Legislature(1997 - 1998)
04/08/1997 01:43 PM Senate L&C
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SENATE LABOR AND COMMERCE COMMITTEE
April 8, 1997
1:43 P.M.
MEMBERS PRESENT
Senator Loren Leman, Chairman
Senator Jerry Mackie, Vice Chairman
Senator Mike Miller
Senator Tim Kelly
MEMBERS ABSENT
Senator Lyman Hoffman
COMMITTEE CALENDAR
Confirmation Hearing:
Board of Psychologist and Psychological Associate Examiners
Susan L. Baxter
E. Ben Crawford
Gail C. Shortell - Anchorage
David J. Sperbeck - Anchorage
Board of Certified Real Estate Appraisers
Eileen R. Bechtol - Homer
Susan K. Crosson - Anchorage
Jon B. Wolfe - Douglas
Alaska Public Utilities Commission (APUC)
James M. Posey - Anchorage
Board of Barbers and Hairdressers
Sheryl Sutton - Juneau
Robert Pearson - Juneau
Board of Public Accountancy
Kathleen Grimes - Palmer
SENATE BILL NO. 122
"An Act relating to unfair discrimination under a group health
insurance policy for services provided by marital and family
therapists; and providing for an effective date."
- MOVED CSSB 122(L&C) OUT OF COMMITTEE
CS FOR HOUSE BILL NO. 30(FIN)
"An Act relating to civil liability for certain skating and cycling
activities; and providing for an effective date."
- MOVED SCSHB 30 (L&C) OUT OF COMMITTEE
PREVIOUS SENATE COMMITTEE ACTION
SB 122 - No previous action to consider.
HB 30 - No previous action to consider.
WITNESS REGISTER
Ms. Rachael Moreland, Aide
Senator Leman
State Capitol Bldg.
Juneau, AK 99801-1182
POSITION STATEMENT: Aide to sponsor of SB 122.
Ms. Beverly Lindell, President
Alaska Association for Marriage and Family Therapy
P.O. Box 32481
Juneau, AK 99803
POSITION STATEMENT: Supported SB 122.
Ms. Marci Wolff
Licensed Marital and Family Therapist
110 W 15th Ave.
Anchorage, Ak
POSITION STATEMENT: Supported SB 122.
Ms. Tima Priess
Licensed Marriage and Family Therapist
P.O. Box 213
Ester, AK 99725
POSITION STATEMENT: Supported SB 122.
Ms. Marianne Burke, Director
Division of Insurance
Department of Commerce and Economic Development
P.O. Box 110805
Juneau, AK 99811-0805
POSITION STATEMENT: Supported SB 122.
Mr. Jerry Reinwand
Blue Cross
2 Marine Way, Suite 219
Juneau, AK 99801-1182
POSITION STATEMENT: Supported CSSB 122(L&C).
Mr. Tim Sullivan, Staff
Representative Eldon Mulder
State Capitol Bldg.
Juneau, Ak 99801-1182
POSITION STATEMENT: Staff to sponsor of HB 30.
Mr. Kevin Ritchie
Alaska Municipal League
217 2nd Street
Juneau, Ak 99801
POSITION STATEMENT: Supported HB 30.
Mr. Jay Saunder
Ms. Melissa Walker
Skate Park Committee
Juneau, AK 99801
POSITION STATEMENT: Supported HB 30.
Mr. Kevin Smith
Alaska Municipal League Joint Insurance Association
217 2nd Street
Juneau, Ak 99801
POSITION STATEMENT: Commented on HB 30.
Ms. Nancy Robb
Parks and Recreation
P.O. Box 1296
Valdez, AK 99686
POSITION STATEMENT: Supported HB 30.
Mr. Bill Musson, Director
Petersburg Parks and Recreation
P.O. Box 329
Petersburg, AK 99833
POSITION STATEMENT: Supported HB 30.
Ms. Marnie Isaacs
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
POSITION STATEMENT: Supported HB 30.
ACTION NARRATIVE
TAPE 97-16, SIDE A
Number 001
CHAIRMAN LEMAN called the Senate Labor and Commerce Committee
meeting to order at 1:43 p.m. and said they would review the Board
nominees for confirmation.
MS. SHERYL SUTTON , Board of Barbers and Hairdressers, thanked
everyone for their consideration of her qualifications for
appointment to the board and apologized for being unable to attend
a previous hearing where her confirmation was taken up.
MR. ROBERT PEARSON , Board of Barbers and Hairdressers, said he
lived in Juneau for the last 10 years and is a full-time student at
the University of Alaska Southeast and studies government. He is
employed by the Alaska Council of School Administrators and works
putting on teacher training and continuing education. He said he
heard of the position from Ms. Sutton and he wanted to get the
experience and learn something pursuant to his studies. He also
feels he has the time to be attentive to the issues and do a good
job.
CHAIRMAN LEMAN said they would take up their confirmations in a
joint session and announced the Board of Psychologists and
Psychological Associate Examiners.
MR. BEN CRAWFORD said his family has been in Alaska about 100 years
and he is trained specifically as a psychologist in relationships
and issues relevant to our lifestyle like substance abuse and
crisis debriefing. He was encouraged as President of the Alaska
Psychological Association to put his name in as an applicant for
this position. CHAIRMAN LEMAN thanked him for his willingness to
serve.
Number 134
MS. SUSAN BAXTER said she has lived in Alaska since 1969 and
received her degree in Psychological Counseling in 1991 and has
been very active in professional issues. She was encouraged by
professionals in her community to offer her services to the Board
and is willing to do that because she is concerned with issues that
have to do with protection of the public and facilitating the
licensing of professionals. CHAIRMAN LEMAN thanked her for her
willingness to serve.
MS. GAIL SHORTELL said she moved to Alaska in 1970 and she is
currently an attorney in solo practice. She is interested in
serving on the Board because she has a sound background in public
social services. CHAIRMAN LEMAN asked her if there were any issues
the legislature should know about. She replied no. SENATOR LEMAN
wished her the best.
MR. DAVID SPERBECK, a clinical and forensic psychologist born in
Anchorage, said he has served the Board for about 10 years as a
consultant on issues related to ethics in complaints. CHAIRMAN
LEMAN thanked him for his willingness to serve and announced the
Board of Certified Real Estate Appraisers.
Number 200
MS. SUSAN CROSSON said she has been a real estate appraiser for
about 18 years and owns her own business. She said this board has
been in existence for only about 4 years and prior to that time
they were not licensed. She said she served under Governor Hickel
and has been invited to reapply.
Number 241
MR. JON WOLFE said he has been a resident of Juneau and Douglas for
about 15 years. He said he is interested in serving because he has
a background in regulations and could benefit this new board. He
has been appraising in Juneau for about seven years.
CHAIRMAN LEMAN asked in an effort to come up with an equitable
system of paying for the cost of education across the State of
Alaska in the REAA areas, there has been a suggestion to use
property taxes and someone said that would cost more to appraise
than they would collect, if that is a valid assessment. MR. WOLFE
said he didn't have an opinion on that. CHAIRMAN LEMAN thanked him
for his willingness to serve and said they would next take up the
Alaska Public Utilities Commission.
MR. JAMES POSEY, 18-year Alaskan resident, said he has had a number
of jobs here. He brings his experience in management, technology,
and problem solving to the Board.
CHAIRMAN LEMAN asked if he could see any particular challenges
coming our way with the federal government mandating deregulation.
MR. POSEY replied that with deregulation as instituted from the
East Coast, one must always look at rural areas and areas that are
disconnected as being special circumstances and if Congress, in its
wisdom, provides the state utility commissions with the support and
regulatory devices that would allow local circumstances to fall
under the local commission, he thought they could successfully
negotiate deregulation. That is what is currently happening in the
area of telecommunications. He said a special situation is that we
are not connected to the grid. We are like an island and there
could be some market failure situations.
CHAIRMAN LEMAN asked if he thought competition in the Alaska market
place in telecommunications has been a success so far. MR. POSEY
replied that it is being instituted successfully because of how the
Act works and also because of the expertise within the various
competing utilities, considering its complexity and new technology.
CHAIRMAN LEMAN thanked him for his willingness to serve and
announced they would next take up the Board of Public Accountancy.
Number 354
MS. KATHLEEN GRIMES said she had been in Alaska since 1974 and
although she is not a CPA, she has an extensive accounting
background of about 15 years. She has an accounting degree and a
master's in governmental and nonprofit finance. She said she has
volunteered her time locally and is ready to volunteer at a state-
wide level.
CHAIRMAN LEMAN asked if the construction projects she worked with
were in rural Alaska. MS. GRIMES said the majority of them were
during the Project 80s when all the schools in Anchorage were being
built. CHAIRMAN LEMAN asked her to help the legislature with her
suggestions for a better government and thanked her for her
willingness to serve. He then announced he would notify the Senate
of their hearings.
Number 450
SB 122 INS.COVERAGE:MARRIAGE & FAMILY THERAPIST
CHAIRMAN LEMAN announced SB 122 to be up for consideration.
MS. RACHAEL MORELAND , Aide to Senator Leman, said that SB 122 was
requested by the Alaska Association for Marriage and Family
Therapy. It adds marital and family therapists to the list of
providers against whom insurers may not discriminate. It does not
mandate insurers to add coverage of marital and family therapists
where the coverage currently is not provided. It merely requires
that insurers treat marital and family therapists on equal footing
with other licensed mental health providers and extend the same
opportunities for coverage that the insurer offers these licensed
providers.
Currently health insurers offering mental health services may not
discriminate against licensed psychologists, psychological
associates, or clinical social workers. SB 122 would allow those
insured with mental health coverage to choose treatment from a
licensed marital and family therapist.
MS. MORELAND said she wanted to correct a phrase on sponsor
statement at the end of paragraph two. It is incorrect where it
says the insurance company offers the same as in other states. It
should read, "It merely requires that insurers treat marital and
family therapists on equal footing with other licensed providers in
their field.
She said marital and family therapists are licensed or certified in
37 states and are recognized by the U.S. Department of Health and
Human Services as one of the five core mental health disciplines in
the U.S.
CHAIRMAN LEMAN asked if it was correct that if an insurance policy
provides for mental health services, then the insurer cannot
discriminate against marriage and family therapists because they
practice in that area. MS. MORELAND said that was correct for
certain services.
Since there was a quorum present, SENATOR MACKIE moved and asked
unanimous consent that the individuals they listened to for
confirmation for the various boards be submitted to the joint
session for confirmation. There were no objections and it was so
ordered.
MS. BEVERLY LINDELL , President, Alaska Association for Marriage and
Family Therapy, supported SB 122 saying it's very simple. They are
just being asked to be added to the list of providers that cannot
be discriminated against by insurers. It's not a mandate for
coverage; it's not any willing provider language.
MS. LINDELL thought this bill is important because it provides
fairness as marriage and family therapists are one of the five core
mental health professions as identified by the National Institute
of Mental Health. The others are already in this legislation.
They are not asking for special treatment.
She said the second issue is cost, the argument being that it will
increase insurance costs. An opinion from the Division of
Insurance on this question a few years ago came back stating they
could find no evidence of that happening and there is some
suggestion that it could actually decrease costs.
MS. LINDELL stated that there is considerable evidence that the
treatment of mental and emotional disorders is not unproductive.
She said a report prepared by the Mental Health Liaison Group out
of Washington D. C. estimated on a national basis over $1 billion
could be saved with appropriate mental health treatment. Another
study by the Harvard Community Health Plan involved patients whose
symptoms may have still included psycho-social problems and when
group therapy was added, there was a reduction by 50% of doctor
visits.
She said there is now considerable evidence that licensed marriage
and family therapists can complete treatment in fewer sessions than
individual treatment which translates into reduced costs for
consumers and insurers.
The third issue has to do with the rights of consumers, and
allowing freedom of choice of qualified providers is fair. In a
1993 survey of consumers, the American Psychologists found that
marriage and family therapists were the type of therapist most
often recommended by consumers to family and friends.
Finally, she said they have heard a lot about how the American
family is in a lot of trouble. They are the profession that has
special expertise in the treatment and care of families and they
would like the opportunity to do that.
CHAIRMAN LEMAN asked if she supported Senator Mackie's proposed
amendment that would insert a new section on page 2, line 11
saying, "(2) "unfair discrimination" does not include requirements
imposed by an insurer for purposes of utilization review, cost
containment, or standards of clinically appropriate health care
services". MS. LINDELL deferred to the Division of Insurance.
Number 500
CHAIRMAN LEMAN asked what the core mental health groups were. MS.
LINDELL replied the other groups are psychiatrists, psychologist or
psych-associates, social workers and professional nurses. CHAIRMAN
LEMAN noted that they are not in this legislation, but are in the
statute.
CHAIRMAN LEMAN said in a letter of support from Dr. Pollick that
insurers do not compensate licensed marriage and family therapists
equally. He asked if the intent was to mean that they did not have
equal access to insurance coverage. MS. LINDELL said that is
correct and agreed that they do not intend to make compensation
equal to that of a medical doctor.
MS. MARCI WOLFF , licensed marriage and family therapist, supported
SB 122. She has specific training for family therapy rather than
a focus on other areas of psychology such as research or social
policy making. She recited an extensive list of credentials and
said she is currently in private practice and regularly receives
referral from doctors, psychologists, social workers, and other
family therapists, attorneys, military sources, and community
agencies. She receives these referrals because she's effective in
providing quality therapy in a brief cost effective manner. She
said marriage and family therapists need to be recognized and
supported legislatively in providing the services for which they
are uniquely qualified to provide.
CHAIRMAN LEMAN asked if any of her services are currently being
paid by insurance. She replied that many are.
Number 540
MS. TIMA PRIESS said she is a licensed marriage and family
therapist. She said she has been accepted as a provider by several
insurance companies including the Veterans Administration. She has
had the experience of being turned down by insurance companies,
including a company that had certified her under their managed care
program, but would not certify her independently for clients who
use their insurance without the managed care which doesn't make
much sense to her.
MS. PRIESS pointed out under section 47.17.020, the Alaska Child
Protection Statute, professionals who are required to report child
abuse include practitioners of the healing arts. These
professionals are defined in section 47.17.290 (13) as including
marital and family therapists. In addition 47.24.010, the statute
that defines who is required to report abuse of elders and disabled
adults also includes marital and family therapists.
Number 561
MS. MARIANNE BURKE, Director, Division of Insurance, said this
particular section of the code has somehow mutated over time. The
original intent, according to her reading of the enacting
legislation, was the practice of unfair discrimination was to mean
unfairly discriminating against similar professions. For example,
if you were an M.D. licensed to perform an appendectomy, an
insurance company could pay one doctor and not another.
MS. BURKE said regarding cost, that the services provided under an
insurance contract is a matter of a contractual arrangement. You
contract to have particular services covered at a particular rate
or up to a particular cap. As long as there's no expansion of
those services by adding another profession, it would not increase
the cost. Her only concern is if a profession expanded the scope
of services that was provided under the contractual arrangement;
for example, expanding marital and family therapists to include
priests, rabbis, or ministers - all of whom provide counseling.
But this is a licensed group and she does not know their scope.
She understand that this is a credible group and has standards of
practice and conduct to which they adhere.
TAPE 97-16, SIDE B
SENATOR MACKIE asked her if she had problems with his proposed
amendment. MS. BURKE replied the first portion, "unfair
discrimination does not include requirements imposed by an insurer
for purposes of utilization review" is perfectly appropriate. She
said cost containment is not inappropriate as long as it is not
used to dictate that you go to the cheapest available service in
town.
MR. JERRY REINWAND, Blue Cross, said SB 122 raises an issue bigger
than just the issue of family and marital therapists. The proposed
bill really talks about unfair discrimination and there is no
statutory definition of what is unfair discrimination, nor is there
in regulation. While the Division has been a tough, but fair
regulator, the legislature is still leaving it up to them to apply
their own idea of what constitutes unfair discrimination. They
support Senator Mackie's amendment, because it puts, by contract,
what terms and conditions would not constitute unfair
discrimination which brings clarity to the issue.
CHAIRMAN LEMAN asked if he thought the legislature should define
unfair discrimination. MR. REINWAND replied that discrimination is
an important issue and there have been cases in the past where
insurance companies have not always done the right thing regarding
discrimination. He thought it would be in everyone's interest and
good public policy if you're going to say you can't do it, to
define what it is.
MS. LINDELL clarified that any licensed group has within its
statutes that regulate the profession the scope of practice. Under
marriage and family therapists it lists first of all the
requirements in terms of formal education, specific courses that
are required, time of supervision, practicum experience, etc. In
terms of what the practice means, that is also in the statute and
includes the diagnosis and treatment of mental and emotional
disorders that are referenced in a standard diagnostic nomenclature
for marriage and family therapy, whether a cognitive affected
behavior within the context of human relationships, particularly
marital and family systems. They must also apply the understanding
of the dynamics.
CHAIRMAN LEMAN noted that some ministers may qualify, but probably
very few. MS. LINDELL agreed.
SENATOR MACKIE moved to adopt amendment #1. There were no
objections and it was so ordered.
SENATOR MACKIE moved to pass CSSB 122(L&C) from committee with
individual recommendations and $0 fiscal note. There were no
objections and it was so ordered.
HB 30 CIVIL LIABILITY FOR SKATEBOARDING
CHAIRMAN LEMAN announced HB 30 to be up for consideration.
MR. TIM SULLIVAN, Staff to Representative Eldon Mulder, sponsor,
said HB 30 was requested by the Municipality of Anchorage. They and
several other municipalities would like to create skating and
cycling parks so skaters and cyclers will have a place to ride
rather than using areas designed for pedestrians. The
municipalities are willing to develop these areas if they can be
insulated from liability for claims arising from claims inherent in
skating and cycling.
MR. SULLIVAN said the intent of HB 30 is to encourage
municipalities to proceed with development of various outdoor
recreation without increasing their liability unnecessarily. This
bill applies only to municipal skating and cycling parks. It is
patterned after legislation passed providing this limited
protection to ski areas. This protection from liability relates to
inherent dangers and risks of skating and cycling. Municipalities
are required to post signs warning of the inherent risks and that
the liability rests with the skater and cycler.
SENATOR KELLY informed the committee that the sponsor came to him
with two amendments. Number 1 on page 1, line 8 after "skating"
would delete "and" and insert "or". Amendment number 2 on page 4,
line 31 would insert a new paragraph to read the facility "does not
include a trail used for skating or cycling." In other words there
was some concern that the current definition or lack of definition
of facility would require the municipality of Anchorage and other
areas to put warning signs up on trails, like the Tony Knowles
Coastal Trail.
SENATOR MACKIE clarified that this amendment referred to only those
facilities that are built specifically for that. MR. SULLIVAN
agreed.
SENATOR KELLY moved to adopt amendment 1. There were no objections
and it was so ordered.
SENATOR KELLY moved to adopt amendment 2. There were no objections
and it was so ordered.
Number 460
MR. SULLIVAN said there was another amendment, number 3, that they
support. He said that several municipalities including Valdez,
Petersburg, Sitka, and Seward expressed the idea that they should
have the ability to determine what is needed to separate the
facility from conflicting uses or hazardous conditions in this
situation. On page 3, line 9 it would delete "with fencing or
another type of enclosing or surrounding structures."
SENATOR MACKIE moved to adopt amendment 3. There were no
objections and it was so ordered.
SENATOR MACKIE asked if there was a number of municipalities
looking at this now. MR. SULLIVAN said there were letters of
support from a number of municipalities, including Anchorage,
Kodiak, Kenai, Juneau, and Fairbanks.
SENATOR MACKIE asked to what degree was the liability a deterrent
to building the parks. MR. SULLIVAN said he would prefer the AML
address that issue.
MR. JAY SAUNDER AND MELISSA WALKER, representing the Juneau Skate
Park Committee, testified before the committee. MR. SAUNDER said
that it is very difficult and expensive to have someone to cover
the insurance of a skate park and this bill would greatly increase
the chances of a skate park happening for a large population of
youth skaters in Juneau.
SENATOR MACKIE asked them if they knew if they go to this park and
are doing flips or whatever and break their arm, are they willing
to accept that responsibility or should their parents be allowed to
sue the CBJ. MR. SAUNDERS replied that they understand and feel
that parents shouldn't be able to sue.
MR. KEVIN RITCHIE, Alaska Municipal League, said they look at this
as another opportunity to provide services for our youth. The
frustrating thing now is that kids can get hurt and in most cases
wouldn't have anyone to sue. Municipalities are not barred from
doing this, but there is a big financial incentive for not putting
together a skateboard park because, even though it's safer, there's
a much greater risk of loss to the municipal government. This bill
just does what ski areas do which is they say if we're negligent in
the ski area and you hurt yourself, it's our fault, but if the ski
area is well maintained, there are inherent dangers in skiing that
you have to accept.
In Juneau there has been some negotiation with kids to use an
approved facility rather than the street. So it's a lot safer for
both pedestrians as well as the kids themselves.
SENATOR KELLY asked if there was an approved facility in Juneau
now. MR. RITCHIE replied that these young adults are currently
working on developing that facility.
SENATOR MACKIE asked what it would cost for insurance now to have
a facility. MR. RITCHIE replied there is a significant difference
in the liability.
MR. KEVIN SMITH, Alaska Municipal League Joint Insurance
Association, said the coverage for skateboard parks in general has
been excluded from most general liability policies available in the
State of Alaska. Recently the Board of Trustees of JIA discussed
this idea and the needs of municipalities to deal with the issue of
getting kids off the streets and into some place. So their
association went ahead and included skateboarding as a covered
item. This is largely in anticipation of passage of the bill and
largely just addressing the needs of the members since it's not
actually an insurance company per se.
MR. SMITH said that coverage is almost impossible to get now. This
bill would help coverage become available at whatever cost.
MS. NANCY ROBB, Valdez Parks and Recreation, said the City of
Valdez is very supportive of HB 30 and the amendments that will
allow municipalities to delineate the boundaries.
SENATOR KELLY asked if Valdez was currently planning a skateboard
park. She replied that they currently have an in-line hockey rink
they constructed last year through some donations and this will
assist them with that. In the past 30 days a number of youth have
expressed interest in developing a skateboard park.
MR. BILL MUSSON, Director, Petersburg Parks and Recreation,
supported HB 30. He said this issue is becoming increasingly
important in many municipalities around the State in expanding
positive recreational opportunities for the youth of communities.
He also supported the amendments.
Number 347
MS. MARNIE ISAACS, Municipality of Anchorage, said she is also the
parent of a skater. She thanked them for considering this for the
kids and that resolutions have been passed by the Anchorage Youth
Commission and the Anchorage Assembly, and are currently pending
before the Anchorage Chamber and the Downtown Anchorage
Association, in support of this legislation.
SENATOR MACKIE moved to pass SCSHB 30(L&C) from committee with
individual recommendations and $0 fiscal note. There were no
objections and it was so ordered.
CHAIRMAN LEMAN adjourned the meeting at 2:55 p.m.
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