HOUSE BILL NO. 36 "An Act relating to the placement of foster children in psychiatric hospitals; relating to the care of children in state custody placed in residential facilities outside the state; and amending Rule 12.1(b), Alaska Child in Need of Aid Rules of Procedure." 3:53:41 PM REPRESENTATIVE ANDREW GRAY, SPONSOR, provided an explanation of the bill. He read from prepared remarks: Due process is a basic constitutional right of every person in Alaska. Due process is a legal process that protects people from arbitrary government actions and guarantees fair treatment. It's a fundamental principle of both the United States and Alaska Constitutions. Due process requires the government follow certain procedures before taking away a person's rights. HB 36 guarantees due process for the most vulnerable people in Alaska, our foster children. What the bill does is require that children who are in the custody of the office of children's services, otherwise known as foster children, receive a hearing in front of a judge in a timely manner to determine that they meet criteria to be held in an acute psychiatric hospital. The Alaska Supreme Court case of The Native Village of Kwinhagak v. State of Alaska Office of Children's Services, published on February 9, 2024, states the following: "There is no doubt that children in OCS custody are at substantial risk of being hospitalized for longer than they need, or when they do not need to be hospitalized at all." "Clarifying the legal protections for a vulnerable population of children in state custody is of utmost importance." The 14-year-old child at the center of that case was hospitalized for 46 days before the court held a hearing to determine if her hospitalization was justified. The Alaska Supreme Court determined that the 46-day wait was far too long to satisfy her right to due process. According to a previous superior court injunction, she should have had a hearing within 30 days, but the Supreme Court further ruled that 30 days was too long. This finding is consistent with what happens in other states: One former employee of an acute psychiatric hospital in Anchorage stated, "I come from the lower 48. Most hospitals, a stay would be a 72-hour hold. Maybe they'd be there for a week or 10 days. Thirty days just blew my mind." Another Nurse from that same facility stated: "you're not go to see any other acute crisis stabilization unit that does a 30 day stay." When a young person is hospitalized in a psychiatric institution, that child has limitations placed on their rights and freedoms. In the case of foster children, the chance that their rights can be unnecessarily restricted are much higher than with the general population. It is incumbent upon the legislature to take up the cause spelled out in Kwinhagak to determine the minimum amount of time between an admission and a court hearing. Many foster youths have suffered trauma and neglect and experience mental health challenges as a result. All foster youth have experienced the trauma of being removed from their biological family and this is in and of itself often the very greatest trauma of all. 3:57:03 PM Representative Gray continued to provide prepared remarks on the bill: We do not have enough foster placements in Alaska lack of foster placements can create pressure to keep a child in a facility longer than absolutely necessary that is not the fault of the facility. But it's also not the fault of the child. We know that kids have suffered from admissions that were too long and sometimes unnecessary that's what HB 36 is seeking to fix. In November I toured the OCS offices in Anchorage and it was an offhand remark of a nurse that provided the timeline in this bill. She said that it can take up to seven days to properly assess a foster child admitted to a psychiatric facility. This bill requires a hearing within 7 days. I believe this satisfies what the Supreme Court is asking in the Kwinhagak decision & provides foster kids with the due process that all Alaskans are entitled to. Representative Gray asked his staff to review the sectional analysis. 3:58:10 PM KYLE JOHANSEN, STAFF, REPRESENTATIVE ANDREW GRAY, reviewed the sectional analysis (copy on file) 4:02:27 PM Co-Chair Foster noted that there had been two people for invited testimony who were no longer available. Representative Tomaszewski looked at section 2 related to acute psychiatric hospitals. He asked how many there were in Alaska. Representative Gray replied that the bill was about any hospital. Representative Tomaszewski asked if there was a number of children placed inside the state. Mr. Johansen replied that he believed the information was reported. In the past several years it was about 100 children, and that it was around 90 children currently. Representative Gray added that any child in a facility in Alaska had OCS as their guardian. 4:04:59 PM Representative Hannan asked about the court rule amendment and the appointment of a Child in Need of Aid (CINA) guardian. NANCY MEADE, GENERAL COUNSEL, ALASKA COURT SYSTEM, replied that under the court rule, children in CINA was actually done almost always in the circumstances already merited it. 4:06:33 PM Representative Hannan recollected details from the prior year Department of Administration subcommittee. Co-Chair Josephson assumed that if Alaska children were in Utah that Utah law would apply. Mr. Johansen did not believe so. Ms. Meade answered that if they were in state custody the Alaska law would apply. 4:08:58 PM Co-Chair Josephson meant if Alaska sent children to Utah. He stated his understanding that Utah law overrode Alaska law. Ms. Meade answered it was correct if it was a CINA. 4:09:32 PM Representative Galvin was surprised to see there was any cost in the fiscal note after hearing that too many children had been in long term intensive care hospitalization for too many days. Representative Gray deferred the concern to Ms. Meade. Co-Chair Foster noted there were also two individuals who would speak to the fiscal notes. Ms. Meade could not comment on the other agency's fiscal impact. Representative Galvin would wait on her other question. She wondered whether too many children were in the intensive hospitals for too long how it would have a fiscal impact. Representative Gray replied that Medicaid was paying $908 per night per child. 4:13:22 PM KIM SWISHER, DEPUTY DIRECTOR, OFFICE OF CHILDREN'S SERVICES, DEPARTMENT OF FAMILY AND COMMUNITY SERVICES (via teleconference), agreed. Representative Allard asked if it could be achieved within the timeframe. Ms. Meade replied that the timeframe was seven to ten days. 4:19:18 PM Representative Johnson would take her question offline. Representative Gray appreciated the question. He would talk with some interested parties about the issue. Ms. Meade added that the attorneys were appointed at OPA. 4:20:39 PM Representative Bynum stated his understanding there was not currently statutory guidance. Representative Gray relayed that he had been working on the bill a long time, and wanted to determine the correct timeframe. Representative Bynum noted that the bill was using a definition from one of the cases related to an acute psychiatric hospital. He asked if the definition constrained the bill, and wondered whether there could be a facility not defined as a hospital. Representative Gray replied that there were currently statutes related to residential psychiatric facilities. Representative Bynum asked about the scope of the issue. 4:25:34 PM Representative Gray deferred the question to Ms. Swisher. Ms. Swisher answered it was how the department currently processed the paperwork. Representative Tomaszewski asked about the parties included in the notice. Ms. Meade answered that it could vary. Co-Chair Foster noted that there was another hearing. He asked for a review of the fiscal notes. Ms. Meade reviewed the fiscal note. 4:29:23 PM Ms. Swisher reviewed the fiscal note. Representative Gray thanked the committee. HB 36 was HEARD and HELD in committee for further consideration. Co-Chair Foster reviewed the schedule for the following meeting.