04/11/2022 03:15 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB174 | |
| HB176 | |
| HB276 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 176 | TELECONFERENCED | |
| + | SB 174 | TELECONFERENCED | |
| += | HB 276 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
April 11, 2022
3:17 p.m.
MEMBERS PRESENT
Representative Zack Fields, Co-Chair (via teleconference)
Representative Ivy Spohnholz, Co-Chair
Representative Calvin Schrage (via teleconference)
Representative Liz Snyder
Representative David Nelson
Representative James Kaufman
Representative Ken McCarty
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 174(EDC)
"An Act relating to dress codes and natural hairstyles."
- HEARD & HELD
HOUSE BILL NO. 176
"An Act relating to insurance; relating to direct health care
agreements; and relating to unfair trade practices."
- HEARD & HELD
HOUSE BILL NO. 276
"An Act relating to licensing of psychologists and psychological
associates; and relating to the practice of psychology."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 174
SHORT TITLE: ALLOW NATURAL HAIRSTYLES
SPONSOR(s): SENATOR(s) WILSON
02/01/22 (S) READ THE FIRST TIME - REFERRALS
02/01/22 (S) EDC, L&C
02/16/22 (S) EDC AT 9:00 AM BUTROVICH 205
02/16/22 (S) Heard & Held
02/16/22 (S) MINUTE(EDC)
02/23/22 (S) EDC AT 9:00 AM BUTROVICH 205
02/23/22 (S) Moved CSSB 174(EDC) Out of Committee
02/23/22 (S) MINUTE(EDC)
02/25/22 (S) EDC RPT CS 1DP 4NR SAME TITLE
02/25/22 (S) DP: HOLLAND
02/25/22 (S) NR: HUGHES, STEVENS, BEGICH, MICCICHE
02/28/22 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
02/28/22 (S) Heard & Held
02/28/22 (S) MINUTE(L&C)
03/23/22 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/23/22 (S) Moved CSSB 174(EDC) Out of Committee
03/23/22 (S) MINUTE(L&C)
03/25/22 (S) L&C RPT CS(EDC) 3DP SAME TITLE
03/25/22 (S) DP: COSTELLO, GRAY-JACKSON, MICCICHE
03/30/22 (S) TRANSMITTED TO (H)
03/30/22 (S) VERSION: CSSB 174(EDC)
04/04/22 (H) READ THE FIRST TIME - REFERRALS
04/04/22 (H) L&C
04/11/22 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 176
SHORT TITLE: DIRECT HEALTH AGREEMENT: NOT INSURANCE
SPONSOR(s): REPRESENTATIVE(s) RASMUSSEN
04/16/21 (H) READ THE FIRST TIME - REFERRALS
04/16/21 (H) L&C, HSS
05/03/21 (H) L&C AT 3:15 PM BARNES 124
05/03/21 (H) Heard & Held
05/03/21 (H) MINUTE(L&C)
05/07/21 (H) L&C AT 8:00 AM GRUENBERG 120
05/07/21 (H) Heard & Held
05/07/21 (H) MINUTE(L&C)
05/12/21 (H) L&C AT 3:15 PM BARNES 124
05/12/21 (H) <Bill Hearing Canceled>
03/23/22 (H) L&C AT 3:15 PM BARNES 124
03/23/22 (H) Heard & Held
03/23/22 (H) MINUTE(L&C)
04/06/22 (H) L&C AT 3:15 PM BARNES 124
04/06/22 (H) -- MEETING CANCELED --
04/11/22 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 276
SHORT TITLE: PSYCHOLOGISTS: LICENSING AND PRACTICE
SPONSOR(s): LABOR & COMMERCE
01/18/22 (H) READ THE FIRST TIME - REFERRALS
01/18/22 (H) L&C, FIN
02/07/22 (H) L&C AT 4:30 PM BARNES 124
02/07/22 (H) -- MEETING CANCELED --
02/09/22 (H) L&C AT 4:30 PM BARNES 124
02/09/22 (H) Heard & Held
02/09/22 (H) MINUTE(L&C)
02/14/22 (H) L&C AT 3:15 PM BARNES 124
02/14/22 (H) <Bill Hearing Canceled>
04/11/22 (H) L&C AT 3:15 PM BARNES 124
WITNESS REGISTER
SENATOR DAVID WILSON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, introduced CSSB 174(EDC).
JASMIN MARTIN, Staff
Senator David Wilson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: On behalf of Senator Wilson, prime sponsor
of SB 174, explained the two differences between CSSB 174(EDC)
and its companion bill, HB 312.
CHELSEA WARD-WALLER, Staff
Representative Ivy Spohnholz
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: During the hearing on HB 176, reviewed the
changes made in the proposed CS for HB 176, Version B.
LORI WING-HEIER, Director
Division of Insurance
Alaska Department of Commerce, Community, and Economic
Development
Anchorage, Alaska
POSITION STATEMENT: During the hearing on HB 176, answered
questions.
HEATHER CARPENTER, Health Care Policy Advisor
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: During the hearing on HB 176, answered a
question.
GRACE KUBITZ, Staff
Representative Zack Fields
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced the proposed CS for HB 276,
Version I, on behalf of the House Labor and Commerce Standing
Committee, sponsor.
MARVO REGUINDIN, Executive Director
Alaska Psychological Association (APA)
Spokane, Washington
POSITION STATEMENT: During the hearing on HB 276, provided
testimony regarding the proposed committee substitute, Version
I.
ERIN JOHNSON, PhD, Chair
Alaska Board of Psychologist and Psychological Associate
Examiners
Anchorage, Alaska
POSITION STATEMENT: During the hearing on HB 276, provided
testimony regarding the proposed committee substitute, Version
I.
ACTION NARRATIVE
3:17:00 PM
CO-CHAIR IVY SPOHNHOLZ called the House Labor and Commerce
Standing Committee meeting to order at 3:17 p.m.
Representatives Kaufman, McCarty, Snyder, Schrage (via
teleconference), and Spohnholz were present at the call to
order. Representatives Fields (via teleconference) and Nelson
arrived as the meeting was in progress.
SB 174-ALLOW NATURAL HAIRSTYLES
3:17:53 PM
CO-CHAIR SPOHNHOLZ announced that the first order of business
would be CS FOR SENATE BILL NO. 174(EDC), "An Act relating to
dress codes and natural hairstyles."
3:18:31 PM
SENATOR DAVID WILSON, Alaska State Legislature, as prime
sponsor, introduced CSSB 174(EDC). He noted that the committee
has already heard the companion bill, HB 312 [heard on 4/4/22].
He explained that the bill would prohibit schools and workplaces
from enacting a dress code that restricts someone from wearing
their natural hair. He said the bill addresses an issue that
most people deal with and endure in silence, and that no
employee or student should be prohibited from participating in a
workplace or attending school just because they are wearing
their natural hair.
SENATOR WILSON stated that people choose to wear their natural
hair for many reasons, including cultural connectedness [and
tradition], protection of hair texture and growth, and
preference. Whatever the reason, hairstyle has no correlation
to workplace performance. One study has shown that people of
color must change their hair from its natural state just to fit
in the office. Another study published last year confirmed that
in job recruitment, natural hairstyle puts people of color at
disadvantage for getting interviewed and subsequently hired.
For both the workplace and schools, this bill clarifies that
this does not apply to health or safety rules or regulations or
ordinance. For example, hairnets still need to be worn in food
services or someone with long hair in dreads should not be
working a woodchipper or welding. The bill defines what
standards are acceptable for the school districts and employers
to place on hair and help end hair discrimination.
SENATOR WILSON noted there is a difference between CSSB 174(EDC)
and HB 312, and deferred to his staff person, Ms. Jasmin Martin,
to outline those differences.
3:20:56 PM
JASMIN MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, on behalf of Senator Wilson, prime sponsor of SB
174, explained the two differences between CSSB 174(EDC) and its
companion bill, HB 312. She stated that Sections 1 and 2 are
basically identical to each other: one deals with the school-
student relationship and the other deals with the employer-
employee relationship. She explained that first difference is
on page 1, line 7, and page 2, line 5, which include the term
headwraps, but headwraps are not included in HB 312. The second
difference, she continued, is on page 1, line 10, and page 2,
line 8, which include the terms afros, cornrows, and bantu
knots, but these terms are not included in HB 312. She said
these terms were added in a Senate committee and that this list
is not exhaustive of all the natural hairstyles, but the Senate
committee thought it important to include some more examples in
the bill.
3:21:56 PM
REPRESENTATIVE KAUFMAN drew attention to page 1, line 11, which
states, "requires a student to permanently or semi-permanently
alter the student's hair". He asked what has occurred to cause
that requirement to be in the bill.
SENATOR WILSON recounted an event in which a young gentlemen had
to cut his hair to be able to participate in a wrestling
tournament. He said this would be an example of where the
governing body of a school cannot say that a student's hair must
be altered [to participate]. Another example, he stated, would
be a place of employment that says employees cannot wear pink
hair or must straighten their hair. Straightening hair requires
use of a chemical relaxer, which can burn the person's head, he
explained. He noted that in places where people of color make
up less than five percent of the population, most local
hairdressers do not work on type 4c hair. Responding further to
Representative Kaufman, Senator Wilson explained that because
many hairdressers do not have enough practice on 4c hair, which
is a coarse texture of hair, they choose not to work on that
type of hair.
3:23:54 PM
REPRESENTATIVE MCCARTY inquired about the reason for including
headwraps in CSSB 174(EDC) while HB 312 does not.
SENATOR WILSON explained that the Senate Education Standing
Committee made this addition because the committee thought that
protective headwraps help in the maintaining of hair appearance.
MS. MARTIN pointed out that this is not necessarily headwraps
that are associated with religion because that is already
protected in different parts of statute. In this case, she
continued, the committee worried that headwraps, such as silk
headwraps that protect the texture of the hair from
environmental damage, was not underneath this legislation. The
committee therefore [included headwraps] so there would be no
ambiguity as to whether [headwraps] were included.
3:25:33 PM
REPRESENTATIVE MCCARTY asked about the implications of some
group of individuals claiming that this is something they are
entitled to wear which symbolizes something else and they know
it symbolizes something else. He recalled that many years ago
schools [prohibited] wearing a certain color hat because it
represented gang symbols. He inquired about what protects the
intended concept regarding hair rather than extending out to
someone who wants to wear a symbol.
MS. MARTIN answered that she would provide members with a letter
written by an invited testifier regarding headwraps as gang
affiliations. She said that to her knowledge there is no
evidence that there are gangs in Alaska high schools that are
using headwraps to identify. A student, she added, is going to
be part of a gang regardless of whether that student is wearing
a certain thing on his or her head. That isn't relevant to a
student's gang affiliation and does nothing to stop gangs or
gang activity.
[SB 174 was held over.]
3:27:48 PM
The committee took an at-ease from 3:27 p.m. to 3:28 p.m.
HB 176-DIRECT HEALTH AGREEMENT: NOT INSURANCE
3:28:05 PM
CO-CHAIR SPOHNHOLZ announced that the next order of business
would be HOUSE BILL NO. 176, "An Act relating to insurance;
relating to direct health care agreements; and relating to
unfair trade practices."
3:28:38 PM
The committee took a brief at-ease.
3:28:52 PM
REPRESENTATIVE SNYDER moved that the committee adopt the
proposed committee substitute (CS) for HB 176, version 32-
LS0784\B, Marx, 4/7/22 ("Version B"), as the working document.
3:29:12 PM
REPRESENTATIVE SNYDER objected for the purpose of discussion.
3:29:23 PM
CO-CHAIR SPOHNHOLZ noted that the proposed CS is substantive and
the intention in adopting Version B is to get a new version on
the record for the committee to review in depth. She explained
that Version B includes consumer protections as recommended by
Ms. Lori Wing-Heier, Director, Division of Insurance, Alaska
Department of Commerce, Community, and Economic Development
(DCCED), during a previous hearing on the bill.
3:30:13 PM
CHELSEA WARD-WALLER, Staff, Representative Ivy Spohnholz, Alaska
State Legislature, reviewed the changes made in the proposed CS
for HB 176, Version B. She spoke from a document in the
committee packet, titled "Summary of Changes, CSHB 176(L&C)
Version A to Version B," which read:
Section 1
Page 1, [line 7]; Removes "or the representative of
the patient" and makes conforming changes throughout
the bill.
Page 1, line [8]; Replaces "periodic" with "annual"
and makes conforming changes throughout the
subsection.
Page 1, [lines 9-11; Adds new subsection (b),
reordering language from version A].
Page 1, [lines 11-14]; Inserts new language requiring
that annual fees must be comparable for comparable
services and may not be based solely on the patient's
health status or sex.
Page 2, [lines 5-6]; Adds a new subsection (c) and
reorders following subsections accordingly. [Adds
language to clarify what entities are involved in
direct health care agreements.]
Page 2, lines [14-23];
Removes language in subsection (4) and replaces it
with additional requirements for the direct health
care agreement as follows:
(4) it must be printed in a font not smaller than 12
points and written using plain language that an
individual with no medical training can understand;
(5) it must identify and include contact information
for the person responsible for receiving and
addressing a complaint made by a patient; and
(6) it must state that the annual fee under the
agreement for services must be comparable to other
patients under the provider's other direct health care
agreements and may not be based solely on the
patient's health status or sex.
Page 2, [lines 24-30];
Inserts a new subsection (d), which allows a patient
to terminate a health care agreement in writing within
30 days of entering the agreement. This subsection
also provides that if a patient terminates an
agreement, the provider must refund to the patient
payments made less payments made for services already
performed within 30 days. A nominal termination fee
may be charged.
Page 2, [line 31 page 3, line 13];
Adds language [in subsection (e)] and a new subsection
(f) to state that a direct health care agreement may
be terminated in writing after at least 30 days'
notice or in accordance with the agreement. An
agreement must provide for a refund and may provide
for a nominal termination penalty or nominal
termination fee.
Additionally, a new subsection (g) is added, which
allows the parties to a direct health care agreement
to modify or renew the agreement by written agreement
of the parties. A health care provider may not change
the annual fee under the agreement more than once a
year and shall provide at least 45 days' written
notice of a change in the annual fee.
Page 3, lines [14-16]; Reverses language in version A
to make direct health care agreements subject to AS
21.07 (Patient Protections Under Health Care Insurance
Policies) and AS 21.36 (Trade Practices and Frauds).
Page 3, line [28 page 4, line 20];
Inserts new subsection (j), that a person may not
make, publish, or disseminate an assertion,
representation, or statement with respect to the
business of direct health care agreements, or with
respect to a person in the conduct of the person's
direct health care agreement business, if that is
untrue, deceptive, or misleading, and may not[:]
(1) misrepresent the benefits, advantages, conditions,
sponsorship, source, or terms of a direct health care
agreement;
(2) use a name or title of a direct health care
agreement misrepresenting its true nature; or
(3) make a false or misleading statement as to a
direct health care agreement.
Additionally, inserts a new subsection (k), which
requires that health care providers entering into
health agreements file a report with the division of
insurance no later than [September] 1 that includes
(1) the number of health care providers in the health
care practice;
(2) the number of direct health care patients the
health care practice has the capacity to serve;
(3) the number of government entities, patients, and
employers of patients that entered or maintained a
direct health care agreement with the health care
practice in the preceding calendar year and the annual
fee paid by each government entity, patient, and
employer of a patient, as applicable, under the direct
health care agreement; and
(4) other information requested by the division.
Page [4, lines 22-23]; Inserts a new subsection (1)
defining a "health care practice" as "a firm,
corporation, association, institution, or other person
licensed or otherwise authorized in this state to
provide health care services;" and renumbers
subsections accordingly.
Page [5, lines 20-22]; Inserts a new subsection (c),
which allows health care providers to decline entering
into a direct care agreement with a new patient if the
health care provider does not have the capacity to
accept new patients.
Page [5, line 26]; References the definition for
"health care provider" in AS 21.03.025(l).
Page [5, line 28]; Inserts a new subsection (58), to
add violating AS 21.03.025 (direct health care
agreements) under the unlawful acts and practices
statute of Article 3, Unfair Trade Practices and
Consumer Protection, and renumbers the following
subsection accordingly.
3:34:59 PM
CO-CHAIR SPOHNHOLZ noted that the page numbers and line numbers
in the Summary of Changes are incorrect, but the content is
correct. She stated that a [corrected] summary of changes would
subsequently be provided to members.
3:35:40 PM
REPRESENTATIVE SNYDER removed her objection to adopting the
proposed CS, Version B, as the working document.
3:35:50 PM
REPRESENTATIVE MCCARTY objected. He asked when members would be
receiving the corrected summary of changes.
CO-CHAIR SPOHNHOLZ replied that members would receive the
corrected summary of changes by 10:00 a.m. [on 4/12/22]. She
reiterated that the content presented was correct, but the line
numbers and page numbers were off. She explained that adopting
the proposed CS will allow for getting Version B of HB 176 on
the public record so the committee can then start drafting
amendments to Version B.
REPRESENTATIVE MCCARTY removed his objection to adopting Version
B as the working document.
3:37:30 PM
CO-CHAIR SPOHNHOLZ announced that there being no further
objection, the proposed CS for HB 176, Version B, was adopted as
the working document.
3:38:09 PM
REPRESENTATIVE KAUFMAN stated that a concern he had with the
original version of the bill [on page 3, Section 2(b), lines 20-
26] was the intractability for the health care provider to shift
somebody to another provider or to cease.
3:39:01 PM
LORI WING-HEIER, Director, Division of Insurance, Alaska
Department of Commerce, Community, and Economic Development
(DCCED), responded that she's not sure whether that continuity
of care provision is included in Version B, which includes many
consumer protections.
CO-CHAIR SPOHNHOLZ interjected that the continuity of care
provision referenced by Representative Kaufman is included in
Version B, Sec. 2(b), on page 5, lines 10-16.
3:39:37 PM
REPRESENTATIVE SNYDER stated she wants to keep close attention
on the issue of primary care providers. She offered her
appreciation for decreasing the patient panel size which
increases the amount of time a provider can spend with an
individual patient, but expressed her concern that reducing the
provider's patient panel effectively means fewer primary care
providers per the population. She related that, according to
what she is reading, the patient panels with direct primary care
agreements are between one-half and one-third.
MS. WING-HEIER answered that before the committee's next meeting
she will pull the number of primary care facilities for
providers in Alaska. Regarding patient panels, she surmised
Representative Snyder is asking how many patients a doctor would
take under a direct primary care agreement. She said it would
be subject to what the doctor wanted, but she believes that, in
testimony, it was stated that the number is somewhere around
600.
REPRESENTATIVE SNYDER recalled that according to what she is
reading the typical target panel size is between 400 and 1,000.
She asked what the current panel size is under the present model
of care so it can be used for comparison moving forward.
MS. WING-HEIER replied that she would get back with an answer.
3:41:52 PM
REPRESENTATIVE MCCARTY recalled testimony [on 3/23/22, provided
by Dr. Lee Gross of Epiphany Health Direct Primary Care, North
Port, Florida], in which [Dr. Gross] stated that this is the
only model his clinic does and any patients needing more intense
treatment are referred outside his practice. He expressed his
concern that Alaska does not have as many physicians as do
Florida and other states. He asked whether Ms. Wing-Heier would
have any concerns if providers were to do direct primary care
agreements as well as being a preferred provider organization
(PPO) with insurance companies under which the provider uses a
CPT code for charges, but the provider is doing the exact same
services under the direct agreement.
MS. WING-HEIER requested clarification on whether Representative
McCarty is asking if the provider is basically double billing
because the provider would get the fee under the contract as
well as billing the insurance company.
REPRESENTATIVE MCCARTY clarified maybe not double dipping but
maybe choosing which is going to pay them the most.
MS. WING-HEIER responded that the doctor or provider will be
able to determine what services are going to be offered in the
[direct primary care agreement] contract. She posed a scenario
in which the provider charges $100 per month under the agreement
and someone wants an MRI or other test that is going to cost
more than the annual fee. Such tests, she said, should be
outside the direct care agreement because otherwise the facility
would go underwater. That will be watched by the division, she
continued, and providers will be given the benefit of a doubt
that they know how to price for the flus, sore throats, and
annual exams that will be covered in these agreements, and that
anything of real extensive cost or that takes a specialist will
be referred out and/or the insurance company charged.
CO-CHAIR SPOHNHOLZ added that from a consumer protection
standpoint the committee must ensure that there is not a
situation where folks are gaming the system. She suggested that
the committee may therefore need to explore this area further to
ensure that consumers don't get hurt along the way.
3:45:21 PM
REPRESENTATIVE MCCARTY stated he can see clients getting
services while providers spend money on billing trying to get
paid and perhaps must write off a tremendous amount because they
can't go after the patient. Through this [proposed] format, he
continued, providers would get paid lots of money upfront and
would be responsible for following the contract's format. He
said he is concerned about physicians who make money through
referrals to a lab they own or a procedure they do and that they
may make unnecessary referrals as a "bait and switch operation."
MS. WING-HEIER replied that those are the things any state would
have to watch for. However, she noted, attendees at today's
Lunch and Learn by Senator Wilson will hear providers talk about
how hard it is to recruit and retain physicians and staff
overall. Yet [during the bill's previous hearing], speakers
said that doctors or providers prefer these types of agreements
because they don't become so burned out and they are not trying
to chase making money off referrals to labs or other additional
tests. Part of [the division's] issue with the cost for health
care under the fee-for-service is that the more [a physician]
sends [a patient] out, the more the physician can make. It is
an antiquated model without a doubt, she said, and this is a new
model that has not been tried in Alaska, but it has some merit.
REPRESENTATIVE MCCARTY stated he is not labeling health care
people as scoundrels, but he wants to make sure there are
provisions in the bill which will make it easy to spot
scoundrels if they do show up.
MS. WING-HEIER expressed her agreement and advised that this is
going to be trial and error. She said the committee has put in
for an annual report to come back to the division and perhaps
there will be facts or data that can be tracked to see if there
is a concern with the way these are being utilized.
CO-CHAIR SPOHNHOLZ added that the annual report was put in by
the committee partly to be able to get some recommendations and
prompt feedback from the division. She said it will provide
clarity on what is happening, whether retooling is needed to
protect Alaskans, and that health care "spend" is not actually
growing rather than improving the experience of folks on both
ends of the health care relationship.
3:49:37 PM
CO-CHAIR FIELDS stated he wants to ensure that people do not
migrate from a health insurance plan to a direct primary care
plan because it is cheaper. He asked whether this has happened
in states that have legalized or encouraged direct primary care.
MS. WING-HEIER responded that she has neither heard nor read
anything about that. But, she advised, [the division] will
watch for that during the first few years as these roll out
after the bill's enactment.
CO-CHAIR FIELDS clarified that he supports greater primary care
access but wants to ensure [the bill] would not unintentionally
encourage a migration away from health insurance.
3:51:08 PM
REPRESENTATIVE KAUFMAN drew attention to page 5, lines 10-18,
and asked whether there might be other language that wouldn't be
so prohibitive from someone entering into the agreement as this
is presently phrased.
3:51:52 PM
HEATHER CARPENTER, Health Care Policy Advisor, Department of
Health and Social Services (DHSS), answered that she would look
at this. She noted that when it comes to Medicaid in this bill
it is a little bit more complicated. The stance of the
department, she advised, is that it would be cleaner if Medicaid
was exempted from direct health care agreements because of
concern over audit trails as well as Medicaid is a care of last
resort and DHSS must track down any third-party liability before
Medicaid can be a payer. In terms of looking at agreements it
gets really complicated fast when there are direct health care
agreements and consideration for a Medicaid population.
REPRESENTATIVE KAUFMAN said he would like to have a conversation
off-line about this. He said his concern is that the committee
comes up with something that works, and that nothing is built
into it that is an impediment on either side of the arrangement.
3:53:09 PM
CO-CHAIR SPOHNHOLZ announced that HB 176 was held over.
HB 276-PSYCHOLOGISTS: LICENSING AND PRACTICE
3:53:27 PM
CO-CHAIR SPOHNHOLZ announced that the final order of business
would be HOUSE BILL NO. 276, "An Act relating to licensing of
psychologists and psychological associates; and relating to the
practice of psychology."
CO-CHAIR SPOHNHOLZ explained that HB 276 is a House Labor and
Commerce Standing Committee bill that is being carried by
Representative Fields. She explained that work was done with
stakeholders to draft a committee substitute (CS), and today's
hearing will get the working document into the public sphere and
will allow Legislative Legal Services to draft amendments.
3:54:04 PM
REPRESENTATIVE SNYDER moved to adopt the proposed CS for HB 276,
version 32-LS0963\I, Ambrose, 3/30/22 ("Version I"), as the
working document.
3:54:21 PM
REPRESENTATIVE SNYDER objected for the discussion purpose.
[REPRESENTATIVE KAUFMAN objected.]
3:54:26 PM
GRACE KUBITZ, Staff, Representative Zack Fields, Alaska State
Legislature, introduced the proposed CS for HB 276, Version I,
on behalf of the House Labor and Commerce Standing Committee,
sponsor. She deferred to Mr. Marvo Reguindin and Dr. Erin
Johnson to address the changes that have been made.
3:55:23 PM
The committee took a brief at-ease.
3:55:51 PM
CO-CHAIR SPOHNHOLZ invited Mr. Reguindin and Dr. Johnson to
provide testimony as representatives of the two leading
stakeholder groups working on the proposed CS for HB 276.
3:57:07 PM
MARVO REGUINDIN, Executive Director, Alaska Psychological
Association (APA), as the representative of a stakeholder group,
provided testimony regarding the proposed CS for HB 276, Version
I. He related that the APA committee working on HB 276 came to
agreement on dropping several sections. Subsequently, the
association met with the state licensing board to review Section
2, where there was concern that public trust could be violated,
and it was agreed to drop Section 2. Part-time licensing was
also dropped, he continued, because the time to process a part-
time license would be the same as a full-time license and there
would not be a reduction of fees. Further, monitoring the
number of part-time hours would not be possible. He said
Sections 10 and 11 were dropped as well, which included tribal
health organizations under a description of what is not included
in psychology plus the aspect of what a tribal health
organization is. There wasn't enough agreement or reaching out
to the tribal health organizations for APA to get clear concise
agreement of whether they would be agreeable to that.
3:59:45 PM
ERIN JOHNSON, PhD, Chair, Alaska Board of Psychologist and
Psychological Associate Examiners, as the representative of a
stakeholder group, provided testimony regarding the proposed CS
for HB 276, Version I. She stated that all board members met
with Mr. Reguindin on 3/18/[2022] and voted to approve the bill
with edits. She said [Version I] appears to have all the edits
included.
4:00:29 PM
MS. KUBITZ reviewed the changes from the original bill [Version
A] to Version I. She explained that in Section 2 [page 2, lines
18-20 of the original bill] language was deleted which stated,
"completed at least 3,000 hours of supervised professional
experience gained through practicum, internship, or postdoctoral
experience approved by the board, or organized through a
combination of those". Also deleted on page 2 of the original
bill was the language on lines 25-27 which stated, "has
submitted an application on a form approved by the board that
includes a brief written account of the person's education,
qualifications, and work history and proof of the person's
competence to practice psychology".
MS. KUBITZ explained that in Section 3 [on page 3, lines 10-11,]
of the original bill the words "three" and "recommendation" were
deleted and words added so that in Version I [on page 3, lines
4-6], the language reads, "letters of reference, as established
in regulations adopted by the board, from professional sources
in the field of behavioral health familiar with the applicant's
clinical level work of the previous five years."
MS. KUBITZ said Section 4 of the original bill was eliminated,
which would have amended the statute by adding a new section
that outlined the qualifications required for the board to issue
a part-time psychologist license. She further noted that
removed from the list of fees under Section 5 of the original
bill were "initial part-time license" and "part-time license
renewal" since these were deleted in the rest of the bill.
MS. KUBITZ explained that in Section 6 of the original bill [on
page 4, line 9], the words "without unreasonable delay" were
deleted. In Section 7 of the original bill [on line 17], the
words "or part-time" were deleted to conform with the rest of
the bill. She said Section 8 of the original bill was deleted,
which would have amended AS 08.86 by adding a new section that
outlined the board's ability to issue a part-time psychological
associate license and the requirements to obtain such a license.
Additionally, she continued, in Section 9 of the original bill
[on page 5, line 13], the words "or part-time" were deleted to
conform with the rest of the bill. Ms. Kubitz stated that
Section 10 of the original bill was deleted, which would have
amended AS 08.86.180(b) to add a "contractor" of "a tribal
organization who is licensed to practice psychology in another
state" to the list of psychologists to whom this section would
not apply. Further, Section 11 of the original bill was deleted
which would have added a new subsection that defined "tribal
organization".
4:03:36 PM
REPRESENTATIVE MCCARTY inquired about Section 7, subsection (a).
MS. KUBITZ replied that she is referring to Version A, Section
7, subsection (a), where the words "or part-time" were deleted.
4:04:47 PM
The committee took an at-ease from 4:04 p.m. to 4:06 p.m.
4:06:51 PM
REPRESENTATIVE MCCARTY pointed out that in the original bill the
words "or part-time" appear in Section 7(a), [on page 4], lines
17 and 23, and those words are deleted in Version I.
MS. KUBITZ concurred and said this error would be corrected in
the summary of changes and the summary would be redistributed to
the committee.
4:07:49 PM
REPRESENTATIVE MCCARTY expressed his appreciation for the effort
involved in making these changes because he was not interested
in moving the original version of the bill. He observed that
Version I, page 1, line 10, would add the words "and a code of
ethics" [to AS 08.86.070]. He submitted that in this profession
there is already a code of ethics. He further observed that
Version I, page 2, lines 5-6, would add the words "maintain an
active membership with a national association of psychology
boards." He asked whether "and a code of ethics" is referring
to a national code of ethics.
DR. JOHNSON responded that the most widely used code of ethics
is the American Psychological Association's (APA's) code of
ethics that is adopted in [the Alaska board's] regulations, and
[Version I] specifically outlines it in the statutes. She said
the "national association of psychology board" is a member
organization. Currently, she continued, [the Alaska board] is a
member of [the Association of State and Provincial Psychology
Boards (ASPPB)], which oversees and supports boards in Canada
and all the United States.
REPRESENTATIVE MCCARTY concurred that Alaska should have a code
of ethics. He expressed his concern that sometimes a national
group of individuals creates a code of ethics that doesn't fit
for Alaska. For example, he said, the state was using the code
of ethics of an association he was part of, but the association
changed its code of ethics to talk about not having any kind of
relationship with a patient, which is appropriate. However, the
association also applied this to any extended family members,
which eliminates a lot of Alaska. A psychologist in a remote
area may find himself or herself romantically infatuated with
someone who is not his or her patient but who is an extended
family member of a patient.
DR. JOHNSON answered that this gives [the Alaska board] the
leeway to change the code of ethics to which it would adhere.
At this point, she continued, [the Alaska board] believes that
APA is appropriate for Alaska as it does not put such a narrow
focus on the topic mentioned by Representative McCarty; also
[the board] can change the regulation if needed.
4:11:25 PM
REPRESENTATIVE KAUFMAN drew attention to [Version I], page 2,
line 22, which read: "provides the documents specified in (c)
of this section." He requested confirmation that the reference
is correct.
CO-CHAIR SPOHNHOLZ responded that subsection (c) is located
under Section 3.
REPRESENTATIVE KAFUFMAN asked whether, to provide clarity, the
reference should state "in (c) of Section 3".
MS. KUBITZ agreed that that is correct and said it would be a
good clarification.
4:12:49 PM
REPRESENTATIVE SNYDER removed her objection to adopting the
proposed CS, Version I, as the working document.
REPRESENTATIVE KAUFMAN removed his objection to adopting the
proposed CS, Version I, as the working document. There being no
further objection, Version I was before the committee.
4:13:12 PM
DR. JOHNSON, responding to Co-Chair Spohnholz, said she had
nothing more to add regarding HB 276.
MR. REGUINDIN, responding to Co-Chair Spohnholz, said he had
nothing more to add regarding HB 276.
4:14:02 PM
CO-CHAIR SPOHNHOLZ opened public testimony on HB 276, then
closed it after ascertaining that no one wished to testify.
[HB 276 was held over.]
4:15:27 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
4:15 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 174 Sectional Analysis v. W 2.28.2022.pdf |
HL&C 4/11/2022 3:15:00 PM |
SB 174 |
| SB 174 Support Letters Received as of 2.27.22.pdf |
HL&C 4/11/2022 3:15:00 PM SL&C 2/28/2022 1:30:00 PM |
SB 174 |
| SB 174 Sponsor Statement v. G 2.10.2022.pdf |
HL&C 4/11/2022 3:15:00 PM SEDC 2/16/2022 9:00:00 AM SEDC 2/23/2022 9:00:00 AM |
SB 174 |
| CS HB 176 (L&C) v. B.pdf |
HL&C 4/11/2022 3:15:00 PM |
HB 176 |
| CS HB 176 (L&C) v. B Summary of Changes.pdf |
HL&C 4/11/2022 3:15:00 PM |
HB 176 |
| SB 174 Letter 2.18.22.pdf |
HL&C 4/11/2022 3:15:00 PM |
SB 174 |
| SB 174 Fiscal Note_DOLWD.pdf |
HL&C 4/11/2022 3:15:00 PM |
SB 174 |
| SB 174 Fiscal Note_DEED.pdf |
HL&C 4/11/2022 3:15:00 PM |
SB 174 |
| HB 276 ver. I 4.5.22.pdf |
HL&C 4/11/2022 3:15:00 PM |
HB 276 |
| HB 276 Sectional Analysis ver. I 4.11.22.pdf |
HL&C 4/11/2022 3:15:00 PM |
HB 276 |
| CS HB 176 (L&C) v. B Summary of Changes_corrected 4.12.22.pdf |
HL&C 4/11/2022 3:15:00 PM |
HB 176 |