HB 52-MINORS & PSYCHIATRIC HOSPITALS  4:16:37 PM CHAIR MINA announced that the next 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." [Before the committee was the proposed committee substitute (CS) for HB 52, Version 34-LS0399\ I, A. Radford, 4/12/25, adopted as a working draft on 4/22/25; left pending on 4/24/25 was a motion by Representative Fields to adopt Amendment 1, with a pending objection for discussion by Representative Schwanke.] 4:17:44 PM REPRESENTATIVE FIELDS provided a brief recap of Amendment 1, which would increase the floor of required communication per week from one to two hours. 4:18:34 PM REPRESENTATIVE SCHWANKE withdrew her objection. There being no further objection, Amendment 1 was adopted. 4:18:51 PM EPRESENTATIVE FIELDS stated that after receiving additional information, he would not be offering Amendment 2. 4:19:14 PM REPRESENTATIVE SCHWANKE moved to adopt Amendment 3 to HB 52, Version I, as amended, labeled 34-LS0399\I.3, A. Radford, 4/23/25, which read as follows: Page 2, lines 7 - 8: Delete "publish the report on the department's Internet website," Page 2, line 9: Delete "," CHAIR MINA objected for the purpose of discussion. REPRESENTATIVE SCHWANKE explained Amendment 3. She expressed concern regarding the mandatory report under HB 52 being published on the Department of Health (DOH) website. CHAIR MINA expressed concern with Amendment 3, explaining that the published report under HB 52 would increase transparency by psychiatric facilities. She maintained her objection. 4:20:42 PM REPRESENTATIVE PRAX asked if publishing the report would assist the public or provide unnecessary, inappropriate information. 4:21:23 PM KIM GUAY, Director, Office of Children's Services, Department of Family and Community Services, deferred to DOH. 4:21:49 PM MATTHEW THOMAS, Nurse Consultant II, Health Facilities Licensing & Certification, Division of Health Care Services, Department of Health, deferred to the bill sponsor, regarding intent. 4:22:24 PM MATTIE HULL, Staff, Representative Maxine Dibert, stated that the intent of publishing the report on DOH website would be to make it more accessible to the public, including different advocacy groups. He added that the goal of this information to for these groups to ensure that the rates of chemical restraint usage is not rising. 4:23:52 PM REPRESENTATIVE GRAY stated that public transparency is good because DOH will not highlight issues it does not want to highlight when giving a presentation to the legislature. He emphasized that this is information that everyone needs to know. 4:25:09 PM REPRESENTATIVE RUFFRIDGE stated that he struggles with Amendment 3, expressing concern regarding unintentional consequences of publishing this report publicly, especially when this report would include usage of restraints even as medication. He agreed with Representative Gray that "if it was my child," he would want the history of a facility's abusive practices to be made public. REPRESENTATIVE RUFFRIDGE [objected] to Amendment 3. 4:27:32 PM CHAIR MINA discussed the Crisis Now framework on psychiatric rights, including the cases of involuntary medications, seclusion, and restraint. CHAIR MINA maintained her objection to Amendment 3. 4:29:20 PM REPRESENTATIVE SCHWANKE said that using "exponential" to describe the increase in use of restraints, seclusion, and psychotropic drugs on minors, is a very significant comment, and that she has not seen data that shows an exponential increase. She added that publishing this data for the public may have unintended consequences, and people will make assumptions. 4:31:38 PM A roll call vote was taken. Representative Schwanke voted in favor of Amendment 3. Representatives Prax, Ruffridge, Mears, Fields, Gray, and Chair Mina voted against it. Therefore, Amendment 3 failed by a vote of 1-6. 4:32:21 PM REPRESENTATIVE GRAY moved to adopt Amendment 4 to HB 52, Version I, as amended, labeled 34-LS0399\I.4, A. Radford, 4/23/25, which read as follows: Page 3, line 25, following "that": Insert "(A)" Page 3, line 26, following "symptom": Insert "; or (B) is used to treat a patient's medical symptom, but is given to the patient in a higher dose than is needed to treat the patient's medical symptom" CHAIR MINA objected for the purpose of discussion. REPRESENTATIVE GRAY explained Amendment 4. He said that Amendment 4 would amend the definition of restraint under HB 52, to address the case where physicians might administer a higher dosage of a patient's prescribed medication to create a restraint. He said that Amendment 4 would avoid the creation of a loophole for physicians to not report under this scenario. CHAIR MINA removed her objection. 4:33:51 PM REPRESENTATIVE RUFFRIDGE objected for the purpose of discussion. Referring to the case where a patient might need medication as they experience a psychotic episode, he asked how Representative Gray would define "medical symptom". REPRESENTATIVE GRAY said that he thinks the intent of Amendment 4 is clear. REPRESENTATIVE RUFFRIDGE said that the goal of HB 52 would not be to avoid using medication, but to avoid using medication as discipline. He said that sometimes patients do require restraint, whether it be physical or chemical restraint. He expressed concern in defining all restraint as bad. 4:37:10 PM REPRESENTATIVE MAXINE DIBERT, Alaska State Legislature, deferred to the committee to decide on Amendment 4. REPRESENTATIVE GRAY said that the purpose of HB 52 would be to increase transparency and Amendment 4 would increase that transparency. 4:38:44 PM The committee took an at-ease from 4:38 p.m. to 4:41 p.m. 4:41:49 PM REPRESENTATIVE RUFFRIDGE referred to AS 47.30.838, which provides guidelines for using psychotropic drugs in crisis scenarios already. 4:43:10 PM CHAIR MINA invited Mr. Thomas to comment on AS 47.30.838. 4:44:53 PM MR. THOMAS responded that he would like to follow up with the committee. 4:45:17 PM REPRESENTATIVE GRAY said that he thinks HB 52 would be adding a definition of chemical restraint, and Amendment 4 would help to clarify that definition. MR. THOMAS said that he thinks there is some confusion about what is in statute and what would be amended in Amendment 4. CHAIR MINA thanked Mr. Thomas for the clarification. 4:47:37 PM REPRESENTATIVE RUFFRIDGE maintained his objection. 4:47:43 PM A roll call vote was taken. Representatives Gray, Schwanke, Mears, Fields, and Mina voted in favor of Amendment 4. Representatives Prax and Ruffridge voted against it. Therefore, Amendment 4 passed by a vote of 5-2. 4:48:56 PM REPRESENTATIVE DIBERT thanked committee members for their hard work to improve HB 52. 4:49:20 PM REPRESENTATIVE MEARS moved to report CSHB 52, Version 34- LS0399\I, A. Radford, 4/12/25, as amended, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 52 (HSS) was reported out of the House Health and Social Services Standing Committee.