out this system to safeguard the public.
She opined that SB 124 has the following issues:
• Lack of accountability and oversight
• Lack of health outcomes
• Wide-open-door to system expansion
• Lack of emphasis on overall health
• Opens the door to increased involuntary commitment of
adults and youth
• Raises concerns regarding parental oversight of minors
MS. WEDEMEYER said focusing on a system that creates health and
identifies physical ailments and disorders that mimic
psychiatric disorders will benefit Alaska citizens.
She said she is willing to impart information to anyone who has
questions about psychiatric illness.
2:10:58 PM
SENATOR HUGHES asked Ms. Wedemeyer to provide language
suggestions to SB 124 that might bring about the principles she
listed in her testimony.
MS. WEDEMEYER replied that she would provide modified language.
She stated she has gone through SB 124 and is very concerned
with the jump from 72 to 120 hours of confinement.
SENATOR REINBOLD said she would like to work with Ms. Wedemeyer
on her concerns about SB 124.
2:14:31 PM
ANN RINGSTAD, Executive Director, National Alliance on Mental
Illness Alaska, Anchorage, Alaska, stated that NAMI provides
education, advocacy, and public awareness so that individuals
affected by mental illness can build better lives. She said that
NAMI Alaska supports SB 124 because it addresses the need for
appropriate lower-level care response for behavioral health.
SB 124 is essential to Alaska implementation of proven crisis
response improvements, including the nationally recognized
Crisis Now model. Instead of an emergency room, first responders
could take individuals in crisis to a low, no barrier, or No
Wrong Door crisis stabilization center. This new approach
follows the national guidelines for behavioral health crisis
care using best practices endorsed by the Substance Abuse and
Mental Health Services Administration of the US Department of
Health and Social Services. Their guidelines are science-based
and real-world tested best practices in the behavioral health
field.
NAMI Alaska applauds the Alaska Mental Health Trust Authority
for analysis and consideration of a framework suited for Alaska
through the Crisis Now model and looks forward to continued
discussions about the Crisis Now initiative.
2:16:59 PM
SENATOR REINBOLD asked if NAMI was involved in drafting SB 124
and whether it would benefit financially from the legislation if
passed.
CHAIR WILSON replied that no one is given funds from the
Department of Health and Social Services (DHSS) to draft
legislation.
MS. RINGSTAD replied that statement was correct.
SENATOR REINBOLD said her question was did NAMI Alaska stand to
financially benefit if the legislation passes.
CHAIR WILSON responded that the entire state would benefit, and
the answer would be opinion-based. He asked if NAMI helped DHSS
write any part of SB 124.
[Online contact with Ms. Ringstad was lost.]
2:18:16 PM
SARAH KOOGLE, Director of Adult Services, Alaska Behavioral
Health, Fairbanks, Alaska, testified that SB 124 would help
individuals receive correct levels of care. With the proper
resources in place, high hospitalization rates can be avoided.
First responders are working outside of their scope of practice
trying to help Alaska's behavioral health crisis. Using the
Crisis Now model, adequately trained individuals will step in to
assist and avoid a trip to the emergency room. Alaska Behavioral
Health supports SB 124.
2:19:27 PM
ROGER BRANSON, representing self, Eagle River, Alaska, stated he
advocates for mental health consumers. In 1987 he was granted a
temporary restraining order to prevent the state from
involuntarily medicating him with Thorazine. Hundreds of people
living on the streets of Anchorage stand to benefit from the
Crisis Now model following the pandemic. SB 124 will enable that
model to be operational in time to serve those people. There has
been a massive grassroots movement to make this care happen.
Passing SB 124 will enable people to help each other. Mental
health problems are hard to define but easily recognizable. From
his personal experience, 72-hours to a scheduled hearing always
took 120 hours because of weekends and holidays. He finds the
increase to 120 hours concerning. However, he urged SB 124 to be
moved forward so that people currently on the streets can
benefit from Crisis Now.
2:22:30 PM
BEVERLY SCHOONOVER, Executive Director, Advisory Board on
Alcoholism and Drug Abuse and Alaska Mental Health Board,
Division of Behavioral Health, Department of Health and Social
Services, Juneau, Alaska said Alaska's citizen-led statewide
advisory boards are tasked with evaluating federal and state
laws concerning mental health, alcoholism, substance misuse,
prevention, and treatment services.
The legislature has supported many policy efforts to build a
continuum of care for Alaska's most vulnerable populations. SB
124 is a crucial policy needed for ongoing behavioral health
reform efforts.
SB 124 would expand existing Title 47 authorities to allow peace
officers and mental healthcare professionals to temporarily hold
Alaskans at subacute mental health facilities if they are
experiencing a mental health crisis. This expansion is an
emergency medical intervention for Alaskans whose mental illness
causes them to be a danger to themselves. It is for Alaskans
experiencing severe mental, emotional, and physical distress.
MS. SCHOONOVER said there are few places for Alaskans to receive
the support they need, and they often end up in emergency rooms
or local jails. Crisis emergency medical centers will be staffed
by medical professionals and trained peers with lived
experience. She urged the members to pass SB 124 and asked for
support with ongoing behavioral health reform efforts.
2:24:26 PM
CHRISTINE ROBBINS, representing self, Fairbanks, Alaska, urged
members to vote against SB 124 because no one should have the
right to impose medical intervention without consent. She
offered her belief that it is unconstitutional, and she said no
insurance would indemnify the administrator against harm caused
to the recipient. Another danger of SB 124 would be the
administration of drugs based solely on training and not actual
medical qualifications and certifications. She offered her
belief that legislators should make public inebriation a
punishable offense to deter it from happening.
2:26:16 PM
MS. ROBBINS testified that as a person who works in jail
ministry, putting mentally ill individuals in jail with inmates
creates a dangerous environment because they are not kept
separate.
2:26:58 PM
ANDREA MCLEOD, representing self, Anchorage, Alaska, stated that
the Mental Health Trust has a lot of programs and grants. NAMI
could be a beneficiary of one of its grants. The mental health
system in Alaska is industry-driven, and the Alaska Mental
Health Trust Authority (AMHTA) is in it for money.
She maintained that:
• SB 124 does not provide proper mental health treatment.
• The mental health system in Alaska is broken and sporadic.
• Programs that were once available are gone.
• Emergency acute psychiatric care standards continue to be
lowered.
• Certification standards are being lowered. A person no
longer needs to be a psychiatrist to administer
psychotropic drugs.
There is a diminishment of real psychiatric help. The mission of
AMHTA is to get people better with its millions of dollars. SB
124 does not get Alaska where it needs to be. Involuntary
injections are not how people get better. It is horrific to be
involuntarily injected, and it does not produce any positive
outcome. SB 124 is a catch and release bill to alleviate the
demands for services at hospitals.
MS. MCLEOD said hospitals have a strong lobby and get what they
want. Hospitals continue to have fewer psychiatric patients as
they are being left on the street with no care. Crisis Now is a
catch and release program. The mentally ill will be caught, kept
involuntarily for a short period, injected, and then be released
back to the street with no genuine care or treatment in the long
term. Fully funding the Alaska Psychiatric Institute (API) would
answer a lot of mental health problems.
2:31:40 PM
LISA GENTEMANN, representing self, Eagle River, Alaska, stated
she is firmly against SB 124. She has been a healthcare
provider, dental hygienist, and mom. She has learned that the
most critical component for good relationships and success is
patient consent. Forcing students to do work or patients to
floss doesn't work. She took someone she loved to a mental
health facility and had a terrible experience involving force,
which hurt her relationship with this person. The person
condition worsened. Success came when this person began
exercising and found spiritual guidance. Desire from the
individual is critical to success.
2:33:50 PM
CHAIR WILSON acknowledged Senator Begichs arrival.
2:33:59 PM
KRISTIANA FITZWATER, representing self, Palmer, Alaska, stated
she has concerns after reading SB 124 and wonders if there are
regulations on what constitutes a mentally ill person. She takes
issue with the state having the ability to drug a person three
times without consent; she believes it is a power easily abused
and violates individual rights.
2:35:49 PM
CHAIR WILSON closed public testimony on SB 124. He called on Ms.
Carpenter.
2:37:16 PM
HEATHER CARPENTER, Health Care Policy Advisor, Office of the
Commissioner, Department of Health and Social Services, Juneau,
Alaska, reminded members that SB 124 is about the civil
involuntary commitment process. The bulk of Alaskans needing
mental or behavioral health treatment are served through
voluntary treatment. Alaskans need a robust and improved crisis
psychiatric response system for individuals experiencing a
crisis and are unable to seek the care they need voluntarily.
The only options for evaluation and treatment are designated
hospitals or API. These facilities are currently only in the
communities of Anchorage, Fairbanks, Mat-Su, and Juneau.
She said there is a constitutional process for involuntary civil
commitment. A person with mental illness who is a threat to
themselves or others or considered gravely disabled is held for
evaluation upon application to the court. Mentally ill, a threat
to self or others, and gravely disabled are defined in statute.
Individuals meeting these definitions are offered voluntary
treatment. When a hospital files a petition, it is signed by a
mental health professional, and a full evidentiary hearing is
conducted where legal counsel represents the patient.
2:39:01 PM
MS. CARPENTER said SB 124 is a monumental shift because care
will be provided in less restrictive environments. Mental health
care at the lower levels of the new system can be compared to
receiving physical help at an urgent care facility.
The 1115 Behavioral Health Medicaid Waiver is also being
leveraged. The 1115 waiver allows for referral-based care
determined by need, which means there is immediate support to
stabilize individuals through crisis stabilization centers.
Crisis stabilization centers are a less restrictive alternative
to traditional involuntary commitment holds. The 1115 waiver
will provide referral pathways for individuals who need
additional behavioral health services, either through admission
to a residential crisis center or community care. The 1115
waiver has already enabled DHSS to set up an administrative
services organization that tracks individuals' outcomes and
referrals to ongoing community care.
The 1115 waiver drives down healthcare costs by enabling payment
for service providers of critical behavioral health support,
including crisis stabilization and residential crisis centers.
Payment is possible because suitable individuals are diverted
from costly hospital and emergency room care to a Medicaid
reimbursable crisis response system, which has already been
approved for Medicaid and Medicare services. These services are
delivered by qualified board and state-licensed mental health
professionals.
MS. CARPENTER said these professionals connect individuals in a
behavioral health crisis to the appropriate level of care,
preventing the crisis from escalating. A goal of DHSS is to have
more treatment options, including crisis stabilization and
residential centers in the nine-state regions served by the
waiver.
2:41:10 PM
MS. CARPENTER said these centers would allow individuals to
receive psychiatric care closer to home. Rural areas often have
long wait times for transport to a designated involuntary
commitment facility.
In 2016, the passage of Senate Bill 74 74 included language that
directed DHSS to specifically apply for the 1115 Behavioral
Health Waiver that would improve behavioral health outcomes
while containing health care costs. This waiver has allowed DHSS
to target resources towards individuals who are super-utilizers.
These users are Medicaid recipients who repeatedly receive care
at the most costly and acute end of the behavioral health care
continuum.
DHSS has established a range of effective needs-based services
and supports through the 1115 waiver. The new options created
under SB 124 supplement Alaska's current psychiatric crisis care
system with less restrictive involuntary commitment care. SB 124
is a win for patients because it provides a less restrictive
system of care. It is a win for hospitals and ERs that
specifically asked for resources to free up beds. It is a win
for law enforcement because it provides broader options for
handling individuals experiencing a mental health crisis.
2:43:33 PM
MS. CARPENTER clarified that minors have the same rights as
adults in civil commitment statutes, and they have more rights
for court-appointed guardian ad litem and parental rights. Any
parent of a minor in an involuntary commitment hold receives all
notices that a minor child receives. A minor and parent each
gets an appointed attorney, which ensures a parent has
representation if there is disagreement with the minor's
attorney.
Emergency involuntary commitment holds can be started by police
officers, physician assistants, physicians, and psychologists,
ensuring that access to care happens quickly when an individual
needs it the most.
The definition of peace officer was expanded to enable peace
officers to hold an in-crisis individual for the purpose of
transport to a treatment center. This change does not mean that
a peace officer may recommend or administer crisis medications,
other care or determine if an individual meets the requirements
of a future hold. The qualified mental health professional on
staff at the center will determine if the individual requires
crisis medication, other care or meets the requirement for a
future hold. Allowing a peace officer hold was requested by
Anchorage providers and the community to assist in their effort
to erect mobile crisis teams.
MS. CARPENTER asserted it is inaccurate to say that SB 124
allows police officers to medicate individuals involuntarily or
provide crisis medication. The language in SB 124 only allows
crisis medication to be prescribed by a physician, an advanced
nurse practitioner, or a physician assistant. At no time can a
police officer administer medicines to a person in their care or
custody.
2:46:12 PM
SENATOR HUGHES opined that involuntary commitment holds should
have defined parameters so individuals are protected. She
suggested SB 124 be referred to the Judiciary Committee since
matters such as constitutional rights, court-appointed
attorneys, and evidentiary hearings are better suited to that
committee's scope.
2:47:39 PM
SENATOR REINBOLD agreed that SB 124 should be referred to the
Judiciary Committee. She offered her belief that the standard of
probable cause in Section 2 should be raised to clear and
convincing or beyond a reasonable doubt. On page 2, line 7,
mental illness should be defined and not left to opinion. Also,
on the top of page 2, she does not think licensed psychiatrists
and physicians should be removed from the language.
SENATOR HUGHES clarified that licensed psychiatrists and
physicians are not being deleted from SB 38. They are being
encapsulated into a definition.
2:51:00 PM
ALBERT WALL, Deputy Commissioner, Office of the Commissioner,
Department of Health and Social Services, Juneau, Alaska,
clarified that the people being added to the definition of peace
officer are not people who are allowed to involuntarily
commitment and individual. They are the people who can take an
individual to a crisis center. Due process does have a legal
definition, as does mental health. He deferred to Mr. Bookman
for the explanations.
2:52:38 PM
STEVEN BOOKMAN, Senior Assistant Attorney General, Human
Services Section, Civil Division, Department of Law, Anchorage,
Alaska, stated that mental illness is already statutorily
defined, and SB 124 would not change that definition. The
definition in AS 47.30.915(14) reads:
mental illness means an organic, mental, or
emotional impairment that has substantial adverse
effects on an individual's ability to exercise
conscious control of the individual's actions or
ability to perceive reality or to reason or
understand; intellectual disability, developmental
disability, or both, epilepsy, drug addiction, and
alcoholism do not per se constitute mental illness,
although persons suffering from these conditions may
also be suffering from mental illness.
MR. BOOKMAN stated that procedural due process is a flexible
idea that depends on the circumstance. It is essentially notice
and the opportunity to be heard. In the current 30-day
commitment laws, due process involves an evaluation period, a
petition, and a hearing in front of a judge. Before the hearing,
the respondent will have had the right to read the plea ahead of
time and have the attorney go over their medical charts. At the
hearing, certain things are proved, and the respondent has the
right to cross-examine, present witnesses, and testify if they
want to.
2:55:00 PM
SENATOR COSTELLO asked if parental rights are relinquished
through the involuntary commitment of a minor. She also asked
how a disagreement between a parent and child's attorney is
resolved.
2:55:59 PM
NANCY MEADE, General Counsel, Administrative Staff, Office of
the Administrative Director, Alaska Court System, Juneau,
Alaska, deferred to Mr. Bookman.
MR. BOOKMAN replied that parental rights would not be
relinquished or suspended during this process. The child will
have an attorney, and each parent will have their attorney. The
judicial officer would resolve disputes. For example, the
child's attorney could argue that the child should be released,
one parent could say that the child should stay, and the other
parent may say the child should be released. The judicial
officer would then make the determination.
2:57:20 PM
SENATOR COSTELLO asked members if they would like the input from
the Disability Law Center to be put into draft language for
consideration. One clarifying suggestion had been whether a
person held involuntarily has a court-appointed attorney.
MS. MEADE replied that a person held on an involuntary
commitment is appointed an attorney, and the court does the
appointing.
2:58:28 PM
SENATOR COSTELLO asked what happens when someone is released
from a stabilization center but is immediately readmitted.
MR. WALL stated there is a provision for preauthorization for
readmittance in SB 124. He said he will find and submit it in
writing to the members.
2:59:41 PM
SENATOR BEGICH asked what happens to the settlement with the
Alaska Disability Law Center, if SB 124 does not pass.
3:00:17 PM
MR. WALL replied to the previous question that readmission for a
patient is subject to a court order and is part of the admission
process.
CHAIR WILSON repeated the question that if SB 124 does not pass,
will the state violate the settlement between the Alaska
Disability Law Center and DHSS.
MR. WALL answered no; as Mark Regan testified, SB 124 is not
tied to that settlement. However, SB 124 would be part of easing
the burden on the system and addressing the needs of patients in
Alaska. SB 124 creates a base level of service and care that
will support the model discussed in the Alaska Disability Law
Center settlement, but it is not tied to it.
3:01:52 PM
SENATOR REINBOLD stated that if SB 124 were only about
establishing subacute care facilities, she would have no issue
with it. She would like the Disability Law Center to draft
suggested language for SB 124. She asked if SB 124 would provide
representation for every person committed involuntarily.
MS. MEADE answered that SB 124 provides public counsel and the
right to a hearing for respondents, including minors, who are
involuntarily admitted to a crisis stabilization center. An
individual is not provided an attorney during the 23-hour hold
period.
3:04:32 PM
SENATOR REINBOLD asked for comment on the advanced health care
directive portion of SB 124.
MS. MEADE replied that Section 9 addresses the advanced
healthcare directive portion of SB 124. The first several lines
of the statute remain unchanged. Section 9 states that
medication can be administered only with court approval. A long-
standing statute regarding the involuntary administration of
psychotropic medication is referenced on page 6, line 22.
Healthcare providers must petition the court. There will be a
hearing and an attorney appointed. A court appointed visitor
will arrange for evaluations to be performed on the respondent
and make recommendations to the court on the individual's
capacity to give informed consent. New language on page 21 says
if the patient can provide informed consent, and gives it, then
medication can be given.
3:06:43 PM
CHAIR WILSON stated Mr. Wall would provide written commentary on
the advanced healthcare directive and answer whether the Alaska
Psychiatric Institute goes through the certificate of need
process.
SENATOR HUGHES stated that the sixth principle of mental
healthcare listed in AS 47.30.655 is concerning. It states,
"that persons who are mentally ill but not dangerous to others
be committed only if there is a reasonable expectation of
improving their mental condition." She asked if consent would be
required in this instance since it is not for protecting anyone.
Her concern is that the sixth principle would allow for
involuntary commitment for non-safety purposes.
[SB 38 was held in committee.]
3:08:43 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Department of Health and Social
Services Standing Committee meeting at 3:08 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 124 Anchorage Fire Department Letter of Support.pdf |
SHSS 5/4/2021 1:30:00 PM |
SB 124 |
| SB 124 Disability Law Center second letter 5.3.21.pdf |
SHSS 5/4/2021 1:30:00 PM |
SB 124 |
| SB 124 Public Input 5.4.21.pdf |
SHSS 5/4/2021 1:30:00 PM |
SB 124 |
| SB 124 Nancy Meade Ak Court System.pdf |
SHSS 5/4/2021 1:30:00 PM |
SB 124 |