SB 8 - MENTAL HEALTH PATIENT RIGHTS: STAFF GENDER 2:55:20 PM CHAIR RAMRAS announced that the next order of business would be CS FOR SENATE BILL NO. 8(FIN), "An Act relating to a mental health patient's right to choose the gender of hospital staff providing intimate care to the mental health patient and to the duties of hospital staff in caring for patients receiving mental health treatment." 2:57:06 PM THOMAS OBERMEYER, Staff to Senator Bettye Davis, Alaska State Legislature, explained on behalf of Senator Davis, sponsor, that SB 8 requires that hospitals providing psychiatric services must offer patients 18 years of age or older gender choice of staff for intimate care, and document in the patient record after "reasonable and good faith efforts to comply" either failure to meet the patient's request for gender choice, but provision of intimate care by a licensed professional, or failure to meet the patient's request for gender choice, but provision of intimate care by a non-licensed professional. The bill further requires posting of the notice of the patient's right of gender choice in intimate care situations. More than half of these patients are reported to have been traumatized by sexual and or physical abuse in the past and they are very sensitive to being touched or assisted by hospital staff who provide intimate care, because the experience may trigger from original abuse, feelings of fear, helplessness, distress, humiliation, and loss of trust in staff. While it is understandable that a hospital may not always be able to comply with a request of gender in all situations due to staffing schedules and shortages on particular shifts or duty units, the bill requires, after a good faith effort, that the hospital document the noncompliance in the patient's record. This information is important for medical purposes and in the event of inquiry during grievance procedures under Title 47. 2:59:37 PM CHAIR RAMRAS referred to page 2, lines 19-22, and asked whether this provision allows for an exemption in the case of a mental health patient who desires a caregiver of the opposite gender which, if granted, would be adverse for the staff and for the treatment of the patient. REPRESENTATIVE HOLMES offered her understanding that that language allows the psychiatrist to overrule the patient's request when compliance would adversely affect patient treatment. MR. OBERMEYER concurred. REPRESENTATIVE HOLMES asked whether non mental health patients have the same right to request caregivers of a certain gender. MR. OBERMEYER responded that the bill was designed specifically for psychiatric hospital patients because admittance to a mental health facility generally removes most of a patient's rights and limits their contact with family or others. Further, documentation of care for mental health patients can be incomplete. REPRESENTATIVE GRUENBERG asked why the right of choice should not be extended to all in-patients. MR. OBERMEYER agreed that all patients should have the right; however, most of the problems that have been identified for intimate care are for those who have been emotionally and psychologically traumatized by perceived or actual contact. REPRESENTATIVE GRUENBERG stated that if the bill extended this right only to non-mental-health patients, that would be a denial of equal protection; therefore, in order for the bill to survive, the provision should apply to everybody. REPRESENTATIVE HOLMES suggested that the request should also be allowed to come from a representative on behalf of the patient, because the patient may be under medication. MR. OBERMEYER informed the committee that there is a grievance procedure to avow patients and guardians of their rights and privileges at the time of admittance to a facility. 3:06:54 PM FAITH MYERS, Mental Health Advocate, described her experience as a patient in mental health facilities in Washington, Alaska, and Nevada. She explained that there is unnecessary trauma of patients in psychiatric facilities and the rules and statutes established by the state may reduce the amount of trauma and recidivism. The percentage of women in acute care mental health facilities, with a history of sexual or physical abuse, is somewhere between 51 percent and 98 percent. The percentage is slightly less for men. Ms. Myers opined that a patient is re- victimized by intimate care given, against their will, by a caregiver of the same gender of the person who abused them in the past. She listed the names and backgrounds of the authors of letters of support for gender choice of intimate care staff. Ms. Myers concluded that SB 8 would only require psychiatric institutions to make a good faith effort to comply, and she asked the committee to pass the bill. 3:10:01 PM DORRANCE COLLINS, Mental Health Advocate, pointed out that a recent ruling by the Alaska Supreme Court cited a clear tension between psychiatric facilities seeking convenience and economics and patient's rights, which can manifest itself into patient abuse. He opined that without regulation, facilities will take short cuts. Mr. Collins read from a letter of support such that many common practices in psychiatric settings cause patients chronic stress and put patients at risk. He noted that a woman can request a female physician for a gynecological exam; however, once admitted to a mental health facility, she no longer has that choice. Mr. Collins then asked the committee to pass SB 8. 3:11:33 PM HOLLY JOHANKNECHT, Attorney, Disability Law Center, relayed that she has provided written testimony in support of SB 8. CHAIR RAMRAS closed public testimony on SB 8. He then noted his satisfaction that language on page 2, lines 19-22, allows for the determination of compliance by the psychiatrist at the hospital, while maintaining respect for the rights of the patient, and expressed his support for the bill. 3:13:12 PM REPRESENTATIVE DAHLSTROM moved to report CSSB 8(FIN) out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSSB 8(FIN) was reported out of the House Judiciary Standing Committee.