HB 181-PUBLIC SCHOOLS: MENTAL HEALTH EDUCATION  8:52:37 AM CO-CHAIR DRUMMOND announced that the final order of business would be HOUSE BILL NO. 181 "An Act relating to mental health education." 8:52:54 AM REPRESENTATIVE MATT CLAMAN, Alaska State Legislature, as prime sponsor, presented HB 181. He cited the Alaska Department of Health and Social Services (DHSS) 2017 Alaska Youth Risk Behavior Survey results, which showed that of the 1,343 ninth- through twelfth-grade students in forty high schools across Alaska, one in three students experienced a depressive episode in the twelve months preceding the survey. He cited the Substance Abuse and Mental Health Services National Survey on Drug Use and Health, in which estimates show that in 2015 and 2016, 15 percent of adolescents aged 12-17 reported that they had at least one major depressive episode in the 12 months preceding the survey. He noted that both surveys are included in the committee packet. REPRESENTATIVE CLAMAN said that HB 181 would require the Department of Education & Early Development (DEED) and the Alaska Board of Education & Early Development to develop guidelines for instruction in mental health education, in consultation with DHSS counselors, educators, students, administrators, and representatives from state and national mental health organizations including rural native health organizations. State and national organizations include but are not limited to: the National council for Behavioral Health, Providence Health & Services Alaska, Southcentral Foundation, Anchorage Community Mental Health Services, Inc., North Star Behavioral Health System, and the National Alliance on Mental Illness in Alaska. He said DEED would then be responsible for the implementation of the guidelines statewide through the health education curricula, and DEED, DHSS, and the Council on Domestic Violence and Sexual Assault - Alaska would provide technical guidance to districts in the development of curricula. He asserted that the State of Alaska is obligated to treat mental health problems facing Alaska's youth as a serious public health issue. He suggested that HB 181 would reduce stigma associated with mental illness and increase student knowledge by having conversations on and around this issue. 8:55:38 AM SOPHIE JONAS, Staff, Representative Matt Claman, Alaska State Legislature, presented HB 181 on behalf of Representative Claman, prime sponsor. She stated that the intent of the legislation is that the Board of Education & Early Development would develop guidelines for instruction in mental health in consultation with mental health organizations. She stated that under the proposed legislation, AS 14.30.360 would be modified to remove the word "physical" when referring to health education instruction and add "mental health" as a curriculum item to be included in district health education programs. She said that under the proposed legislation, AS 14.30.360 would clarify that health guidelines developed by the Alaska Board of Education & Early Development must provide standards for instruction on mental health and shall be developed in consultation with DHSS and representatives of national and state mental health organizations. 8:56:55 AM REPRESENTATIVE ZULKOSKY referred to student testimony in support of HB 181 provided on February 24, 2020, and recounted their expressed shared need for mental health education. She asked how the "subject matter expert contractor" listed in the fiscal note and the individuals representing the variety of professional organizations listed in the bill would be selected. 8:58:13 AM REPRESENTATIVE CLAMAN answered that the fiscal note for a contractor was unexpected, and he suggested that it was unnecessary due to the assumption that the state has adequate resources to conduct the facilitation described therein. He referred to committee packet items showing current standards, and he said the proposed changes are not substantive enough [at the state level] to warrant a contracted facilitator for implementation. He suggested that local districts would develop curricula based upon their local circumstances and needs. He acknowledged that statewide conferencing might require some coordination; however, he opined that limited conferencing could be coordinated with existing resources. 9:02:01 AM REPRESENTATIVE ZULKOSKY requested that a representative from DEED provide a response to her question. 9:02:28 AM TAMARA VAN WHYE, Division Director, Educator and School Excellence Division, Department of Education & Early Development, answered that the fiscal note includes funds that would be used to update standards in health education. She noted that the department's "Skills for a Healthy Life" have not been updated in more than 20 years. She noted that health education standards are voluntary, and that a minor change would likely not result in widespread adoption of the changes; therefore, the minor change would likely not have widespread impact across the state. She noted that there is a process for standards review and update panel member selection including open calls to credentialed individuals to participate. 9:04:40 AM REPRESENTATIVE ZULKOSKY asked what the selection process itself and contractor selection process would entail. 9:05:24 AM MS. VAN WHYE answered that regional and grade level representation credentials are taken into consideration in selecting individuals from outside organizations in order to represent all of Alaska. She added that a facilitator would be selected after development of scope and subject matter expertise and would be solicited through state procurement processes. 9:06:47 AM REPRESENTATIVE ZULKOSKY allowed that the standards are "clearly outdated"; however, also taking into consideration advances in technology, she opined that the wholesale review of standards in order to meet the needs of this bill is a "peculiar" fiscal requirement. 9:07:57 AM CO-CHAIR DRUMMOND asked about the goal of school health and safety within Alaska's Education Challenge, whether mental health education [as proposed by HB 181] furthers the advancement toward that goal. She asked whether the department has a schedule for updating standards, and why the standards have not been updated in excess of 20 years. 9:08:49 AM MS. VAN WHYE answered that regarding the health and safety goal, mental health education and trauma informed schools would advance that goal. She indicated that there is a schedule for updating standards prioritized by need, and that those for math, language arts, and science are standards which contribute to test scores and are therefore higher priority. She would need to investigate health and safety standards timeline for update. She added that since health education standards are voluntary, they are updated at a lower priority. 9:11:47 AM CO-CHAIR DRUMMOND requested copies of Transforming Schools: A Framework for Trauma-Engaged Schools in Alaska for the committee members. 9:12:55 AM The committee took an at-ease from 9:12 a.m. to 9:15 a.m. 9:15:07 AM REPRESENTATIVE CLAMAN played a YouTube film produced by Mental Health Advocates Through Storytelling (MHATS) in support of HB 181. 9:19:30 AM CO-CHAIR DRUMMOND asked whether HB 181 would make mental health education mandatory. She added that it seems that students in Alaska are asking to make this mandatory. 9:19:48 AM REPRESENTATIVE CLAMAN answered that under current statute, districts are not required to follow health education guidelines. He suggested that the committee may amend the bill to include language to make mental health education mandatory. 9:20:31 AM CO-CHAIR STORY expressed support for HB 181, along with concerns regarding effective implementation through the exiting health education guidelines, recognizing reduced school funding statewide. She noted that HB 181 would require implementation of mental health education through school counselors and existing health educators, and that, for example, the Juneau School District has only 1 counselor for 450 students and 1 for 500 students, for the two high schools, respectively. She suggested that implementation of the bill would be akin to an unfunded mandate. She stated her belief that the proposed legislation is very important, and the implementation is equally important. She suggested that education of students cannot effectively take place without addressing underlying mental health issues among students. 9:22:45 AM REPRESENTATIVE CLAMAN noted that there has been discussion about adding counselors and adding social workers into districts; however, HB 181 would be implemented by health teachers into the classroom. He added that budget cuts have precipitated a decline in resources throughout the state resulting in fewer counselors and social workers. 9:24:07 AM REPRESENTATIVE ZULKOSKY suggested that without mental health education, students can and would seek information on their own, which puts them at risk for misinformation. 9:25:02 AM CO-CHAIR DRUMMOND opined that HB 181 could be implemented throughout many academic curricula. She asked Representative Claman whether he was aware of any curricula developed and implemented for mental health in any district in Alaska. 9:25:52 AM REPRESENTATIVE CLAMAN answered that there is caution in conversations about the implementation of the proposed bill as to avoid an unfunded mandate. He suggested that curricula is best left to the discretion of local jurisdictions to develop and implement the most effective curricula for their community. 9:26:58 AM RICHARD NAVITSKY, MD, Director, Pediatric Emergency Medicine, Providence Health & Services, testified in support of HB 181. He echoed the messages conveyed in the MHATS video audio, and he explained that the emergency department is the "final destination" for youth that have had mental health issues. He referred to Center for Disease Control and Prevention (CDC) data that reflects a 31 percent increase in the total suicide rate from 2001-2017 across all age groups, and in teenagers in particular. He suggested that peer to peer support and early intervention is beneficial to youth mental health and could reduce morbidity and mortality associated with suicide, and in turn would result in lower health costs. 9:29:31 AM CO-CHAIR DRUMMOND thanked Dr. Navitsky for his expert testimony and invited him to contact the legislature to offer invited testimony. 9:29:57 AM CRIS EICHENLAUB testified that he was unsure that a bill is the most appropriate mechanism through which to address mental illness among youth in Alaska. 9:32:02 AM CO-CHAIR DRUMMOND closed public testimony HB 181. 9:32:16 AM CO-CHAIR DRUMMOND announced that HB 181 was held over.