This meeting of the House Health and Social Services Committee will now come to order.
It is 3.19 p.m. Thursday, January 22nd, 2026 in Davis 106.
Members present, our representatives, Swanki, Meers, Gray, Fields, Prox, and myself, Representative
Mina Chair.
Let the record reflect that we have a quorum to conduct business.
Please take this time to silence your cell phones for the duration of this meeting.
Staffing the committee today, we had Andrew Gianati as our Health & Social Service's
Secretary David Monroe as our LIO moderator and Katie Giorgio, my committee aide.
If you need anything during the meeting, please don't hesitate to get their attention.
First on the agenda today, we are returning to House Bill 147 by Representative Prox on
the practice of naturopathie.
I had previously set an amendment deadline for yesterday, January 21st at noon.
Since it's been a few months since we last heard this bill in committee
I would like to invite Representative Prox and staff Riley Knight to come to the presenters table and please give us a recap of House Bill 147
So thank you chair Mina I'm representing Mike Proxx
represent District 33 and sponsoring House Bill 137 and with me is my aide Riley nigh
and we did hear
Several hearings on this bill, so I'm not going to go through all of the details, but at a high level
what we're trying to do is just establish a
licensing procedure that meets
the
that allows naturopaths to work up to their level of education and training and very much not the same standards necessarily but very
much what we do with all the other medical professions is they establish the standards at their accredited universities and we recognize those standards.
The licensed Alaska natural path who passes appropriate pharmacology exams approved by the department may apply for a temporary endorsement
to prescribe medications, and what that temporary endorsement allows is for them to enter into a collaborative agreement
with an MD for the minimum of a year,
collaborating physician would either recommend them for a
lice full prescriptive rights or maybe not it would be up to
that recommendation and it does require naturopaths to have
60 hours of continuing education including 20 hours in
and naturopaths would not be allowed to prescribe a controlled substance, poison, cancer, chemotherapeutic drug,
antipsychotics, or using ionizing radiation or radioactive substances.
And we did have some testimony from gentleman Clyde Jensen from the Rocky Vista University
give virtually the same training for allopathic physicians or natheopathic
physicians. And what are some of the other we have 15 other states have this
provision licensed naturopath can prescribe medications. There have been no
disciplinary actions within for prescribing physicians or prescribing
naturopaths in those states and we heard that quite a few patients that come to
emergency rooms are really seeking primary care and
we have a primary-care shortage in Alaska primary
care physicians. This would help that it's basically the same level of care
And then I think since we last met, the Rural Health Transformation Project came up.
And one of the things, it's not naturopath specifically, but one
of their requirements is for Alaska to join multi-state comp.
licensure compacts for medical providers, there's five of them specific, the naturopaths weren't
one, but it's the same idea. They want us to get, make it easier for
medical provider to practice in Alaska. So with that, we do have some folks
available to answer questions, I'd rather just see what questions anybody has and we'll be happy to
answer them.
Thank you for the recap, Representative Prox.
Do committee members have any questions or comments?
We have a few people available to answer questions.
In the room, we have Sylvan Rob,
the director of the Division of Corporation
Business Professional Licensing.
Dr. Scott Lupert, naturopathic doctor in Fairbanks.
Dr Clyde Jensen, a PhD professor at pharmacology,
as well as Dr Natalie Wiggins
from the Alaska Association of Naturopathic Doctors.
Thank you, Chirmina. I will make a comment I am a co-sponsor of house bill 147
And I want to just explain that for a moment
so
Allopathic medicine is the
Antithesis of naturopathic under allopathic
Medicine we have the medical doctors doctors of osteopath
Puthy, nurse practitioners and physician assistants like myself and that's the more traditional
medical providers that we have in our community. In Alaska, we
have lots of folks who choose not to see traditional medical
providers. They would prefer to get their care from a naturopath and
that is for a variety of reasons. And since the late 80s, natura paths in
Alaska have been able to order labs and imaging.
They are able order the tests that would diagnose somebody with diabetes or
cholesterol, but they're not allowed to treat those by the standard of care that I would or
somebody in the more traditional path would. Natural Pathic Medical School involves four
years of school in which they learn about traditional pharmacology. They know how to prescribe the
standard-of-care medications that would adequately treat these folks who are choosing not to be seen
what we need to do is allow for meet folks where they are and we have
Alaskans who are choosing not to be seen but are having these serious medical
problems that because of the way our licensing is we're creating extra
hurdles that they must jump through in order to get adequate treatment. So as
the sponsor, Representative Prox, said
This is about expanding access. This about making sure that we have more primary care available
Accessible and what I would offer
And I don't want to say this in a derogatory way
But when we had a system that doesn't allow naturopaths to practice the way
They're trained to we end up with naturepath's in Alaska who are for lack of a better word kooky and they
don't use the standard of care.
They only use supplements.
They really reject sort of traditional medical practice.
And that's not in the best interest of our patients.
We've created a culture that encourages substandard care,
and so I think it's time that we pass this bill
so that, we can attract
good naturopaths who will practice the standard of care and medicine in our
country and treat folks who need to be treated who for a variety of reasons
have chosen not to go a traditional path. So I would urge people to vote. Yes.
Thank you.
Thank You and Representative Gray. Does anybody else on the committee have any
questions or comments?
Representative Chunky.
Thank
you,
reiterate representative Gray's comments that much more eloquent than I
could ever express. I am also a co-sponsor of this bill.
I would absolutely agree that this comes down to increasing opportunities for
care for Alaskans. In all honesty I co sponsored this
bill prior to having an experience in my own family with a natural path who
today. I ended up seeking additional advice and input after a family member had a stroke
this summer. And as my family was being discharged from the hospital after having a
Diagnoses that that he would probably pass within a month after leaving the hospital and
Of course family members are oftentimes looking for some additional information and comfort and ideas to help them and
With the with the help of a specific naturopath here. I'm dr. Lupar who is listening in I I felt like we were able to offer
an alternative path
and happy to say that my father is alive and well
and enjoying his winter in Florida this year.
So we have an opportunity here to write something
as Representative Gray noted.
Alaska is one of a growing number of states,
I believe 26 states now, that license
and regulate naturopath doctors.
it's pretty commonly known that Alaska is the most restrictive when it comes to
any sort of pharmaceutical prescriptive authority so I just want to throw my
support behind Representative Prox thank you for bringing this bill and I look
forward to passing this out of committee today thank
you. Thank you Representative Schonke and good to hear about your father. Is
I would now entertain a motion at this time if there are no further questions.
Chair Mina, I move House Bill 147, Work Order 34-LS 0136G, from committee with individual
recommendations and attached fiscal notes.
Is there any objection?
Seeing none, House bill 147 passes from Committee.
Let's take a brief at ease to sign the committee report.
Back on the record.
Next on The Agenda today, we have the initial hearing for House Bill 232 by Representative Gray on Mental Health Age of Consent for Miners.
I'd like to begin by inviting Representative Grey to give a brief introduction on House bill 232.
And my understanding is that we will also be hearing from Senator Giesle and her staff, Paige Brown, to present the bill.
Representative Green.
Thank you, Chair Mina.
Yes, so House Bill 232 does several things,
but the most important thing that it does
is it lowers the age of consent for mental health care
from 18 to 16.
This would allow 16 and 17 year olds
to seek mental healthcare up to five visits
without parental consent.
Currently, they are not able to do that.
In order to give a more thorough introduction of the bill,
forward to talk a little bit more about the bill and her staff.
Hello, Madam Chair, members of the Health Committee here in the House.
For the record, I'm Kathy Geesole.
I represent Senate District E.
That's House Districts 9 and 10 in The Anchorage Area.
I am speaking to House Bill 232.
As Representative Gray said, this will open the door to allow individuals,
16 and older, to access mental health services.
This bill is motivated through data and experience.
I'm a nurse practitioner.
I'm more certified in family practice and my clinical practice site these days, since
I can't hold down a full-time job because of this job, I volunteer in our public schools
in Anchorage, in the Anchorage School District.
During my time serving in The Anchorage school district clinics,
services for the students. But in doing so, I also scream for behavioral health challenges that the
students might be facing. And in Doing So, one of the things that I have observed is particularly
after COVID, the number of students experiencing anxiety, depression, even the idea that
I mean, the multiplier is four and five times what it was before COVID.
Our kids were highly stressed by that experience and continue to be so.
So I primarily work with middle school students, so we're talking about 12 to 14 year olds.
We'll explore them together during the visit, even though I'm there for physical health care.
I ask them more questions.
And one of the things I say to them is, you know, we have counselors that could help you work through these issues.
There are ways that you can manage this anxiety.
And the world is not.
better without you, you are special and we need you here, but there are folks that can
help you with this.
Would you be interested in speaking to a counselor?
And it is, I think I had one student once say no, every student has said yes,
I would like to do that.
That's great. I can make that referral. We have clinicians who are here in the school, mental health clinicians here
in this school that can see you just like you're seeing me today during the
school day so your parents don't have to drive anywhere or anything but we need to
get consent from your parent's. Inevitably, the child's face falls. Oh, my parents will never give consent.
We do contact parents, and you're going to hear from the director of health services,
one of the health service contractors at the Anchorage School District,
and she'll give the statistics.
It's about one third of parents actually end up giving consent.
So two thirds of their parents deny the mental health
services for their student who has said, yes, I need help.
That's what motivates me to do this bill, because it breaks my heart to see these kids wrestling with these mental health issues that don't have to.
There is help available, we have the tools.
So the data is that the average age of onset for mental healthcare challenges is about 14 years of age.
You can actually, there's a great book out there,
written by Dr. John Medina.
It's called The Attack of the Teenage Brain.
He is a brain physiologist.
He's on the faculty of The University of Washington.
He has a speaker.
a public speaker in multiple venues, but he's also spoken at NCSL before.
This book is super great. I have recommended it to the parents of teenagers.
During the teen years, beginning about age 12 to 14, the brain begins to restructure itself.
All of that learning goes on during those pre-school and school years,
but when they hit teen years and their physiology,
their whole body physiology begins to change, those connections begin to reform.
Breaking down and restructuring as they begin
to form adult functions, prefrontal cortex and executive function processes.
Teenagers, we know, explore risky behavior and that's part of that brain restructuring
that is going on.
They are searching for who they are.
Again, that part is of the brain-restructuring.
So knowing that these things begin at age 14, this is the time to really respond when a child
says, I can't sleep at night.
I can't sleep at night because I think the world would be better without me.
This is the time to reach in and help those kids.
So that's the data part.
Early detection, we know results in better treatment.
We know prevention is always less costly than treatment, suicide is a second leading cause
of death for people aged 15 to 34, and it's a serious issue here in Alaska.
reported feeling sad or hopeless in 2023, some of our latest data. Alaska leads the nation
in youth suicide. So getting parental consent from parents is a challenge. There's a lot of
parents get a call from a school saying, you know, your child expressed some challenges,
behavioral health challenges. And we have services, would you be willing to allow them?
That parent is probably going, wait a second, hold it, this is a label,
you can see why there would be anxiety and lack of consent. Sometimes there's privacy concerns,
particularly in rural areas, right? Small communities, things like that. But we know
can have worsening outcomes. You know, when I read stories about some of these horrible
school shootings that are executed by teenagers, it breaks my heart because I'm thinking about
that child as a junior high kid. Even as an elementary school kid, what were they going through
point what could have been prevented if someone had been able to reach out to
them and their family by the way I'll refer to that in a moment but the
family gets involved here too but we could prevent a lot of these really
heartbreaking situations. In any case what this bill House Bill 232 does is it
lowers the age of consent for mental and behavioral health services from 18 which
down to 16, but there are limitations in it.
It's not a wide open thing.
It limits it to five sessions of therapy.
No medication is permitted.
That's a key point that many people
have expressed concern about.
There is no medication involved.
In fact, we know that most of these type of mental health challenges don't need medication.
It's much better handled with counseling, which then results in life long changed behavior, ability to cope.
After the five services are discontinued, the services
are discontinued unless parents say yes.
And it's at that point that parents are consulted.
for sure. It may be after only three sessions. And the student says, hey, you know, I talked
to my mom. I told her this is I'm having this counseling and she wants to help too. She wants
to get involved. The goal here is that getting the students on the right track, the hope is
better able to talk with me, things like that, what's going on here? Can I get involved too?
You know, we can't help a young person unless we help the situation they're living in as well.
And a lot of times parents know their children are going through some stressful things.
Maybe it'd be better if I wasn't here, you know,
the suicidal ideation.
But the parent doesn't quite know how to help.
The clinician can help those parents, too,
and help the family function better as well.
So that's actually the ultimate goal
is to get the parents involved aswell.
We know that we can prevent risky behaviors.
If these issues aren't handled at an early age,
Kids commonly turn to substance use and so we can prevent that
But we want to equip
Equip our students the American School of Counselors
The American school Counselor's Association actually has some recommendations. They have some policy priorities
Number one fully fund public education number two recruit retain educated
or qualified educators, but number three, invest in student mental health.
And they are advocating that these services be available in schools,
where it's a place children feel safe.
They go to on a regular basis and this also offering the services in the school the parents
aren't having to make an extra trip, another appointment, drive the kids here and there.
Now last year we passed a bill that allows schools to actually set up clinics in schools.
It would require them to set up billing services and
HIPAA compliant computer systems, etc.
What we have going on right now in the Anchorage School District is contractors who, in
the community, who come into the school to provide the behavioral health services.
It's happening in Fairbanks also.
And the beauty of this is that these private sector entities are actually available on
weekends, nights, and when school's out.
And so by having them provide their services in school, the family and the student have
when there's a crisis happening.
So, because we know everything doesn't happen
during the school hours.
So that's kind of the outline of what's in the bill
and the motivation for doing it.
So I'm happy to take any questions, Madam Chair.
Thank you, Senator Giesle.
Do we have any question for Senator Kiesel
or is that representative Mears?
Thank you through the chair to Senator Diesel, more of a comment and a support.
My children are 19 and 22.
And I.
I'm grateful that I knew about these changes that happened to children as they go through
their teenage years. I see where my 22-year-old is compared to where, you know, he was when he
was just graduating from high school. His junior year was COVID year and the differences between
how that impacted a high-school student and an eighth grader. Seeing all of their friends and
and as close as I am to my children and their friends we need other people to be able to talk to
and sometimes the parent our family member is not the right person to
talk about things that having multiple people in our community is to support our children is
really important and having folks available that have got medical expertise and the background
to being able support them is important. The role that schools and educators are playing in
communities are changing and the more support that we can have for them better
off we are so thank you for your work on this and I appreciate to the conversation
and learning more thank
you representative fields thank
you through the chair I guess I want to first acknowledge that if these services
aren't available.
People are going to consult AI chat bots, which their records of AI
chatbots include encouraging teens to kill themselves.
So I think talking to an actual professional counselor is
clearly preferable to AI Chatbots, where we don't know what the
AI Chappbots are gonna recommend.
I guess my question was on, yeah, really important bill.
There's some details, like, 16 years old, or I
guess one question I would have is, why not 13?
or 12 even certainly someone could easily need mental health services younger than 16 so should
we go a little lower and girls grow up faster than boys their brains develop faster then boys
and maybe if the sponsor could talk about
the five outpatient appointments, why is that the threshold?
I mean, the structure seems really well designed.
I'm just curious if you have thoughts on some of the details
on here and how you arrived at those thresholds.
Thank you.
Thank You.
Through the chair, it was, this is an incremental step.
I know that this a new concept for Alaska.
About half the states have a lower age of consent.
One state does go down to age 12.
The rest are majority at age 16.
I agree that 14 would be ideal, but we chose 16
The five appointments is actually an idea that one of your colleagues,
Representative Ruffridge brought to me.
It's the format that another state uses.
have these type of services available to kids at younger ages.
And this was what one state did.
We thought it was a really good structure.
I don't recall, but I'm pretty sure that state also prohibited the use of any drugs, any medications.
Just a follow up.
Follow up?
I would be curious from both committee members and the bill sponsor.
14 year olds should be able to access this treatment I would support that if it would diminish the support for the bill
Then I don't want to put it forward and just ask for collective input on the age threshold. Thank you
Thank You representative Fields representative box. Thanks. You chair Mina
Well to the chair if we were talking about Kathy Giesel
And if you were willing to clone yourself 20 or 30 times,
I wouldn't have any reservations about that.
But can't do that, and they're in the problem lines.
And I think you mentioned that a third, well, many students
say, ooh, don't call parents.
And then I'd think, you said about a 3rd of the parents that
do get called consent.
two-thirds do not, and that's a challenge.
And that would bring up a problem in my mind.
Why are they not?
And schools are mandatory reporters.
And I appreciate the teachers being in a really tight box,
and anybody that works with kids being
in the tightbox in that situation.
statistically, from this limited study, two-thirds of the parents are apparently against this.
And that brings in a problem because quite a few of
the
parents that I talk to in the interior, not just North Pole,
are just plain taking their children out of public schools because of actions like this, they don't.
realize that you're the one who's going to be there and it might be somebody else.
And so I'm really not being entirely facetious.
It's a problem, that it will, my concerns is going
to drive more parents away from the public school system.
And that's gonna cause funding problems and other problems.
And we are taking away the authority or
Rats, there's a legal term for children that have not reached the age of majority or infringing
on that.
And it goes broader than just this, where children aren't able to contract.
And if they give consent, you were saying that schools are providing the paperwork.
doing this so if they're consenting to some treatment from their parents insurance policy
um how are we going to address those sort of issues? Madam Chair, Representative Prakce,
let me expand perhaps the the patient population we're talking about here. First of all we
would be accessed through schools.
First of all, I think you're referring to emancipated minors.
Mancipiated minors, thank you.
And that's great.
Those students can, those young people can give consent
for themselves, but there are 17-year-olds that,
and 16- year olds, who are not living at home anymore
for various reasons.
They are homeless, essentially, and they know they need services.
They can go to a behavioral health clinic and request services and
they are turned away because they can't get consent.
Sometimes the parents are incarcerated.
Sometimes parents have disappeared.
So do we say to this 16 and 17 year old, sorry, you're not old enough.
Students these days, and you have to actually be in the setting
where you're talking to these young people,
they are surprisingly astute, they're certainly aware
that they have challenges that need to be addressed.
They don't want to be anxious, they don t want
to depressed, and they want help.
But sometimes the parents are not the communication,
they're not available for communication.
We know one of the questions that I ask the student is,
is there any adult in your life
that you can confidently speak to?
Straight on and they will give you good advice. You trust that person if this if the students says yes
That that student is typically very safe
They have a safe person to go talk to but there are a lot of kids out there that don't cannot answer
Yes to that question those students are at risk. Yeah, so
So, it goes beyond just schools, okay?
I want to make sure that we're not talking only about schools here.
It happens to be the experience that brings this to the forefront for me.
And I should clarify that two-thirds of parents either don't respond...
that's a very large number and some decline. There is an individual that is invited testimony
Heather Ireland who actually operates or is manager of one of these these clinics and she
can give you actual data she's kept data. Thank you Madam Chair. Follow? Yes well yeah but the
what you say. And I'm learning more and more how big the problem is. But the root of the
problem, it's parents. I am going to blame parents because they're parents, you can't
blame the children, but the lack of ability to communicate with parents and parents have
And I hope we can explore this because that's my concern right now.
Are we enabling to a degree parents to not be parents?
Instead of recognizing that no harm, no foul, but hey, we got a problem here.
We got to sit down and talk and get the parents involved.
Don't have the answer,
but that is my concerns right right with this bill.
Representative Fields, I'm angry.
Madam Chair, just to the risk of stating the obvious, the primary reason that it's hard to get
consent from parents on issues as simple as permission to go ice skating at recess
is because kids lose notes, parents work two jobs. That's actually the number one barrier,
so I just want to recognize that when it comes to behavioral health,
consultation, which is very time sensitive with someone who's experiencing suicidal ideation,
You don't want that person not to get consultation because their parent was working two shifts
or the note got lost from their backpack.
So it's not just an issue of the parents who won't give consent.
I think the bigger issue is why would we let this minor logistical issue get in the way
of time sensitive medical attention.
So again, thank you and I don t have Senator Giza wants to comment on that but I see that
all the time in my school and it s unbelievable how hard it is to note back again on stuff
Madam chair, could I comment on that thank you
Not only are parents working two jobs, but we're using a plural parents sometimes. There's one parent
Sometimes that parent isn't home much
Some of the stories that I've been told
One of questions I ask students is how many hours do you sleep at night that?
Because it tells me a lot about their health, right?
We know that our bodies repair during sleep.
But it also tells how well their brain is repairing,
because that's what happens when we sleep,
to have a student tell me, oh, I go to sleep
about 3 a.m., I have to get up at five.
Really?
Why don't you go and go bed sooner?
What's going on?
Well, my mom goes out at night.
And so I had younger brothers and sisters
I'd have look after.
worried that my mom won't come back. No middle school student should have to be
thinking these kinds of things worried about this kind of problem but that's
the reality. In Anchorage, in Alaska, I mentioned suicide, you know, last spring
when this bill was going through the other body. There were four suicides
in the North Slope Burl, same school.
Why are we sitting by and watching this?
There had to be signs that someone could have reached out
and provided services for those students.
And that's just one example.
Thank you, Madam Chair.
Thank You, Senator Giesel.
Representative Gray.
Thank-you.
Through the chair, I'm just going to make a comment
on the line of questioning from Representative Prox.
And that is, when I was 17 years old,
I very rebellious.
I sneaking out of my parents' house all the time.
I drinking heavily, getting in a lot of trouble.
And my parent's forced me to get mental health care.
And when you force a 17-year-old to do anything,
it doesn't go well.
It was really a waste of their time and money and effort.
And so when I think about the bill, I
think if there had been an opportunity for me
to seek out mental health care on my own
in some way, shape, or form.
And I had chosen that it might have made a difference.
It might've gone better.
And especially when we're talking about 16 and 17-year-olds
and what parents can and can't make them do,
At least in my case, my parents created this obstacle.
I was opposed to receiving any sort of mental health care.
So, I'm just giving the sort
of alternative view that allowing kids
to proactively consent to this sort
of care will make the care more beneficial.
Thank you, Representative Gray.
Representative Prox.
Yes, thank you.
Through the chair, this bill is broadly broad authority for
children to make two consent or authorized care. Schools, hospitals, wherever. Is that true?
That would be true, yes. No, I'm sure.
in the medical industry which you're familiar with, you can get medical power of attorney,
you could give medical a power attorney to your husband or your daughter or I suppose me.
I don't know if I'd do that, but you know,
you couldn't do it I think, right? And then there is prior authorization to not take
care in a hospital. I don't remember what that's called. But if you, if
you find yourself in an really difficult situation, do not resuscitate orders.
For instance, we can sign those ourselves. Correct? Yes. Yes, I'm sure.
Yes? Would it be worth considering, especially,
I guess, in the school environment that
Parents could opt in with that consent.
I don't know, first day of school or whatever,
but think about it.
We offer this service if you need it,
we can't get in touch with you,
da-da-dah-ta-ra.
And maybe first skating rinks and all that other stuff,
where they'd opt-in at the start of the school, for instance.
Is that a possible solution to solving at least part
of this problem?
where parents are still in control, I guess that's where I'm thinking about it.
Madam Chair, this is already done with physical care.
At the beginning of the year, actually when the students register for school,
they allow physical-care school nurse or the sports physical.
Right.
That would be up to school districts.
I don't know right yes, but there is a person invited testimony that actually is the manager of a clinic that offers referrals
She can talk about data. I also have an invited testifier. Who is high school student?
Mm-hmm who can certainly speak to this and her experience with her colleagues
Okay, thank you
representative reference
Thank you, Chair Mina, through the chair.
Thank You, Senator, for being here.
I wanted to go just briefly to the matter of cost.
And I think that might be also for the invited testifier as well.
So under on page four of the bill, line 30,
the minor is relieved of financial obligations
to provider of a service under the section.
Is there an idea of how, I guess I'm not aware of, so providers would essentially be offering
the service pro bono or would the, this seems to indicate that the minor would not be responsible
for any payment as well.
How would you envision letter F of this bill to be implemented?
The way this works if it's a school setting right now is the student's insurance covers, right?
So the billing goes to insurance.
That is typically or often is Medicaid.
So Medicaid is automatically billed or the students insurance, but you're right.
Otherwise, it is pro bono care.
licensed professional counselors,
psychologists, etc. that provide these kinds of services are
They're amazing people who do provide a lot of pro bono care
So I think again, we have invited testimony a person who manages
these kinds of services. She could best answer that. But having spoken to some clinical social
workers, they recognize the desperation of individuals and often do pro bono care.
Just to follow up if I may.
Follow up?
Thank you. I guess my concern for letter F is
I agree with you.
I think there's a lot of amazing people in this line of work that would offer pro bono
care.
This section just seems to be very rigid.
Let's say a 17 year old goat is not in school, drives themselves to a facility for mental
health services and that facility wanted to receive remuneration for said services.
This section seems to prohibit them from doing so.
Is that how you read that?
That is how I read it.
I'll read more as a permission.
I understand how you're reading it.
Okay.
Thank you.
Yeah, thank you, Madam Chair,
thank-you.
Thank-ya.
Representative Schwonke.
Thank You through the chair,
thank You Senator Giesle for being here.
And, you know, this bill,
I very much understand
where you are coming from,
where Ray's coming, from on this.
I'm a parent of a teenager.
I've been a youth sports coach.
I've been a volunteer educator, been around an awful lot of kids.
I have had a lot really hard conversations with kids that we're struggling, so I very
much understand where you're coming from.
You made a comment that really kind of got me.
You said the ultimate goal here is to get parents involved, but this bill does exactly
the opposite.
reality because as parents we do have ultimate control and say over our children's lives
until they are no longer a minor.
And then I kind of follow up question, I'll just throw out at the same time.
So you mentioned that there were several other states that had these opportunities for minors
to seek care without parental guidance.
we can perhaps change the course of suicide rates.
Is there evidence to support that?
Madam Chair,
I'm gonna be just wonky.
First of all, you're asking for evidence
that prevention worked and that's impossible.
It's like saying we've saved money
by vaccinating against measles.
Well, I guess if we stop vaccinating measles, we'll find out, won't we?
So have we prevented suicides? That would be an interesting question for some clinicians.
I believe they would identify the positive outcomes. I can't enumerate that.
I cannot put that into numbers.
When a child is having these kinds of issues at school
or personally, anxiety, depression, anger issues,
these are playing out in the family situation
also, not just at the school.
And I have hope, I don't have proof of this,
but as the child, the student,
the young person, is...
Given the tools to control their anger, to deal with the anxiety, that will be, I believe, evident to the people around them.
We have reports from teachers in classrooms where these services are available that this has made a huge difference in the classrooms as the student is getting services during the school day that the classroom conduct is completely different.
They're doing so much better.
How are you doing so well?
I think we will actually reach parents
with the positive evidence in their children.
I have no proof of that.
We have proof it in schools
for the students that do get services.
Quick follow up.
Follow up?
I've no doubt that there are individual students
and individual young people that will say yes,
this is very helpful and it had helped them.
That I don't doubt.
My concern comes in when a parent finds out,
when the parent understands that this is happening,
especially in a school setting.
If there's billing that happens,
if a Medicaid charge is forwarded on behalf of a student
and it comes back to the parents.
I have to agree with Representative Prox.
This is going to absolutely result in more students being
pulled out of our public schools if this happens
within the school unless there are some sort of caveats
some sorts of opt out opportunities for parents.
So I just I really have a concern with that and I would.
To me if the ultimate goal is to get parents involved
then the minute that a school hears or understands
issues, they contact the parent every time and in my experience in local school districts
that I've been involved with, that is the case.
So I just, I'm going to wrestle with this bill significantly, but I do appreciate you
bringing it and trying to make an attempt to help our young people because we do have
Thank you. Thank You. I'm going to make a
quick comment before we go turn to the invited testimony.
I had the opportunity to be a part of the National Conference of State
Legislatures Youth Homelessness Fellowship
and learning about what other states have been doing to really address this issue
program, I was able to see different organizations in other states and also talk with a lot of our
partners on the ground in Anchorage, in the Matsu, and ask, what are low-hanging fruit that we can
do in The Legislature to be able help youth experiencing homelessness and the minor mental
health age of consent was one of the biggest things that people were talking about and it really is
access to youth behavioral health services, it happens so frequently that it is the situation
of a youth who doesn't have that contact with the parents that wants to seek help and the
folks who are in between are trying the best that they can't to have any sort of response
or engagement from a parent even if they are available and they cant and it's painful
And it's the lack of engagement, no matter what the provider in between can do.
So that really help enlighten how this bill fits in context with our other broader issues,
such as experiencing homelessness.
So just wanted to comment on that.
If we have no other questions or comments at this time, I will now turn to the invited testimony for
Well, before we turn to the Invited Testimony would we like to hear a sectional or committee
members?
Good.
All right.
Well we'll turn the invited testimony for House Bill 232.
First we have Teresa Roble, Policy and Advocacy Program Specialist at the Alaska Children's
Trust.
Good afternoon, committee, can you hear me?
Okay, good afternoon, Chair Mina and committee members.
For the record, I am Teresa Robles, program specialist for Policy and Advocacy at the Alaska Children's Trust.
Today I'm touched by in support of House Bill 232, which would allow 15 and 17-year-olds the ability to provide self-consent to receive up to five behavioral health treatment sessions.
At the Alaskan Children Trust, we believe in a future where Alaska's children, youth and families have the knowledge, skills, supports and resources they need to thrive.
Achieving this vision needs ensuring that the next generation of parents,
especially those navigating adversity, have access to timely behavioral health support before
challenges escalate into crisis or harm and ensure they are equipped with the tools and
prospective sectors they need as they enter adulthood and become parents themselves.
According to kids count 2025, two out of every five high school students in Alaska
report clearly persistently sad or hopeless for an extended period during the previous year,
This number has steadily moved upward, increasing almost 50% in the past decade.
Attempted suicide rates among high school students in Alaska have generally increased over the years,
with statewide rates rising from 10.7% to 2007 to 19% into 2023. These numbers highly
House Bill 232 creates a critical pathway for 16 and 17-year-olds to access behavioral
health services and situations where seeking parental consent may be unsafe, unrealistic,
or act as a barrier to care.
Alaska's youth experience a wide range of family circumstances, including exposure to
trauma, substance abuse, domestic violence, neglect, or housing instability.
This bill carefully balances the course of parental involvement and treatment,
while also recognizing that limited short-term access to care could be life-saving for some use.
Importantly, House Bill 232 is intentionally limited in scope.
It does not allow for the prescription medication,
nor does it remove parents from the broader behavioral health system.
It Does provide a narrow preventative opportunity for early intervention,
and of course, it aligns with best practices in public health and mental health services.
From a prevention standpoint, this bill is especially important.
Research consistently shows that unaddressed mental health needs during adolescence increase
the risk of substance abuse, unsafe coping behavior, family conflict, and future involvement
assistance designed to respond after harm has occurred. By allowing youth to access
grief of behavioral health support earlier, hospital 232 helps reduce the likelihood
that challenges escalate into situations that result with abuse and neglect or system involvement.
This bill ensures they have the tools they need to thrive, which greatly reduces their risk of entering a child welfare system.
The option for youth to consent to behavioral health treatment is a policy to its implemented states across the country.
Research demonstrates that allowing youth self consent for behavioral
health services can support youth engagement and treatment and empower youth
to make informed decisions leading to more effective care.
High School 232 reflects a balanced and pro-separated head prevention, early intervention, and youth wellbeing while respecting the role of parents.
By expanding access to behavioral health services, this bill strengthens Alaska's commitment to
primary prevention and support healthier outcomes for our youth as they transition into adulthood.
We encourage your support of House Bill 232.
Thank you so much for the opportunity to testify today.
Thank You Miss Mobile for your testimony.
Our next testifier is Lance Johnson, COO at Alaska Behavioral Health Association.
We can hear you.
Great.
Great, thank you, Chair Mina, representative Gray, members of House HATS, for the record
my name is Lance Johnson.
I'm the COO for The Alaska Behavioral Health Association, a trade organization for over
a 115 community behavioral health providers in St. Coleses, New States.
I am offering my support for HB 232 and appreciate this companion building put forward by Representative
Gray.
I've got a whole script here, but I'm at the risk of going off tangent.
I want to respond to a couple of things that I heard if I may, just color in the lines a little bit.
We've heard a lot of some stats and everything else.
I just want remind everybody in a committee that, as Senator Giesle pointed out,
this is not just about school access for care.
youth who want to go to their community behavior health clinics and maybe primary care where
the referrals can be sent over to community behavioral health.
So we need to think about multiple access points that youth can have and the more access
points we have available, the accessibility there will be for these youth.
give you several different stats, and I just want to point out one national one,
I'll skip the one that I have here, but between 2020 and June 2024, the age category presenting
at a Laskan emergency room for suicide attempt related needs were 11 to 14 year olds and 15
to 19 year old for 1000 ER business. That's the highest statistical category of any group.
For many years, and for 12 years I worked in rural Alaska with the Abraham Health Services
Director.
And locally, we just encountered so many heartbreaking situations.
In one year we had a 9-year-old, an 11- year- old, in a 12-years-olds commit suicide, not
a term, but complete suicide.
In that same span, I had 16- years-Old Beach Avenue personally looking for services,
but unfortunately, as best efforts, so we could not obtain parental consent to proceed.
We looked at other resources and a possible parent negligence complained with OCS but the youth attempted suicide in that time.
Upon turning 18, she was able to enroll in services on her own and now continues to thrive.
But the cost of waiting almost cost her her life.
and that's very true. That's true for adults as well. Just not wanting to seek services
because of the perceived stigma out there. But I've heard a lot about the reasons why
parents may not cooperate and it could be their own experiences with behavioral health services
that weren't positive. It could just be that they're just negligent in finding consent forms
may be seeking those services because of the trauma that their parents or guardians have caused them.
So to involve them and get consent from them is almost impossible
because those families are going to be very protective of what's happening inside the house or in the community or wherever it may
be. So I don't want to just focus on the fact that we should have parents always involved.
Sometimes it's not clinically sound because they're involved in their children's needs.
So I also heard here that, you know, payment is an issue, certainly, and I appreciate that being brought up.
This is why it's really important that there are community behavior health grants because you're absolutely right.
There will be proven services given because of the field that we're in and knowing that
we have to provide services to these youth.
But that can be expensive for agencies, too.
They can only do that so much, especially these smaller agencies.
So these grants are really important.
That can help cover those services.
The asking about evidence as well about, you know,
how do we know these are having positive outcome.
I can tell you, and I cannot quote the data.
I am happy to provide it.
And once I do, in Minnesota, where they offer 12 services,
before you involve family.
You can do it before that, of course,
as Sarah gave a point of doubt.
But they offer up the 12 services first in Minnesota.
Those numbers of youth suicide have gone down
as a result of that access being given.
This is also true in New Mexico as well.
So I can pull current data and submit that
when I have a moment if you're interested in that.
But HB 232, it enhances AF-25.0, 20.025.
And a lot of great work has been put into the language of this bill.
I'd like that it has five services there.
We're not pioneers in this area, as I said.
So I would be willing to support even more services.
And again, using sound clinical judgment,
putting the faith in clinicians to enchanters,
to involve the family where it is feasible, where
it's to the betterment of the youth.
involved, but also to make those clinical decisions where it would be a detriment sort of as such
as that trauma that I bought up that they may be causing. I have two suggestions that
I think would make this bill a little bit stronger. In AAC 160.990, this is a definition connection,
behavior health services, which is put in this Bill in the language quite a bit. It's defined
and behavior health rehabilitation services.
At the big scope, it includes a lot of services, which is great.
And we know that this bill would not include in that prescription or medication that could be used in this intervention.
But that definition excludes the majority of substance use services and I don't want to overlook this.
In the most recent YRBS, 22% use alcohol regularly in schools, 13.1, we've been drinking, 21.5
or using marijuana.
And the substances are often a catalyst for a youth to self-harm, to attempt suicide.
Sometimes they're using it as numbing agents.
it's important to be able to have access to those types of counseling services as well,
because there's often co-occurring disorders, right? So I would suggest in line 29-31,
page two, under A, to read a minor who is 16 years of age or older may give consent to receive
outpatient behavioral health or mental health services under the state plan and 11-15 labor
Almost all of the substance use services are under the 11-15 labor now, so I would not
want to exclude that because it's an important part of treatment where it is applicable.
I'd also suggest that in line 29-231, but throughout the bill, I recommend changing
instances of mental health provider.
I suggest using mental help and or substance abuse disorder provider because I really encourage
and we know through our data that, and I can speak from my experience locally in rural Alaska,
that a high percentage of the cases, I won't give you a false number because I don't remember
off the top of my head right now, but I know it's a higher percentage
of cases where there is an attempted suicide, substances are on board. So again,
I think it is really important to broaden who can provide those services.
And I'm with Representative Fields.
I would be very supportive of even lowering that again,
not to the detriment of this bill being passed.
But 14 years of age is very realistic.
Youth today are exposed to so much more at a younger age.
And, I have had to turn away 14 year old so many times
who have come to want services.
And i can't do it because I can get parental permission
Again, negligence on the parent part or they're just not in the lines of these
use. So I, you know, emphasize, I think this
robo said this as well, that,
you, know this bill is not seeking to remove parents and guardians from
consenting the services. Outcomes for youth are much better when the
family is involved, for sure. But this is a bill to address youth
consent when families choose not to participate.
So, i encourage you to please support this, Bill. We can't
have the status quo any longer we need to get these youth in the services much sooner especially
when they want them and then they can't get the support at home. So thank you for your ongoing
commitment to the last year's and all your hard work. I truly appreciate it. Thank you.
Thank You. Mr. Johnson looks like we have a question from Representative Fields.
Thank, you ma'am chair. And I mean, I guess I would be interested in Mr Johnson's take,
So the structure of this bill adds behavioral,
mental health, comma following medical.
We could also make the case that behavioral and mental
health services are part of medical services
and maybe the bill sponsors or Dr. Johnson want to address
what's the best way systematically
to a dress behavioral mental, health and statute.
Because I'm sure that the term medical applies elsewhere.
Do we want be adding behavioral
and middle health throughout statute
to define medical care throughout statute to include behavioral health is just a
structural question but I don't want to expand it here and then you know in some other area of
statute have ambiguity about whether behavioral Health Services are covered because we added
behavioral here but not elsewhere thank you. Thank you Representative Fields. Mr. Johnson do you
I do and this is part of my script that I left out as well.
I think I have a whole thing to hear about that section of regulation that it does include medical.
The definition of medical is not well defined in regulation.
I would argue that medical should include behavioral health and substance use services as
well, so it could be a tweak of that language, particularly because it's not in definition.
Yes, follow-up. I guess the follow up for the bill sponsors and maybe legislative legal would be is there a way
We can put in this bill clarifying that
Throughout statute is our intent that medical care includes behavioral and mental health services
Is there way to do that in the in-this bill and just be done with it? Thank you
Thank You
You know what actually
kind of a time check. There's still a couple more test fires.
I do, at this point, have a question for Mr. Johnson, but I don't want to
run out of time before the other test fire. So we're doing good. You can go
ahead. We're good doing, good, okay.
So Mr Johnson
you, you talked about lack of
access and right, I'm trying to figure out what we have right now.
couple in the Fairbanks area. If a child goes to a youth shelter, then these services
would be available. Is my understanding today? Is that correct or can you help me with that?
Sure, it's a good chair. It depends on what you're considering shelters.
They may or may not have those services, but they do have people who would throw out their
services where they're unavailable.
So I would say, again, it's another access point for either on-site treatment or for
referral to those who can provide that.
And I'll follow it.
Yeah.
You know, if parents don't get involved or refuse to get
involved, that's kind of an indication of child abuse,
or it could be.
My reading of the mandatory reporting requirements
would lead me to conclude that if a parent is asked,
doesn't consent,
that is a reportable event.
that the mandatory reporter would be held liable
if they didn't report that event.
Can you tell me how that works a little better?
Sure, through the chair, excuse me.
We have reported the OCS,
providers have recorded the OCS when there is a non-response
or a not, particularly let's say that
you've tried all your best.
the current statute, there is the ability to seek out those parents and ask them to please
get counsel.
Here's what's going on with the youth.
If that's appropriate, the thing is, is that the parents are willfully being negligent
if they, even if their agreed to it and aren't bringing their youth and making them accessible
for treatment, those are reportable for sure.
to see how that would play into the treatment of the youth.
But, and I said in here earlier that 16-year-old that came to me
and ultimately attempted suicide that we were working with OCS
to present a negligent case on those parents.
So, I guess the short answer is yes, that is a tool,
but it's a lesser tool that will be needed.
beef youth can access services first without having to go through parents who
again may be the source of trauma.
Follow up? Yeah follow up. Thank you through the chair. I guess I want to
press that a little more. You you're a clinician.
You probably have a license or something like that
for your job. If I was a hockey coach
I would think that if I was confronted with that situation,
I wouldn't impose any clinical evaluation on that.
I'd be required to report that to OCS.
How does that differ in your situation?
Through the chair, not everything is recordable.
Again, it has apparently been attempted to be contacted.
Where does negligence come in as far as when you have,
what's taken you to is, has recorded suicidal ideation.
Reaching after the parents, the parent's don't respond.
They do multiple attempts. That could be a reportable offense.
And you go ahead and call it as they would screen it out.
They would determine whether or not it's negligence and to move further
through supervision of the youth or removal of youth from the home.
Only because the parents could have been out of town.
The parents, for whatever reason, couldn't be accessed right away.
So you have to do your due diligence before you take that step.
Okay, thank you.
Representative Gray.
Thank you, Madam Chair.
I was going to reply to Representative Field's question about the addition of the words behavioral
and mental health afterwards medical in the bill.
As a medical provider, I absolutely provide mental health care all the time.
Mental health is part of medical care.
But in this case, we are giving consent to a 16 and 17 year old to consent only to mental and behavioral health.
So if we didn't have it here, it'd be consenting to medical and that's not the point of the bill.
And the difference is, is that although my license allows me to provide
We don't need somebody who also does medical care, we just need someone who does mental health care.
So it's really allowing for this bill to be very specific about the type of care that we're providing.
It's not about changing the definition of medical
care it is about just basically specifying out two aspects of
medical so we can just allow this very narrow consent to happen.
Thank you.
Representative Schwonke and then Representative Meers.
Thank You through the chair.
Mr. Johnson, I have kind of a side question.
Could you describe what the different service looks like
when say a youth calls the suicide hotline
versus maybe walking into your office, your facility?
When they call the care line or 988, they will sometimes be able to be handled by the professionals
who are on that line, and maybe it's something that they're just feeling down, but they are
not suicidal.
These are trained professionals on the Care Line to make those determinations.
Often though, if they feel there is something more to this, then they'll do referrals out.
to agencies in that person's local community, where they exist.
If they don't, in most even rural communities, they have access points for sure.
And, of course, on this world today with telehealth, it can provide even more access.
So it's a two-step procedure.
It may be able to be handled competently and appropriately through the Caroline professionals,
but when more service is needed or they determine that,
Would you like to receive services and the youth says, yes, they can refer that youth
to their local communities, be it their health clinic or whatever made this there.
Thank you.
Representative Mears.
Thank You through the chair.
I'll get to a question at the end, but I've got a little journey stitching some things together.
So one of my desired goals from serving on this committee is to be able to.
do what we can to address things upstream.
My Thursdays and Tuesdays are interesting
because we start with community and regional affairs
where we talk about Department of Public Safety
and the Department Of Corrections
and we've had, you know, DOC folks in here.
Our Department OF Corrections
is the largest provider of mental health services
in the state.
Folks that are incarcerated very often,
substance issues involved with how they ended up there.
We discussed earlier today how the sooner we can provide care,
the better we are.
Mr. Johnson talked about youth turning to substances for
numbing, but really I believe it's
self-medication and self medication leading to substance misuse.
The sooner that we can provide services and get ahead of things it's not just dollars cost
but it costs to our community. So having a proposal like this it seems like we're getting a little
the further upstream we can go the happier I am I think that's where our
responsibility lies. So Mr. Johnson I guess on the question and you know if
you could expand a little bit on if I'm on
the right track with youth seeking numbing if that has connection to self
Yes, through the chair, absolutely.
Definitely could be self-medication and using different substances, for sure.
That can lead to, as we know, decisions that they might not normally make
if they are sober or not using their clear-headed, let's say.
And so that's why I'm really trying to impress on the committee for this bill
that we should not exclude substance use.
services here because those prevention services and those treatment services
could really make the difference in helping that youth get through the
mental concerns that they have. So that's why we should ignore that.
Thank you.
Madam Chair if I may. Mr. Johnson.
I just want to point out to you in the statute in 25.20.025
That in Section 8.4, a minor can give consent for diagnosis, prevention, or treatment of pregnancy
and for diagnosis and treatment at venereal disease.
That's a big deal.
They can get their own consent to that.
To me, that just means they really should be able to get consent
for their mental health needs as well.
So I just want to point out there is some exceptions to consent.
Already in that statute and I really believe that there should be for these behavior health services
Thank you, mr. Johnson saying no other questions we do have two more testifiers for hospital 232, so I'd like to get through those testifier
Next we have Heather Ireland executive director for the Anchorage school-based health centers as Ireland
Chair Mina and House and Health and Social Services Committee members, my name is Heather
Ireland.
For over 10 years, I've served as Executive Director of Anchor's School-Based Health
Centers, a Division of Christian Health Associates, listening to committee questions.
My testimony is grown, but I'll try to be quick.
Thank you for the opportunity to comment on the importance of House Bill 232.
If you want to make a difference in adolescent mental health, you will pass this bill.
allowing 16 and 17 year olds to access behavioral health services, even for a limited number
of sessions, has the potential to make a huge difference in their lives. We're grateful for
the volunteer services that Senator Diesel has provided. She spoke eloquently and comprehensively
about the need for this bill. Anchorage School-based Health Centers is a nonprofit
separate from the Anchorage school district operating medical clinics in high schools and
middle schools. And the care that we provide is for those that cannot access it in the community.
Parental consent is required for students
to receive medical care from advanced nurse practitioners
and doctors in our clinic.
Ingrid School-Based Health Centers
has served thousands of students since the inception in 2010.
Similar to providers in the community,
our medical providers screen for many types of risks.
And we have seen increasing numbers of student
who exhibit symptoms of depression, anxiety,
and other behavioral health challenges.
Also, we see students for acute care,
present with medical issues like belly pain or insomnia but it's really more of a psychological
than physical issue. Schools often occur, schools often concur with our initial assessment that
youth are struggling and more often than not, students are willing to pursue behavioral health
treatment. Probably 75% of the students that have concerns are going to get treatment, 25%
for clinic providers to even consider approaching their parents.
Of the parents who are approached, parental consent is a huge barrier for the youth
to access the care they desperately need and want, unfortunately.
Frequently youth are hesitant to ask their parent for treatment.
My observation has been that the adults are reluctant to give permission
because the stigma associated with mental illness,
which the younger generation has moved past.
It can also be logistically challenging for adults to give consent, especially in school
setting where families are not present.
And finally, some adults don't want their students discussing their personal life with
a healthcare professional, despite how desperately they need the treatment.
I only have data on students seen in the clinic and referred to District Keeps Track of all
the school-based providers and the numbers of referred students who enroll.
I will try to get that data from them for the future.
Through my networking with school-based health programs
in other states, I learned that Colorado lowered
the age of consent from 16 to 12.
It was like a lightning bolt.
This is a way that we can actually help kids.
Sadly, after many years, Alaska has done nothing
to change the situation.
A higher age in consent for mental health treatment
is correlated with a higher suicide rate.
When you look at the rankings of suicide rates
of the three states with the
Lowest rates of suicide, the age of consent is 16 or lower.
Of the state with the highest suicide rates, including Alaska,
the aging consent, is 18.
Obviously, there are many factors that influence the suicide rate in Alaska.
But by allowing 16 and 17-year-olds to consent for their own care,
it would only be one tool to help youth.
Youth can connect with a clinician who can assess their safety
and broach the possibility of involving the parent in their treatment.
Early access to care prevents issues from developing into crisis and needing hospitalization
are worse.
In 2018, a study in Minnesota showed that a school-based mental health program reduced
self-reported suicide by 15%.
This is just one example of how increasing access for care can make a difference.
Early intervention not only helps youth and families, but it also saves money and saves
The limited number of sessions stipulated in the bill allows for the clinician to coach
the students how to talk to their parents about the value of the services provided.
Ideally, the parents' consent to continued care.
The current limited access to care makes it impossible even to help the student navigate
this conversation with their parent.
Some people might have criticisms with this bill.
Of course, parents would like to know everything that their child does, but that is not a reality
for some families.
prohibiting access to mental health treatment may enable further abuse.
In cases where abuse is not a concern, mental
health providers would explore with students their reluctance to letting parents know about
mental-health needs and give them tools to communicate. This bill does not force providers
to see youth for free in the community. There are grants that support both school-based care
Plus, as Senator D so mentioned, program bono care is an option for clinicians or providers in an or or provider organization.
Like representative near said, adults outside the family can be a tremendous support for use.
As a parent, I would much rather my daughters access care without my knowledge than suffer the consequences of untreated mental health issues, including suicide.
Please pass house bill 232. Please help you to our struggling. Thank you.
Thank You Miss Ireland
Representative Prox. Thank you miss Ireland through the chair
If you encounter a parent that is reluctant to give permission for their child to get
mental health services
At what point do you report that to OCC?
O CC
office of child services? I guess I would say that's on a case-by-case basis.
You know, obviously, if it's students who is eminently contemplating self-harm, that would
You know, anxiety of social, you know if they're socially not comfortable at school, for example, or they are depressed and not engaged in their learning or something.
And I think, first of all, the clinic, a lot of the services that we provide are often.
We do a lot of physical so that kids can participate in sports, and so, that alone is sort of self-selecting of these are higher functioning kids that want to be involved in things in school.
Like, we're not necessarily seeing some of those kids who are very depressed and not engaged in their learning,
and those are often times kids, who aren't even at school as much because it's hard for them to get there.
So, sorry, I'm not totally able to answer your question.
I think like school counselors would have a better handle on that of how quickly they
report things to OCS if a parent is not addressing a mental health need for a student.
But I would say it's pretty rare for the kids that we see, but it would be a self-harm related
issue.
Saying no other questions from Ms. Ireland. Thank you for your testimony. Our last testifier today is
Bella Gunther Chavez a student at South Anchorage High School
Good afternoon, can everyone hear me? Yes, we can hear you great
Perfect, thank you. Good Afternoon, Madam Chair and respected committee members. My name is Bela Gunder Chavez
I'm a senior at south Anchorage high school
Today I'm calling in to voice student support on House Bill 232 to ensure early intervention
and access to essential mental health support services for Alaska youth.
At my high school, we only currently have school counselors whose jobs are to help
students with their school schedules. They have very basic training and therapy,
yet students come to their counselors seeking help with anxiety, depression,
and navigating mental-health challenges. Many students show up to the counselor's office
I've literally seen this. I have been waiting outside the door like, oh, I need help in
my school schedule and they're talking someone out of the community suicide.
These school counselors help students by referring them to train mental health professionals
to assist students in need. To do this, counselors have to reach out to the parents
of students. However, a lot of parents drop the ball
on following up or they'll want to get consent for students to receive mental
health support, even if the students requested it themselves.
This may be due to students' problems stemming from their home lives, parents brushing off
their children's feelings, or parents not believing in mental health.
Last year, I had a friend who seemed perfectly fine.
She was socially engaged and involved in school and extracurriculars.
However, she was secretly struggling with her mental help and no one knew.
Tragically, She attempted to take her life.
Thankfully,
she is still with us today.
Shortly after attempt, doctors diagnosed her with major depressive disorder, a neurological brain disorder that impacted her mood, changing the status of her mental health.
If teens ever notice a change in their mental state, like experiencing feelings of despair or cause and sadness, they should share these concerns with their parents.
This bill would empower students to advocate for themselves and their health needs because,
at the end of the day, only the person struggling knows what they're feeling or experiencing.
Teens can be their best advocates if we let them. This legislation would do that if passed.
And service early intervention allowing teens to gain access to medical professionals who can
assist their needs and equip them with coping skills needed to handle life challenges,
During my high school journey, I have witnessed the rise of youth mental health needs,
and I've lost friends in classmates and suicide. I am heartbroken that these individuals felt like
there was no hope. i'm about to honor them by finding ways to support mental-health initiatives.
Reflecting upon my Christian faith, i know that expanding access to mental
health services is not just about providing care. It is an essential part of protecting each
has the ability to save lives and allow teams to seek help in a timely matter free from judgment.
Thank you for your time and I hope you pass this bill.
Thank You Representative Gray.
Thank, you through the chair to Bella. Thank
you so much for taking the time to provide your testimony today. You did a great job.
Before we close on discussion on hospital 232,
I wanted to see if Ms. Brown, if you wanted
to come up and do that section all that we didn't do earlier.
Yes, thank you, Madam Chair.
I think it would be just to be clear,
we should read the whole sectional.
Thank you.
For the record, Paige Brown, staff to Senator Kathy Keasel, section one amends the examination
and treatment of minors statute and it adds youth who provide documentation demonstrating
that they are an unaccompanied homeless minor to the list of minor who can consent to medical
treatment.
This section would also add behavioral health and mental health to the list of services
in unaccompanied minor, a minor living apart from their parents or legal guardian and a
minor who is the parent of a child are able to consent to.
Section two adds new subsections to
the examination and treatment of minors statute relating to documentation required
by homeless unaccompanied minors for the purposes of giving consent.
It requires that the documentation must state that
the minor is 16 years of age or older.
Does not have a fixed regular adequate nighttime residence and
is not in the care and physical custody of a parent or guardian.
The document must also be signed by a director, a designee of director
of governmental or non-profit entity that receives funds to provide assistance to those who are homeless.
A local educational.
agency liaison for homeless youth, a local educational agency, foster care point of
contact, or a licensed clinical social worker employed by a school in the state,
an attorney that represents the minor or the
minor in two adults with actual knowledge of the minors situation.
Section 3 adds a new section to the parent and child statutes that would give a minor
age 16 years or older the ability to consent to receive 5, 90-minute sessions of outpatient
behavioral health or mental health appointments without obtaining the consent of the minors
parent or guardian.
A mental-health provider may not prescribe medication without consent for the parents
or guardians.
attempting to get consent from the minor's parent or guardian would be detrimental to the
minor as well-being. By the behavioral or mental health services are related to allegations of
neglect, sexual abuse, or physical abuse by the minors parent, guardian,
or that the provider finds that requiring the consent of the
minor parent to guardian cause the miner to reject services, failing to provide services
knowingly and willingly, and the minor has the maturity to
productively participate in services, as well as the
provider determines that contacting the parent or
guardian would not be detrimental to the minors' well
being. The provider has informed the
minor that parental consent is required to continue services.
The provideer has made at least two unsuccessful attempts to
contact the miner's parent regarding by email,
by mail, email phone, um,
and The Mental Health Provider has written consent of the
If a provider continues treatment due to the belief that obtaining consent from the
minor's parent or guardian would be detrimental to
the minor as well-being, the mental or behavioral health provider may
continue services with documentation of the determination
in the patient's clinical record, written consent
from minor and evaluations every 60 days about if the
minor is well being is continually in question
until either the provider discontinues services or the
If a mental health provider has decided to continue services due to the relief that obtaining the parent or guardian's consent would be detrimental to
the minor's well-being, they may not contact the minors' parent
or Guardian without written consent from the Minor.
A provider may now disclose the information to a parent
or a Guardian of the Miner if the miner chooses to
continue service after being informed that they must obtain parental consent after five sessions.
A provider may deny a minor's parent or guardian access to any part of the minor clinical record if the provider has compelling reasons to deny the parent
or Guardian access.
A parent of guardian is relieved of any financial obligation to pay for services consented to buy this new section.
Nothing in this news section can be taken as an excuse to remove liability of
the person performing the examination or treatment for failure to meet typical standards of care in the state.
Section 4 amends the legal custody, guardianship,
and residual parental rights and responsibilities,
and adds the new section from section 3
to the list of exceptions
of a parent's residual rights
and responsibility section 5 aments the same statute
with the information, and then section 6 is the effective date
for January 1st, 2026.
Do we have any further questions or discussions on hospital 232 from the committee?
Seeing none.
Thank you, Ms. Brown, and for Senator Giso and also Representative Gray for bringing this
bill forward and presenting it to the committee.
At this time, I'm setting House Bill 232 aside for a future hearing.
Looking forward to next week, there will be no meetings of the standing committee, but
I will see you all here for our first Finance Subcommittee meeting on Tuesday, January 27th.
The time is 4.59 p.m., and this hearing of The House Health and Social Services Committee