CS FOR SENATE BILL NO. 97(FIN) am "An Act relating to mental health services and programs; relating to liability for payment for mental health evaluation and treatment services; and providing for an effective date." LORNA RAMBERT, SENATOR P. KELLY testified on behalf of the sponsor in support of SB 97. She read the sponsor statement: DHSS reimburses private community hospitals (Designated Evaluation and Treatment Facilities) throughout Alaska to provide emergency mental health inpatient evaluation and treatment services. Hospitals provide these services to individuals who are at risk of harming themselves or others. or who are so severely impaired by mental health symptoms that they are unable to care for themselves. Often these individuals are experiencing severe psychiatric symptoms, such as depressive or psychotic symptoms, and need intensive inpatient mental health services. Senate Bill 97 seeks to clarify the state's responsibility for payment for services and the responsibility of the state to determine the ability of patients to pay for those services. The proposed legislation clarifies client eligibility for these services. Additionally, it establishes procedures for determining eligibility, processing applications, and paying claims. SB 97 creates an entitlement for eligible clients, thus allowing payment for serving those individuals whose mental illness increases their danger to themselves or others. The following are criteria for eligibility: * A patient is determined to be "suffering from a mental illness, and as a result is likely to cause serious harm to themselves or others, or is gravely disabled." and; * The patient's gross monthly household income falls below 185% of the federal poverty guideline. SB 97 amends current statutes defining the state's responsibility for payment for inpatient psychiatric service for those patients needing intensive services. Historically the Department of Health and Social Services (DHSS) has reimbursed hospitals for only those patients who are committed by the courts for evaluation and treatment services. This legislation would require the department to reimburse hospitals for individuals who meet the commitment criteria, but who voluntarily admit themselves into the hospital. These individuals are therefore, not court ordered into care, but could be held under court order if they attempted to leave the hospital. GINA MACDONALD, DEPARTMENT OF HEALTH AND SOCIAL SERVICES offered to answer questions. She noted that the Department does support the bill. She noted that the API 2000 project will reduce the number of beds at the Alaska Psychiatric Institute from 79 to 54. The legislation would provide a clear structure to direct how private hospitals would be paid to perform some emergency mental health functions. In response to a question by Representative Austerman, Ms. MacDonald explained that federal funds would be used through FY 2001. PAT CLASBY, ALASKA STATE HOSPITAL AND NURSING HOME ASSOCIATION stated that the Association supports the legislation. Most hospitals in the state provide some type of emergency mental health evaluation services. Several hospitals also provide treatment services beyond 72 hours. The hospitals around the state have been working with the state as Alaska Psychiatric Institute is downsized. She emphasized that there needs to be a clear understand of when patients are the state's responsibility. Hospitals would be concerned if the services were developed and became an unfunded mandate. Representative Kohring MOVED to report CSSB 97 FIN) am out of Committee with individual recommendations. There being NO OBJECTIONS, it was so ordered. CSSB 97(FIN) am was REPORTED out of Committee with a "do pass" recommendation and with a published fiscal note by the Department of Health and Social Services dated4/21/99.