01/29/2014 03:15 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| HB239 | |
| HB240 | |
| HB241 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 239 | TELECONFERENCED | |
| *+ | HB 240 | TELECONFERENCED | |
| *+ | HB 241 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
January 29, 2014
3:19 p.m.
MEMBERS PRESENT
Representative Kurt Olson, Chair
Representative Lora Reinbold, Vice Chair
Representative Bob Herron
Representative Dan Saddler
Representative Andy Josephson
MEMBERS ABSENT
Representative Mike Chenault
Representative Charisse Millett
COMMITTEE CALENDAR
HOUSE BILL NO. 239
"An Act extending the termination date of the Board of Examiners
in Optometry; and providing for an effective date."
MOVED HB 239 OUT OF COMMITTEE
HOUSE BILL NO. 240
"An Act extending the termination date of the Board of
Chiropractic Examiners; and providing for an effective date."
MOVED HB 240 OUT OF COMMITTEE
HOUSE BILL NO. 241
"An Act extending the termination date of the Board of Marital
and Family Therapy; and providing for an effective date."
MOVED HB 241 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 239
SHORT TITLE: EXTEND BOARD OF EXAMINERS IN OPTOMETRY
SPONSOR(s): REPRESENTATIVE(s) REINBOLD
01/21/14 (H) PREFILE RELEASED 1/10/14
01/21/14 (H) READ THE FIRST TIME - REFERRALS
01/21/14 (H) L&C, FIN
01/29/14 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 240
SHORT TITLE: EXTEND BOARD OF CHIROPRACTIC EXAMINERS
SPONSOR(s): REPRESENTATIVE(s) REINBOLD
01/21/14 (H) PREFILE RELEASED 1/10/14
01/21/14 (H) READ THE FIRST TIME - REFERRALS
01/21/14 (H) L&C, FIN
01/29/14 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 241
SHORT TITLE: EXTEND BOARD OF MARITAL & FAMILY THERAPY
SPONSOR(s): REPRESENTATIVE(s) REINBOLD
01/21/14 (H) PREFILE RELEASED 1/10/14
01/21/14 (H) READ THE FIRST TIME - REFERRALS
01/21/14 (H) L&C, FIN
01/29/14 (H) L&C AT 3:15 PM BARNES 124
WITNESS REGISTER
CRYSTAL KOENEMAN, Staff
Representative Lora Reinbold
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 239 on behalf of the prime
sponsor, Representative Lora Reinbold.
CRYSTAL KOENEMAN, Staff
Representative Lora Reinbold
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 240 on behalf of the prime
sponsor, Representative Lora Reinbold.
KRIS CURTIS, Legislative Auditor
Division of Legislative Audit
Legislative Agencies and Offices
Juneau, Alaska
POSITION STATEMENT: Answered questions on auditor findings and
recommendations during the discussion of HB 240.
DON HABEGER, Director
Division of Corporations, Business, and Professional Licensing
Department of Commerce, Community, & Economic Development
Juneau, Alaska
POSITION STATEMENT: Answered questions during the discussion of
HB 240.
JIM HESTON, D.C.; Chair
Board of Chiropractic Examiners
Department of Commerce, Community & Economic Development (DCCED)
Homer, Alaska
POSITION STATEMENT: Testified and answered questions during the
discussion of HB 240.
CRYSTAL KOENEMAN, Staff
Representative Lora Reinbold
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 241 on behalf of the prime
sponsor, Representative Lora Reinbold.
KRIS CURTIS, Legislative Auditor
Division of Legislative Audit
Legislative Agencies and Offices
Juneau, Alaska
POSITION STATEMENT: Presented auditor findings and
recommendations and answered questions during the discussion of
HB 241.
DON HABEGER, Director
Division of Corporations, Business, and Professional Licensing
Department of Commerce, Community, & Economic Development
Juneau, Alaska
POSITION STATEMENT: Briefly testified during the discussion of
HB 241.
LEON WEBBER, D.Mn., LMFT; Chair
Board of Marital & Family Therapy (BMFT)
Department of Commerce, Community & Economic Development (DCCED)
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during the
discussion of HB 241.
KENNITH MCCARTY, Board Member
Board of Marital & Family Therapy
Department of Commerce, Community & Economic Development
Eagle River, Alaska
POSITION STATEMENT: Testified and answered questions during the
discussion of HB 241.
ACTION NARRATIVE
3:19:30 PM
CHAIR KURT OLSON called the House Labor and Commerce Standing
Committee meeting to order at 3:19 p.m. Representatives
Saddler, Reinbold, Josephson, Herron, and Olson were present at
the call to order.
HB 239-EXTEND BOARD OF EXAMINERS IN OPTOMETRY
3:19:56 PM
CHAIR OLSON announced that the first order of business would be
HOUSE BILL NO. 239, "An Act extending the termination date of
the Board of Examiners in Optometry; and providing for an
effective date."
3:20:27 PM
CRYSTAL KOENEMAN, Staff, Representative Lora Reinbold, Alaska
State Legislature, on behalf of Representative Reinbold,
sponsor, stated that HB 239 will reauthorize the Board of
Examiners in Optometry for eight years at the recommendation of
the Legislative Audit Division. The division concluded that the
termination date of June 30, 2022 was sufficient since the board
serves the public interest by effectively licensing and
regulating the industry. The legislative auditors recommended
that the Division of Corporations, Business, and Professional
Licensing (DCBPL) within the Department of Commerce, Community,
and Economic Development (DCCED) continue its efforts to improve
the case management system. In the past few years, the division
has taken great strides to improve the integrity of the
aforementioned system and she anticipated the efforts would
continue.
3:22:00 PM
REPRESENTATIVE SADDLER asked whether any developments or changes
have arisen for the practice of optometry.
MS. KOENEMAN answered no. In further response to a question,
she was not aware of any other bills that affected this board.
3:23:46 PM
CHAIR OLSON, after first determining no one else wished to
testify, closed public testimony on HB 239.
REPRESENTATIVE HERRON remarked that this is clearly needed.
3:24:19 PM
REPRESENTATIVE SADDLER moved to report HB 239 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 239 was reported from the
House Labor and Commerce Standing Committee.
3:24:47 PM
The committee took an at-ease from 3:24 p.m. to 3:26 p.m.
HB 240-EXTEND BOARD OF CHIROPRACTIC EXAMINERS
3:26:48 PM
CHAIR OLSON announced that the next order of business would be
HOUSE BILL NO. 240, "An Act extending the termination date of
the Board of Chiropractic Examiners; and providing for an
effective date."
3:27:10 PM
CRYSTAL KOENEMAN, Staff, Representative Lora Reinbold, Alaska
State Legislature, on behalf of Representative Reinbold,
sponsor, stated that HB 240 would extend the Board of
Chiropractic Examiners (BCE). The auditors recommended that the
BCE be extended for a full eight years until June 30, 2022 since
the board has been effectively serving the public interest and
effectively licensing and regulating the chiropractic community.
She highlighted two recommendations the auditors made. First,
the auditors indicated a prior audit recommendation should be
implemented, such that the governor shall appoint board members
in accordance with statute. One board member did not meet the
statutory requirements at the time of the appointment, although
the governor subsequently took the appropriate steps and removed
the person from the board and reappointed another member.
Second, the auditors recommended that the Division of
Corporations, Business, and Professional Licensing (DCBPL)
improve its investigative case management system. As previously
mentioned the division has taken great strides in the past few
years to improve the integrity of the aforementioned system and
she anticipated the DCBPL's efforts would continue.
3:28:57 PM
REPRESENTATIVE SADDLER referred to the fiscal note for the prior
bill, HB 239, relating that the fiscal note for Board of
Examiners in Optometry (BEO) was for $6.8 thousand. However the
fiscal note for HB 240 lists $16.6 thousand for BCE's travel
costs. He noted that the fiscal note narrative indicates that
BCE's board members would attend an out-of-state conference. He
asked for more details on the out-of-state conference since the
fiscal notes don't seem to match up.
MS. KOENEMAN answered that BCE board members attend out-of-state
trainings and conferences to keep current with national
practices and other state's laws pertaining to the practice or
any trends.
3:30:09 PM
REPRESENTATIVE SADDLER detailed that the Board of Examiners in
Optometry (BEO) projected travel costs for two meetings a year
at $6.8 thousand whereas this board would attend four meetings
per year estimated at $16.6 thousand. He asked for further
clarification since he did not think the out of state conference
figures seemed comparable.
3:30:40 PM
KRIS CURTIS, Legislative Auditor, Division of Legislative Audit,
Legislative Agencies and Offices, stated that the division
conducted a sunset audit dated June 6, 2013. The auditors
recommended extending the termination date of the board for
eight years, which is the maximum allowed in statute. The
auditors concluded the BCE was operating in the public's
interest since it monitors licensees and ensures that only
qualified individuals practice. From fiscal year 2006 (FY 06)
through FY 12, the board adopted, repealed, or revised 35
regulations The regulation changes focused primarily on
updating continuing education, adding an oral examination to the
licensing requirement, requiring criminal background checks for
applicants, and clarifying and defining regulatory language.
During that same time, FY 06-FY 12, the number of license
applicants increased by 28 percent, from 226 in FY 06 to 290 in
FY 12. As previously mentioned, the auditors recommended two
changes regarding the appointment of board members: first, to
the DCBPL's director, and second, to the Office of the Governor.
In response to a question on the number of regulations the BCE
addressed, Ms. Curtis answered that the auditors found 35
regulations were revised, repealed, or adopted during that time
period.
3:32:57 PM
REPRESENTATIVE SADDLER asked for specific purpose of the travel
and whether the travel was for training to improve the
chiropractic practice or for training members of a professional
licensing board to improve board performance.
MS. CURTIS answered that the audit addressed travel. She
acknowledged that some boards have had difficulty in obtaining
authority to use funding for out-of-state travel; however, of
the five occupational sunset reviews the division conducted,
this is the only one not permitted to travel. She referred to
page 15 of the BCE's sunset audit for the BCE and said the
auditors concluded the restrictions impeded the board's ability
to operate as a board. Additionally, the audit concluded that
BCE's board members were prohibited from travel due to DCBPL's
budgetary restrictions. She said, "According to DCBPL
management, restrictions on travel should be alleviated in FY 14
by an increase in the travel budget and the ability to receive
third-party reimbursements for some board member travel." She
explained that this means that in some cases travel is
reimbursed since it is built into a portion of the fees paid to
be part of the national organization.
3:34:24 PM
REPRESENTATIVE SADDLER asked for clarification. He related his
understanding that board members could not obtain permission
from the division to attend out-of-state conferences. He asked
whether the ultimate determination on how to spend the fees
generated through licenses rests with the division and not the
board.
MS. CURTIS deferred to the division director; however, she
recalled testimony at last year's hearings that some complaints
were voiced about restrictions boards faced when using their
budgets for out-of-state travel. Thus auditors included the
complaint in scope of sunset audits conducted in 2013. She
reiterated the BCE was the only board experiencing this specific
problem.
3:35:10 PM
REPRESENTATIVE JOSEPHSON asked for clarification on the process
used for the 35 aforementioned regulations. He asked whether
the regulations were initiated by the individual board members
or if the BCE had absolute power to create regulations subject
to the Lieutenant Governor's approval.
MS. CURTIS deferred to the division director for details, noting
regulation changes may vary from board to board. One criteria
auditors use when evaluating boards during the sunset audit
process is to measure to what degree the board addresses public
interest and one way boards do this is by enacting regulations,
she said.
3:36:42 PM
REPRESENTATIVE JOSEPHSON clarified that he was interested in the
"check" on the body itself.
MS. CURTIS answered that all regulations go through a public
process.
3:37:00 PM
DON HABEGER, Director, Division of Corporations, Business, and
Professional Licensing (DCBPL), Department of Commerce,
Community, & Economic Development (DCCED), with respect to
travel costs, answered that it varies by board. In some
instances board members attend regional meetings. In other
instances board members attend a national conference, often with
a membership connected to it. The national organizations
consist of a group of likeminded state regulators and board
members across the nation meet periodically to regulate the
specific practice. Typically, the national organization will
review practice decisions, for example, it may consider
something such as injectible nutrients. The national
organization will come to consensus or it will agree to disagree
on a variety of national practice decisions that affect the
profession. Additionally, the national organization requests
BCE's board members participate in a national group to design
the national test and review questions as part of this process.
He believed the Chair, Dr. Heston, has participated in this
process. Referring to the fiscal note he said the $15.0
thousand represents the biennial costs for travel in FY 14. He
clarified the division assesses board costs based on the prior
two years.
3:39:49 PM
MR. HABEGER turned to limited travel. As previously stated,
this issue has been corrected. The DCBPL considered travel
costs to be a budgetary appropriation issue. At the time he
became director, the DCBPL had over $300,000 in travel
appropriations; however, each board prepares an annual report
and the total travel requests exceeded $550,000. Typically, he
approved in-state travel, but out-of-state travel was based on
available funding so the division denied some travel requests.
He emphasized that in 2014, the legislature increased the
division's travel budget by $200,000, which alleviated the
problem. He explained that a number of national organizations
encourage board members to attend conferences and reimburse the
state through a third-party reimbursement for travel costs.
Previously, the division lacked the mechanism to restore funds
to each board; instead, travel reimbursements were deposited to
the general fund; however, that was corrected last year, he
said.
3:42:04 PM
MR. HABEGER reviewed the promulgation of regulations process,
such that the statutes under Title 8, give boards practice
authority. The boards identify which statutes need to be
repealed or amended to reflect any additional practices
necessary, such as adopting or changing continuing education
requirements. He didn't recall the specific BCE regulation
changes; however the boards work with the regulations
specialist, regulations are drafted, noticed - typically for 30-
days - for public comment, the board reviews public comments and
determines whether to adopt the regulations or make changes. He
said the legislature receives copies of all proposed
regulations.
3:43:42 PM
REPRESENTATIVE SADDLER asked whether any developments have
arisen for chiropractors that need to be addressed.
MR. HABEGER offered his belief that chiropractors are
considering allowing injectible nutrients, but he offered to
confirm this.
3:44:27 PM
JIM HESTON, D.C.; Chair, Board of Chiropractic Examiners (BCE),
with respect to travel, commented that the BCE connects with
fellow boards at conferences. The travel to conferences helps
board members keep informed, proactively, on national trends and
potential regulation changes. He recalled the BCE made about 10
regulation changes and was unsure of the 35 regulation changes
previously mentioned. In response to a question, Dr. Heston
said the number of regulations changed seemed high.
3:46:11 PM
REPRESENTATIVE REINBOLD explained that the total number of
regulations included repealing, amending, and revising
regulations.
DR. HESTON said, "I can believe that."
CHAIR OLSON, after first determining no one else wished to
testify, closed public testimony on HB 240.
3:46:52 PM
REPRESENTATIVE SADDLER moved to report HB 240 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 240 was reported from the
House Labor and Commerce Standing Committee.
3:47:23 PM
The committee took an at-ease from 3:47 p.m. to 3:49 p.m.
HB 241-EXTEND BOARD OF MARITAL & FAMILY THERAPY
3:49:27 PM
CHAIR OLSON announced that the final order of business would be
HOUSE BILL NO. 241, "An Act extending the termination date of
the Board of Marital and Family Therapy; and providing for an
effective date."
3:49:41 PM
CRYSTAL KOENEMAN, Staff, Representative Lora Reinbold, Alaska
State Legislature, stated that the bill will extend the Board of
Marital and Family Therapy (BMFT) until June 30, 2018, based on
a previous audit. Auditors recommended a four-year extension
based on two prior audit recommendations from the 2009 audit
that had not been fully resolved. First, the audit recommended
that the Board of Marital and Family Therapy (BMFT) develop a
strategy for distance therapy and distance supervision. She
said she discussed this with the BMFT's chair. The chair
advised that the board worked with the division and the
Department of Law and concluded that the matter will require
statutory language to implement changes. She said the board is
moving forward for proposed language for possible introduction
next legislative session.
3:51:01 PM
CHAIR OLSON asked whether the small size of the BMFT adds to the
present challenges.
MS. KOENEMAN answered yes. Auditors also recommended that the
Office of the Governor and the board work together to fill
vacant board seats timely. She recalled the BMFT consists of
almost 100 licensees, although the board or the division could
confirm the figures. She advised that the board member vacancy
has since been filled. Finally, the auditors recommended that
the BCBPL's investigative case management system be improved,
but as previously mentioned the division has made improvements
in this area. The sponsor agrees with the legislative auditors
on the recommended four-year extension, she said.
3:52:25 PM
REPRESENTATIVE JOSEPHSON was surprised by the small number of
licensees.
MS. KOENEMAN explained that by statute, one requirement for
marital and family therapist licensures is the therapist must
have 1,500 hours of practice, of which 200 hours must be
supervised. In response to a question on whether the clients or
the professional needs distance supervision she deferred to the
division.
3:54:11 PM
KRIS CURTIS, Legislative Auditor, Division of Legislative Audit,
Legislative Agencies and Offices, explained the division
conducted a sunset audit dated June 19, 2013, with the main
objective to determine whether the board is serving the public's
interest and if it should be extended. The legislative auditors
recommended only a four-year extension since the board had not
fully addressed the prior sunset audit recommendation to pursue
regulation changes that are necessary to protect the public's
interest. The prior audit's reasoning on the recommendation was
slightly different. Although the board initiated one regulation
change, the board has not addressed the need for distance
supervision and distance therapy. She explained that distance
supervision pertains to licensure, such that an applicant must
have a certain number of supervised hours to become licensed as
a marital and family therapist. Distance supervision would be
provided electronically, possibly through the Internet, or from
other technology. Currently, BMFT's services are not widely
available in some areas of the state and distance delivery has
been viewed as being a means to address this disparity.
MS. CURTIS said that during the current audit period the board
extensively researched and discussed the topic; however, it made
little progress in developing regulations and the board does not
have a strategy to move past the discussion phase. The auditor
recommended the board develop a strategy to address the need for
distance services, and the board and division concurred with the
recommendation. She reported that as of March 2013, 91
applicants applied for licensure. Additionally the BMFT
licenses associates, although she did not have the figures for
that category of license. In response to Representative
Josephson, Ms. Curtis replied that the BMFT offers one type of
license, but people can obtain services in other areas, such as
social worker examiners, professional counselors, and
psychologists.
3:57:17 PM
REPRESENTATIVE SADDLER asked for the historical counts on
licensees.
MS. CURTIS referred to page 17 of the audit that shows a count
by year on the number of new licenses issued, which varies from
three to nine licenses.
3:57:54 PM
DON HABEGER, Director, Division of Corporations, Business, and
Professional Licensing (DCBPL), Department of Commerce,
Community, & Economic Development (DCCED), deferred to Mr.
Webber, Chair, Board of Marital & Family Therapy (BMFT).
3:58:46 PM
LEON WEBBER, D.Mn., LMFT; Chair, Board of Marital & Family
Therapy (BMFT), Department of Commerce, Community & Economic
Development (DCCED), related his understanding that the board
previously faced financial difficulties, stemming from
investigative expense, with fees increasing to $1,000 for a
biennial license, resulting in some licensees transferring to
larger boards with lower fees. Currently, the board licenses
118 "marriage and family therapists" and "marriage and family
therapy associates." Although marital and family therapists
practice in the specific field, as previously mentioned,
services are also being provided other professionals such as
those providing couples therapy. The field of marital and
family therapy specifically requires licensees to achieve a
masters' level or doctorate level in marriage and family
therapy.
REPRESENTATIVE JOSEPHSON acknowledged the fields have all become
very sophisticated and complicated.
4:01:18 PM
REPRESENTATIVE SADDLER wondered about the quality of service
provided by the other professionals when the BMFT's licensees
shift to other boards.
MR. WEBBER answered that he couldn't answer that question. He
said the BMFT's responsibility is to ensure that those who are
licensed by the board provide quality services and for other
professions to monitor and oversee services provided under other
licenses to ensure their licensees are qualified to perform
them. He lauded DCBPL's director, Mr. Habeger, for providing
financial assistance to the board. He said the sunset review
was very thorough and he reported that the BFMT has subsequently
contacted 49 states to obtain research and has worked with other
boards and health care agencies on tele-therapy and tele-
supervision. For example, tele-therapy might mean a licensed
therapist in Alaska is providing therapy to an out-of-state
client in Idaho or it may mean a therapist in a residential
treatment center in Idaho is providing family therapy to someone
in Alaska. Thus far, the board hasn't established any
guidelines to address those issues or any competency issues for
tele-therapy services, noting that an average therapist may not
feel as competent providing distance therapy, he said.
Additionally, confidentiality issues have arisen, for example,
whether encrypted communications are needed. The BMFT
considered these matters at its last board meeting, and plans to
address proposed statutes, regulations, and ethical guidelines
at its next meeting, which he said has been a huge challenge.
4:03:48 PM
REPRESENTATIVE SADDLER asked whether the division's remedies on
investigation costs will stabilize the number of licensees and
curtail the drift of BMFT's licensees to other boards.
MR. WEBBER thought it would do so. He anticipated that license
fees will drop to within several hundred dollars of other
similar professional fees. He did not envision more therapists
would leave the field. He characterized the total clarity on
finances as being a relief.
4:04:52 PM
REPRESENTATIVE SADDLER asked whether he envisioned other changes
in the field that will need to be addressed.
MR. WEBBER answered that it will be important to monitor how
well tele-therapy is handled. For example, he related that he
is participating in this hearing from Hawaii, while
simultaneously his friend is at a military base hospital
conducting tele-therapy with five members of a family who are
located in Iraq, North Carolina, and Honolulu. He said that his
board recognizes that this type of service is beginning to
become predominant in the field. He looked forward to working
with the legislature on statutory and regulation changes. In
further response to a question, he said the BMFT hopes to have a
bill introduced next year.
CHAIR OLSON said appreciated the work Mr. Habeger has done to
address the investigative costs and level the fees for all
boards.
4:07:02 PM
KENNITH MCCARTY, Board Member, Board of Marital & Family Therapy
(BMFT), Department of Commerce, Community & Economic Development
(DCCED), stated he also serves as the president of the
Association for Marriage and Family Therapists. He provided a
brief background of his service and the board issues that arose
from an investigation. He explained that the BMFT's statutes
have title protection, but not practice protection. In other
words, unless a person is licensed by the BMFT, the professional
cannot call themselves a family therapist on his/her business
card, but the person could offer other services such as "couples
counseling." In response to a question on practice protection,
he said the board was unsure of how to proceed with practice
protection. For example, in the instance of couples counseling,
the board could examine the type of experience in terms of
education and training; however, the board is holding ongoing
discussions.
CHAIR OLSON suggested members could contemplate statutory
remedies to assist the board.
4:10:46 PM
MR. MCCARTY, in response to the comment on the number of
licensees, agreed that higher license fees has affected the
number of overall practitioners, but the division's efforts to
reduce license fees have helped remedy this and may lead to some
professionals applying for dual licenses.
REPRESENTATIVE REINBOLD lauded Mr. McCarty. She encouraged him
working with Mr. Webber, and her staff and congratulated him on
his wedding.
4:12:21 PM
CHAIR OLSON, after first determining no one else wished to
testify, closed public testimony on HB 241.
4:12:40 PM
REPRESENTATIVE SADDLER moved to report HB 241 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 241 was reported from the
House Labor and Commerce Standing Committee.
4:13:00 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
4:13 p.m.