SENATE BILL NO. 53 "An Act relating to involuntary civil commitments." 9:07:57 AM Co-Chair Olson read the title of the bill and asked the sponsor to give a brief synopsis. He noted that Version O of the bill was before the committee for consideration. 9:08:23 AM SENATOR MATT CLAMAN, SPONSOR, relayed that he supported the Committee Substitute - Version O as adopted in committee the previous day. He referenced previous discussion that had pertained to the concept that there were two different tracks for involuntary commitment. He noted that the bill itself did not create anything that did not already exist for people in short term psychiatric care and people in long term psychiatric care. He explained that there was a practical difference between those that were there for long periods, and some had been held for as long as 9 years. He referenced testimony that indicated there was no difference in the process of whether an individual stayed or did not stay, and there was no legal distinction. The practical consideration had to do with beds for long term patients and beds for short term patients. Senator Claman continued his remarks and noted that the bill would close the gap between individuals whose case may be dismissed for incompetency and starting an involuntary commitment proceeding. He wanted to clarify that the process in court whereby an involuntary commitment proceeding was filed (in terms of the bill) was a fairly simple process. The court was likely to have a one- or two- page form which would take a short time for the prosecutor to fill out before the charges were dismissed. He thought more detailed questions (such as who was raising competency questions and whether an individual was found incompetent) were not changed by the bill and were already in statute. Co-Chair Olson commented that the longer the bill was discussed the less likely it was to pass. Senator Wilson asked if the committee could hear from Nancy Meade, the General Counsel for the Alaska Court System. Senator Wilson referenced the sponsors remarks about not having a two-tiered system, and asked if the courts saw a difference in short term and long-term civil commitment. He asked about the process. He asked if the court had any issues with the current system for civil commitments. 9:12:17 AM NANCY MEADE, GENERAL COUNSEL, ALASKA COURT SYSTEM, was not certain by what Senator Wilson meant by "two tiers." She clarified that with the bill, it was the case that someone who had previously been found incompetent to stand trial and was subsequently admitted for the beginnings of a mental commitment, could (after the periods of commitment in the statute) be additionally committed for a 5-year term. The additional commitment was only available if the individual had previously been found incompetent to stand trial, which was different to an individual that entered the mental commitment system without having been previously found incompetent to stand trial. Senator Wilson asked about a person that might be committed for 5 years rather than a similar individual that was committed for 180 days. Ms. Meade affirmed that it was true that someone in the system not as a result of being found incompetent to stand trial in a criminal case (and entered the system another way) could not be committed for 5 years and would have a 180-day commitment that could also be subsequent 180-day commitments. She noted that as Dr. Becker had testified the previous day that there were long-term committed individuals with serial 180-day commitments. She thought the bill did set up a different system for someone who had been previously found incompetent to stand trial in a criminal case; and the person would not be going through (necessarily) a series of 180-day commitments but could be committed once for five years. The distinction was based on being previously found incompetent to stand trial. Senator Wilson asked if the hearings proposed in the bill and the normal civil commitment process time frames were the same. Ms. Meade answered "yes," and noted that the bill set up a three-day evaluation, which most mental commitments started with. During the 3-day evaluation at the Alaska Psychiatric Institute (API), if the professional person in charge had reason (mental illness and likely to seriously harm self or others), the professional could file for a 30-day mental commitment and follow with a 90-day and 180-day commitment if warranted. The bill would create an option for individuals whose commitment came from a criminal case in which the person was found incompetent, there was an additional option to be committed for five years. The five- year commitment was not an option for individuals that did not enter the system after a finding of incompetence. 9:15:58 AM Senator Kiehl MOVED to ADOPT Amendment 1, 33-LS0172\O.1 (Dunmire, 5/2/23). Co-Chair Olson OBJECTED for discussion. Senator Kiehl spoke to Amendment 1. He thanked the sponsor and Co-Chair Olson's office for the CS, which he thought made some material improvements in the bill and addressed some of his concerns. He addressed a concern that there was potential for the government to hold an individual that had not been convicted of a crime for up to five years. He commented that the span of five years was longer than he trusted the government and longer than could be justified medically or constitutionally. He noted that the amendment took the maximum of five years down to a maximum of two years, which was still four times the longest that was currently in place. Senator Kiehl explained that the reason that the amendment proposed two years was due to the powerful testimony offered by a person that had been stabbed. He thought there was a rationale for allowing a longer commitment than the current law but considered that raising the limit by 10 times raised constitutional questions. He contended that it was difficult to concur when medical personnel had testified that the current system was working. He noted that after two years the government would have to prove a person was still dangerous. He noted that the provision applied to any felony charge, some of which did not result in two years of jail time. He thought a length beyond two years brought up constitutional and freedom issues. Co-Chair Olson questioned how to protect society from a person with mental issues, especially in rural areas. Senator Kiehl clarified that he was referring to people that were already hospitalized and had been in a locked mental health facility, wherein medical personnel had judged the person to be dangerous. He considered that if a person was still deemed as medically dangerous, the hold would be renewed. He mentioned the victims perspective. 9:20:30 AM Senator Bishop asked the bill sponsor if the change to two years proposed in the amendment defeated the purpose of the bill. Senator Claman expressed that the two-year period proposed in the amendment did not completely defeat the purpose of the bill, but the five-year time period was what was consistently proposed by testimony. He referenced multiple hearings and thought that from a victim's perspective, five years offered more assurance than two years. He noted that the bill allowed a person committed for five years that was shown to be safe the ability to go before the court in six months to establish that they were no longer a danger and be released. He reiterated his point about a five-year commitment offering more assurance to victims. He agreed that two years was better than six months. Senator Bishop expressed concern that dangerous individuals would be released to commit additional crimes. Senator Wilson had similar concerns as Senator Kiehl. He referenced testimony. He thought there was a difference between different court systems including a jury versus not having due process. He had concerns about individuals being committed without being evaluated. He referenced testimony from API and the Court System, and the lack of necessary facilities. He suggested that the topic would come up when considering the budget the following year as a result of API needing to renovate its facility to accommodate long term stays. He supported the amendment. 9:24:11 AM Senator Merrick asked the sponsor if there was a way to assure that an individual released would continue on medication. Senator Claman relayed that the most significant way for API to accomplish that was to keep individuals in involuntary commitment on an out-patient basis. He continued that API currently engaged in the practice, and API testimony had referenced an individual currently engaged in out-patient supervision. Co-Chair Olson asked Representative Claman to comment on the amendment. Senator Claman did not support the amendment. Co-Chair Olson discussed individuals that could not be rehabilitated. He questioned how to stop the backup so that there was no capacity in the dedicated beds. Senator Claman identified that a key provision of the bill was the ability for the courts to release people that were being evaluated for competency in secured release on bail. Instead of all individuals in custody through restoration, the bill provided for more ability for custody to take place not in the in-patient setting. There was testimony that indicated there were efforts already to increase the amounts of outpatient evaluation and restoration efforts, which would relieve backup. Co-Chair Olson WITHDREW his objection. Senator Merrick OBJECTED to Amendment 1. A roll call vote was taken on the motion. IN FAVOR: Kiehl, Wilson, Hoffman, Olson OPPOSED: Bishop, Merrick The MOTION PASSED (4/2). Amendment 1 was ADOPTED. Senator Wilson MOVED to WITHDRAW Conceptual Amendment 2, 33-LS0172\P.6 (Dunmire, 5/3/23). There being NO OBJECTION, it was so ordered. 9:27:19 AM AT EASE 9:28:02 AM RECONVENED Co-Chair Bishop MOVED to ADOPT Amendment 3, 33-LS0172\O.2 (Dunmire, 5/3/23). Co-Chair Olson OBJECTED for discussion. Senator Bishop explained that the previous day the committee had heard testimony from the Department of Law and the amendment provided for allowing a victim to attend the hearing of an individual that had committed the crime. Senator Kiehl asked if the amendment allowed for the victim to have access to information beyond what was discussed in court. 9:29:16 AM AT EASE 9:29:19 AM REONVENED Senator Wilson relayed that he had discussed the topic of the amendment with the Court System and the Department of Family and Community Services. He thought that if Amendment 3 were to pass, a victim in a case could attend but court proceedings would change to exclude certain information. He cited that there could be a chance that a victim could inadvertently be present during a breach of information and should be aware of confidential medical information. He supported the amendment with caution. He thought a victim should have the right to attend a trial but had concerns about the respondent's right to privacy. Senator Kiehl asked to hear from the sponsor. Co-Chair Olson asked the sponsor to comment. Senator Claman relayed that he supported Amendment 3. He thought a victim should be able to attend the hearing and affirmed that it would be made apparent that it was a closed hearing with confidential information that should not be disclosed. Senator Wilson wanted to ensure that people understood that there was nothing in the bill that made the hearing confidential. Co-Chair Olson asked the sponsor to comment. Senator Claman deferred to the Department of Law. 9:32:11 AM STACIE KRALY, DIRECTOR, CIVIL DIVISION, DEPARTMENT OF LAW, affirmed that a civil commitment hearing was confidential under state law. She agreed with Senator Claman that if individuals attended the hearing, they should be cautioned and instructed about the confidential nature of the hearing and maintain the confidentiality after the hearings. Senator Wilson asked if the information should be put in the bill. He shared concerns that confidential information could be shared after a hearing. Ms. Kraly thought a provision could be added to make it clear that the hearings were confidential. She believed that confidentiality was already part of the process. She noted that when the Civil Division processed commitment hearings, confidentiality was understood. She did not know if an additional provision was necessary since the hearing in and of itself and the entire statutory scheme was rendered confidential. She assumed that if there was a third party attending, the court would explain the confidential nature of the proceedings. Senator Bishop asked for Ms. Meade to comment. Ms. Meade agreed with Ms. Kraly that hearings were generally confidential. She thought that the victim's attendance was one exception and trusted that a judge would convey to those present that confidentiality must be maintained. She believed the caution from the judge would be routinely given. Senator Claman conveyed that the structure of closed hearings was that the judges assistant closed and locked the doors, and a victim would be aware that it was a closed proceeding. Co-Chair Olson asked for Senator Clamans stance on the amendment. Senator Claman supported the amendment without change. Co-Chair Olson WITHDREW his objection. There being NO further OBJECTION, it was so ordered. Amendment 3 was ADOPTED. 9:35:34 AM Senator Wilson MOVED to ADOPT Amendment 4, 33-LS0172\O.4 (Dunmire, 5/3/23). Co-Chair Olson OBJECTED for discussion. Senator Wilson spoke to Amendment 4. He considered that the committee had heard from the Department of Law, the Court System, and the sponsor that there was currently a problem in the system. He thought everyone agreed that after someone was found incompetent, no one filed for a continuation of an evaluation. The amendment left in place to allow for the prosecuting attorney to mandate a filing and included the previous amendment. He thought the committee had heard from API that it would need funding in the future to address capacity. He contended that the amendment tried to keep a one tier system. The amendment would return the commitment process to a 180-day cycle. Co-Chair Olson WITHDREW his OBJECTION. 9:37:27 AM Senator Kiehl OBJECTED. Senator Kiehl MAINTAINED his objection. Senator Claman did not support the amendment, which he thought changed a key part of the legislation. He furthered that part of the bill required the prosecution to file the petition for involuntary commitment, but had the person held for 3 days and started the 30-day commitment process. He summarized that the proposed amendment would continue the gap that currently existed in the system. Senator Claman continued to speak to his objection. He conveyed that part of the bill had specific provisions that allowed for people to be bailed out if the court believed the person could be out on bail while doing an evaluation for competency and also restoration. He thought the amendment would take out provisions that were intended to relieve some of the pressure on the system for those being evaluated for competency. Senator Kiehl spoke to his objection. He expanded on the bill sponsor's comments regarding the potential for out- patient restoration of competency. He thought the possibility of out-patient restoration had potential and mentioned advances in medication. He mentioned improvement in the backlog of individuals waiting in jail for evaluation. Senator Wilson MOVED to WITHDREW Amendment 4. There being NO OBJECTION, it was so ordered. Senator Kiehl MOVED to report CSSB 53(FIN) as amended out of Committee with individual recommendations and the accompanying fiscal notes. Senator Wilson OBJECTED for discussion. He felt the bill was a good piece of legislation that would fix an established problem but considered that the bill would cause a myriad of legal challenges within the disability community. He thought there would be imbalances in how systems were handled. Senator Wilson WITHDREW his objection. There being NO further OBJECTION, it was so ordered. CSSB 53 (FIN) was REPORTED out of committee with three "do pass" recommendations and with one no recommendation recommendation and with two amend recommendations, and with one new zero fiscal note from the Department of Family and Community Services, one new fiscal impact note from the Department of Law, one new zero fiscal note from the Judiciary, and two previously published fiscal impact notes: FN3 (ADM), FN 5 (ADM). 9:41:06 AM AT EASE 9:43:39 AM RECONVENED