HB 52-MINORS & PSYCHIATRIC HOSPITALS  4:38:55 PM CHAIR MINA announced that the final order of business would be HOUSE BILL NO. 52, "An Act relating to the rights of minors undergoing evaluation or inpatient treatment at psychiatric hospitals; relating to the use of seclusion or restraint of minors at psychiatric hospitals; relating to a report published by the Department of Health; relating to inspections by the Department of Health of certain psychiatric hospitals; and providing for an effective date." 4:39:22 PM REPRESENTATIVE GRAY moved to adopt the proposed committee substitute (CS) for HB 52, Version 34-LS0399\I, Radford, 4/12/25, as the working document. CHAIR MINA objected for the purpose of discussion. 4:39:49 PM REPRESENTATIVE MAXINE DIBERT, Alaska State Legislature, as prime sponsor, provided a brief recap of HB 52 and thanked the committee for the support she has seen for the bill so far. She emphasized that the goal of HB 52 is to protect the state's most vulnerable youth receiving care from psychiatric facilities, while also protecting the rights of their guardians. 4:42:01 PM MATTIE HULL, Staff, Representative Maxine Dibert, on behalf of Representative Dibert, prime sponsor, read the summary of changes from the original bill version to Version I of HB 52 [included in the committee file], which read as follows [original punctuation provided]: Section 1  Page 2, line 1  Following charge. Inserts: The minor, the minor's parent or legal guardian, or another adult approved by the professional person in charge may request the confidential communication. Page 2, line 4:  Following Communication. Deletes "May place reasonable limits on the number of calls permitted," Section 4  Page 3, line 13:  Following subsection. Inserts: Unless the department of health requests staff presence during the interview to ensure safety. Section 5  Page 3, line 19  Inserts 72 hours as a replacement for "one business day", which is deleted. Section 6  Inserts: AS 47.32.900 Is amended by adding a new paragraph to read: (22) "chemical restraint" means a psychopharmacologic drug that is used on a patient for restraint, discipline, or convenience and that is not required to treat a medical symptom.   Section 7  Page 3, Line 27:  Inserts "2026" as a replacement for 2025 which is deleted. 4:44:33 PM REPRESENTATIVE GRAY, referring to page 3, lines 25-26, in Section 6 of HB 52, Version I, pointed to the language "that is not required to treat a medical symptom". He said that increasing the dosage of a medication that is already prescribed to a child could be used as a restraint. He asked if this language would create a loophole to inappropriately administer an already prescribed drug. 4:45:20 PM MR. HULL responded that there must be "an assumption of good faith" for these institutions and he was advised by Legislative Legal Services to finalize this language. 4:46:08 PM REPRESENTATIVE RUFFRIDGE asked about other legislation that already governs the use of psychotropic medications in crisis situations. He asked if HB 52 and that existing legislation would conflict with each other. 4:48:17 PM MR. HULL responded that HB 52 would require the reporting of chemical restraint usage but would not prohibit institutions from providing care. He said that the usage of chemical restraints would need to be reported under HB 52, even is used in a crisis situation. 4:49:01 PM REPRESENTATIVE FIELDS asked about the difference between requiring one hour versus two hours of communication between a patient and their legal guardian. 4:50:04 PM MR. HULL responded that HB 52 would create a minimum requirement for communication allowed but would not create a maximum requirement. 4:51:04 PM CHAIR MINA asked how that hour of communication would be monitored or recorded. She asked if that would be done by the facility of by the Division of Health Services. MR. HULL offered his understanding that it would be monitored by the hospital. 4:52:06 PM ROBERT NAVE, Operations Manager, Division of Health Care Services, Department of Health, responded that the hospital would track the one-hour time limit. 4:52:38 PM REPRESENTATIVE GRAY explained that sometimes requiring a young child to talk on the phone for even five minutes can be very difficult. He asked about the possibility of a phone call including that child engaging in their own activities while their guardian simply stays connected on the line. 4:53:17 PM REPRESENTATIVE RUFFRIDGE asked about the purpose of a psychiatric hospital notifying the Department of Health (DOH) of any use of chemical restraint. He said he does not know the case of another healthcare entity that is required to report their administered healthcare to DOH. He asked what DOH would do with that reported information. 4:55:09 PM MR. HULL responded that psychiatric hospitals have shown a history of abuse of children in their facilities. He said that HB 52, at its core, would seek more transparency from psychiatric facilities. 4:56:41 PM REPRESENTATIVE DIBERT added that she would often see the nurses in her own schools writing up reports to send on to higher supervision, creating transparency. She also stated that requiring reports would create more timely responses to inappropriate administration of chemical restraints. REPRESENTATIVE RUFFRIDGE agreed that the timeliness of this reporting, especially to the patient's family, is extremely important. He asked what DOH is going to do with this information. He asked how this reporting to DOH accomplishes the intended goal of HB 52. 4:59:31 PM CHAIR MINA clarified that DOH would be required to submit their report to the legislature, which would also become available online. 4:59:54 PM REPRESENTATIVE GRAY, in response to Representative Ruffridge's question, discussed his experience reporting patient treatment to DOH, adding that there is typically some level of follow-up from DOH. He said that he believes requiring the report itself may reduce the use of chemical restraints. He agreed that the committee should consider who this report would be submitted to. 5:02:12 PM MR. NAVE responded that currently when DOH receives reports of chemical restraint usage, it determines whether that restraint was justified or unjustified. He said if the determines that the restraint was unjustified, it conducts an unannounced investigation. 5:03:22 PM REPRESENTATIVE PRAX asked about the requirement to notify guardians of chemical restraint use within 72 hours. He said that guardians may want to know more immediately than that. He asked about unintended consequences of this 72-hour requirement and about how DOH responds to these notifications. MR. NAVE responded that DOH triages the reports it receives to determine the priority of conducting on-site investigations. REPRESENTATIVE DIBERT clarified that HB 52 originally asked for a report within 24 hours of chemical restraint usage, but one psychiatric hospital asked for 7 days, so 72 hours was a compromise. REPRESENTATIVE PRAX asked if DOH agrees that this timeframe would be a reasonable compromise. MR. NAVE responded that 72 hours is a reasonable timeline. 5:08:14 PM CHAIR MINA removed her objection to the motion to adopt the proposed CS for HB 52, Version 34-LS0399\I, Radford, 4/12/25,as the working document. There being no further objection, Version I was before the committee. [HB 52 was held over.]