HB 214-MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES  1:15:07 PM CHAIR KELLER announced that the next order of business would be HOUSE BILL NO. 214, "An Act relating to mental health patient rights, notifications, and grievance procedures." REPRESENTATIVE LYNN moved to adopt the proposed committee substitute (CS) for HB 214, labeled 28-LS0869\Y, Mischel, 4/4/14, as the working document. There being no objection, Version Y was before the committee. 1:15:44 PM REPRESENTATIVE PETE HIGGINS, Alaska State Legislature, said HB 214 is a patients' rights bill for the mentally ill. "We want to give them the rights that everybody else basically should have when they go into a facility," he explained. "You're going hear words like [indecipherable] and grievances and procedures and that's what facilities have now already, and they do have that. And we're not asking them to create anything more or anything less beyond that point, but what we are asking them to do is to forward those grievances onto the administration so we can take a look at them and make sure they're doing the job." He said he has worked this bill through and it has been heard frequently in another committee, and "we've done a great job on basically trying to address everyone's needs and making sure we're not doing undue burden on other facilities that may not participate in overnight stays for patients." He said the bill basically breaks down the grievances into three categories. 1:17:22 PM REPRESENTATIVE HIGGINS said the first category includes small grievances "that don't really affect the state." He gave the example of "my peas are too cold and my cocoa's too hot," and other such grievances that the facility can take care of fairly easily. But the grievances he wants to hear about deal with the patient's rights, he said, like being denied a patient advocate or telephone access. Such grievances will be forwarded to the administration, he said. The third category, he explained, includes criminal grievances, and they need to be forwarded to the administration. "We don't want any of that hidden," he added. This is a bill of transparency; this is letting the state know that the facilities are doing the right thing, he stated. He said the facilities are doing the right thing. Some facilities do not support HB 214, he noted, because they do not like oversight, and that is a red flag. He is in the health profession, and when he first started taking Medicaid, people told him that he would not like the audits. But he said he had no problem with audits since he was not doing anything wrong. He added that he is computerized, so audits are easy, and they help him know where he is doing something wrong so he can do better. This bill is about basic patient rights and there is pretty good support, he said. 1:19:13 PM TOM STUDLER, Staff, to Representative Pete Higgins, Alaska State Legislature, directed the committee's attention to the sectional analysis of HB 214. Section 1 adds mental health grievance appeals to the jurisdiction of the Office of Administrative Hearings; Section 2 requires the Office of Administrative Hearings to maintain confidentiality of these records and their grievance appeals; Section 3 amends AS 47.30.660 by defining and limiting the powers and the duties of the department on what it can delegate; and Section 4 adds to the list of rights of a person undergoing mental health evaluation or treatment, including involuntary commitments. 1:19:59 PM MR. STUDLER said the additional rights include the right to file a grievance; the right to have a designated representative of their choosing to act as their advocate and to assist in the filing of a grievance; the right to natural support systems, including family, friends, and help networks after being in a locked facility for over three days; and the right to maintain confidentiality of their records. He said Section 5 establishes a grievance procedure including a call center, departmental review, and appeal. It also establishes three categories of grievances and defines grievance, grievant, and unit, he explained. Section 6 requires the Department of Health and Social Services (DHSS) to provide a standardized notice of patients' rights, assistance, and grievance procedures. He said Section 7 of HB 214 requires a transition period. 1:20:57 PM MR. STUDLER said this bill has been much belabored to make changes for patients' rights and to meet the needs of DHSS. He expressed his belief that this bill represents a consensus. He explained how the CS changes the bill. Section 3 was changed after discussions with the Department of Law and DHSS so that DHSS can maintain what it needs to do and to delegate those powers necessary to facilitate a good mental health program in the state. Section 4 was just renumbered for the CS, he stated, and the definition of "unit" was added to Section 5. This was for the benefit of individuals in community health centers or in centers that do not perform evaluations or have people committed. "It takes the local community health centers out of the equation; they're no longer required to participate in this program," he explained. 1:23:46 PM MR. STUDLER said Section 7 amends the uncodified law by adding that the DHSS shall implement these changes as soon as feasible. He then noted that he failed to explain a change with the 24- hour call center, which was removed in an earlier version of the bill and will reduce the fiscal note. Also, defining the term "unit" will further reduce the fiscal note, he said. He added that he is hoping to hear from DHSS soon regarding the note. CHAIR KELLER called for public testimony. The committee took an at-ease from 1:25 p.m. to 1:26 p.m. 1:26:40 PM FAITH MYERS, Psychiatric Patient Advocate Volunteer, said she received psychiatric treatment in 2002 from the state-run Alaska Psychiatric Institute, the Providence psychiatric emergency room, and Anchorage Community Mental Health Services. She stated that she had reasons to file complaints that included denial of service, physical assault, getting a black eye by staff, and denial of basic rights. She explained that in all cases she never received written copies of grievance and appeal procedures. She could not file an appeal and did not get a written answer in two cases. 1:28:12 PM MS. MYERS said the mentally ill come in all shapes and sizes. As a group they are mistreated [indiscernible]. She urged the passage of HB 214 so that psychiatric patients get more equitable and fair patient rights. CHAIR KELLER thanked her for her volunteer work and her testimony. 1:29:21 PM DORRANCE COLLINS, Psychiatric Patient Advocate Volunteer, stated that he supports HB 214, giving psychiatric patients an absolute right to file a grievance and to appeal. It will force psychiatric institutions to improve patient care, he added. [Inaudible] As of now, psychiatric institutions hold too much power in a patient's grievance and appeal process. The DHSS [supports] the Alaska Psychiatric Institute where 97 percent of its patients arrive involuntarily, and DHSS claims that only 15 patients wanted to file a grievance last year and even less could file an appeal to resolution, he said. The hospital treats about 4,000 patients per year, and several thousand are involuntarily [committed]. Providence Hospital testified to the HESS Committee that only 10 patients wanted to file a grievance last year, he stated. [Inaudible] 1:30:39 PM CHAIR KELLER said the committee is having difficulty hearing Mr. Collins, and he asked for written comments. MR. COLLINS said the federal government and the Joint Commission for accreditation of hospitals have rules that help protect the patient and the grievance process, "but there is absolutely no protection for the psychiatric patients and the informal complaint process." He requested that patients get the right to file a grievance at the time of their choosing, and "following the initial evaluation, psychiatric patient rights 4, 5, 7, and 9 can only be temporarily removed if the professional in charge determines that granting those patients those rights will pose a threat to the safety and wellbeing of the patient or others." He said HB 214 should state that the patient advocate shall have mental health advocacy training and that there will be an advocate available 24 hours a day, seven days a week. 1:31:35 PM MR. COLLINS said patients are locked up on Sunday, not just during the week. They are locked up at midnight, and they need an advocate available all of the time, he explained. He said HB 214 should add an urgent grievance [process]. Patients are often in facilities for less than 14 days, and they could be denied their rights the entire time. He said there should be some kind of phone line where a patient can call a help center. He suggested adding clarity to when a patient grievance starts- "you tell when it ends, but when does the patient grievance start-when it's dropped in the box or when they call it in?" It should be in the bill, he opined. Closing the loopholes in HB 214 will determine if patients will actually be able to file a grievance in a fair way, he concluded. 1:33:43 PM CHAIR KELLER briefly set aside HB 214 in order to hold a confirmation hearing. HB 214-MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES  1:36:44 PM CHAIR KELLER announced that the committee will return to public testimony for HB 214. J. FAITH BURKHART, Executive Director, Alaska Mental Health Board, spoke of the changes made by the sponsor for HB 214, particularly [the change] ensuring that behavioral health centers [inaudible]. The committee took an at-ease from 1:38 p.m. to 1:43 p.m. 1:43:55 PM MS. BURKHART said she will submit her comments in writing. The committee took an at-ease from 1:44 p.m. to 1:45 p.m. 1:45:25 PM CHAIR KELLER ended public testimony [audio difficulties]. REPRESENTATIVE LYNN moved to report the CS (Committee Substitute) to HB 214, labeled 28-LS0869\Y, Mischel, 4/4/14, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 214(JUD) was reported out of the House Judiciary Standing Committee.