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SENATE CS FOR HOUSE BILL NO. 36(FIN)
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-FOURTH LEGISLATURE - SECOND SESSION
BY THE SENATE FINANCE COMMITTEE
Offered: 5/13/26
Referred: Rules
Sponsor(s): REPRESENTATIVES GRAY, Fields, Burke, Jimmie, Foster, Story, Mina, Eischeid, Bynum,
Galvin, Hannan, Josephson, Stutes, Ruffridge, Schrage, Costello, Mears, Saddler
SENATORS Merrick, Kawasaki, Giessel, Gray-Jackson, Stedman, Dunbar, Claman
A BILL
FOR AN ACT ENTITLED
"An Act relating to treatment foster homes; relating to the placement of foster children 1
in hospitals and residential psychiatric treatment centers for psychiatric care; relating to 2
the duties of the Department of Family and Community Services; relating to the care of 3
children in state custody placed in psychiatric residential treatment facilities outside the 4
state; amending Rule 12.1(b), Alaska Child in Need of Aid Rules of Procedure; and 5
providing for an effective date." 6
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 7
* Section 1. AS 12.62.400(a)(25) is amended to read: 8
(25) licensure, license renewal, certification, or certification renewal 9
by the Department of Family and Community Services of an individual or entity, or 10
payment from the Department of Family and Community Services to an individual or 11
entity, subject to the requirements for a criminal history check under AS 47.05.310 for 12
an entity [A FOSTER HOME, CHILD PLACEMENT AGENCY, AND RUNAWAY 13
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SHELTER] listed in AS 47.32.010(c), including an owner, officer, director, member, 1
partner, employee, volunteer, or contractor of an entity. 2
* Sec. 2. AS 47.07.020(b) is amended to read: 3
(b) In addition to the persons specified in (a) of this section, the following 4
optional groups of persons for whom the state may claim federal financial 5
participation are eligible for medical assistance: 6
(1) persons eligible for but not receiving assistance under any plan of 7
the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act, 8
Supplemental Security Income) or a federal program designated as the successor to the 9
aid to families with dependent children program; 10
(2) persons in a general hospital, skilled nursing facility, or 11
intermediate care facility, who, if they left the facility, would be eligible for assistance 12
under one of the federal programs specified in (1) of this subsection; 13
(3) persons under 21 years of age who are under supervision of the 14
department, for whom maintenance is being paid in whole or in part from public 15
funds, and who are in foster homes, treatment foster homes, or private child-care 16
institutions; in this paragraph, "treatment foster home" has the meaning given in 17
AS 47.32.900; 18
(4) aged, blind, or disabled persons, who, because they do not meet 19
income and resources requirements, do not receive supplemental security income 20
under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not 21
receive a mandatory state supplement, but who are eligible, or would be eligible if 22
they were not in a skilled nursing facility or intermediate care facility to receive an 23
optional state supplementary payment; 24
(5) persons under 21 years of age who are in an institution designated 25
as an intermediate care facility for persons with intellectual and developmental 26
disabilities and who are financially eligible as determined by the standards of the 27
federal program designated as the successor to the aid to families with dependent 28
children program; 29
(6) persons in a medical or intermediate care facility whose income 30
while in the facility does not exceed 300 percent of the supplemental security income 31
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benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) but who 1
would not be eligible for an optional state supplementary payment if they left the 2
hospital or other facility; 3
(7) persons under 21 years of age who are receiving active treatment in 4
a psychiatric hospital and who are financially eligible as determined by the standards 5
of the federal program designated as the successor to the aid to families with 6
dependent children program; 7
(8) persons under 21 years of age and not covered under (a) of this 8
section, who would be eligible for benefits under the federal program designated as 9
the successor to the aid to families with dependent children program, except that they 10
have the care and support of both their natural and adoptive parents; 11
(9) pregnant women not covered under (a) of this section and who 12
meet the income and resource requirements of the federal program designated as the 13
successor to the aid to families with dependent children program; 14
(10) persons under 21 years of age not covered under (a) of this section 15
who the department has determined cannot be placed for adoption without medical 16
assistance because of a special need for medical or rehabilitative care and who the 17
department has determined are hard-to-place children eligible for subsidy under 18
AS 25.23.190 - 25.23.210; 19
(11) persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title 20
XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom 21
a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title 22
XVI, Social Security Act) because they meet all of the following criteria: 23
(A) they are 18 years of age or younger and qualify as disabled 24
individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act); 25
(B) the department has determined that 26
(i) they require a level of care provided in a hospital, 27
nursing facility, or intermediate care facility for persons with 28
intellectual and developmental disabilities; 29
(ii) it is appropriate to provide their care outside of an 30
institution; and 31
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(iii) the estimated amount that would be spent for 1
medical assistance for their individual care outside an institution is not 2
greater than the estimated amount that would otherwise be expended 3
individually for medical assistance within an appropriate institution; 4
(C) if they were in a medical institution, they would be eligible 5
for medical assistance under other provisions of this chapter; and 6
(D) home and community-based services under a waiver 7
approved by the federal government are either not available to them under this 8
chapter or would be inappropriate for them; 9
(12) disabled persons, as described in 42 U.S.C. 10
1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under 11
applicable federal regulations or guidelines, is less than 250 percent of the official 12
poverty line applicable to a family of that size according to the United States 13
Department of Health and Human Services, and who, but for earnings in excess of the 14
limit established under 42 U.S.C. 1396d(q)(2)(B), would be considered to be 15
individuals with respect to whom a supplemental security income is being paid under 16
42 U.S.C. 1381 - 1383c; a person eligible for assistance under this paragraph who is 17
not eligible under another provision of this section shall pay a premium or other cost-18
sharing charges according to a sliding fee scale that is based on income as established 19
by the department in regulations; 20
(13) persons under 19 years of age who are not covered under (a) of 21
this section and whose household income does not exceed 175 percent of the federal 22
poverty line as defined by the United States Department of Health and Human 23
Services and revised under 42 U.S.C. 9902(2); 24
(14) pregnant women who are not covered under (a) of this section and 25
whose household income does not exceed 225 percent of the federal poverty line as 26
defined by the United States Department of Health and Human Services and revised 27
under 42 U.S.C. 9902(2); 28
(15) persons who have been diagnosed with breast or cervical cancer 29
and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII). 30
* Sec. 3. AS 47.10.087 is amended to read: 31
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Sec. 47.10.087. Placement in [SECURE] residential psychiatric treatment 1
center. (a) The court may authorize the department to place a child who is in the 2
custody of the department under AS 47.10.080(c)(1) or (3) or 47.10.142 in a 3
[SECURE] residential psychiatric treatment center if the court finds, based on the 4
testimony of a mental health professional, that 5
(1) the child is gravely disabled or is suffering from mental illness and, 6
as a result, is likely to cause serious harm to the child or to another person; 7
(2) there is no reasonably available, appropriate, and less restrictive 8
alternative for the child's treatment or that less restrictive alternatives have been tried 9
and have failed; and 10
(3) there is reason to believe that the child's mental condition could be 11
improved by the course of treatment or would deteriorate if untreated. 12
(b) A court shall review a placement made under this section at least once 13
every 90 days. The court may authorize the department to continue the placement of 14
the child in a [SECURE] residential psychiatric treatment center if the court finds, 15
based on the testimony of a mental health professional, that the conditions or 16
symptoms that resulted in the initial order have not ameliorated to such an extent that 17
the child's needs can be met in a less restrictive setting and that the child's mental 18
condition could be improved by the course of treatment or would deteriorate if 19
untreated. 20
(c) The department shall transfer a child from a [SECURE] residential 21
psychiatric treatment center to another appropriate placement if the mental health 22
professional responsible for the child's treatment determines that the child would no 23
longer benefit from the course of treatment or that the child's treatment needs could be 24
met in a less restrictive setting. The department shall notify the child, the child's 25
parents or guardian, [AND] the child's guardian ad litem, and any other parties of a 26
determination and transfer made under this subsection. 27
(d) In this section, 28
(1) "likely to cause serious harm" has the meaning given in 29
AS 47.30.915; 30
(2) "residential psychiatric treatment center" has the meaning 31
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given in AS 47.32.900. 1
* Sec. 4. AS 47.10 is amended by adding a new section to read: 2
Sec. 47.10.105. Short-term psychiatric care. (a) The department may seek 3
services for a child who is in the custody of the department under AS 47.10.080(c)(1) 4
or (3) or 47.10.142 at a hospital that is not a residential psychiatric treatment center to 5
receive psychiatric care if the person in charge of admittance to the hospital finds that 6
(1) the child is suffering from a mental illness and, as a result, may 7
cause serious harm to the child or another person; and 8
(2) there is no reasonably available, appropriate, and less restrictive 9
alternative for the child to receive treatment. 10
(b) Within 24 hours after seeking services for a child at a hospital as 11
authorized under (a) of this section, the department shall notify the court, the child, the 12
child's parents or guardians, the child's guardian ad litem, and any other parties to an 13
ongoing child-in-need-of-aid case involving the child of the placement. Providing 14
notification under this subsection does not relieve the department of the duty to 15
promptly look to place the child in a less restrictive setting. The department is not 16
required to provide notice to the court under this subsection if the child is released 17
from the hospital to a less restrictive placement within 23 hours after arriving at the 18
hospital to seek services. 19
(c) A court shall review a placement made under (a) of this section within 20
seven calendar days after the child's placement in a hospital. The court may grant one 21
request to continue the hearing for up to seven calendar days if necessary to secure the 22
attendance of the child, a party, or a material witness. The court may authorize the 23
department to continue the placement of the child in a hospital if the court finds by 24
clear and convincing evidence, based on the testimony of a mental health professional, 25
and taking into account the length of time the child has been in the hospital, that the 26
conditions or symptoms that resulted in the initial placement made under (a) of this 27
section have not ameliorated to the extent that the child's needs can be met in a less 28
restrictive setting, and that the child's mental condition could be improved by the 29
course of treatment or would deteriorate if untreated. If a court does not make the 30
findings required under this subsection, the child shall be released from the hospital 31
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for placement in a less restrictive setting. The court may vacate a hearing scheduled as 1
required under this subsection if either 2
(1) the child is released to a less restrictive setting before the scheduled 3
hearing; or 4
(2) all parties agree that the initial placement under (a) of this section 5
was reasonable and necessary, the parties submit to the court a written stipulation that 6
includes a treatment plan and timeline that will result in releasing the child to a less 7
restrictive setting, and the court finds in writing that the treatment plan and timeline 8
are reasonable and will result in releasing the child to a less restrictive setting. 9
(d) The court shall review a placement approved under (c) of this section 10
(1) at least once every 30 days; and 11
(2) when requested by the child, the child's parent or guardian, the 12
child's guardian ad litem, or any other party, upon a showing of good cause. 13
* Sec. 5. AS 47.10.990(12) is amended to read: 14
(12) "foster care" means care provided by a person or household under 15
a foster home license or treatment foster home license required under AS 47.32; 16
* Sec. 6. AS 47.14.010 is amended to read: 17
Sec. 47.14.010. General powers of department over juvenile facilities and 18
institutions. The department may 19
(1) purchase, lease, or construct buildings or other facilities for the 20
care, detention, rehabilitation, and education of children in need of aid or delinquent 21
minors; 22
(2) adopt plans for construction of juvenile detention facilities, juvenile 23
treatment facilities, and other juvenile institutions; 24
(3) adopt standards and regulations for the design, construction, repair, 25
maintenance, and operation of all juvenile detention facilities, juvenile treatment 26
facilities, and institutions; 27
(4) inspect periodically each juvenile detention facility, juvenile 28
treatment facility, or other institution to ensure that the standards and regulations 29
adopted are being maintained; 30
(5) reimburse municipalities maintaining and operating juvenile 31
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detention facilities; 1
(6) enter into contracts and arrangements with cities and state and 2
federal agencies to carry out the purposes of AS 47.10, AS 47.12, and this chapter; 3
(7) do all acts necessary to carry out the purposes of AS 47.10, 4
AS 47.12, and this chapter; 5
(8) adopt the regulations necessary to carry out AS 47.10, AS 47.12, 6
and this chapter; 7
(9) accept donations, gifts, or bequests of money or other property for 8
use in construction of juvenile institutions, detention facilities, or juvenile treatment 9
facilities; 10
(10) operate juvenile detention facilities when municipalities are 11
unable to do so; 12
(11) receive, care for, and place in a juvenile detention facility, the 13
minor's own home, a foster home, a treatment foster home, a juvenile treatment 14
facility, or treatment institution all minors committed to its custody under AS 47.10, 15
AS 47.12, and this chapter. 16
* Sec. 7. AS 47.14.110(a) is amended to read: 17
(a) A representative of the department shall visit, as often as is considered 18
necessary, every foster home, treatment foster home, or institution in which a child 19
is placed, and, if not satisfied as to the care given, may remove the child from the 20
foster home or institution and place the child elsewhere. 21
* Sec. 8. AS 47.14.112(d) is amended to read: 22
(d) The division of the department with responsibility over the custody of 23
children shall prepare and make available to the legislature an annual report on 24
employee recruitment and retention, including a five-year plan, for the division. Not 25
later than November 15 of each year, the department shall deliver the report to the 26
senate secretary and the chief clerk of the house of representatives and notify the 27
legislature that the report is available. The report prepared under this subsection is 28
separate from the annual report to the legislature required under AS 18.05.020 and 29
must include, for the previous 12 months, 30
(1) the number of frontline case [SOCIAL] workers employed by the 31
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division, the annual average turnover rate of the workers, and the average caseload of 1
the workers on January 1 and July 1 of that year; 2
(2) the number of children removed from their homes; 3
(3) the achievement of success measured by the following: 4
(A) rate of family reunification with a biological parent; 5
(B) average length of time children spent in custody of the 6
department; 7
(C) rate of placement with an adult family member or family 8
friend; 9
(D) number of children placed in a permanent living 10
arrangement with a guardian or [BIOLOGICAL OR] adoptive parent; 11
(E) number of children released from the custody of the 12
department; 13
(4) if the department has met or exceeded the caseload standards under 14
this chapter and, if the standards were exceeded, the number of caseworker positions 15
in the division that could be eliminated and the amount of funding that could be 16
reduced while continuing to meet but not routinely exceed the caseload standards; 17
(5) the performance of the department on federal benchmarks focused 18
on the safety, well-being, and permanent placements of foster children compared with 19
the previous five years; 20
(6) the number of children placed in psychiatric residential 21
treatment facilities providing care for children outside the state. 22
* Sec. 9. AS 47.14.115 is amended by adding a new subsection to read: 23
(c) The department shall require a foster parent who has a treatment foster 24
home license under AS 47.32 to participate in ongoing training in providing trauma-25
informed care. 26
* Sec. 10. AS 47.14.900 is amended by adding a new paragraph to read: 27
(13) "treatment foster home" has the meaning given in AS 47.32.900. 28
* Sec. 11. AS 47.32.010(c) is amended to read: 29
(c) The following entities are subject to this chapter and regulations adopted 30
under this chapter by the Department of Family and Community Services: 31
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(1) child placement agencies; 1
(2) foster homes; 2
(3) runaway shelters; 3
(4) treatment foster homes. 4
* Sec. 12. AS 47.32.032(b) is amended to read: 5
(b) The department shall approve a variance of the applicable building code 6
requirements for licensure of a foster care home or treatment foster home to the 7
extent permitted by federal law if an applicant does not meet the requirements at the 8
time of inspection and 9
(1) the home design and construction is consistent with homes located 10
in the community; and 11
(2) the home is otherwise a safe environment for a child. 12
* Sec. 13. AS 47.32.032 is amended by adding a new subsection to read: 13
(d) A treatment foster home shall ensure that the treatment foster home meets 14
the training requirements provided under AS 47.14.115(c). 15
* Sec. 14. AS 47.32.900(3) is amended to read: 16
(3) "child placement agency" means an agency that arranges for 17
placement of a child 18
(A) in a foster home, treatment foster home, residential child 19
care facility, or adoptive home; or 20
(B) for guardianship purposes; 21
* Sec. 15. AS 47.32.900 is amended by adding new paragraphs to read: 22
(22) "specialized services" includes medical care, trauma-informed 23
care, and interventions for post-traumatic stress disorder, abuse-related trauma, 24
depression, anxiety, suicidal ideation, and substance abuse; 25
(23) "treatment foster home" means a place where specialized services 26
are provided on a 24-hour continuing basis to children who have a special behavioral, 27
developmental, emotional, or medical need resulting from a condition determined by a 28
person who is licensed, certified, or otherwise authorized by the law of this state to 29
administer health care in the ordinary course of business or practice of a profession. 30
* Sec. 16. AS 47.10.990(31) is repealed. 31
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* Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to 1
read: 2
DIRECT COURT RULE AMENDMENT. Rule 12.1(b), Alaska Child in Need 3
of Aid Rules of Procedure, is amended to read: 4
(b) Appointment Types. 5
(1) Mandatory Appointments. 6
(A) The court shall appoint an attorney for a child who is 10 7
years of age or older in any of the following circumstances: 8
(i) [(A)] The child does not consent to placement in a 9
[PSYCHIATRIC HOSPITAL OR] residential treatment center; 10
(ii) [(B)] The child does not consent to administration 11
of psychotropic medication; 12
(iii) [(C)] The child objects to disclosure of 13
psychotherapy information or records under CINA Rule 9(b); 14
(iv) [(D)] A request for a court order authorizing 15
emergency protective custody has been made under AS 47.10.141(c); 16
or 17
(v) [(E)] The child is pregnant or has custody of a minor 18
child; and 19
(B) The court shall appoint an attorney for a child who has 20
been placed in a hospital as authorized under AS 47.10.105. 21
(2) Discretionary Appointments. The court may appoint an attorney 22
in other circumstances including, but not limited to: 23
(A) The child's and guardian ad litem's positions are not 24
aligned on placement, family or sibling contact, permanency goal, case plan, or 25
another important issue in the case; 26
(B) The child would benefit from a confidential relationship 27
with an attorney; or 28
(C) The child is not residing in the designated placement. 29
* Sec. 18. The uncodified law of the State of Alaska is amended by adding a new section to 30
read: 31
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MEDICAID STATE PLAN; WAIVERS. The Department of Health shall, as 1
necessary for federal approval by the United States Department of Health and Human 2
Services, submit amendments to the state plan for medical assistance coverage or apply for 3
any waivers necessary to implement sec. 2 of this Act. 4
* Sec. 19. The uncodified law of the State of Alaska is amended by adding a new section to 5
read: 6
CONDITIONAL EFFECT; NOTIFICATION. (a) Section 2 of this Act takes effect 7
only if, and to the extent that, the United States Department of Health and Human Services 8
approves, on or before July 1, 2031, waivers or amendments to the state plan submitted under 9
sec. 18 of this Act. 10
(b) The commissioner of health shall notify the revisor of statutes in writing within 30 11
days after the United States Department of Health and Human Services approves the waivers 12
or amendments to the state plan. 13
* Sec. 20. If sec. 2 of this Act takes effect, it takes effect on the later of July 1, 2028, or the 14
day after the date the United States Department of Health and Human Services approves the 15
waivers or amendments to the state plan submitted under sec. 18 of this Act. 16
* Sec. 21. Sections 1, 5 - 7, 9 - 15, 18, and 19 of this Act take effect July 1, 2028. 17