CS FOR HOUSE BILL NO. 493(JUD) am "An Act relating to treatment for alcoholism or drug abuse." Tom Wright, staff aide to Representative Ivan was invited to join the committee. He said under current statutes there were provisions allowing for voluntary commitment of alcoholics which allow for 30-day commitment with re- commitment up to 90 days. The current law was found to be unwieldy, expensive and treatment options were not readily available according to a City and Borough of Juneau survey. It also said the current commitment program was not working. He said this bill would correlate to the involuntary commitment for mental health. The bill also would change the definition of intoxication to include drugs as defined under the controlled substance statutes. Senator Phillips asked how this would affect other communities. Mr. Wright said the study was done in Juneau because other communities were not using this process. This bill is modeled after the mental health commitments and it would be easier now for other communities to use the laws. Loren Jones, Division of Alcohol and Drug Abuse was invited to join the committee. He referred to the statutes for private commitment done by doctors, physicians or relatives and involves no representation from the Attorney General's office. The City of Juneau does have a municipal attorney's office and they have accepted the policy of representing the city program for that purpose. This bill would help educate and make it easier for the local communities to use this program at less expense and it would be more clinically appropriate. There was support from the treatment providers but no comments from the different municipalities. Most of them would not be involved because those who offer services are private, non-profit organizations. Co-chairman Halford said he has had constituent concern over the way treatment is provided for alcohol but not provided for drug abuse. Mr. Jones said this would not be a mandate on local municipalities but would rather rest with the relative or program attempting the involuntary commitment. Co-chairman Halford said this was not a local government issue other than the fact that Juneau has gotten interested and gotten involved. Senator Rieger referred to page 4, line 7-9 regarding commitment for emergency care and asked if this was covered elsewhere in the statutes and not part of this bill. Mr. Jones said the emergency care was covered elsewhere and was for 48 hours. It would not be affected by this bill. By the end of the 48 hours the individual would have to be in Court. Don Dapcevich, State Advisory Board on Alcoholism and Drug Abuse was invited to join the committee. He said this bill was top priority for the citizen's advisory board. This bill reflected the necessary strategy to deal with inebriation. Treatment providers around the state strongly supported the bill. The cities of Ketchikan, Dillingham and Bethel have expressed interest learning more about the mechanics of doing commitments and training individuals to provide earlier help. This would be a viable strategy to use in the State, a way to save lives and would help get people into treatment. (tape change to SFC-96, #99, side 1) Senator Phillips asked why the City and Borough of Juneau was involved and other communities are not. Mr. Dapcevich said the other municipalities do not run their treatment programs and therefore do not become involved. The municipality here operated the hospital, treatment center and emergency services patrol and they felt the impact of public inebriation more strongly. Co-chairman Halford referred to amendment #1 and it was moved by Senator Zharoff. Barbara Craver, assistant City and Borough attorney was invited to join the committee. She said she has been involved in the filing of petitions for involuntary commitments on behalf of the administrator of the local treatment center, Juneau Recovery Hospital. She addressed amendment #1 as moved by Senator Zharoff. It would address the situation encountered in Juneau and would clarify the law that would provide a better continuum of care for the treatment of alcoholics. She explained the routine from the emergency services patrol to Bartlett Hospital emergency room and the transfer to a treatment center if the patient is found to be medically stable. If the individual is not found medically stable they are held at Bartlett Hospital. The individual may be held for up to 48 hours on an emergency alcohol commitment. A public treatment facility may hold an individual up to five days with Court approval. The clinical staff would at this time make the decision to contact the attorney's office in order to file a petition for involuntary commitment. Under current statute this continuum is not clearly authorized. The problem arises that a person admitted to a public treatment facility must both be incapacitated by alcohol and intoxicated. After an individual has been in the hospital for 12 - 24 hours they are no longer intoxicated. The hospital must let them go and wait for them to enter the cycle again another way. This amendment would clearly authorize a public treatment facility to place a hold on an individual located at the hospital due to medical issues and the individual would transferred to the treatment facility upon release from the health facility. Senator Rieger questioned the liability matter and specifically referred to page 7, line 3. He suggested to cover this the word "shall provide adequate and appropriate treatment". What if a mistake were made? Ms. Craver referred to section (d) AS 47.37.200 and said this placed the burden on the petitioner to prove there is an appropriate treatment facility for the individual's alcohol problem. The concern is based on if there is a viable treatment option available in the State. The liability issue would occur earlier. Mr. Jones said the definition of a public or private facility was a treatment facility that was grant funded and approved by the division. Co-chairman Halford and Senator Rieger expressed concern over limitation on liabilities. He asked Senator Rieger to work on an appropriate amendment. Senator Rieger was also concerned about "good cause". Co-chairman Halford said he would hold Senator Zharoff's amendment #1 pending and he further held the bill in committee. ADJOURNMENT Co-chairman Halford recessed the meeting at 2:10 P.M. until 5:00 P.M. if the Senator Floor session recessed in time. Otherwise calendar would be carried over until tomorrow at 9:00 A.M.