Alaska Senate panel hears bill requiring 7-day review for foster youth in psychiatric hospitals

The Alaska Senate Finance Committee heard legislation May 10 that would require judicial review within seven calendar days when foster children are placed in psychiatric hospitals, a change supporters say is needed to prevent lengthy stays that have cost the state hundreds of thousands of dollars.

House Bill 36 responds to a February 2024 Alaska Supreme Court ruling in Quinnahawk v. Office of Children's Services that found children in state custody face substantial risk of being hospitalized longer than necessary. The bill would cut the current 30-day review window to seven days, with a possible seven-day extension in cases where a hearing cannot be scheduled.

According to previously reported court records, the Alaska Supreme Court ruled in 2021 in the case of April S. that children in state custody cannot be held under voluntary admission frameworks when the Office of Children's Services is not a statutory parent or guardian. That decision reversed a lower court order that had treated an initial 30-day commitment as voluntary, establishing that involuntary commitments require full hearings or jury trials. A 2022 U.S. Department of Justice report documented that lengths of stay in psychiatric hospitals for children involved with the Office of Children's Services exceed 80 days on average, with out-of-state stays increasing from 17 days in fiscal year 2021 to over 42 days in the first half of fiscal year 2022.

Representative Andrew Gray told the committee that current law allows foster children admitted to short-term psychiatric facilities to remain there for extended periods without review of whether they need to be there. He cited one case from 2012 to 2013 where a facility billed Medicaid $330,000 to keep a child hospitalized for her 13th and 14th birthdays when she did not need to be there.

"The facility is able to bill Medicaid about $1,000 per night for the child," Gray said. "And one particularly egregious case, Katrina Edwards from 2012 to 2013, the facility was able to bill $330,000 to Medicaid to keep her there for her 13th and 14th birthdays when she did not need to be there."

Gray said the Supreme Court ruled in the February 2024 Quinnahawk v. Office of Children's Services case that 30 days is too long to wait for review. "In February 2024, in the case of Quinnahawk versus OCS, the Supreme Court said that there is no doubt the children in OCS custody are at substantial risk of being hospitalized for longer than they need, or when they do not need to be hospitalized at all," Gray said. "The Supreme Court has said we must close this loophole. In that Supreme Court case and that decision, they said that 30 days is too long. What House Bill 36 does is says that these children's cases need to be reviewed within seven calendar days."

The bill represents a compromise from Gray's original proposal for a 72-hour requirement. "I introduced this bill in a previous legislative cycle with a 72-hour requirement. We have compromised on seven calendar days," Gray said. "There are many entities involved in a child in need of aid case, and so this allows for that extra time. There is a provision in the bill that says they can have a seven-day extension. I want to say it on the record as a sponsor of the bill, it is my intent that that seven-day extension is rarely used."