Senate bill warped by Sen. Giessel into allowing transition counseling for students without parents’ knowledge

Senate Bill 240 started out as a legislative way to ensure that disabled students can get the help they need at school, and that Medicaid will be able to pay for some of the services. It was Gov. Mike Dunleavy’s bill to clean up some processes in the technical world of federal reimbursements.

But by the time Sen. Cathy Giessel of South Anchorage finished with the bill, it had been completely rewritten. Now, the committee substitute for the bill makes it into a law saying that 16-year-olds can get counseling and clinical services at school without their parents’ knowledge. In other words, counselors can do traditional counseling work or even gender-transition counseling within the high school framework, and hide that work from parents.

The completely rewritten bill passed out of committee on a vote of 3-2, with its Senate Sponsor, Sen. David Wilson firmly against the changes.

The committee substitute passed the Senate floor, again with Wilson opposed to the amendments to the bill, and with Sen. Shelley Hughes arguing against the changes on the Senate floor. But the committee substitute, as authored by Giessel and passed by her committee, was adopted by the Senate, 13-7.

On Wednesday, the rewrite will be up for a final vote in the Senate.

The original version said that school-based services for students with disabilities could be paid for by Medicaid, with or without an individualized education program, also known as IEP. It is explained in the governor’s sponsor statement:

The new version of the bill eclipses the original intent. Sen. Giessel wants school personnel to be able to recommend behavioral health or mental health services to a child who is 16 or older, and that child would be considered adult enough to consent to those services without their parents’ knowledge. For example:

“Insert ‘allowing minors 16 years of age or older to consent to behavioral health and mental health services; authorizing school personnel to recommend a behavioral health or mental health professional to a child 16 years of age or older;'” the bill reads now.

It also says, “Notwithstanding AS 14.30.l7l (a)(3) and (S), a behavioral or mental health professional working within a public school system may, in compliance with federal health professional … (1) recommend, but not require, a psychiatric or behavioral health evaluation of a child; AND recommend, but not require, psychiatric, psychological, or behavioral treatment for a child; and obtain informed consent from and provide behavioral or mental health services to a child who is 16 years of age or older.”

The bill goes on to say that minors can give consent for medical or dental services if the parent or legal guardian cannot be contacted or if the parent or legal guardian is unwilling to grant consent.

The bill says the medical provider at the school shall counsel the minor “keeping in mind not only the valid interests of the minor but also the valid interests of the parent or guardian and the family unit as best the provider presumes them.”

It continues to say that the minor can give consent to receive outpatient behavioral or mental health services, but that such services to not include the prescribing of medication to the minor without a parent or guardian’s consent. The bill says the mental health provider shall contact the parents and offer to provide services to the family unless there “are clear clinical indications that doing so would be harmful to the minor receiving such services.”

The entire amendment that has transformed the bill now allows not only counseling but, although not explicitly saying so, allows gender transition counseling.

The original bill had the support of those in the health field. They offered letters explaining why.

The Alaska Hospital and Healthcare Association wrote, “AHHA is pleased to offer our support for SB 240 and its removal of the requirement that Medicaid can only reimburse for school-based services if the student has a disability and the services are included in the student’s Individualized Education Plan.”

The association continued, “We view this change as a means of increasing flexibility for schools to seek Medicaid reimbursement for eligible students and extending this coverage to all Medicaid eligible students. This bill matters to Alaskans because it will increase healthcare access and improve child health outcomes. Additionally, schools will be able to fund health-related services like school nurses. AHHA urges the passage of SB 240 to better align with the Centers for Medicare and Medicaid Services and support access to services within schools for Medicaid eligible children.”

The new Senate bill, however, has AHHA on record supporting the counseling and possible gender transition of high school students without their parents consent — something that AHHA might not have wanted to sign onto.

The Alaska Behavioral Health Association also signed on to support the original version of the bill, but is now on record supporting what is an entirely different bill.

The ABHA wrote, “Alaska Behavioral Health is pleased to offer support for SB 240 and HB 343. These bills align with our organization’s priorities to increase access to health care services for children and will increase flexibility for schools to seek Medicaid reimbursement for eligible children.

“Currently, for Medicaid to cover services provided in schools, the child must have a disability and the services must be included in the child’s Individualized Education Plan (IEP). Currently, some children lose supportive services when they age out of infant learning programs because they do not meet the requirements for an IEP, though they still have needs that can be met in a school setting. These bills remove those current requirements. In doing so, they present an opportunity for schools to seek Medicaid reimbursement for services provided on site. They will promote early intervention and prevention, and they will promote more convenient choices for parents seeking the care their children need.”

The original bill supported parent-directed services provided in the school setting, maintained the current scope of school-based services, preserved parent choice in children’s care, including what services they receive and where they receive them. Read the original bill explanation and summary here.

But with the radical changes to the bill, parents are cut out of the equation.

The ABHA is now on record as supporting a bill that has gone from being a technical fix to a permission slip for school counselors, who may or may not share the values of the family, to have extraordinary influence over the decisions of youth during a time of their lives when they are most impressionable.