SB 100-SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS  2:01:42 PM CHAIR BETTYE DAVIS announced SB 100 to be up for consideration. SENATOR ELLIS, sponsor of SB 100, cited statistics regarding alcohol abuse in Alaska, and said that it's no revelation that the issue is huge, tragic and expensive. The bill is long overdue, and the state of Washington (WA) has set an example for what SB 100 could do in Alaska. There is growing recognition of the link between substance abuse and mental illness. As resources allow, these would be the priorities outlined in the bill: treatment for incarcerated sufferers, children, and certain populations. The bill also mandates priority treatments for pregnant women in in-state programs, and provides a non- discrimination clause for effective faith-based programs, which have shown to be very helpful in prisons and other public institutions when state services are lacking. He continued to explain that section eight of the bill would create a facility for involuntary commitments. The state of WA has shown that it's an effective solution for many people; it would not be for street inebriates, but rather people who are severe substance abusers who are dangerous to themselves and others. This bill would simply expand the existing program, which is currently underused; it proposes a small number of beds and a secure facility. People often walk out of detoxification facilities and return to the same abusive lifestyles; the population of these repeat offenders is around 40 in anchorage. A University of Alaska Anchorage study recommended that forced interventions towards these users could be effective. These high-end users constantly cycle through the system at great cost to the state. He said that the bill could be a vehicle for working together to find a better approach to treating this issue. 2:12:32 PM SENATOR DYSON asked which part of the bill addresses the faith- based-initiative funding. SENATOR ELLIS replied that the provision is in line 30 of the bill. SENATOR DYSON commented that faith-based programs are very effective, and asked if that provision of the bill might be challenged in any way. SENATOR ELLIS said that he'll have the Department of Law look at the language of the bill. SENATOR DYSON commented on a program in Anchorage that's currently underused because it's faith-based. SENATOR ELLIS said that the bill has a fiscal note of $1.9 million for the secure-bed facility, and that it would make sense to have the beds co-located with a detoxification program. 2:16:07 PM SENATOR COWDERY asked when the pilot program in WA state will be completed. KATE HERRING, aide to Senator Ellis, said that the WA program is just now getting underway and will be completed in 2 years. WA has had the facilities for years now, and the new program is just for a secure facility. SENATOR COWDERY asked how SB 100 differs from the WA bill. MS. HERRING said that the language in Alaska's bill is less colloquial, and that the one main difference is that Alaska only sets up one pilot program versus WA's two. 2:18:30 PM SENATOR DYSON said that some people in Juneau who have been using an involuntary commitment program are claiming significant success. SENATOR ELLIS said that he would look for data on this. 2:19:42 PM SONIA SUBANI, with AARP Alaska, asked if the committee received her letter of support. CHAIR DAVIS replied that they had. MS. SUBANI said that substance abuse is prevalent in Alaska, particularly among older citizens. Currently there's only one treatment center for older Alaskans in Anchorage; often abuse problems are confusing to a lot of people and are misdiagnosed by those treating them. The AARP is also concerned with how abuse affects grandchildren of its members, who often live with the grandparents because of their own parents' problems. 2:23:10 PM NATHAN JOHNSON, Division Manager for the Anchorage Municipal Department of Health and Social Services (DHSS), said that the department continually struggles with treating abuse and the bill will help its efforts greatly. The Alaskan statistics for alcohol and drug related issues are high, and treatment ability is critical to reduce costs. The lifetime financial cost for a baby with Fetal Alcohol Syndrome, for example, is almost $3 million. A limited number of people are responsible for the bulk of drug and alcohol abuse incidents in Anchorage; they're a major burden on tax dollars and a more comprehensive means of treating them is necessary. 2:26:00 PM MIKE FORD, with the Alaska Native Health Board, said that this area of concern deserves a sharper focus, and the individuals being discussed today are a major cost and should be targeted. 2:27:33 PM LONNIE WALTERS, Chair of the Advisory Board on Alcohol and Drug Abuse, related his history with involuntary commitment work, and said that he has never seen more success than with such programs. The system won't necessarily burden the court system, because people can often be persuaded to enter on their own recognizance. Cuts in treatment funding for involuntary commitment have made the waiting list incredible long. He concluded by saying that he wholeheartedly recommends the program and its high success rate. 2:31:02 PM SENATOR ELTON asked what the commitment process entails. MR. WALTERS said that state laws need to be carefully consulted before the involuntary commitment process is used, and the Alaskan and Washingtonian laws are very similar. In his experience, he would obtain letters of support from family and friends of individuals. SENATOR ELTON asked if Mr. Walters, in his past involuntary commitment experience, had remained involved through the patient's process and treatment. MR. WALTERS said that he did not, and gave an example of how the program worked in WA. SENATOR ELTON asked how Mr. Walters felt about turning a patient over to people unfamiliar with their particular case. MR. WALTERS said that it's not a problem with a good counselor, and that the counselors were provided with information beforehand; such programs have the highest success rates he's ever seen. 2:35:35 PM MARGARET LOWE, with the Alaska Mental Health Trust Authority (AMHTA), said that substance abuse is very often linked to child abuse, and the state is in great need of more treatment options. Far more money needs to be spent on treatment facilities and personnel to make a difference in the future of the state. JEFF JESSE, Chief Executive Officer for the AMHTA, said that he's pleased with the bill and impressed with the grants for evidence-based programs and the prioritization of pregnant women; in the long run, there will be significant cost savings. The pilot program is important because 20 percent of chronic substance abusers cases incur 80 percent of the associated costs; they need to be held accountable for their behavior. 2:40:20 PM MATT FELIX, with the National Council on Alcoholism and Drug Dependence, said that during the years when the Juneau Hospital did involuntary commitments the program was very successful. The most chronically addicted were committed, and many of them are still sober today; they needed to be forced to turn their lives around. Addiction isn't a choice, but a loss of control. 2:42:58 PM SENATOR ELTON asked for the elements that lead to commitment. MR. FELIX said that laws protect civil rights very well, so the process before court is lengthy; loss of control must be proved, as well as the chance of rehabilitation. The program was successful in Juneau because it was a city program with access to the city lawyers. 2:44:36 PM SENATOR THOMAS said that hopefully the program will do some good because the present situation needs to be changed; he asked what the problem is with convincing people to agree to funding the program, and what effort is needed to show that the program is effective. MR. FELIX said that per capita alcohol consumption has fallen to under a gallon annually in Alaska, partially due to awareness of abuse problems. He added that addiction is better understood now, and treatment is getting to be more effective. SENATOR THOMAS asked if alcohol abuse is being replaced by drug abuse. MR. FELIX said that alcohol is a drug of choice, and in Alaska it's the major problem. 2:50:09 PM SENATOR THOMAS moved to report SB 100 from committee with individual recommendations and attached fiscal note(s). There being no objection, the motion carried.