Safer Alaska, Building Resilient Communities

Improving Access to Mental Health and Substance Abuse Treatment

medics work on patient at the airportRecognizing and addressing mental health and substance abuse problems will be a critical component of improving public safety in Alaska. An essential first step to improving access to treatment will be working to increase the number of beds at treatment facilities in Alaska. To that end, DHSS plans to reach out to hospitals to advocate for more designated evaluation and treatment beds. Longer-term, state agencies will evaluate options for how the Palmer Correctional Center might be used for a mental health or substance abuse evaluation and treatment facility, pursue an exemption from federal regulations that limit the number of beds a provider can operate for residential substance abuse disorder treatments, and look into the possibility of releasing some patients subject to around-the-clock monitoring.
 
43. Continue interagency coordination to
allocate reinvestment funding.
IN PROGRESS: Collaboration among DPS, DHSS, DOC, and LAW on reinvestment funding and recidivism reduction efforts is occurring in the
Integration Workgroup.
44. Continue and expand crisis intervention training for law enforcement. IN PROGRESS: Next training is scheduled for Oct.
2018 in Mat-Su Valley.
45. Propose ongoing stakeholder meetings to discuss the civil commitment process and options for improving the state psychiatric emergency system. (DHSS, LAW) IN PROGRESS: DHSS is coordinating ongoing meetings with on-the-ground staff from DHSS, LAW, court system, PDs, OPA, and eventually to
include representative from hospitals.
46. Approach hospitals about opening more designated evaluation and treatment beds
to increase capacity and improve
availability of acute care mental health
treatment and evaluation beds at Alaska Psychiatric Institute (API). (DHSS)
ONGOING: In Nov. 2017, DHSS approved the
Certificates of Need for two projects to move
forward: Mat-Su Regional will build a new, 36-
bed behavioral health unit; Alaska Regional is
planning to convert 24 existing medical beds into
an adult inpatient psychiatric unit. Both hospitals would accept individuals subject to court
ordered hospitalization for evaluation and treatment.
47. Legislation to authorize court orders
requiring DOC to hold people who are
intoxicated when they are arrested until they are sober.
COMPLETED: Addressed in SB 54, bail schedule changed.
48. Evaluate current use of Title 47 safety net for individuals incapacitated due to substance abuse until a better long-term solution is found. IN PROGRESS: 
LAW evaluated the current use of Title 47 holds; DOC considering policy revisions.
49. Evaluate ways to increase availability of
treatment resources for outpatient services.
ONGOING:
•DHSS submitted an 1115 Behavioral Health Medicaid Waiver application on Jan. 31, 2018. If the waiver is approved, DHSS expects that a new array of local adult outpatient and acute care behavioral health services for children and adults to become available in 2019;

• $18 million for expanding substance use disorder services over 3 years was included in the Governor’s budget request, the Legislature funded $12 million of this request;

•DOC continues to assist offenders who are in their last 30 days before release to complete Medicaid applications for submission upon release.
50. Evaluate how to incentivize treatment on
demand so it is available when needed.
IN PROGRESS: Also, see #46 and #52 regarding increasing available treatment capacity at
facilities. Agencies also engaging with stakeholders in ACJC to develop solutions.
51. Evaluate the ability to establish a restorative
justice facility, such as a mental health and substance abuse evaluation and treatment facility.
IN PROGRESS: DHSS determined that the Palmer Correctional Facility is not suitable for their needs at this time; DOC is working with the
Governor’s office to study potential uses of that facility and opportunities for inmate training programs. At the request of DHSS, the Legislature approved funding for a feasibility study to explore the value of establishing a forensic hospital in Alaska.
52. Pursue an exemption from the federal institute for mental disease (IMD) rule limiting how many beds a provider can operate for residential substance abuse
disorder treatment. (DHSS)
IN PROGRESS: DHSS including request in 1115 Waiver application (to be submitted in Jan. 2018).
53. Increase and improve services for children who need institutional care, including increasing the number of beds at treatment facilities like API. (DHSS) IN PROGRESS: Pursued through the 1115 Behavioral Health Medicaid Waiver. If approved, implementation of new targeted children’s treatment services to begin in 2019.
54. Develop a standardized system for evaluating and treating non-restorable patients and explore possibility of
releasing some patients subject to around-the-clock monitoring to reduce costs and open rooms for other patients at API. (DHSS)
IN PROGRESS: DHSS is studying options, with a focus on the forensic feasibility study to explore the value of a forensic hospital for Alaska,
including providing treatment for persons found non-restorable. The Legislature provided funding for this study.
55. Develop long-term strategy for Title 47
holds.
IN PROGRESS: ACJC discussing long-term options.
56. Evaluate possible legislative or
administrative options to ensure timely
competency hearings. (LAW)
IN PROGRESS: Work group coordinated by the court system is evaluating Title 12 issues, including cases involving potential “not guilty but mentally ill” verdicts.
57. Establish a clear system for persons who have been civilly committed for involuntary inpatient psychiatric treatment to give up their guns before returning home. (DHSS, DPS) IN PROGRESS: LAW and DPS formulating a
policy.

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Email Safer.alaska@alaska.gov