SB 166-MENTAL HEALTH/PSYCHEDELIC MED. TASK FORCE  [CSSB 166(L&C) was before the committee.] 1:56:22 PM CHAIR CLAMAN announced the consideration of SENATE BILL NO. 166 "An Act establishing the Alaska mental health and psychedelic medicine task force; and providing for an effective date." He said this is the first hearing of SB 166 in the Senate Judiciary Committee. He invited the bill sponsor to identify himself for the record and begin his remarks. 1:56:48 PM SENATOR FORREST DUNBAR, District J, Alaska State Legislature, Juneau, Alaska, introduced the bill as sponsor of SB 166. He presented the following sponsor statement: [Original punctuation provided.] SPONSOR STATEMENT CSSB 166(L&C): MENTAL HEALTH/PSYCHEDELIC MED. TASK FORCE Senate Bill 166 establishes the Alaska Mental Health and Psychedelic Medicine Task Force. The goal of this legislation is to be ready should the federal government approve psychedelics for medicinal use; it is not the intent of this bill to legalize these substances. Conditions such as PTSD, depression, anxiety, substance-use disorders, and TBI are highly prevalent in Alaska, particularly among veterans and survivors of domestic violence. Advanced trials show that psychedelic-assisted therapies can be effective in treating these conditions. The Task Force will explore how psychedelic-assisted therapies would fit into Alaska's healthcare system. It will meet at least four times, submit a report of recommendations to the legislature and the governor by December 31st, 2024, and terminate at the convening of the Thirty-Fourth Legislature. Proposed members include healthcare professionals, Alaska Native communities, veterans, and mental health advocates. 1:57:47 PM CHAIR DUNBAR commented that one of the lessons learned from other states is that it is important to include Indigenous voices who have been using psychedelics for medicinal use in traditional healing for many thousands of years in some cases. SB 166 includes Indigenous voices in a way that some other states did not. The Task Force will address questions such as what barriers exist to the implementation and access of these therapies, what licensing and regulatory requirements should exist, and other guidelines that may be appropriate for the safe integration of psychedelic medicine into Alaska's healthcare framework. On February 9th, 2024, the FDA accepted a new drug application for MDMA for treatment of PTSD, with a decision expected this August. I urge timely passage of SB 166 to ensure that Alaska is prepared to consider these treatments in addressing mental health challenges. 1:58:32 PM SENATOR DUNBAR commented that the previous committee significantly changed this bill based on work done to its companion bill in the other body. He said these changes include: • clarifying that SB 166 is not about advocating for legalization; • adding two new seats, one for nurses and one for counselors; and • changing this from an executive to a legislative task force, and because of that, SB 166 no longer has a fiscal note. 1:59:18 PM SETH TIGARIAN, Staff, Senator Forrest Dunbar, Alaska State Legislature, Juneau, Alaska, presented an updated version of the sectional analysis on behalf of the sponsor: Section 1. This section adds a new section to the uncodified law of the State of Alaska to establish the Mental Health and Psychedelic Medicine Task Force in the Legislature, and establishes: • The purpose of the task force; • Membership of the task force; • A process for the election of the chair of the task force; • A process for filling a vacancy on the task force; • There is no compensation for task force members; • A schedule and timeline for submission of the task force report and recommendations; • Termination of the task force at the convening of the 34th Legislature. Section 2. This section establishes an immediate effective date. 2:00:21 PM SENATOR TOBIN drew attention to Section 1, stating SB 166 proposes a comprehensive, varied list of task force members. She noted that law enforcement is noticeably absent. She mentioned that following the decriminalization of certain controlled substances in Oregon, the absence of law enforcement's perspective was evident. Law enforcement could offer insights into the legal ramifications and practical interpretations of decriminalization as well as offer support. She inquired about the omission of law enforcement from the list. 2:01:21 PM SENATOR DUNBAR replied that SB 166 is primarily about licensing, not legalization. This bill proposes a task force that deals primarily with the Department of Commerce, Community and Economic Development (DCCED). He explained this is why he initially established the task force in that department. He said it is under the federal government's purview to legalize these substances; it is sort of out of the State's hands. SENATOR DUNBAR said that the purpose of psychedelic medicine is as treatments similar to ketamine or other medications, which typically rely on licensing rather than law enforcement. He does not oppose the participation of the Department of Public Safety (DPS) on the task force. He said he tried to engage with every organization to get them to send a participant. For example, DCCED representatives were eager to participate in this task force. He said that law enforcement was not the primary focus of the task force because the focus is on licensing and not on Resistance, Aggression, Violence, and Escape (RAVE) risks. 2:02:41 PM SENATOR TOBIN recalled an Anchorage Assembly member who advocated for public safety officers to have access to marijuana for treatment purposes. She noted it was insightful and impactful to hear from those who serve on the frontlines and benefit from these pharmaceuticals and substances, helping them avoid other types of interventions. She clarified that her question pertains not only to enforcement but also to the valuable input from officers in frontline positions. 2:03:25 PM SENATOR KIEHL brought up a couple of mechanical questions. He said the benefit of placing the responsibility in the legislative branch instead of the executive is that it eliminates the need for a fiscal note. However, the downside is determining who will provide staff support to the commission. He questioned who would gather the necessary materials, conduct research, organize the agendas, and manage all related tasks. SENATOR DUNBAR replied that his office would partly handle it. He expressed his intention to be involved in the task force. He believes that a number of other organizations might be interested in helping and have indicated their interest in the work. He acknowledged that it is a challenge but cited the successful example of the Food [Strategy] Task Force. Nonprofits provided a lot of money and support along with real work from the legislators who helped to pass the legislation. 2:04:31 PM SENATOR KIEHL questioned the timeframe, stating that it is ambitious. He surmised that a best-case scenario would have SB 166 enacted by the end of March. He recalled his service in municipal government after marijuana legalization when the assembly formed a task force. He noted that the municipality had fewer issues to consider than the legislative task force on mental health and psychedelic medicine. Yet, it took over a year, meeting every other week. He sought confirmation that the bill sponsor was comfortable with a December deadline. He asked whether the committee should consider giving the task force more time to complete the work and submit the report. SENATOR DUNBAR replied that if the committee extends the timeline, it would not be a deal breaker for the bill. However, the federal government imposed a timeline on the people who are working in this space. A conference in Colorado drew about 14,000 people last summer, indicating tremendous interest in these treatments. He explained that stage III trials are expected to conclude by the end of the summer. It is the last part of the research necessary for the Federal Drug Administration (FDA) to take action on this. People expect this by the end of the summer; it is the motivator to implement the task force quickly. He agreed that it is an ambitious timeframe but pointed out that the task force is not tasked with implementing regulations. He surmised that task force discussions will continue beyond its disbandment, leading to regulatory efforts in 2025 and 2026. 2:07:00 PM SENATOR TOBIN said that many states propping up a similar task force expanded their scope beyond mental health to post- traumatic stress disorder (PTSD), long-COVID treatment, and depression. She drew attention to page two, line one of SB 166, citing "ongoing mental health crisis." She asked whether this verbiage encapsulates other psychedelic treatments for health concerns, like long-COVID, depression, or PTSD. She sought confirmation the bill verbiage is encompassing enough. SENATOR DUNBAR replied that he thought it was, but he recommended that the committee hear it from the invited testimony. 2:08:13 PM CHAIR CLAMAN said he had a technical question. He drew attention to page two of the bill, noting that the senate president and speaker of the house each appoint a member from their respective body but not in an ex officio capacity. He asked if there was a reason for this, explaining that in other instances he is familiar with these appointments were ex officio members. SENATOR DUNBAR replied that this topic has not yet been thoroughly discussed. He said he is not opposed to an ex officio appointment if the chair thinks it is more appropriate. CHAIR CLAMAN observed that in instances where legislators were appointed to executive branch groups, not legislative ones, the theory is that legislators cannot speak on behalf of the legislative body. They could only speak on behalf of themselves. He said that the committee could discuss this further. 2:09:25 PM CHAIR CLAMAN found no further questions and opened invited testimony on SB 166. 2:09:44 PM KATELYN MCKINNEY, representing self, Juneau, Alaska, gave invited testimony in support of SB 166 and an overview of her background and professional experience as a therapeutic backcountry guide. She said that she is a social worker specializing in taking veterans with complex disorders of trauma and physical disabilities into the backcountry for therapeutic and restorative expeditions. Through this work, she encountered over two dozen clients who participated in psychedelic-supported and assisted therapy research. She stated that these veterans overwhelmingly described this modality as lifesaving. MS. MCKINNEY said several of these veterans indicated they would not be alive without access to this treatment. She explained that this is where psychedelic therapies stand apart from other treatments. She explained that some symptoms are treatment- resistant, like treatment-resistant depression (TRD). These clients tend to thrive and benefit from psychedelic therapies. 2:11:02 PM MS. MCKINNEY emphasized acknowledging that these treatments were taken from the American public under false pretenses. She explained that contrary to past misconceptions, these therapies are not harmful. Instead, they are mechanisms of wellness. They have historically been used in the medical industry and indigenous communities as healing modalities for a very long time. She highlighted that current data demonstrates individuals and communities can benefit from this modality. She affirmed that conditions like PTSD, depression, and long COVID are mental health-affiliated conditions, and all three would fall within the bill's "mental health crisis" terminology. She expressed appreciation that SB 166 applies more broadly than just as an intervention for the most extreme mental health conditions. MS. MCKINNEY expressed her support for SB 166 as a community member, social worker, and veteran. She highlighted the importance of the government process, its capacity to support the restoration of liberties, and allow for equitable and insurable access to what will become federally legalized treatments. She emphasized the need for a well-researched process to ensure fair access and preparedness so the legislature is ready when it comes time to make decisions. She expressed her belief that aligning intention with outcomes is crucial. 2:13:34 PM STEPHANIE BIRCH, Secretary, Alaska Advanced Practice Registered Nurses (APRN) Alliance, gave invited testimony in support of SB 166, stating that she is family nurse practitioner working in a nurse-practitioner owned private clinic in East Anchorage. She said the clientele are a multicultural patient population, mainly with Medicaid and Medicare, and are very low-income. The APRN Alliance represents 1,800 advanced practice registered nurses in Alaska, including certified nurse practitioners, certified nurse midwives, nurse specialists, and certified registered nurse anesthesiologists. She is the secretary of the organization. She said that as independently licensed healthcare professionals, they play a pivotal role in meeting and helping to design the healthcare needs of Alaskans. MS. BIRCH said a sizable number of her patients have significant behavioral health concerns and conditions with many experiencing severe trauma as a young child, teen, or adult. Most have never been treated for this trauma due to a lack of: • resources, • supportive family structures, • accessibility to primary care through their Medicaid insurance, and most importantly, • easily accessible behavioral health resources. 2:15:03 PM MS. BIRCH said that it should come as no surprise that many individuals utilize alcohol and street drugs to manage their symptoms. While the use of psychedelic drugs is not the starting point for treating severe trauma, severe depression, or other mental health conditions, it is an important tool that needs to be readily available for referred patients. Treatment settings need to offer a multidisciplinary approach when using psychedelic therapies. A task force of multidisciplinary members, including advanced practice registered nurses, is essential to ensure the use of psychedelics is properly managed with a fully supportive team available to the patient. A well- designed task force has the potential to provide evidence-based, multidisciplinary guidance to Alaskan healthcare organizations and licensing boards on how to create: • accessible, • ethical, and • effective healthcare using psychedelic modalities. MS. BIRCH expressed appreciation on behalf of the APRN Alliance for the committee's support of SB 166. 2:16:33 PM BAILEY STUART, Consultant, Stuart Consulting, Wasilla, Alaska, gave invited testimony in support of SB 166, stating that she is an adjunct professor at the University of Alaska Anchorage (UAA). She educates students on cannabis science regulation. She opened the first cannabis retail in the Mat-Su Borough. She serves on the Alaska Marijuana Industry Association as the chair of the Public Relations and Governance Committee, and on Limitless Advance, a veterans' nonprofit. She said that given her Schedule I substance expertise, she believes it is in the best interest of Alaska to begin holding these discussions. Currently, these substances are in phase III clinical trials, meaning human trials. She pointed out that in January, the U.S. Department of Veterans Affairs (VA) issued a request for proposal (RFP) to study the use of certain psychedelic compounds in treating PTSD and depression. This is the first time since the 1960s that the VA has funded research on these compounds. She said the State should prepare for the imminent approval of these substances and recommended: • Discussing what follows the FDA approval of psychedelic substances as medicine. • Researching what to expect before approval. • Discussing the framework for how these substances will be regulated. 2:18:13 PM MS. STUART expressed her belief that these substances should have a regulatory framework before FDA approval. She explained that, based on her experience with the legalization of marijuana in Alaska, she saw firsthand the confusion legalization caused by the lack of a regulatory framework. Although legalization and FDA approval are different, she believes it is important to prevent confusion among practitioners after FDA approval. She urged preparing an anticipated framework for providers to use as a resource for their practices. She said that allowing educated volunteers to hold important conversations poses no harm since there is no fiscal note. The task force could be vital in preventing the misuse of these substances and addressing Alaska's mental health crisis. MS. STUART advocated for regulatory framework discussions to protect residents. She urged the committee to support SB 166, allowing the state to prepare for anticipated psychedelic medicine use while prioritizing public health and safety. 2:19:54 PM BETH LAW, representing self, Wasilla, Alaska, gave invited testimony in support of SB 166, stating she is a retired Army veteran with 34 years of experience, including fourteen years on active duty in Alaska. She described her trauma background as follows: • Survived alcoholic parents. • Experienced several sexual assaults. • Experienced severe combat-related trauma from Operation Iraqi Freedom. • Had a diagnosis of stage four lung cancer in 2009 and the subsequent chemotherapy treatment lasted over two years. • Served as her sister's caregiver. • The death of her sister followed by the death of her father and friend shortly after that. • Struggled with depression and anxiety and years of antidepressant use, mood stabilizers, and therapy. 2:21:44 PM MS. LAW said she found a retreat in Jamaica called MycoMeditations, which provided a one-week therapy session with three psilocybin treatments. The facility had medical doctors, therapists, and facilitators. Each participant had a dedicated facilitator or therapist to guide them in processing and integrating their experiences back into society. MS. LAW emphasized that this treatment is serious and not about getting high. She said it involved difficult work and helped with her fear of dying. She reiterated that she has experienced anxiety, depression, and PTSD since 2009. She urged the committee do everything possible to help her fellow veterans who are suffering similarly. 2:23:36 PM CHAIR CLAMAN opened public testimony on SB 166. 2:23:56 PM MEGAN LINGLE, representing self, Juneau, Alaska, testified in support of SB 166, stating she is a University of Alaska- Fairbanks graduate specializing in clinical mental health counseling. She said that her passion for mental health advocacy and the potential benefits of psychedelic-assisted therapy align closely with the objectives of this legislation. She witnessed the devastating impacts of substance abuse and suicide growing up in the Native community of Kake, Alaska. These experiences fueled her commitment to advocate for change and pursue a clinical mental health counseling career. MS. LINGLE expressed her belief that psychedelic-assisted therapy holds immense promise for addressing Alaska's mental health crisis. The proposed task force reflects a forward- thinking approach to mental health treatments. She said that as a graduate student, she is particularly interested in the therapeutic benefits of psychedelics for treating mood, anxiety, and substance use disorders. She said the FDA has acknowledged these benefits. She commended the bill sponsor for recognizing the importance of involving a diverse group of representatives, including Alaska Natives, veterans, and survivors of domestic violence and sexual assault. It is encouraging to see an emphasis on the inclusion of Alaska Native communities. She noted that she is an Alaska Native woman from the Tlingit tribe. She said that including Alaska Natives ensures their unique needs and perspectives are considered. 2:25:49 PM MS. LINGLE said that SB 166 demonstrates a proactive approach to psychedelics in Alaska, facilitating discussions on potential barriers to access, insurance, licensing requirements, and regulations. She noted this foresight is essential to ensure assisted therapy is accessible to those who can benefit from it after psychedelics are legalized. This legislation represents a significant step toward addressing mental health challenges in Alaska through innovative and evidence-based approaches. She expressed confidence that the establishment of the psychedelic medicine task force will pave the way for a more comprehensive understanding and integration of these therapies. 2:26:56 PM CHAIR CLAMAN closed public testimony on SB 166. CHAIR CLAMAN held SB 166 in committee.