Legislature(2009 - 2010)CAPITOL 106

03/19/2009 03:00 PM HEALTH & SOCIAL SERVICES


Download Mp3. <- Right click and save file as

Audio Topic
03:05:06 PM Start
03:05:39 PM HB110
04:23:13 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 110 PSYCHOLOGISTS' LICENSING & PRACTICE TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         March 19, 2009                                                                                         
                           3:05 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Bob Herron, Co-Chair                                                                                             
Representative Wes Keller, Co-Chair                                                                                             
Representative Bob Lynn                                                                                                         
Representative Paul Seaton                                                                                                      
Representative Sharon Cissna                                                                                                    
Representative Lindsey Holmes                                                                                                   
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative John Coghill                                                                                                     
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                              
HOUSE BILL NO. 110                                                                                                              
"An   Act   relating   to   the   practice   and   licensing   of                                                               
psychologists."                                                                                                                 
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                              
BILL: HB 110                                                                                                                  
SHORT TITLE: PSYCHOLOGISTS' LICENSING & PRACTICE                                                                                
SPONSOR(s): REPRESENTATIVE(s) HERRON                                                                                            
                                                                                                                                
02/04/09       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/04/09       (H)       HSS, L&C                                                                                               
03/19/09       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
MARIANNA CARPENETI, Staff                                                                                                       
to Representative Bob Herron                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 110 on behalf of the prime                                                                  
sponsor, Representative Herron, and responded to questions.                                                                     
                                                                                                                                
DR. LORIN BRADBURY, Chair                                                                                                       
Board of Psychologist and Psychological Associate Examiners                                                                     
Bethel, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions regarding HB 110.                                                                     
                                                                                                                                
DR. PHILLIP BAKER, Legislative Chair                                                                                            
Alaska Psychological Association                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered questions regarding HB 110.                                                                     
                                                                                                                                
DIANE CASTO, Prevention & Early Intervention Manager                                                                            
Prevention and Early Intervention Section                                                                                       
Division of Behavioral Health                                                                                                   
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Spoke about HB 110.                                                                                      
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:05:06 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WES KELLER  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:05   p.m.                                                               
Representatives Keller,  Herron, Seaton, and Holmes  were present                                                               
at the  call to order.   Representatives Lynn and  Cissna arrived                                                               
as  the meeting  was  in progress.    Representative Coghill  was                                                               
excused.                                                                                                                        
                                                                                                                                
HB 110-PSYCHOLOGISTS' LICENSING & PRACTICE                                                                                    
                                                                                                                                
                                                                                                                                
3:05:39 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER announced that the  first order of business would                                                               
be  HOUSE BILL  NO. 110,  "An Act  relating to  the practice  and                                                               
licensing of psychologists."                                                                                                    
                                                                                                                                
3:06:28 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON,  speaking as the  prime sponsor of HB  110, said                                                               
that the bill was at the request of his constituency.                                                                           
                                                                                                                                
3:07:05 PM                                                                                                                    
                                                                                                                                
MARIANNA CARPENETI,  Staff to  Representative Bob  Herron, Alaska                                                               
State Legislature, said that HB  110 was introduced at the behest                                                               
of the Board of Psychologists  and Psychological Associates.  She                                                               
explained that HB 110 referred  to the licensing of psychological                                                               
associates.   She  noted that  the most  important change  was to                                                               
amend AS 08.86.180(b) which provided  exemptions to the licensing                                                               
law.  She opined that the  current statute was vague, and offered                                                               
an  impression  that  employees of  the  government,  educational                                                               
institutions, or  private agencies  could work as  a psychologist                                                               
without  a license.   She  noted that  this was  a public  safety                                                               
issue.     She  said   that  the   Board  of   Psychologists  and                                                               
Psychological  Associates suggested  that the  only exemption  be                                                               
for  school psychologists,  under very  limited conditions.   She                                                               
noted that Section  2 of HB 110 also allowed  an exemption for an                                                               
employee  of the  federal government  while on  the discharge  of                                                               
official duties,  which clarified  the legal doctrine  of federal                                                               
pre-emption.  She summarized the  two additional changes: removal                                                               
of the time  limit for licensure reexamination;  expansion of the                                                               
definition  "to  practice  psychology"   to  now  include  unpaid                                                               
services,  which  would  conform  the  statute  to  the  American                                                               
Psychological Association's model licensure act.                                                                                
                                                                                                                                
3:09:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HOLMES  asked  to clarify  that  Section  2(b)(1)                                                               
would not have  any negative effect on the  University of Alaska,                                                               
non-profits,  Department of  Health and  Social Services,  or the                                                               
municipalities.                                                                                                                 
                                                                                                                                
3:10:38 PM                                                                                                                    
                                                                                                                                
MS.  CARPENETI  expressed that  it  would  only have  a  positive                                                               
affect.   She  reiterated  that  HB 110  only  dealt with  people                                                               
offering  psychological  services.   She  compared  psychological                                                               
associates  to mid-level  providers.   She declared  that HB  110                                                               
would ensure the qualifications for psychological associates.                                                                   
                                                                                                                                
3:12:53 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  asked  if   there  were  any  other  jobs                                                               
requiring these qualifications which this bill would impact.                                                                    
                                                                                                                                
MS. CARPENETI said there were not.                                                                                              
                                                                                                                                
REPRESENTATIVE  SEATON asked  if there  were jobs  that had  this                                                               
examination   as  criteria   for  employment.     He   asked  for                                                               
clarification of who HB 110 would affect.                                                                                       
                                                                                                                                
MS. CARPENETI,  in response to  Representative Seaton,  said that                                                               
the bill was preventative.  She  explained that in the last year,                                                               
there  had  been two  cease  and  desist orders  for  individuals                                                               
practicing without the proper licensing.                                                                                        
                                                                                                                                
3:16:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON referred  to Section 1, line 8,  of HB 110,                                                               
and asked for a definition for psychometry.                                                                                     
                                                                                                                                
3:17:17 PM                                                                                                                    
                                                                                                                                
DR.   LORIN   BRADBURY,   Chair,  Board   of   Psychologist   and                                                               
Psychological Associate Examiners,  in response to Representative                                                               
Seaton, said  that HB 110  required licensing, and  clarified the                                                               
ambiguous language  of the  statute, in order  to make  it easier                                                               
for interpretation and enforcement.                                                                                             
                                                                                                                                
3:21:08 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  KELLER asked  if  the state  had  taken action  against                                                               
anyone practicing as psychologists.                                                                                             
                                                                                                                                
DR. BRADBURY replied  that the Board would only  receive a notice                                                               
of  action from  the investigative  unit, which  would include  a                                                               
letter  to cease  and  desist.   He  noted  that  names were  not                                                               
revealed, unless there was a resistance to compliance.                                                                          
                                                                                                                                
3:22:09 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON  commented that HB  110 would ensure that  no one                                                               
without a license could bill for the service.                                                                                   
                                                                                                                                
DR. BRADBURY  said that the Board  requested public clarification                                                               
that  no  one  could  practice psychology  in  Alaska  without  a                                                               
license.                                                                                                                        
                                                                                                                                
3:23:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON asked if  a license examination requirement                                                               
was  to  have  a recommendation  from  a  licensed  psychologist,                                                               
regardless of the degree an individual had earned.                                                                              
                                                                                                                                
DR. BRADBURY  replied that an application  had to be made  to the                                                               
licensing board,  and then, if the  educational requirements were                                                               
met,  the  board  would  approve the  examination.    He  further                                                               
explained  that  a  psychological associate  license  required  2                                                               
years  of   supervised  practice,  and  a   psychologist  license                                                               
required an additional year of supervision.                                                                                     
                                                                                                                                
3:25:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  asked if  there were  any other  jobs that                                                               
would require this license.  He  specified that he wanted to know                                                               
who was being restricted from jobs with this bill.                                                                              
                                                                                                                                
DR. BRADBURY replied  that it would prevent  someone from stating                                                               
that they were a psychologist and  having a client.  He explained                                                               
that the  licensing board was  responsible for the  protection of                                                               
the public.                                                                                                                     
                                                                                                                                
3:28:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA said  that many  health problems  included                                                               
mental health problems.  She  noted that the tribal health system                                                               
had community health  aides and behavioral health  aides, and she                                                               
expressed concern  that HB 110  would jeopardize  these necessary                                                               
positions.                                                                                                                      
                                                                                                                                
DR. BRADBURY responded that it  would not impact these positions,                                                               
and that HB  110 would only affect those  referring to themselves                                                               
as psychologists or psychological  associates, without the proper                                                               
licensing.                                                                                                                      
                                                                                                                                
3:31:04 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER  noted that "psychologist"  was not  well defined                                                               
in   the   statute.     He   asked   about  the   exemption   for                                                               
psychotherapists and psychoanalysts.                                                                                            
                                                                                                                                
3:31:55 PM                                                                                                                    
                                                                                                                                
DR. BRADBURY said that HB 110 did not address those exemptions,                                                                 
although he noted that it was standard language from the 1987                                                                   
APA Model Act for State Licensure of Psychologists.  He reported                                                                
that an updated model act was currently being drafted.  He                                                                      
referred to AS 08.86.180(d), which guaranteed that other                                                                        
licensed health professionals were not impacted.                                                                                
                                                                                                                                
3:33:21 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER referred to the  earlier mentioned criteria for a                                                               
psychologist which included therapy given  to "a client," yet, he                                                               
noted in  Section 3 that "for  a fee" was proposed  to be removed                                                               
from AS  08.86.230(6).  He  expressed concern that  this proposal                                                               
to amend allowed for too broad a context.                                                                                       
                                                                                                                                
3:34:52 PM                                                                                                                    
                                                                                                                                
DR.  PHILLIP  BAKER,   Legislative  Chair,  Alaska  Psychological                                                               
Association,  expressed  that  the current  statute  allowed  for                                                               
consumer vulnerability that should be  clarified and amended.  He                                                               
reported  that  the  psychologist services  were  controlled  and                                                               
defined  and that  services  were not  being  provided by  people                                                               
without the  appropriate training.   He expressed support  for HB
110.   In  response to  an earlier  question from  Representative                                                               
Seaton, he noted that psychometry meant psychological testing.                                                                  
                                                                                                                                
3:36:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON referred  to the  proposed definition  for                                                               
"to practice  psychology" in Section  3 of  HB 110, and  asked if                                                               
there was  anyone else offering  these services.  He  opined that                                                               
it was too broad.                                                                                                               
                                                                                                                                
3:37:33 PM                                                                                                                    
                                                                                                                                
DR.  BRADBURY  clarified that  the  proposed  definition was  not                                                               
addressing "counseling."   He stated that the  definition was for                                                               
those offering psychological services as psychologists.                                                                         
                                                                                                                                
3:38:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON replied that  the proposed definition would                                                               
require a  license "to  practice psychology."   He asked  for Dr.                                                               
Bradbury to interpret Section 3 of HB 110.                                                                                      
                                                                                                                                
3:40:29 PM                                                                                                                    
                                                                                                                                
DR.  BRADBURY explained  that  Section  3 specifically  addressed                                                               
those who were licensed to  practice independently.  He said that                                                               
the attorneys  for the  American Psychological  Association (APA)                                                               
suggested the removal of "for a fee."                                                                                           
                                                                                                                                
3:42:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  detailed  the unintended  consequence  of                                                               
amending the  definition of "to practice  psychology" by removing                                                               
"for a fee" in Section 3 of HB  110.  He offered his opinion that                                                               
everyone  who had  a  prior  exemption would  now  have  to be  a                                                               
licensed psychologist.                                                                                                          
                                                                                                                                
3:45:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   LYNN    asked   if   the    difference   between                                                               
psychologists and  psychiatrists was  the authority  to prescribe                                                               
medication.                                                                                                                     
                                                                                                                                
DR.  BRADBURY  agreed,  and  he  noted  that  psychiatrists  were                                                               
exempted in Section 2(b)(5).                                                                                                    
                                                                                                                                
REPRESENTATIVE   LYNN   asked   about  other   distinctions   for                                                               
psychiatrists which were not listed in Section 3 of HB 110.                                                                     
                                                                                                                                
DR.  BRADBURY replied  that  a psychiatrist  does  not engage  in                                                               
psychological testing.                                                                                                          
                                                                                                                                
REPRESENTATIVE LYNN asked about the use of psychometrics.                                                                       
                                                                                                                                
DR. BRADBURY agreed that both  professions often used the results                                                               
of a licensed psychologist to establish a diagnosis.                                                                            
                                                                                                                                
3:48:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA  cited  examples of  counseling  services,                                                               
including peer  counseling for substance abuse  and volunteers in                                                               
the prisons,  which could  be included  in Section  2 of  HB 110.                                                               
She expressed a desire for  an opinion from Legislative Legal and                                                               
Research  Services  that   these  classifications  of  counseling                                                               
services were not affected.                                                                                                     
                                                                                                                                
DR. BRADBURY,  in response to Representative  Cissna, referred to                                                               
Section  2 of  the bill,  proposed AS  08.86.180(b)(1), and  said                                                               
that  these aforementioned  were  peer counselors,  and were  not                                                               
trained to offer  psychological services.  He said  there was not                                                               
any intent to affect these peer counselors.                                                                                     
                                                                                                                                
3:53:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA  clarified  that  she meant  to  refer  to                                                               
Section  3   of  the  bill,   the  discussion  of   "to  practice                                                               
psychology," and  stated that the aforementioned  counselors were                                                               
not psychologists.                                                                                                              
                                                                                                                                
DR. BRADBURY,  in response  to Representative  Cissna, reiterated                                                               
that this was the language from  the 1987 APA Model Act for State                                                               
Licensure of Psychologists.                                                                                                     
                                                                                                                                
3:54:25 PM                                                                                                                    
                                                                                                                                
DR. BAKER, in response to  Representative Cissna, said that there                                                               
were  four mental  health licenses  and  "that all  of them  were                                                               
there to provide  mental health care services in  urban and rural                                                               
areas."    He agreed  that  there  were similar  services,  which                                                               
provided  psychological  services  based  on  training,  but  not                                                               
examination.   He explained  that this was  part of  the original                                                               
mental health  service license.   He expressed that,  through the                                                               
definition  of  the  license,  it  was  possible  to  define  the                                                               
practice  of psychology.   He  said  that this  did not  restrict                                                               
providers,  but that  the specialized  training allowed  specific                                                               
providers to call themselves psychologists.                                                                                     
                                                                                                                                
3:58:23 PM                                                                                                                    
                                                                                                                                
DR. BRADBURY read from AS 08.86.180(d):                                                                                         
                                                                                                                                
     Nothing in  this section prohibits a  licensed clinical                                                                    
     social   worker,   a   licensed  marriage   or   family                                                                    
     therapist,  or a  licensed professional  counselor from                                                                    
     holding out to the public  by a title or description of                                                                    
     services   incorporating   the  words   psychoanalysis,                                                                    
     psychoanalyst,   psychotherapy,   psychotherapist,   or                                                                    
     psychotherapeutic.                                                                                                         
                                                                                                                                
He  explained  that they  are  exempted.    He also  referred  to                                                               
Section 2(b)(5) of the bill, and  noted that a physician was also                                                               
exempted.   He expressed that there  was a great deal  of overlap                                                               
among the providers.                                                                                                            
                                                                                                                                
3:59:59 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON  asked that the  statute which Dr.  Bradbury read                                                               
be included in the members' packets.                                                                                            
                                                                                                                                
4:00:19 PM                                                                                                                    
                                                                                                                                
CO-CHAIR   KELLER  asked   about   the  psychological   associate                                                               
examination.                                                                                                                    
                                                                                                                                
4:00:41 PM                                                                                                                    
                                                                                                                                
DR. BRADBURY,  in response  to Co-Chair  Keller, spoke  about the                                                               
two  licenses  the  Board   of  Psychologists  and  Psychological                                                               
Associates  offered:  psychologist and  psychological  associate.                                                               
He  said that  both  licenses required  the  same two-part  test,                                                               
which  included  the  Examination for  Professional  Practice  in                                                               
Psychology (EPPP)  exam, and the state  law and ethics exam.   He                                                               
added  that this  exam was  in  addition to  the educational  and                                                               
supervisorial criteria.                                                                                                         
                                                                                                                                
4:02:24 PM                                                                                                                    
                                                                                                                                
DIANE CASTO, Prevention &  Early Intervention Manager, Prevention                                                               
and Early  Intervention Section,  Division of  Behavioral Health,                                                               
Department of  Health and Social  Services (DHSS),  reported that                                                               
DHSS  had discussed  the  possible impacts  to  tribal health  or                                                               
mental  health and  concluded that  HB 110  would not  impact its                                                               
services.  She noted that due  to the low number of psychologists                                                               
and   associate  psychologists   in  Alaska,   the  majority   of                                                               
behavioral health services were adequately provided by                                                                          
                                                                                                                                
     a  qualified member  of  another  profession, in  doing                                                                    
     work  of a  psychological nature  consistent with  that                                                                    
     person's  training  and  consistent with  the  code  of                                                                    
     ethics...                                                                                                                  
                                                                                                                                
She offered  her belief that  the critical nature was  for people                                                               
to practice  what they had  been trained.   She noted  that there                                                               
was  training  for  peer  counselors,  behavioral  health  aides,                                                               
substance  abuse counselors,  and  providers in  the rural  human                                                               
service program.   She clarified that many  small communities had                                                               
contract  psychologists to  do the  psychological  testing.   She                                                               
referred   to  the   exemption  provided   by  the   proposed  AS                                                               
08.86.180(b)(4) in Section 2 of the bill.                                                                                       
                                                                                                                                
4:07:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON referred  to Section  3 of  the bill,  and                                                               
asked if the  proposed elimination of "for a fee"  was of concern                                                               
to DHSS.   He  offered his  belief that  this proposed  change to                                                               
Section 3 would  eliminate the exemption in  Section 2, mentioned                                                               
above, and these persons would now be practicing psychology.                                                                    
                                                                                                                                
4:08:34 PM                                                                                                                    
                                                                                                                                
MS. CASTO,  in response to  Representative Seaton,  observed that                                                               
the definition  had been in law  for some time.   She pointed out                                                               
that people  did provide  services, regardless of  a fee  or not.                                                               
She offered  her belief that the  definition in Section 3  of the                                                               
bill   was  referring   to  a   specific  group,   identified  as                                                               
psychologists.  She specified that  psychological testing was the                                                               
specific  training to  differentiate  the  psychologists and  the                                                               
counselors.                                                                                                                     
                                                                                                                                
4:11:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HOLMES referred to  Section 2(b)(4) and questioned                                                               
the  use of  the word  "profession" instead  of "occupation,"  as                                                               
"profession"  was  understood  to  be   for  a  higher  level  of                                                               
education and training.   She noted that if  a service provider's                                                               
role did not have a code of  ethics, then it would not be covered                                                               
under this proposed subsection.                                                                                                 
                                                                                                                                
4:13:09 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER  asked about the  set rates for  reimbursement to                                                               
the providers.                                                                                                                  
                                                                                                                                
4:13:38 PM                                                                                                                    
                                                                                                                                
MS. CASTO agreed that there were  set rates, but that she did not                                                               
know the specific rates.                                                                                                        
                                                                                                                                
4:14:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  mentioned Alcoholics  Anonymous (AA)  as a                                                               
group without formal training but  with experience.  She endorsed                                                               
the need for  peer level, non-conventional provider  groups.  She                                                               
reiterated her  earlier request for  an opinion  from Legislative                                                               
Legal and Research Services.                                                                                                    
                                                                                                                                
4:16:05 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER reiterated the  earlier comment by Representative                                                               
Seaton  that the  law was  vague,  and upon  change, the  vaguery                                                               
became larger.                                                                                                                  
                                                                                                                                
4:17:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE LYNN observed that  licensing indicated a level of                                                               
knowledge and competence.                                                                                                       
                                                                                                                                
4:19:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  said that  the  removal  of "for  a  fee"                                                               
changed the meaning to include anyone engaged in the activity.                                                                  
                                                                                                                                
4:20:56 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON, in response to Representative Seaton,                                                                          
reiterated the testimony of Dr. Bradbury in which he stated that                                                                
the national association of lawyers recommended it.                                                                             
                                                                                                                                
4:21:58 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER noted that public testimony would remain open.                                                                  
                                                                                                                                
[HB 110 was held over.]                                                                                                         
                                                                                                                                
REPRESENTATIVE LYNN pointed out that a psychologist offering pro                                                                
bono work would be "without a fee."                                                                                             
                                                                                                                                
                                                                                                                                
4:23:13 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 4:23 p.m.                                                                                                          
                                                                                                                                

Document Name Date/Time Subjects
HB110-M19.PDF HHSS 3/19/2009 3:00:00 PM
HB 110
M19.PDF HHSS 3/19/2009 3:00:00 PM