Alaska officials propose legislation addressing gaps in psychiatric response system
On behalf of Governor Mike Dunleavy and in response to a 2019 Superior Court ruling, the Departments of Health and Social Services and Law proposed legislation to address gaps in the state’s psychiatric response system.
The proposed bills, released Friday, outline procedures for involuntary commitment to mental health treatment for mentally ill patients. They would also streamline the process through which defendants are deemed insane or mentally unfit to be put through criminal trial.
This draft legislation comes as a result of different events: (1)
for providing inadequate care for patients, and (2) a subsequent
over psychiatric patients being held involuntarily in jails and emergency rooms while awaiting placement into treatment facilities.
Alaska Superior Court Judge William Morse issued a ruling in October 2019 giving state officials a timeline to improve placement procedures for mentally ill patients. Morse said that the practice of involuntarily detaining patients on psychiatric holds due to API’s insufficient capacity for treatment was causing irreparable harm to the patients.
On Jan. 22 DHSS
for improving mental health evaluations and treatment placement practices. That plan included contracting with mental health providers who will evaluate patients and order admissions at API by priority instead of only chronology.
The Disability Law Center (DLC) issued a response to the state’s plan, outlining areas of improvement. DLC Staff Attorney Joanna Cahoon says the state acknowledged the merits of a program called “Crisis Now” – proposed by the Alaska Mental Health Trust Authority -- which would establish infrastructure for a mental health crisis response system to alleviate strain on API. However, Cahoon says the state has not committed funding to those improvements.
“Another significant problem with this plan is we need some guarantee that this process is going to be set up, that it will be set up the right way, that it will be set up quickly,” Cahoon said. “So we can be sure that in the future this long-going problem with API can be alleviated.”
The bill released by DHSS and DOL Friday outlines involuntary commitment procedures, and the circumstances under which patients can be held in DOC facilities: “…protective custody in a DOC facility or jail is only authorized after a person is involuntarily committed for mental health evaluation, and designated treatment facilities lack the capacity to safely admit the person in a reasonable amount of time.
,” the bill reads.
The bill also outlines how long patients can be held at DOC facilities. It says DHSS would provide a mental health professional to reevaluate a person who has not been transported to an appropriate facility within 48 hours.
DHSS would also have custody of the individual when they’re admitted to API, or while they’re being transported by DHSS to a designated evaluation and treatment facility.
Lastly, the bill would allow a mental health evaluation facility to observe an individual being committed involuntarily for the
72 hours before their court hearing. Currently, the hearing must happen
72 hours, so the court doesn’t have the benefit of the full evaluation period.
Cahoon, with the DLC, says the bill does not accomplish what Judge Morse mandated in his Superior Court order. She says it simply legalizes and clarifies what the state is already doing with these patients.
“What this bill does is allow for that person to be held in DOC while they’re waiting to be admitted to an evaluation facility,” Cahoon said. “So if this bill were to be passed it would legalize this practice that the court has said under current statutes is not legal.”
Stacie Kraly with the Department of Law's Human Services Section responded to Cahoon's concerns Friday afternoon.
"The court order contemplated that an individual should not be held in a correctional facility for more than 24 hours,” Kraly said. “We do believe that should be the goal. However, if we don't meet that 24-hour time period, then this will require by statute an automatic evaluation and review by a mental health professional."
DHSS confirms that if these bills do not pass this legislative cycle the state would be forced to continue providing status quo services for these patients. However, Kraly says the proposed legislation is only a small piece of a larger plan to improve psychiatric services in Alaska.