Legislature(1997 - 1998)
03/18/1998 03:24 PM House L&C
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SSHB 349 - REGULATION OF SOCIAL WORKERS Number 2042 CHAIRMAN ROKEBERG announced the committee's next order of business was SSHB 349, "An Act prohibiting the use of the title 'social worker' without a license; relating to social workers, licensure of social workers, and the Board of Clinical Social Work Examiners; and providing for an effective date." Number 2063 REPRESENTATIVE JEANNETTE JAMES came forward to present SSHB 349. She thanked the chairman for having such a prompt hearing on the bill, stating she has never worked so hard on any piece of legislation trying to orchestrate all the various interests. She said she finally realized she needed a sponsor substitute to include the amendments but there are still a few more. The sponsor statement reads: HB 349: Act prohibiting the use of the title 'social worker' without a license; relating to social workers and to the Board of Clinical Social Work Examiners; and providing for an effective date. There are some key points on "Multi-level" licensure for Social Workers in Alaska. First, it requires the State of Alaska to recognize social work as a profession, and social workers as professionals. The licensure of professional social workers will protect the health, safety and welfare of Alaskans through the effective control and regulation of persons using the title of social worker. This bill will prohibit the use of the title "social worker" for those who do not have a license, while maintaining what is in current law that a person must be licensed as a clinical social worker to practice clinical social work. As stated in the backup, this bill amends the current statute by adding two additional levels of professional social work licensure. Currently available in Alaska is the following: 1. Licensed Clinical Social Worker (LCSW), which requires a Master's of Social Work Degree (MSW) or doctorate, and two years of supervised experience. This proposed legislation would add the following: (1) a Licensed Master's Social Worker (LMSW), which requires a MSW, and (2) a Licensed Bachelor's Social Worker (LBSW), which requires a Bachelor's of Social Work degree (BSW). This legislation establishes the minimum qualifications for each level of social work licensure, and requires that those practicing as professionals in the state of Alaska hold a license. The bill also defines the duties of the Board of Social Work Examiners; identifies those individuals who are exempt from social work licensure in Alaska; establishes the grounds on which the Board of Social Work Examiners can impose disciplinary sanctions on a licensee. HB 349 provides for an exemption from social work licensure, or optional licensing for individuals employed under the title of "social worker" but who lack the educational requirements. At the same time it is designed to protect all people in Alaska by ensuring the most positive, professional influence and direction possible for vulnerable children and adults. Social Work licensure will promote professional social work practices by setting educational and ethical standards for professional social workers, and by offering consumers a legal recourse against unethical or damaging social work services. We must consider the responsibility of social workers to have a healthy positive influence on their clients. I am sponsoring this legislation because of my growing concern about the quality of care provided for the people of Alaska. As well, the State of Alaska has the goal and the responsibility to provide the best care possible. This legislation, I believe, will help us to achieve that goal. REPRESENTATIVE JAMES emphasized at the beginning of her reading of the sponsor statement that HB 349 is an Act prohibiting the use of the title "social worker" without a license, but not the practice of social work. After reading the statement, she re-stressed her concern about people dealing with vulnerable children and adults, making decisions affecting people for the rest of their lives. She said she wants to be absolutely sure that these practitioners are qualified to make those decisions, and if they have the opportunity to make mistakes, there is some recourse for those people affected by errors. She commented it has been difficult to coordinate the various interests throughout the various agencies and practitioners; they tried very hard to get a balanced piece of legislation. Representative James noted Ms. Angela Salerno, Executive Director, Alaska Chapter, National Association of Social Workers (NASW), had worked very hard with her on this legislation and asked that any technical questions about the inner workings of the bill be directed toward Ms. Salerno. Number 2255 REPRESENTATIVE COWDERY said in the Division of Family and Youth Services (DFYS), Department of Health and Social Services (H&SS), "social worker" is used as a job title. He asked if that was a union description, noting he has been told "social worker" is described in the union's contract. Number 2269 REPRESENTATIVE JAMES said other witnesses might correct her, but she indicated she thought the drafting of the titles came from administration by the state, and that the union, if it has interest in these titles, received the titles from the state, not the other way around. She reiterated this legislation does not seek practice protection, only title protection at this point. She commented that practice protection could be pursued if title protection works well. She said practice protection really should be the goal, stating, "Because if you're doing anything called a social worker, or doing anything that isn't even called a social worker which is really social work, that's another area where we should have the consumer protection." Number 2305 REPRESENTATIVE RYAN said his only problem with SSHB 349 is the exemption, Section 08.95.911, on page 10, relating the great personal effort and personal expense he went to to receive the necessary training and certifications in his fields as an aircraft mechanic and licensed airline transport pilot. He indicated grandfathering in people without the required educational background didn't seem professional or fair to those people who had made the effort and put in the work to attain the required education, and he asked how that was justified. Section 08.95.911. of the bill reads: Section 08.95.911. Exemption. (a) Notwithstanding AS 08.95.100(b)(1), a person who, on June 30, 2000, was employed or providing services under the title "social worker" may, without obtaining a license under this chapter, continue to use the title "social worker" while the person is employed by the same employer or, if self- employed, while providing the same scope of services, as on June 30, 2000. (b) The exemption under (a) of this section does not authorize use of the title "social worker" outside the context of the person's employment or self-employment, as applicable. (c) For purposes of this section, a person who is employed by (1) the federal government is not considered to have changed employers if the person begins employment with a different agency of the federal government; (2) the state is not considered to have changed employers if the person begins employment with a different agency of the state; (3) a municipality is not considered to have changed employers if the person begins employment with a different agency of the municipality. Number 2361 REPRESENTATIVE JAMES agreed with Representative Ryan, but said the reality of the issue is that people who are working for the state fall into different categories: some do not have the educational requirements, some have degrees in other fields, and some do have the proper degree and would qualify for licensure. She commented that the job security provision and union contracts were also a concern, noting the union would be perfectly happy if the state could provide education to bring these people up to the requested level, but she said that is not a possibility. She stated, therefore, there has to be a transition period as far as having people out there qualified to do the work. There is probably a current shortage of licensed social workers or those who qualify, and the department has been working with the university to set up specific types of classes, et cetera, so that those who are able can bring up their skills. She indicated that someone who has been doing social work in a department for ten or more years without having the educational requirements probably has some level of skill, but, because of financial limitations, would not be able to take off from work to go to school. She said that was the reality and a concession that had to be made in order to get started on this program, noting that was her best explanation. Representative James also commented they had worked very hard to get a zero fiscal note for this legislation and she thought they had made all necessary concessions, but had received a fiscal note that day for $25,000 from the Division of Occupational Licensing. Number 2439 CHAIRMAN ROKEBERG invited Representative James to join the committee at the table. He requested a brief explanation of the fiscal note from Ms. Reardon. Number 2460 CATHERINE REARDON, Director, Division of Occupational Licensing, Department of Commerce and Economic Development (DCED), came forward to testify. She noted employees from the division staff the Board of Clinical Social Work Examiners which would be taking on the additional licensing responsibility for these two other social worker levels. She said the explanation is on the second page of the fiscal note; the division asks for a half-time licensing examiner [$20,300] and $4,700 for ..." [TESTIMONY INTERRUPTED BY TAPE CHANGE] [From page 2 of division's fiscal note: Contractual Services, $4,700. "This funding covers communication costs, public noticing, printing, advertising and legal services to establish new regulations."] TAPE 98-31, SIDE B Number 0001 MS. REARDON continued, "... a brief explanation right below that, which does indicate that occupational licensing programs are required to cover fees to cover their costs so this would not be an additional contribution to the budget balancing problem." She added that there are currently 253 LCSWs. One licensing examiner staffs the board dealing with those social workers and also staffs the boards of Marital and Family Therapy, Psychologist and Psychological Associate Examiners, State Physical Therapy and Occupational Therapy Board, and State Athletic Commission. This examiner estimates 20 to 30 percent of her time is currently being spent with social work. Ms. Reardon stated she is concerned that if she adds to this examiner's workload, the responsibility for the State Physical Therapy and Occupational Therapy Board would have to be removed in order for this examiner to deal with the 250 applicants the division estimates will be seeking licensure at these other levels in the coming two years. Ms. Reardon commented she has found in preparing fiscal notes that it is not possible to ask for a quarter of a person, stating, "You either ask for no new staff and say, 'I can absorb the function,' or you need to have half. There's nothing in between." She indicated that sometimes there are functions which take more staff work, causing problems, but perhaps not reaching the threshold of half a position, and she noted she had been somewhat in that place in this situation. Ms. Reardon stated the other factor is that the licensing examiners keep time sheets and bill the programs for time actually spent. If half an examiner is not spent, particularly in later years after the program is "up and going," social work would not continue to be billed for that time. She also noted she hasn't asked for any new investigative or enforcement resources, and it is possible that if there are more complaints because there are more social work licensees, some of the existing investigators would spend more time with social work and that would show up in the social work fees. Number 0113 REPRESENTATIVE RYAN commented he was not putting this particular question on Ms. Reardon, noting he intended to speak with the commissioners in the budget subcommittee. He referred to a legislative audit done on DCED last year, which brought forth that the department had attributed certain department costs to the Division of Occupational Licensing. He said this was a nice way of getting some extra money because the division "charges whatever the traffic bears and if you incur a cost then you just increase the fee, so there's a little bit of legerdemain that allows the Department of Commerce to perhaps have a little more money for discretion or to offset some of their - their costs on your division, and therefore, have extra budget fund." He asked what there was to insure them that something similar would not happen with this program, that it would increase to 1 1/2 to 2 people, therefore driving the cost up to not only these licensees, but perhaps all of the licensees. Representative Ryan said he understands there were a lot of fees this year because of a lawsuit which went awry involving an airline pilot or something. He stated, "(Indisc.) great increase in license fees this year, many rumors running around (indisc.) cost, but ...." Number 0162 MS. REARDON assured Representative Ryan that did not have to do with anything outside the division's licensee areas, and had nothing to do with aviation as the division does not license in those areas. If the division has an additional half-time employee and that person is used on some occupations in the division, she agreed that someone will get billed for it. She said there will be $25,000 in additional fees charged to someone in the division's world of 35,000 licensees, noting it would not all necessarily go to the social workers if it turns out and additional half person is not necessary. Ms. Reardon indicated that person's time would be billed to the programs actually receiving that time and those programs would see fee increases. Referring to the issue brought up in the legislative audit, which she said she thought had also been had began to be addressed with the commissioner in her confirmation hearing [House Labor and Commerce Standing Committee, March 4, 1998], Ms. Reardon stated there are costs in the Division of Administrative Services and the commissioner's office that are assessed to the Division of Occupational Licensing. The department's position is that these are reasonable costs associated with having a Division of Occupational Licensing, and licensing occupations. She noted costs, for example, in the Division of Administrative Services of having, she stated, "A personnel and a fiscal and a - a units, and that they do handle matters connected with bills from Occupational Licensing or - or people that we hire, and that the oversight from the commissioner's office is also a cost of regulating professions, that if the division didn't exist and we weren't regulating professions, then these activities would not have to be engaged in by the commissioner's office. But as you said there - there are other opportunities probably to discuss this, (indisc.) probably want to discuss it in greater detail." REPRESENTATIVE RYAN stated, "We're just want to be assure that, you know, won't (indisc.--rest of sentence)." Number 0259 CHAIRMAN ROKEBERG asked the management cost, personnel time required, and number of people covered currently for this occupational license. MS. REARDON replied there are currently 253 people at the clinical social worker level, the only level the division licenses. She said, in terms of direct staff, there is one range 12 licensing examiner spending an estimated 20 to 30 percent of her time handling this program, in addition to the other programs Ms. Reardon mentioned. She noted there is also part of a range 18 investigator who handles complaints related to the other behavioral health programs: psychology, and marital and family therapy, as well as dentists and optometrists. CHAIRMAN ROKEBERG asked the amount of the current biennial fee. MS. REARDON replied $410. Number 0312 CHAIRMAN ROKEBERG noted the stand-in teleconference monitor, Randy Lorenz, an intern in Chairman Rokeberg's office and for the House Labor and Commerce Standing Committee, is studying for a degree in social work at the University of Alaska Anchorage and therefore Chairman Rokeberg's office has a keen interest in SSHB 349. Number 0350 EILEEN LALLY, Deputy Director, Community Programs, Hope Cottages, Incorporated, testified next via teleconference from Anchorage in support of SSHB 349. She stated she has been a professional social worker since 1970; coming to Alaska in 1973 and teaching at the University of Alaska Anchorage (UAA) and the University of Alaska Fairbanks (UAF). She noted she had recently taken a sojourn to New Mexico State University in Las Cruces. She is a LCSW, and has worked with child protection and developmental disabilities in a variety of areas with children and families. Speaking in support of SSHB 349, she noted she has struggled for multi-level licensing for well over 20 years. Ms. Lally stated she has served on the board of directors for the NASW at two different times, once before there was any licensing for social workers. She said, unfortunately, during both of those times that board of directors had to hear sanctions brought to NASW by community members who had been egregiously treated by social workers. Ms. Lally stated the problem has not been solved by licensing only at the LCSW level. She indicated really the only policing action the NASW could take then and currently is, if the offender is an NASW member, the organization can exclude that person from membership in the professional organization. Ms. Lally said that is not very effective for consumer protection in terms of malpractice and ethical issues, and that is the main reason she asks the committee to pass this bill, so that the public will have some other recourse as they do now with LCSWs. She noted there were also other reasons she believes SSHB 349 should be passed. Number 0468 BETH SIRLES, Chair, Department of Social Work, University of Alaska Anchorage, testified next via teleconference from Anchorage. She provided background on bachelor's and master's level social workers for the committee's understanding. There are two accredited bachelor degree social work programs in Alaska, at UAA and UAF. The University of Alaska Anchorage also has a master's level social work program which is in the final stages of achieving accreditation, graduating its first master's level social workers in 1997. Both the Anchorage and Fairbanks campuses are working very closely with DFYS to create educational opportunities for DFYS social workers. She pointed out that professional education serves some very significant functions, one of which is screening for readiness to assume responsibility in a very complex field. She indicated social workers deal on a daily basis with vulnerable children and adults; specifically with child abuse and neglect, domestic and family violence, substance abuse, poverty and many other social problems. Professional education provides supervised experience working with very complex problems. At the bachelor's level, a social worker is trained in interviewing skills, case management, crisis intervention, advocacy, problem solving; and entry-level skills in working with individuals, families and groups. Bachelor's level social workers have learned about human development, understand public policy, and have been very carefully supervised in learning the code of ethics which teaches what is and is not appropriate conduct for social workers working with clients. The bachelor's level prepares people for entry-level social work practice. Ms. Sirles stated there is also very close supervision and training in the code of ethics at the master's level, but master's level training prepares people for advanced practice in a variety of arenas; primarily in administration, program development and evaluation, community organization, et cetera. A person with a master's degree in social work is ready to work autonomously, and to supervise entry-level practitioners. She noted both are very important degrees; she said they support this bill because they believe strongly that someone without the education should not be practicing social work. Number 0620 CECILIA KLEINKAUF testified next via teleconference from Anchorage in support of SSHB 349. She stated she had been in Alaska since 1969 and has been practicing social work in one capacity or another for all of that time. She noted she is a lawyer by profession as well as a social worker. Ms. Kleinkauf stated she was on UAA's faculty for many years, helping start UAA's baccalaureate social work program and helping the program receive national accreditation. For many years, as the committee has heard, they've been trying to get public recognition for the social work profession. She indicated they want social work recognized as a profession, but more importantly, they want the clients who receive services from social workers to have two assurances: 1) The person providing services has had certain training and education, has passed examinations, and been supervised adequately. This allows the consumers of services to have some assurances the provider has the necessary knowledge, and ethical base the consumer can trust. 2) Without licensing two levels, the client served by a provider with a baccalaureate degree in social work, or a provider under the master's degree in social work, has no place to go to actually get a grievance addressed. She said they believe all social workers should be licensed because consumers of social work services need a place where their grievances can be heard if inadequate or harmful services are received from someone practicing under the title social worker. Number 0700 MS. KLEINKAUF indicated that is one the benefits of licensure; the establishment of a board that can hear, review and investigate complaints and issue sanctions against a professional in any profession who is not practicing adequately. Since 1988 LCSWs have been licensed in Alaska, but she said probably four times as many people in Alaska receive services from baccalaureate level and master's level social workers, stating, "Who have not, because licensing does not exist now for those two levels, have not been able to be assured of those two requirements: both for someone who is assured of meeting standards and someone who is subject to review and possible sanctions by a board of examiners and a licensing board." For those reasons as well as many others, she said they would like to urge very swift passage of SSHB 349. She thanked the committee for hearing the bill so soon, also thanking Representative James for her hard work and support for what is needed as the problems of abused and neglected children in Alaska are grappled with, as well as the other clients served by social workers including the mentally ill and senior citizens. Number 0767 CHAIRMAN ROKEBERG indicated he had questions about the Class B misdemeanor penalty provided in the bill for the title misuse, noting it seemed to be a relatively draconian penalty in terms of licensure law. He referred to other sanctions and advisory groups, asking about a commission. Number 0793 MS. KLEINKAUF replied that the new licensees at the baccalaureate and master's level would be licensed by the existing Board of Clinical Social Work Examiners, whose functions are expanded under this bill to issue those licenses as well as hear any complaints about those new licensee groups, as the board currently does for LCSWs. The licensees are responsible to that entity for their standards of practice, and for review and sanctions should clients complain about services. Number 0866 COLLEEN PATRICK RILEY testified next via teleconference from Anchorage in support of SSHB 349. She noted she is a lifelong Alaska resident and has been employed as social worker for the past 25 years. She works in both nonprofit agencies with children and families, and for the state of Alaska as a mental health clinician for both the Division of Mental Health and Developmental Disabilities, H&SS, and the Department of Corrections. She was chair of the NASW licensing committee at the time the 1988 licensure for LCSWs passed, and has served on the NASW board. She has been a member of the Board of Clinical Social Work Examiners since 1990 and is currently the board's chair. She is quite familiar with the deficits in the current licensing statutes for LCSWs and she believes this bill corrects those, as well as expands and extends consumer protection to the citizens of Alaska. In reality, thousands of consumers in Alaska are served by social workers and are currently not really protected from that service. As chair of the current board, she said they have had social workers who have had sex with clients and have lost or surrendered their licenses, but have still been able to continue practicing because there is currently no practice protection for clinical social work. She stated this bill, as she understands it, affords practice and title protection to LCSWS, and title protection to bachelor's and master's level social workers. She believes those are critically important points in providing consumer protection, stating the board itself fully supports like multi-level licensure including the BSW, MSW and LCSW levels, with any additions or amendments recommended by the Division of Occupational Licensing. Number 0971 REPRESENTATIVE HUDSON asked if this would have any effect on payment through Medicaid or Medicare, for example. Number 0983 MS. PATRICK RILEY replied it was her understanding it would not, noting Ms. Reardon might have other comments. She indicated she thinks Medicaid currently has certain provisions for allowed providers, and she knows that already certain individuals who could be exempt under licensing statute have elected to become licensed because, in nonprofit agencies in particular, they favor having licensed individuals provide that service. She noted licensure is, in fact, an advantage. Number 1044 JOHN WATERS, President, Board of Directors, Alaska Chapter, National Association of Social Workers; licensed clinical social worker, testified next via teleconference from Fairbanks in support of SSHB 349. Mr. Waters spoke from a prepared statement: I am speaking in support of HB 349. I'm a Licensed Clinical Social Worker and the current President of the Board of Directors of the National Association of Social Workers, Alaska Chapter. Our organization has a membership of over 470 Alaskan social workers. I'm also employed as the social worker at the Fairbanks Pioneers' Home and I'm supervisor of Adult Protective Services for the Northern Region. I believe passage of this legislation will help our elders receive the highest quality professional social work services possible. Often in protective services, when a report of harm is received a person is at significant risk because of abuse or neglect. These persons are the most vulnerable Alaskans and deserve the services of well-trained and skilled social workers. When family members seek assistance for a loved one in danger they need to know the social worker they call on is someone who is knowledgeable and competent to guide them through some very difficult life decisions. Positive aspects of this bill include that licensed social workers will be held accountable to well- established professional social work practice standards. These standards are found in a social work code of ethics that was established first in 1955 and extensively revised in 1996. To protect consumers, licensing regulations provide a system to investigate and address complaints against social workers. And also, licensed social workers will have continuing education requirements to maintain [and] enhance their professional skills. I applaud Representative Jeannette James, the sponsor of this bill, for her understanding of, and commitment to, adequately trained and regulated Alaskan social workers. And I also thank you, Representative Rokeberg for allowing this bill to be heard so quickly in your committee. Number 1171 MARIANNE MILLS, National Association of Social Workers, came forward to testify next in support of SSHB 349. She stated she is a professional social worker working in the private sector with senior citizens. Ms. Mills spoke from a prepared statement: I'm here today to please urge you to support House Bill 349, Representative James' bill to license and limit the title "social worker" to those who are properly trained. This bill will protect Alaskans; those who receive services as well as those who want to see their money invested wisely. At the current time the term "social worker" is used, not to refer to a professional with a degree in social work, but as a job title. The actions or failure to act by a social worker often have significant effects on the health and mental health of both individual clients and their families. Regulation by licensing will hold social workers accountable to one of the most comprehensive code of ethics in the helping professions. In light of concerns regarding Alaska's fiscal gap, it is essential that money spent on services be used effectively to assist people in providing for themselves and to protect those at risk of harm. An effective way to monitor our investment in social services is to require the hiring of qualified social work personnel. House Bill 349 will enforce standards for social work practice and allow Alaskans to raise charges of malpractice and complaints of improper conduct. On behalf of all Alaskans, potential recipients of social work services, I thank you for your consideration of my request. Number 1262 REPRESENTATIVE HUDSON restated his previous question, "Will this bill increase the opportunity for people of your profession and people who would fall under this professional [designation] to have access to Medicaid or Medicare, or other funds that they do not have access to at the present time? That is, will this give us an advantage of placing more of these professionals into the line for Medicaid or Medicare, for example?" MS. MILLS replied she did not know the answer to that question, but confirmed raising the standards would not be a disadvantage. Number 1305 REPRESENTATIVE RYAN stated, "I'm not really sure if I can answer that question, but I think our agency -- we got our people licensed as clinical social workers so they could fall under the Medicaid -- I think that was one of the requirements. I'm not sure what a master's level would do." Number 1321 CHAIRMAN ROKEBERG acknowledged Representative Ryan's comments, stating he sees a clear case of "insurance creep" in this bill, indicating this would need to be considered by the committee. He asked Ms. Reardon if she had anything else to offer. Number 1341 MS. REARDON stated she had some items written in amendment form she viewed as minor and technical in nature, which she distributed to the committee. These recommended amendments from the Division of Occupational Licensing read: [Note: capitalization and punctuation per amendment copy] Amendment 1 Delete page 2, lines 18-20 Amendment 2 Page 7, following line 14, Insert (d) The board may refuse to grant a license to any applicant for the same reasons that it may impose disciplinary sanctions under AS 08.95.050. Amendment 3 delete page 7, lines 23-24 Amendment 4 Page 8, line 3, following "suspended", insert or surrendered in lieu of disciplinary action Page 8, line 24 same as above Amendment 5 page 10, following line 2, insert (c) As used in this section "health care or mental health professional" means "practitioner of the healing arts" as defined in AS 47.17.290(13) Page 10, following line 11, insert As used in this section "health care or mental health professional" means "practitioner of the healing arts" as defined in AS 47.17.290(13) Number 1374 REPRESENTATIVE JAMES said she was unable to comment on these proposed amendments because she had just seen them a few moments ago. CHAIRMAN ROKEBERG asked Ms. Reardon to explain the amendments. Number 1387 MS. REARDON stated most were items she had gone over very briefly a few days previously with the sponsor's aide, but had not been typed up in amendment form at that time. Regarding the division's amendment 1, she stated the Department of Law had commented the lines being amended there had been repealed with HB 265 [HB 265 - Reports & Records of & to State Agencies], reducing the number of reports state agencies are required to make. She noted HB 265 had passed relatively recently and was, she thought, currently in the Governor's hands. The division's amendment 2 was suggested by the Department of Law to augment the Board of Clinical Social Work Examiners' ability to reject applicants it did not feel comfortable with. She commented she thought this was a relatively innocuous change, but has found the NASW may not want in included. Ms. Reardon said it is not really important to her, stating that it is just whether the legislature would like to have that option for denial of license. Number 1482 CHAIRMAN ROKEBERG referred to page 2, line 21, of the bill, noting it seems to him that they have deleted the duties of the board by deleting "imposing disciplinary sanctions." He asked if he had missed something and was the division adding that back. Number 1505 MS. REARDON said amendment 2 was on page 7, following line 14, where the qualifications for licensure are discussed. This amendment would allow the board to reject an applicant for the same reasons it may discipline someone. She indicated the list of disciplinary sanctions occurs on pages 3 and 4 of the bill, beginning with line 19. The division's proposed amendment 3 was also supplied by the Department of Law. It would delete lines 23 and 24 on page 7, "(3) has not failed the examination for a license to practice clinical social work in this state;". The reasoning for this deletion is that the new lines 25 and 26 on page 7 require all the applicants to pass the examination. She explained that previous to this bill it was licensing by credentials and that language had been in there to prevent people from failing the test in Alaska, getting licensed in another state and coming back to the state to get in that way. The division's amendment 4 on page 8, lines 3 and 24, goes back to grounds for denying a license, suggesting the insertion of "or surrendered in lieu of disciplinary action" after "suspended" in the bill's current language which reads on line 3, "(6) has not had a license to practice clinical social work revoked or suspended in this state or another jurisdiction;" and on line 24, "(6) has not had a license to practice social work or to use the title "social worker" revoked or suspended in this state or another jurisdiction;". She noted sometimes in other states people will turn in their licenses instead of getting it disciplined and we might not want to have those people come here either. Number 1668 MS. REARDON referred to the division's amendment 5, deferring to legislative drafters. She stated the Department of Law felt that health care or mental health professional might need to be defined and wasn't defined in the bill. The terms are used in the confidentiality of communication and immunity sections; she said there is a reference to information that is given or obtained from health care or mental health professionals "and yet that they weren't defined as what they are" so the suggestion is just to say it is the same list of professionals already found in the bill as practitioner of the healing arts, found on page 12, beginning line 6, which reads: * Sec. 25. AS 47.17.290(13) is amended to read: (13) "practitioner of the healing arts" includes chiropractors, mental health counselors, social workers, dental hygienists, dentists, health aides, nurses, nurse practitioners, occupational therapists, occupational therapy assistants, optometrists, osteopaths, naturopaths, physical therapists, physical therapy assistants, physicians, physician's assistants, psychiatrists, psychologists, psychological associates, audiologists licensed under AS 08.11, hearing aid dealers licensed under AS 08.55, marital and family therapists licensed under AS 08.63, religious healing practitioners, acupuncturists, and surgeons; MS. REARDON commented this includes all the people they would want to consider health care and mental health professionals, and by saying it is that same list they would have a definition in case there is any question about who or who doesn't count. REPRESENTATIVE RYAN commented it is an ever expanding list. CHAIRMAN ROKEBERG disagreed. MS. REARDON noted she had had an additional amendment 6 which she was convinced out of. Number 1767 REPRESENTATIVE HUDSON confirmed this was HB 349's first hearing in the committee. He asked if the chairman wished to consider the amendments. CHAIRMAN ROKEBERG deferred to the sponsor's and staff's ability to sort the amendments out. Number 1813 REPRESENTATIVE JAMES stated there was another proposed amendment, which read: Page 4, line 17 before "engaged": Insert "while practicing clinical social work" The language to be amended begins on page 4, line 17, of SSHB 349 and currently reads: (11) engaged in sexual contact with a person during the time period that the person was a client or within two years after termination of the licensee's professional relationship with the client. REPRESENTATIVE JAMES stated, "That was a real difficult (indisc.- noise) -- the sexual contact issue was very difficult, and we put it in and took it out, and put it in and took it out over the period of time. ... That is a very important part of the requirements to have a license, and it's in the ethics of the licensure, so, it's already protected without putting it in the bill, and so I'm comfortable with taking it out and there are some interests in taking it out of the bill and so I have no problem with that. And what I would suggest, Mr. Chairman, if I might, is that what I would like to see go through you as the chairman, if you might, and staff, to go through these amendments and if you wish to come back with a CS [committee substitute] I wouldn't have any problem with that." Number 1881 CHAIRMAN ROKEBERG indicated it might be more expeditious if the sponsor provided the proposed committee substitute. He commented there is one major question in his mind concerning Sections 24 and 25, relating to the definition of a social worker as a practitioner of the healing arts and the proposed amendments. Chairman Rokeberg stated that, unless she could convince him otherwise, he is adamantly opposed to those sections. His reason, as he indicated earlier, is "insurance creep," the problems of health insurance in Alaska, and the "whole global issue of it." He said he is not sure why they are even getting into that there and he was assured previously that is not the bill's intention, noting he doesn't consider social workers practitioners of healing arts "for terms of insurance purposes." Section 24, page 11, beginning line 21, reads: [Note: bracketed, capitalized text is being deleted; Section 25 was shown above] *Sec. 24. AS 47.17.020(a) is amended to read: (a) The following persons who, in the performance of their occupational duties, have reasonable cause to suspect that a child has suffered from harm as a result of child abuse or neglect shall immediately report the harm to the nearest office of the department: (1) practitioners of the healing arts; (2) school teachers and school administrative staff members of public and private schools; (3) [SOCIAL WORKERS; (4)] peace officers[,] and officers of the Department of Corrections; (4) [(5)] administrative officers of institutions; (5) [(6)] child care providers; (6) [(7)] paid employees of domestic violence and sexual assault programs, and crisis intervention and prevention programs as defined in AS 18.66.990; (7) [(8)] paid employees of an organization that provides counseling or treatment to individuals seeking to control their use of drugs or alcohol. Number 2001 ANGELA SALERNO, Executive Director, Alaska Chapter, National Association of Social Workers, came forward to testify next. She stated this provision's inclusion is not about insurance at all; it is about some of the duties or responsibilities of practitioners of the healing arts, and came as a request from the LCSW licensing board. Those individuals who are practitioners of the healing arts are able, without parental permission, to send a child for a medical exam or x-ray, or to take a picture of a child. She explained the thinking was that is certainly what a DFYS social worker and a professional social worker should be doing, and that is why they are trying to make the change. Referring to Section 24, she noted "social worker" is being removed from the list of mandatory reporters of child abuse in order to avoid redundancy because practitioners of the healing arts are mandatory reporters. She note she does not believe "practitioner of the healing arts" is a term associated with insurance but she could be wrong. She reiterated that certainly was not their intent. REPRESENTATIVE JAMES commented it was a whole different statute. CHAIRMAN ROKEBERG said he knew, but commented this committee was the "gatekeeper." Number 2120 MS. SALERNO said a division representative was present and might be able to more definitively answer the chairman's question. CHAIRMAN ROKEBERG suggested this be taken up when the bill was brought back before the committee, indicating SSHB 349 would be held, and said he was not convinced at this juncture "if that's the reason, if a ... [DFYS] social worker is to refer a child for some medical treatment, I still am not sure I am convinced that's an appropriate reason to change their definition ...." He stated the committee would open-minded on this, but he referred to several current bills "attempting to add themselves as a profession to the list of people who qualify for reimbursement by medical insurance carriers, ... and that is, I view as a very negative thing to the consumers of the state of Alaska because of the chilling effect it has on insurance companies underwriting business and providing for insurance for the people of the state of Alaska." Number 2200 MS. SALERNO reiterated that certainly was not their intent. Number 2207 CHAIRMAN ROKEBERG indicated that was his reason for pointing it out and why he looks with a jaundiced eye upon things of this nature that could be interpreted as insurance creep. He indicated he wished the committee to be convinced otherwise. Chairman Rokeberg asked if there were any further questions of Representative James or Ms. Salerno. There being none, he stated SSHB 349 would be held for further consideration.
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