Legislature(1993 - 1994)

04/14/1994 03:00 PM L&C

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    HOUSE LABOR AND COMMERCE                                   
                       STANDING COMMITTEE                                      
                         April 14, 1994                                        
                            3:00 p.m.                                          
  MEMBERS PRESENT                                                              
  Rep. Bill Hudson, Chairman                                                   
  Rep. Joe Green, Vice Chair                                                   
  Rep. Eldon Mulder                                                            
  Rep. Brian Porter                                                            
  Rep. Jerry Mackie                                                            
  MEMBERS ABSENT                                                               
  Rep. Bill Williams                                                           
  Rep. Joe Sitton                                                              
  COMMITTEE CALENDAR                                                           
  *HB 545:  "An Act including marital and family therapists as                 
            providers protected from unfair discrimination                     
            under group disability insurance; and providing                    
            for an effective date."                                            
            PASSED OUT OF COMMITTEE                                            
  HB 458:   "An Act relating to certain licenses and                           
            applications for licenses for persons who are not                  
            in substantial compliance with support orders or                   
            payment schedules for child support."                              
            HEARD AND HELD IN COMMITTEE                                        
  (* First public hearing.)                                                    
  WITNESS REGISTER                                                             
  DIXIE HOOD                                                                   
  Licensed Marriage and Family Therapist                                       
  222 Seward, Suite 210                                                        
  Juneau, Alaska  99801                                                        
  Phone:  (907) 586-2200                                                       
  Position Statement:  Testified in support of HB 545                          
  SHERRIE MARKIN GOLL, Lobbyist                                                
  Alaska Association for Marriage & Family Therapists                          
  P.O. Box 22156                                                               
  Juneau, Alaska  99827                                                        
  Phone:  (907) 463-6744                                                       
  Position Statement:  Answered questions on HB 545                            
  REP. JOHN DAVIES                                                             
  Alaska State Legislature                                                     
  State Capitol, Room 400                                                      
  Juneau, Alaska 99801                                                         
  Phone:  (907) 465-4457                                                       
  Position Statement:  Prime Sponsor of HB 458                                 
  MARY GAY, Director                                                           
  Child Support Enforcement Division                                           
  Department of Revenue                                                        
  550 W. 7th, Suite 312                                                        
  Anchorage, Alaska  99501-3556                                                
  Phone:  (907) 269-6800                                                       
  Position Statement:  Testified in support of HB 458                          
  MATT ANDERSON, Training Coordinator                                          
  Emergency Medical Services                                                   
  Division of Public Health                                                    
  Department of Health and Social Services                                     
  P.O. Box 110616                                                              
  Juneau, Alaska  99811-0616                                                   
  Phone:  (907) 465-3027                                                       
  Position Statement:  Testified in support of HB 458                          
                       with considerations                                     
  PATRICIA J. O'BRIEN                                                          
  Social Services Program Officer                                              
  Division of Family and Youth Services                                        
  Department of Health and Social Services                                     
  P.O. Box 110630                                                              
  Juneau, Alaska  99811                                                        
  Phone:  (907) 465-2145                                                       
  Position Statement:  Testified in support of HB 458                          
                       with considerations                                     
  PREVIOUS ACTION                                                              
  BILL:  HB 545                                                                
  SPONSOR(S): LABOR & COMMERCE BY REQUEST                                      
  JRN-DATE    JRN-PG                     ACTION                                
  04/06/94      3155    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  04/06/94      3155    (H)   LABOR & COMMERCE                                 
  04/12/94              (H)   L&C AT 03:00 PM CAPITOL 17                       
  04/12/94              (H)   MINUTE(L&C)                                      
  04/14/94              (H)   L&C AT 03:00 PM CAPITOL 17                       
  BILL:  HB 458                                                                
  SPONSOR(S): REPRESENTATIVE(S) DAVIES                                         
  JRN-DATE    JRN-PG                     ACTION                                
  02/09/94      2320    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  02/09/94      2321    (H)   L&C, JUDICIARY, FINANCE                          
  04/05/94              (H)   L&C AT 03:00 PM CAPITOL 17                       
  04/05/94              (H)   MINUTE(L&C)                                      
  04/07/94              (H)   L&C AT 03:00 PM CAPITOL 17                       
  04/08/94              (H)   FIN AT 01:30 PM HOUSE FINANCE                    
  04/14/94              (H)   L&C AT 03:00 PM CAPITOL 17                       
  ACTION NARRATIVE                                                             
  TAPE 94-37, SIDE A                                                           
  Number 001                                                                   
  CHAIRMAN HUDSON called the meeting to order at 3:17 p.m.,                    
  stated there was a quorum present and announced the                          
  calendar.  He said the committee would address committee                     
  substitute (CS) HB 545 dated 4/11/94 and he also mentioned                   
  that SB 64/HB 251 would not be addressed at today's meeting.                 
  He asked DIXIE HOOD to present the bill.                                     
  HB 545 - DISCRIMINATION UNDER HEALTH INSURANCE                               
  Number 025                                                                   
  DIXIE HOOD, Licensed Marriage and Family Therapist,                          
  testified in support of HB 545.  She said it was not                         
  possible for a board member of the Alaska Association for                    
  Marriage and Family Therapy to attend the meeting, but a                     
  document from Mercy Dennis, chair of the association's                       
  legislative committee, was made available to committee                       
  members.  She presented the following statement:                             
  "My name is Dixie Hood.  I am a licensed marriage and family                 
  therapist in private practice in Juneau.  I am here to ask                   
  your support for HB 545.  This bill would provide licensed                   
  marriage and family therapists parity with other licensed                    
  health care professionals in Alaska.  In addition to private                 
  practice I have worked as a mental health clinician and as a                 
  substance abuse counselor with the Juneau Department of                      
  Health and Social Services.  My training and experience                      
  includes working with clients who are experiencing                           
  depression, severe anxiety, eating disorders, phobias,                       
  schizophrenia and other serious mental disorders as well as                  
  clients who are suffering emotional stress from family or                    
  work situations.  I developed a substance abuse treatment                    
  program at the State Correctional Center at Lemon Creek.  I                  
  mention these things because some of you may have the idea                   
  that the work of marriage and family therapists is limited                   
  to minor personal problems or marriage and divorce                           
  "I would like to briefly describe my own experience in this                  
  profession in Alaska.  Because of limited academic resources                 
  in this state, I went to California for clinical training.                   
  After two years of graduate school, 3,000 supervised hours,                  
  and written and oral exams, I earned licensure in                            
  California.  In California one could not call themselves a                   
  counselor or do the work of counseling without such                          
  preparations and licensure.  I returned to Alaska to work                    
  and learned that there were no standards or license for                      
  counselors and that only a state business license was                        
  required.  For this I paid seven dollars and 50 cents.  This                 
  was ten years ago.  I inquired about the standard counseling                 
  fees in Juneau.  Counselor friends told me that the going                    
  rate was 40 dollars per hour because that was half of what                   
  psychologists charged.  Medical insurance would reimburse 50                 
  percent for services provided by psychologists so 40 dollars                 
  was the amount a client had to pay out of pocket.                            
  Therefore, in order to compete, counselors charged 40                        
  dollars.  It was not a level playing field.  As I                            
  established myself as a psychotherapist in the community I                   
  was able to increase my professional fee to a more                           
  supportable income.  However, Juneau is a government town                    
  with many employees having good medical insurance.  When                     
  seeking health services, they want maximum reimbursement.                    
  Licensed medical doctors, psychiatrists, and psychologists                   
  have been regularly reimbursed by insurance companies.  When                 
  licensed social workers were added to the list of providers                  
  not to be discriminated against, that offered another level                  
  of service and fee options to perspective clients.  Adding                   
  marriage and family therapists to this list would not expand                 
  the number of clients served or the cost.  It would add an                   
  alternative level of treatment.  This is comparable to nurse                 
  practitioners versus physicians for medical treatment.  It                   
  can actually decrease the costs of service.  Marriage and                    
  family therapists are qualified to do much of the same work                  
  as other licensed mental health professionals and can do it                  
  cheaper.  In Juneau there is a shortage of psychiatrists.                    
  They often see clients only for the prescription and                         
  monitoring of medication and not for psychotherapy.  There                   
  are often waiting lists for psychiatrists and psychologists                  
  because of insurance reimbursement considerations.  In many                  
  smaller communities in Alaska there are neither                              
  psychiatrists nor psychologists nor social workers.                          
  "Passage of HB 545 would enable clients some reasonable                      
  options in choosing treatment.  Thanks to lobbying efforts                   
  by the Alaska Association for Marriage and Family Therapy                    
  and the support of the legislature and the administration                    
  two years ago, there are now established standards for                       
  licensing marriage and family therapists in this state.                      
  Parity in terms of third party payment is the logical next                   
  step.  The ability to conduct a private practice depends, to                 
  a significant extent, upon insurance and other forms of                      
  reimbursement.  I urge you to move this bill forward.  I                     
  would be glad to answer any questions."                                      
  Number 080                                                                   
  REP. MULDER asked about the standards adopted for licensure                  
  in Alaska.                                                                   
  Number 082                                                                   
  SHERRIE GOLL, Lobbyist, Alaska Association for Marriage and                  
  Family Therapy, replied that standards are similar to those                  
  in California and consist of a master's degree and 3,000                     
  hours of supervision.                                                        
  MS. HOOD referred to a grandfather clause that enabled those                 
  who qualified to become licensed in Alaska last August.  She                 
  said because she was licensed in California and was also a                   
  member of the American Association for Marriage and Family                   
  Therapy, she presented the necessary background to become                    
  REP. MULDER asked if there were people grandfathered-in who                  
  did not possess the minimum qualifications.                                  
  MS. GOLL indicated that national standards had to be                         
  REP. MULDER asked if a master's level training was offered                   
  in Alaska.                                                                   
  MS. HOOD said she thought the nearest program was in                         
  Seattle.  It was pointed out that neither a social work                      
  program nor a master's level training program was available                  
  in Alaska.                                                                   
  Number 097                                                                   
  REP. GREEN mentioned that nurse practitioners have certain                   
  restrictions as compared to physicians.  Comparably, he                      
  posed a question about the limitations imposed on therapists                 
  when dealing with emotional or psychological problems.                       
  Number 101                                                                   
  MS. HOOD replied that she was trained and qualified to do                    
  psychological evaluations, diagnosis, and treatment within                   
  the range of her background experience.  She stated she was                  
  not able to issue prescription medication or provide                         
  psychological testing.  She added that some marriage and                     
  family therapists have the expertise to do that sort of                      
  testing and therefore the limitation would be in terms of                    
  experience.  She said she has worked at in-patient                           
  psychiatric facilities and also at a day care center for                     
  chronic schizophrenics, so she has worked with a severely                    
  mentally ill population.                                                     
  Number 117                                                                   
  REP. GREEN asked if she would know if she was working with                   
  someone who was depressed as opposed to someone who was                      
  schizophrenic and needed psychiatric treatment.                              
  Number 120                                                                   
  MS. HOOD replied that her responsibility was to do an                        
  evaluation and determine if a situation was within the scope                 
  of her experience and training; if this was not the case,                    
  she would make an appropriate referral.                                      
  Number 125                                                                   
  REP. MULDER said, "You mentioned it would be less expensive                  
  to have you included under this umbrella because you provide                 
  many of the same services for less cost.  How do your                        
  average charges reflect against those of a licensed                          
  Number 129                                                                   
  MS. HOOD replied that her fee is 75 dollars and she believes                 
  the psychiatrists in Juneau charge 100-125 dollars, and                      
  psychologists charge 80-100 dollars.                                         
  Number 134                                                                   
  REP. MULDER asked if it was reasonable to expect that her                    
  fee structure would change if insurance was involved.                        
  MS. HOOD said she did not think this would be the case.  She                 
  explained that the Human Affairs Managed Care Organization                   
  determines an appropriate rate and will not offer                            
  reimbursement if someone charges more than what has been                     
  determined as fair.  She said she knows of at least one                      
  psychologist in Juneau who experienced a problem being                       
  accepted as a preferred provider because insurance was                       
  reluctant to pay the additional amount that was being                        
  Number 149                                                                   
  REP. MULDER asked if any insurance plans currently cover the                 
  services Ms. Hood provides.                                                  
  MS. HOOD replied in the affirmative.                                         
  REP. MULDER asked about the tolerances currently provided by                 
  insurance companies.  He posed a question about the upper                    
  level Ms. Hood could charge and still remain covered by                      
  MS. HOOD said she had not heard a stated figure.                             
  Number 150                                                                   
  REP. MULDER said he thought it was common practice that                      
  insurance companies allowed up to "x" amount of dollars.                     
  MS. GOLL (indiscernible) said the top limit is not really                    
  known because marriage and family therapists charge below                    
  that limit, and therefore what they do charge is acceptable.                 
  MS. HOOD said she thought the Juneau Department of Health                    
  and Social Services bills insurance companies at a higher                    
  amount for their clinicians than what private practice                       
  therapists charge.                                                           
  Number 160                                                                   
  REP. MULDER asked Ms. Hood if her practice was covered by                    
  state employee coverage.                                                     
  MS. HOOD said she could see clients who were state                           
  employees, but she had to do this in a roundabout way.  She                  
  explained that a physician's referral and supervisory                        
  statement was needed because of the physician's license.                     
  She said physicians were very supportive of counseling                       
  because it often helped with medical symptoms, such as                       
  chronic headaches and stomach aches, which frequently have                   
  psychosomatic aspects.  She added that she thought it a                      
  legitimate consideration to be working under her own license                 
  rather than a physician's.                                                   
  Number 174                                                                   
  REP. MULDER asked if the administration viewed this as a                     
  cost saving mechanism for health care.                                       
  CHAIRMAN HUDSON indicated a zero fiscal note and stated that                 
  HB 545 simply adds marital and family therapists to the line                 
  for insurance so that they might receive treatment similar                   
  to that of other professionals.  He said they had not                        
  received any negative remarks from the administration.                       
  Number 180                                                                   
  REP. MACKIE moved to pass CSHB 545(L&C) from committee with                  
  individual recommendations and zero fiscal note.                             
  Number 184                                                                   
  CHAIRMAN HUDSON, hearing no objection, declared it was so                    
  CHAIRMAN HUDSON then announced HB 458 was the next order of                  
  HB 458 - CHILD SUPPORT NONPAYMENT/LICENSING BAN                              
  Number 187                                                                   
  REP. MACKIE moved to adopt CS, 4/14/94 work draft, for HB
  458, thereby officially placing it before the committee.                     
  Number 194                                                                   
  (Chairman Hudson excused both Rep. Mackie and Rep. Porter                    
  from the meeting.)                                                           
  Number 195                                                                   
  CHAIRMAN HUDSON said because of the late date in the                         
  session, the committee would honor its commitment to the                     
  prime sponsor.  He asked Rep. John Davies to explain the                     
  difference between the CS and HB 458 that was previously                     
  Number 197                                                                   
  REP. JOHN DAVIES, Prime Sponsor of HB 458, presented a list                  
  of desirable changes that had been incorporated into the CS.                 
  He read these changes to the committee from the document                     
  entitled, "Changes to CS HB 458; Work Draft 8-LS1440\E".  He                 
  referred to the request  to include the word "reasonable"                    
  and said this was not included because it seemed to be                       
  redundant and because of consistency difficulties throughout                 
  the document.  He also acknowledged that the concern                         
  pertaining to "parallel appeal processes" had been                           
  addressed.  He said if this bill wanted to go to the Finance                 
  Committee there could be further discussion about which                      
  items should be included on the list given the financial                     
  impact.  He said, "If you are happy with the way the bill                    
  is, if we were to just move it out of the committee so that                  
  the CS became the committee substitute, then we could                        
  request official fiscal notes to the substitute and that                     
  information would then be available to the Finance                           
  Committee, if they choose to look at what the fiscal impacts                 
  would be for the various licenses on the list."                              
  Number 320                                                                   
  MARY GAY, Director, Child Support Enforcement Division                       
  (CSED), Department of Revenue, said the changes would                        
  enhance the bill and she was pleased that a licensing bill                   
  to help with the collection of child support had been                        
  brought forth.  She said this legislation would serve as a                   
  vehicle to induce self-employed people to pay their child                    
  MS. GAY said last year CSED collected 50 million dollars in                  
  child support from 46 percent of the cases with established                  
  orders, indicating that child support was not received from                  
  54 percent of the cases.  She said a national statistic                      
  estimates 46 percent of the population as self-employed.                     
  She explained that by estimating 25 percent of self-employed                 
  people as not paying child support, an estimated six million                 
  dollars could be collected.  She further explained that 50                   
  percent of that would be for Aid to Families with Dependent                  
  Children (AFDC) cases totaling approximately three million                   
  dollars, one and one half million of which would be returned                 
  to the general fund.  She concluded by saying this would                     
  help the state and it would help families.                                   
  Number 345                                                                   
  REP. MULDER asked if this would assist the division in                       
  identifying people who owe money in child support payments.                  
  MS. GAY replied that hopefully people would come to CSED                     
  because they would want to keep their licenses.                              
  REP. MULDER asked if this would diminish CSED's pursuer                      
  MS. GAY responded in the affirmative.  She mentioned that                    
  congress is considering mandating the licensing law                          
  nationally so that certain licenses would have to interface                  
  with CSED.  She commented that Alaskans might have a higher                  
  percentage of self-employed people than other places.  In                    
  response to Rep. Mulder's question about the amount of money                 
  in arrears, she said the total amount was 330 million                        
  dollars.  Ms. Gay considered input from Lorraine Derr and                    
  then said she was unsure of the annual arrears amount, but                   
  she could check into it.                                                     
  REP. MULDER wondered how big this problem was and if the                     
  proposed legislation was an effective means of reaching                      
  Number 395                                                                   
  MS. GAY said this approach has been helpful in other states                  
  such as California, Washington, South Dakota, Minnesota, and                 
  REP. DAVIES interjected and said the following states "go                    
  after licenses":  Arizona, California, Maine, Minnesota,                     
  Pennsylvania, South Dakota, and Vermont.                                     
  MS. GAY said she had access to more complete information in                  
  this regard.                                                                 
  Number 410                                                                   
  REP. MULDER pointed out that taking away a person's                          
  commercial fishing license or limited entry permit might, in                 
  effect, deny that person the opportunity to catch up in                      
  their child support payments.                                                
  MS. GAY said they put liens on permits but do not enforce                    
  the sale of permits.                                                         
  REP. MULDER confirmed with Ms. Gay that CSED would be the                    
  first in line and would have to be satisfied before the                      
  permit could be transferred.  He considered this to be a                     
  reasonable means.                                                            
  Number 429                                                                   
  REP. DAVIES said the intent of the bill is not to take away                  
  licenses, but to get people's attention in order to begin a                  
  serious dialogue regarding the level of payment capable of                   
  being made.  He said experience from other states indicates                  
  that 80 percent of the cases come into compliance upon                       
  notification.  He said the other 20 percent would be worked                  
  with to determine possible arrangements.  He added he did                    
  not think it was CSED's intent to be collecting licenses,                    
  although he indicated there might be cases where the ability                 
  to pay is demonstrated and yet the person shows contempt for                 
  the process.  He said in those cases the ability to earn a                   
  livelihood is clearly demonstrated and there is no question                  
  of taking livelihood away from a person.                                     
  Number 447                                                                   
  REP. MULDER said this was an important point to have on                      
  record.  He asked if this legislation could be viewed as                     
  helping to establish the connection between payer and payee,                 
  thereby resorting to seizure of the license or permit as a                   
  means of last resort.                                                        
  MS. GAY answered this was correct.  She mentioned that                       
  keeping the focus on occupational licenses is most                           
  appropriate because what CSED really wants is compliance.                    
  REP. MULDER recommended that if the costs of performing                      
  computer match-ups proved to be substantive, those costs be                  
  charged to the person in arrears so that the state would not                 
  bear additional costs.                                                       
  MS. GAY explained that approximately 100 percent of CSED's                   
  budget is provided by the federal government and is                          
  determined from a combination of federal incentives based on                 
  collection, and a 66 percent match.  She said the state                      
  would not be responsible for the data processing expenses                    
  incurred because those expenses could be submitted to the                    
  federal government.  She added that CSED could feasibly                      
  collect three million dollars from AFDC cases and 50 percent                 
  of the portion collected would go to the general fund.                       
  Number 496                                                                   
  REP. DAVIES added that in a net sense, there would be                        
  minimal implementation costs involved in collecting even one                 
  million dollars.  He also mentioned that in the CS, page 6,                  
  line 8, section (o), there is already a provision pertaining                 
  to Rep. Mulder's suggestion.                                                 
  Number 500                                                                   
  REP. GREEN referred to the sum of approximately one-half                     
  million dollars in fiscal notes and asked if there were                      
  statistics from other states indicating their success rates                  
  with implementing this type of program.  He explained the                    
  basis of his inquiry was he wondered about the probable                      
  stability of some of the people in arrears and asked if the                  
  CSED would have to go back and forth on a given case because                 
  people would have a series of excuses, specifically if a                     
  lien was put on a license.                                                   
  Number 506                                                                   
  MS. GAY replied that she thought a portion of the people                     
  notified would respond and pay, and a portion would ignore                   
  their responsibility.  She reiterated that noncompliance                     
  provided for a 2,500 dollar minimum and explained that liens                 
  were put on fishermen's licenses and not on something like a                 
  hairdresser's license.  She said CSED would not pro-actively                 
  be taking licenses away.  She explained that a person would                  
  have the choice to have a payment plan and to continue their                 
  license.  She pointed out to Rep. Green that even if a large                 
  sum of money were owed, a person could still be in agreement                 
  with CSED by paying something toward the arrears.  She said                  
  this situation is more difficult in court-ordered child                      
  support cases.                                                               
  TAPE 94-38, SIDE B                                                           
  Number 019                                                                   
  MATT ANDERSON, Training Coordinator, Emergency Medical                       
  Services, Division of Public Health, Department of Health                    
  and Social Services, referred to CS page 2, line 9,                          
  paragraph (d).  He mentioned that his office commonly issues                 
  certificates that are 60 days in length and he inquired as                   
  to the appropriate method of managing this situation.  He                    
  suggested the language be changed to read, "up to 150 days".                 
  REP. DAVIES said possibly the way to handle this situation                   
  was to exempt temporary licenses from the list.                              
  Number 039                                                                   
  MR. ANDERSON agreed this would address that particular                       
  problem.  He then referred to page 8, line 18, and asked if                  
  this query was clearly from CSED and not from any other                      
  agency.  Upon hearing from Rep. Davies's staff that, yes,                    
  the query was from CSED, he suggested that the language                      
  read, "when queried by an agency under (a) of this section                   
  as to the license status..."  He said the division is                        
  supportive of HB 458 and wants to make sure they can                         
  implement it properly.                                                       
  Number 072                                                                   
  PATRICIA J. O'BRIEN, Social Services Program Officer,                        
  Division of Family and Youth Services (DFYS), Department of                  
  Health and Social Services, said DFYS supports the intent of                 
  HB 458 but has concerns pertaining to children's programs.                   
  She noted that DFYS is short-staffed and currently                           
  recognizes HB 412's "community care facilities" as an                        
  attempt to help streamline their licensing process and views                 
  this legislation as complicating that process.  She also                     
  mentioned that if the assisted living bill passes, it might                  
  affect adult foster homes and adult residential care                         
  She said DFYS's largest concern with regard to HB 458 is                     
  foster homes.  She mentioned the 90-day emergency licensing                  
  at foster homes and several other reasons as evidence that                   
  child foster care facilities should be removed from this                     
  list.  She mentioned other facilities, such as family child                  
  care homes and child care centers, as facilities that might                  
  be negatively affected by HB 458.  She said with regard to                   
  family child care homes, Alaska has one of the most liberal                  
  statutes in the nation in that a person can care for four                    
  children without a license.  She explained that DFYS                         
  encourages people to become licensed and because this                        
  legislation might dissuade that from happening, the division                 
  would prefer that this not apply to family child care homes.                 
  She explained that DFYS is concerned about potential                         
  litigation and safety for children, and as they do not allow                 
  child care centers to operate without a license, they would                  
  prefer that child care centers also not be included on this                  
  Number 137                                                                   
  CHAIRMAN HUDSON said the committee would hold HB 458 and                     
  suggested that Rep. Davies contact the Finance Committee.                    
  He said he did not want to move the bill on to the Judiciary                 
  Committee until they had responded to the concerns expressed                 
  in today's meeting.  He said Rep. Davies could submit                        
  another draft and the committee would be happy to bring the                  
  bill back up again.                                                          
  Number 157                                                                   
  REP. DAVIES replied that concerns mentioned today seemed to                  
  be straightforward and relatively easy to address.  He                       
  thought the issue regarding which licenses to include on the                 
  list should be approached from a financial context                           
  pertaining to a cost benefit analysis of the impact on the                   
  agencies.  He added that this would be difficult to                          
  accomplish until he had a current fiscal note.                               
  REP. MULDER said he was particularly sensitive to the                        
  concerns expressed by Ms. O'Brien.  He said helping one                      
  child at the expense of others is not good policy, even if                   
  there were economic benefits involved.  He said he was                       
  interested in the cost benefit but suspected the overall                     
  benefit would be toward excluding some categories from the                   
  Number 179                                                                   
  CHAIRMAN HUDSON said this was a policy call that could be                    
  based on costs and other things, but he appreciated the                      
  input from Ms. O'Brien.                                                      
  Number 182                                                                   
  REP. DAVIES agreed that testimony from Ms. O'Brien was well                  
  received and indicated that he did not see a problem with                    
  excluding certain facilities from the list.                                  
  Number 183                                                                   
  CHAIRMAN HUDSON adjourned the meeting at 4:20 p.m.                           

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