Lawmakers debate time used to transport patients to crisis stabilization centers

Alaska lawmakers discussed concerns about the amount of time patients spend at crisis stabilization centers during a Senate Health & Social Services Committee meeting on Tuesday.

 

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Committee members discussed a proposed amendment to Senate Bill 124, which would establish various definitions for mental health facility measures. Sen. Lora Reinbold (R-Eagle River) proposed amending the bill to include any time used to transport patients to centers. The bill does not currently include transportation time in its 72-hour evaluation period that is necessary for patients. Without including transportation time, patients could end up spending more than 72 hours waiting to be evaluated.

“It’s a lot of time for the patient to be in an unknown situation,” Reinbold said. “The amendment includes transportation time. It [adds] the time it takes to get the patient to the facility.”

However, Sen. Tom Begich (D-Anchorage) said he was concerned that adding transportation time could reduce the amount of time patients spend at centers.

“This changes the standards,” Begich said. “It could limit the service to the patient. By throwing in the transportation time, you may be providing no clinical facetime for the patient. I think you want to have that interaction; that’s when the assessment is done.”

Alaska Department of Health and Social Services Health Care Policy Advisor Heather Carpenter said there are times when the department has to coordinate for a patient’s transport from a rural location or someplace off the road system, which can add more time to the process. She discussed a recent case in the southeast part of the state, where a designated evaluation and treatment center was not available.

“It took us over 24 hours to get transportation,” Carpenter said. “It really does go back to having the maximum amount of time [for] clinical assessment for the 72 hours.”

Sen. Shelley Hughes (R-Palmer) said transportation through inclement weather conditions can add time to the process as well.

“Having lived in rural Alaska, having been stuck due to weather, I appreciate that,” Hughes said.  “I am uncomfortable with allowing some residents of our state to be held for longer than 72 hours.”

Hughes said utilizing telehealth services could help provide a resolution to the issue. 

“With telehealth, I think you could begin the services,” Hughes said. “It’s not like being at the center, but it could still begin, so we [don’t] put our rural residents in an unfair situation of having to wait extra days.”

Sen. David Wilson (R-Wasilla) said there can be billing issues associated with telehealth services, however, although upcoming legislation could help with that issue.

“We have a piece of legislation in this committee that [aims] to fix that situation with some of the payment issues,” Wilson said. “Without having payment, a lot of providers won’t offer those services for the benefit of the community without being able to be reimbursed for them, is what our office has heard.”

Carpenter said the availability of telehealth services will depend upon which facility the patient is ordered to be taken to. 

“Not all of these patients are going to be transported just to [Alaska Psychiatric Institute],” Carpenter said. “We are going to use three hospitals that are designated evaluation treatment centers, which are Fairbanks Memorial, Mat-Su Regional, and Bartlett Regional Hospital. It will depend on if each of those have telehealth capabilities set up, and are willing to start doing that. I would have to reach out to each of the hospitals to communicate with them.”

The proposed amendment to Senate Bill 124 failed on a 4-1 vote.