SB 154-REPEAL SUNSET OF MENTAL HEALTH ASSISTANCE  MS. WENDY HALL, staff to Senator Pete Kelly, sponsor of SB 154, informed the committee that representatives from the Department of Health and Social Services (DHSS) were available to answer questions about the bill. She then read the following statement. The designated evaluation and treatment program [DET] is a critical component in a continuum of mental health services in Alaska, particularly for indigent persons with mental illnesses who are being civilly committed or met the criteria for civil commitment. Through this program many poor people with mental illnesses, who do not qualify for Medicaid, are able to receive services in community hospitals across the state, closer to their families and local support systems. Without the DET program, it would be necessary to transport many consumers in crises to the Alaska Psychiatric Institute [API] to receive evaluation and treatment sources. MS. HALL explained that SB 154 repeals the sunset clause in statute. CHAIRWOMAN GREEN clarified that Version A was before the committee and said this concept is part of an ongoing discussion about API, which she believes is a great idea. Number 1668 SENATOR LEMAN asked why the legislature put a sunset date on the bill in 1999. CHAIRWOMAN GREEN thought it was done for financial reasons. MR. ELMER LINDSTROM, Special Assistant to the Commissioner of DHSS, recalled the sunset date was included because the state had received a federal grant that was non-continuing. A portion of that grant was earmarked for DET costs, but the Legislature was aware that the federal funds would not be available in 2002. In the meantime, DHSS has located another funding source to continue the program. CHAIRWOMAN GREEN asked Mr. Lindstrom to review the fiscal note. Number 1735 MR. LINDSTROM said the rules for fiscal notes have changed so that the cost of an entire program is to be shown, even though the funds might be included in the Governor's, House or Senate budget. He thought, as of yesterday, the DET program was fully funded in the Senate version of the operating budget. CHAIRWOMAN GREEN asked for verification that SB 154 will have no additional fiscal impact, other than the amount included in the operating budget. MR. LINDSTROM said it will not. Number 1833 MR. MIKE POWERS, administrator of the Fairbanks Memorial Hospital Denali Center, told the committee that three years ago the hospital completed a strategic plan, of which a major platform was community accountability. Hospital staff, public safety officials, and social service workers attended planning sessions and, as a community, identified psychiatric program excellence as a key effort. The DET funds were instrumental to the hospital's ability to offer its psychiatric program. About the same time, Senator Kelly introduced legislation allowing limited state dollars to four communities to help protect one of the most vulnerable segments, the working-poor mentally ill. That funding mechanism has proven to be very cost effective - it has minimized the cost borne by multiple state agencies. He urged committee members to support SB 154. MR. CARL SANFORD, assistant administrator at Fairbanks Memorial Hospital, informed the committee that two years ago he was very involved in the mental health infrastructure at the hospital and around the state, particularly the transfer of mentally ill patients from the Fairbanks community to API for treatment. At that point in time, the predominant issue was open funding. In 1999, 70 patients were transported out of Fairbanks. In 2000, 5 to 7 individuals were transferred to API for care, providing dollar savings to the public safety and correctional sectors and allowing troopers to remain in the community. In addition, patients receive timely access to care and do not delay the decision to seek care as often. MS. LIZ LAZARIA (ph), nurse manager on the Mental Health Unit at Fairbanks Memorial Hospital, told the committee she would like to speak to the personal side of the benefits of the DET program. One patient in the mental health unit is a 23 year old with schizophrenia. It is very important for the family to be involved with the treatment and follow-up of this patient. This patient is likely to be hospitalized several times during his lifetime. The unit has developed a treatment plan with family members that provides family support. She urged committee members to support SB 154. CHAIRWOMAN GREEN asked Ms. Lazaria whether that patient would have been transported if the DET program was not available in Fairbanks. MS. LAZARIA said it is highly likely the patient would have been transferred to API as the patient is on a 30-day commitment. The DET program supports keeping the patient in the community. DR. HOPSON, a psychiatrist from Fairbanks, stated support for SB 154. As a member of the medical staff at Fairbanks Memorial Hospital and the medical director of Mental Health, one of his goals is to support and direct the development of an acute care mental health system, which provides the highest level of care to its patients and support to their families. DR. HOPSON said when treatment is delayed or a mental illness is untreated, the patient may decompensate to the point that involuntary treatment through court commitment is required. That process not only adds costs but may require a longer length of treatment due to the fact that he or she may be seriously decompensated. He believes that passage of SB 154 will allow for earlier interventions, earlier hospitalizations, shorter lengths of stay, and less cost to the patient, family and taxpayers. Earlier treatment of patients, from a physician's standpoint, is the ultimate goal and will provide the highest quality of mental health care in the Interior. MR. GARTH HAMLIN, Chief Financial Officer at Bartlett Memorial Hospital, stated support for SB 154. SENATOR LEMAN moved to pass SB 154 from committee with individual recommendations. CHAIRWOMAN GREEN announced that with no objection, SB 154 would move to its next committee of referral. The committee took a brief at-ease and then Chairwoman Green handed the gavel to Vice- Chair Leman and the committee took up SB 94.