SB 331 - PROFESSIONAL COUNSELOR LICENSING CHAIRMAN WILKEN informed committee members a new draft version of SB 331 was prepared (version B). SENATOR WARD moved to adopt CSSB 331 (version B) as the working document of the committee. There being no objection, the motion carried. BETH HAGEVIG, legislative aide to Senator Wilken, gave the following explanation of the measure. CSSB 331 establishes a board to license and regulate experienced Masters and Doctoral level professional counselors whose education and experience do not fall within the existing behavioral health specializations of Licensed Clinical Social Worker, Licensed Marriage and Family Therapist, Psychologist, or Psychological Associate. This bill benefits counselors because it opens doors to employee assistance programs that currently require that service providers be licensed to qualify for their programs; it broadens career opportunities for counselors who wish to work for entities that require licensure; it provides incentive for Masters level behavioral health graduates of Alaska's university system to stay in state and take advantage of licensing opportunities that already exist in 44 other states; and it includes licensed professional counselors under Rule 504, protecting them from contempt of court, in cases where client confidentiality must be protected. MS. HAGEVIG explained CSSB 331 is good for Alaska's consumers because it establishes a minimum standard of education and experience that clients can trust, eliminating the buyer beware situation that currently exists. It institutes grievance procedures and gives legal recourse for clients of licensed professional counselors who feel they have been victims of fraudulent, unethical, or negligent practices. It gives clients, who require mental health services, greater choice and comfort in choosing a provider that best suits their needs, both emotionally and financially, and it increases the availability of licensed mental health providers who practice statewide, giving rural residents better access to mental health care. This bill has the support of the American Counseling Association (ACA), the ACA of Alaska, the Alaska School Counselor Association, numerous professional counselors and clients. Number 082 CHAIRMAN WILKEN pointed out a two-page document in committee members' packets shows where Alaska fits into the scheme of counselor licensing nationwide. The remainder of the packet contains letters of support. SENATOR LEMAN noted SB 122, dealing with family and marriage counselors, is currently in the House. He asked Ms. Hagevig if any thought was given to combining the counseling and marriage and family therapy boards into a common board, instead of creating a new board. He commented he serves on a professional board made up of architects, engineers and land surveyors, and although the professions differ, their common board is able to take care of the professional interests of all three groups. MS. HAGEVIG replied the counselors support combining the boards and are working with the marriage and family therapists' board members on creating a joint board. She suggested asking Pamela Watts and Ann Henry, from the American Counseling Association of Alaska, to address that question. Number 122 ANN HENRY, a member of the American Counseling Association of Alaska (ACAA), gave the following testimony. SB 331 is a title restriction bill, rather than a practice restriction bill, which means that people can continue to practice counseling in Alaska if they are practicing now. That arrangement will especially benefit the bush areas where counselors might now be practicing without the required education. Nationally, 44 states have some kind of licensure certification and 80,000 licensed professional counselors are nationally recognized. As a private practitioner, clients are often referred to her, but because she is not a licensed practitioner, employee assistance programs will not provide insurance coverage for her services. Managed care programs also require licensure. Ms. Henry believes clients need to be able to choose their counselor. MS. HENRY noted that in regard to Senator Leman's question about combining the two boards, the marriage and family therapists' board supports SB 331 and discussed, at its last meeting, the need to speak to ACAA about the possibility of combining the boards. The ACAA definitely favors combining the boards. She assumed that counselors will not be a viable group for the family and marriage therapists' board to deal with until they get licensing certification in Alaska. Number 172 PAM WATTS, President of the American Counseling Association of Alaska, gave the following testimony. When ACAA began efforts to require counselor licensure, it heard from several University of Alaska graduates who were having difficulty obtaining and maintaining employment or advancing in their positions. They support licensure because the lack of licensure requirements is limiting employment opportunities for them after they graduate. A second issue is that hundreds of Masters and Doctoral level counselors are currently providing counseling services around the state. ACAA is concerned that without licensure, they will not be able to practice, and in some cases, they are the only people available in those areas to do this work. Because they are trained to provide a range of counseling services that are not necessarily limited to the specialty licenses that Alaska currently has, such as marriage and family, or psychology or social work, they do not fit anywhere in the licensure scheme. SB 331 offers consumer protection, easier access to mental health services, and will provide Alaskans the opportunity to pursue occupations within the state for which they have been trained. MS. WATTS reiterated that ACAA is interested in looking at combining with the marriage and family therapists' board. She agreed that closely related fields can function very well on combined boards. She pointed out that other states, such as Georgia, have an omnibus board that includes social workers, chemical dependency counselors, licensed professional counselors and marriage and family therapists. She thought creating a similar board in Alaska in the future would be fiscally responsible. Number 227 SENATOR LEMAN encouraged Ms. Watts to further the dialogue about combining the two boards because he thought SB 331 would be a good vehicle in which to do so this year. He advised that if they do not combine boards, counselors will incur all of the initial costs of establishing a separate board which will increase the fees. CHAIRMAN WILKEN asked about the status of SB 122. SENATOR LEMAN stated it is in the House and he believes it is scheduled to pass. ROBERT POUND, a counselor with Southcentral Counseling Center in Anchorage, testified in support of SB 331. The Southcentral Counseling Center has developed a system in which a person must be licensed to reach the highest level of clinician. SB 331 would enable him to obtain a license and become a senior clinician. Without a licensing requirement in Alaska, agencies are forced to find people outside of the state to fill these positions. Requiring experience and education will ensure better quality treatment to clients. He received a professional counselor license in the State of Colorado around 1989. That license allowed him to do contract work, EAP work, and to have a private practice. The certification process requires a disclosure statement to be filled out by clients. He found clients responded very positively and the ability to do so relieved clients of worry. Mr. Pound believed SB 331 will have positive results on both counselors and consumers. Number 308 ALLAN MOROTTI, representing the Alaska School Counselors' Association, and the counseling program at the University of Alaska Fairbanks, gave the following testimony. The Alaska School Counselors' Association supports SB 331. Many rural counselors feel that passage of SB 331 will improve the delivery of mental health services. Students from the UAF program who end up counseling in rural areas often find themselves functioning in the role of a crisis counselor. As they move from site to site, the majority of their work is dealing with crisis issues, rather than the more traditional school counseling issues. Passage of SB 331 will allow those counselors to get the additional supervision necessary to provide quality mental health services, and passage will allow many of UAF's graduates to move out into the mental health agencies. Once employed by those agencies, the graduates feel pressured to acquire some type of licensure. Many agencies hire out-of-state because of the lack of licensed practitioners in the state. He believes the course work for Masters level counselors nationwide, in the area of supervision, clinical hours, diagnosis and appraisal, compares favorably with the requirements for clinical social workers and marriage and family therapists. He concluded by saying he strongly supports the bill both as an individual and on behalf of the Alaska School Counselors' Association. Number 371 CHAIRMAN WILKEN asked Mr. Morotti his opinion of combining the counselors' board with the marriage and family therapists' board. MR. MOROTTI said he thinks it is a good idea because he sees no need to have a proliferation of boards providing mental health services. DIXIE HOOD, a licensed marriage and family therapist from Juneau, and a member of the Board of Marital and Family Therapy, gave the following testimony. As a 23 year Alaska resident and psychology professor at the University of Alaska Southeast, she moved to California to complete a Masters in Counseling program for two years. That program required 3,000 supervised hours and an oral and written exam. She was licensed in California and upon returning to Juneau in 1985, contacted the Division of Occupational Licensing to find out what requirements she needed to meet to practice. Purchase of a business license was the only requirement until 1992. She commented that marriage and family therapy is not a specialty field. It is a theoretical approach in terms of counseling individuals, couples, or family members within the family systems approach and their interrelationships. Marriage and family therapists also treat people with alcohol problems, serious chronic mental illness, and depression and anxiety. MS. HOOD indicated at the February 10, 1998 Marital and Family Therapy Board meeting, the Board expressed interest in supporting standards and licensure for professional counselors in Alaska, and in discussing with them consideration of a combined board. The board has sought information from other states with omnibus boards to find out how their systems work. MS. HOOD commented she has testified on and followed SB 122; it is scheduled before the House Labor and Commerce Committee this afternoon for a second hearing. During the first hearing, held last week, information was requested and an amendment was discussed. The same amendment failed the Senate last year and would have added licensed marriage and family therapists to a list of health care providers who cannot be discriminated against in third party reimbursements. MS. HOOD believes it is important for consumers to have some trust in the amount of training and experience required of mental health providers. Licensure requirements are also important for the professional in terms of standing in the professional community and employee assistance programs and insurance companies. SENATOR LEMAN noted his memory of what happened regarding the amendment differed from Ms. Hood's. He recalled the amendment passed the Senate but its passage created challenges in the bill that some did not want to address at the time, therefore the amendment was removed and the bill passed. MS. HOOD added the amendment created a furor from chiropractors, dentists and other professionals. The Omnibus Insurance Reform Act did not take up that amendment, therefore the Board of Marital and Family Therapy is hoping it will be taken up in SB 122 or in another venue. There being no further testimony on SB 331, CHAIRMAN WILKEN announced the committee would hold the bill to investigate whether it can be incorporated into SB 122 or vice versa. SENATOR LEMAN stated whether SB 122 is the right vehicle in which to combine the boards or not, he thought the Legislature should consider combining the two boards and use a separate piece of legislation if necessary. CHAIRMAN WILKEN indicated the bill would be brought before the committee on Wednesday and a report on SB 122 would be provided.