Legislature(2005 - 2006)BUTROVICH 205
01/25/2006 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
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| Start | |
| SB177 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 177 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
January 25, 2006
1:32 p.m.
MEMBERS PRESENT
Senator Fred Dyson, Chair
Senator Gary Wilken, Vice Chair
Senator Lyda Green
Senator Kim Elton
Senator Donny Olson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 177
"An Act eliminating the requirement that persons using titles or
descriptions of services that incorporate the terms
'psychotherapy,' 'psychotherapeutic,' or 'psychotherapist' be
licensed by the Board of Psychologist and Psychological
Associate Examiners."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 177
SHORT TITLE: PRACTICE OF PSYCHOLOGY
SPONSOR(s): HEALTH, EDUCATION & SOCIAL SERVICES BY REQUEST
04/15/05 (S) READ THE FIRST TIME - REFERRALS
04/15/05 (S) HES, L&C
04/20/05 (S) HES AT 1:30 PM BUTROVICH 205
04/20/05 (S) Scheduled But Not Heard
01/25/06 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
Anne Henry, Chair
Board of Professional Counselors
Division of Corporations, Business, and Professional Licensing
Department of Commerce, Community & Economic Development
PO Box 110800
Juneau, AK 99811-0800
POSITION STATEMENT: Supported SB 177.
John Miller, Ph.D., Chair
Board of Psychologist and Psychological Associate Examiners
Division of Corporations, Business, and Professional Licensing
Department of Commerce, Community & Economic Development
PO Box 110800
Juneau, AK 99811-0800
POSITION STATEMENT: Supported SB 177.
ACTION NARRATIVE
CHAIR FRED DYSON called the Senate Health, Education and Social
Services Standing Committee meeting to order at 1:32:39 PM.
Present were Senators Donny Olson, Kim Elton, Gary Wilken, Lyda
Green, and Chair Fred Dyson.
SB 177-PRACTICE OF PSYCHOLOGY
CHAIR DYSON announced SB 177 to be up for consideration. He
informed members that the purpose of the bill was to bring
statute in accordance with regulation with regard to the
nomenclature used by mental health practitioners. [In committee
packets was a proposed committee substitute, version G, labeled
24-LS0893\G, Mischel, 1/17/06.]
1:38:43 PM
ANNE HENRY, Chair, Board of Professional Counselors, said she
and John Miller, chair of the Board of Psychologist and
Psychological Associate Examiners, have worked with other
members of the mental health community to expand the categories
of mental health practitioners allowed to use the terms
"psychotherapist," "psychotherapeutic" and "psychoanalyst" to
describe their professional practices.
CHAIR DYSON asked whether members of the community of mental
health providers have reached a consensus regarding the use of
those terms.
MS. HENRY replied that they have reached a consensus.
CHAIR DYSON asked her to describe the history of the problem
that the bill intends to solve.
MS. HENRY replied that when the board was established, it
limited the categories of practitioners legally permitted to use
the aforementioned terms in the interest of public safety.
Since that time, Medicaid regulations have allowed several
different groups, including Licensed Professional Counselors
(LPCs) and Marriage and Family Therapists (MFTs), to use these
terms to describe their practices. Since the original
limitation language remains in statute, many of these groups,
including LPCs and MFTs, are prevented from using these terms.
SENATOR GREEN moved to adopted CSSB 177(HES), version G, labeled
24-LS0893\G, Mischel, 1/17/06, as the committee's working
document. There were no objections and it was so ordered.
SENATOR OLSON asked whether passage of this bill could create
changes in the amount of Medicaid reimbursement that the state
receives.
MS. HENRY replied that it would not create any such changes
because Medicaid already recognizes all of the disciplines that
would be allowed.
SENATOR WILKEN referenced an April 16, 2005, letter from Pam
Watts to Chair Dyson, prompting the question of whether the
reclassification of terms would create additional Medicaid
services and increase the state's Medicaid budget.
MS. HENRY responded that the bill would not create additional
Medicaid services because it only applies to categories of
mental health providers already covered by Medicaid.
1:45:34 PM
SENATOR GREEN asked whether the practitioners within different
disciplines receive different rates of Medicaid reimbursement.
MS. HENRY advised that Medicaid reimbursement is $85 an hour
regardless of the discipline of the practitioner or the level of
education required to achieve licensure to practice in a given
discipline.
1:47:19 PM
SENATOR GREEN remarked that the committee might benefit from a
chart showing the qualifications of different practitioners
relative to their typical rates. She asked whether a private
health carrier would have to recognize an LPC or MFT as a
psychologist if the bill were to become law.
MS. HENRY offered to provide the committee with a chart showing
a matrix of the requirements for licensure in the four
disciplines. She said she could not give a concise answer to
the question about the private sector.
1:49:18 PM
CHAIR DYSON asked if he was correct in his understanding that a
psychiatrist is a medical doctor specializing in mental health
and a psychologist is a mental health worker with a Ph.D.
MS. HENRY affirmed that.
CHAIR DYSON asked whether the rest of the aforementioned
practitioners are qualified by a master's degree.
MS. HENRY replied yes.
CHAIR DYSON asked if the reclassification of terms would entitle
some practitioners to additional third-party payments from
private insurance companies.
JOHN MILLER, Ph.D., Chair, Board of Psychologist and
Psychological Associate Examiners, replied that the bill only
pertains to practitioners that are already Medicaid providers.
1:54:54 PM
CHAIR DYSON reiterated his question of whether private-sector
practitioners would be able to use the aforementioned terms to
qualify themselves for additional third-party payment from
private insurers.
DR. MILLER replied that SB 177 would not enable them to receive
additional payment from third-party insurers.
CHAIR DYSON asked if there are insurance companies that make
coverage decisions based on the titles of practitioners and, if
so, whether passage of the bill would allow practitioners to
change their titles to receive additional reimbursement from
insurance companies.
DR. MILLER replied no, because insurance companies do not make
coverage decisions based on the terms "psychotherapy,"
"psychotherapist" or "psychoanalyst," but make them on the basis
of the type of license that a practitioner holds.
SENATOR GREEN referenced the following paragraph from the
April 16, 2006, letter from Pamela Watts:
For Alaskans, this would mean greater access to needed
services, often at less cost to them than they
currently might pay. They could receive mental health
services, and have greater opportunity to use their
own insurance to cover those services provided by
agencies and providers qualified to perform them.
She asked Ms. Henry to clarify whether the aforementioned
paragraph indicated that practitioners would receive additional
third-party payments under this bill.
1:56:55 PM
MS. HENRY replied that she does not know of any insurance
company that reimburses payment for a type of treatment on the
basis of its title. She said when an insurance company makes a
coverage decision, it does so on the basis of the license held
by the practitioner, rather than on the title of the treatment.
Since the bill would have no effect on the types of licenses
issued by the board, it should not have an effect on coverage
decisions made by insurance companies.
2:00:33 PM
CHAIR DYSON thanked both Ms. Henry and Dr. Miller and asked them
to excuse the skepticism that the committee has gained from the
constant bombardment from people trying to use whatever means
necessary to gain access to third-party payments. He said he
appreciates their efforts. He added that his wife, who is
retired, held one of these licenses; while he does not believe
this represents a conflict of interest, he wished to mention it
for the record.
2:02:17 PM
CHAIR DYSON set aside the public hearing on the content of
SB 177 in order to hear the comments of the witnesses on the
proposed combination of the LPC and MFT boards.
SENATOR OLSON asked whether combining the boards could have any
foreseeable impact on the rates for malpractice insurance in the
state.
MS. HENRY replied it is unlikely that it would have a negative
impact on the rates.
DR. MILLER surmised that, if anything, it might help many
practitioners with their malpractice rates because the terms
"psychotherapist" or "psychotherapy" likely appear in their
insurance policies and they cannot apply these terms to
themselves under current statute.
SENATOR OLSON asked if combining the boards could raise the
board fees paid by practitioners.
MS. HENRY replied that that board fees could increase if the
boards were combined, because the larger board would have at
least as many meetings as the smaller boards and the meetings
would cost more because of the larger size. She did not see how
combining the boards could protect public safety any more
effectively than the existing separate boards.
2:07:44 PM
DR. MILLER noted, if the boards were combined into one, its
members would be subject to the cost of disciplinary actions
taken against members of the other discipline. He said it is
unfair to expect individuals to pay for the mistakes of the
members of a separate discipline.
2:10:33 PM
CHAIR DYSON said he recognizes that requiring boards to pay for
their own administration has created a dilemma for the state.
While the state is concerned about the aforementioned situation,
it does not want to create a disincentive for responsible
disciplinary practices.
He continued, saying one of the boards had more investigations,
arguably because it was more professional, and this caused board
fees to go up. As a consequence, new graduates moving into the
state are choosing to be licensed by the board with lower fees,
thus causing the arguably more professional board to further
suffer because of its professionalism. He asked the witnesses
if it is possible to arrange things so the responsible
whistleblowers wouldn't have to assume the entire cost of their
police actions.
2:14:15 PM
MS. HENRY added that the difference between the boards may be
explained by the fact that when one board was established, it
grandfathered in a large group of people who were ineligible to
qualify for either psychology or social work licenses; as a
result, a lot of problematic people were licensed. She surmised
that the other, seemingly less professional board might have had
fewer disciplinary actions because it was established later,
when many of these people were already licensed.
2:16:13 PM
SENATOR ELTON voiced appreciation for the work of the witnesses.
CHAIR DYSON held SB 177 in committee.
CHAIR DYSON adjourned the Senate Health, Education and Social
Services Standing Committee meeting at 2:18:53 PM.
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