SB 331 - PROFESSIONAL COUNSELOR LICENSING MS. BETH HAGEVIG, staff to SENATOR GARY WILKEN, presented SB 331, a bill to license professional counselors. MS. HAGEVIG reported the bill broadens the career options of counselors, increases counselors' ability to keep client information confidential and allows counselors to be covered under many employee assistance programs (EAPs). MS. HAGEVIG said the bill is good for Alaska mental health consumers since it establishes minimum educational and experiential requirements and will partially eliminate the "buyer beware" situation that now exists. She said the bill also institutes grievance procedures and provides legal recourse for clients who feel they have been wronged. MS. HAGEVIG said the bill has the support of numerous professional organizations. MS. ANNE HENRY, a professional counselor, said Alaska is one of only six states that do not currently license professional counselors. In one of those states, legislation is pending to do so, and similar legislation is being debated at the federal level. MS. HENRY said the bill is a title restriction and not a license restriction bill; if people do not want to get the license they are not forced to, they are simply disallowed from calling themselves licensed professional counselors. MS. HENRY said the bill has similar educational requirements as those that exist in other states and allows professional counselors to become an integral part of available mental health services. She urged the committee's support for the bill. CHAIRMAN TAYLOR noted that SENATOR WILKEN, Pamela Watts and Robert Lane have corresponded regarding this issue and are concerned there are insufficient course work requirements to help prepare professional counselors to treat serious mental disorders of to administer complex psychological testing measures. MR. GARY CLEMENT, a mental health clinician for the Juneau Mental Health clinic, said he works in an emergency room and administers psychotherapy every day. MR. CLEMENT said he does not do testing other than that for which he has been trained in the field of substance abuse. MR. CLEMENT said he does not believe testing is the issue here, and all mental health providers are trained to deal with serious mental illnesses. MS. HENRY added that the Diagnostic and Statistical Manual, (DSM IV) is used by virtually every mental health care provider and sets the standards for any type of mental health disorder. The manual standardizes the terminology and criteria used in diagnosis. MS. HENRY said this bill requires either a MA or a Ph.D. from an accredited program as well as practical experience and 2,000 hours of supervised work. MS. HAGEVIG noted that there is a limitation of practice in the bill, allowing a person to provide only those services which he or she has been appropriately trained to perform. Number 231 CHAIRMAN TAYLOR mentioned there had also been concern expressed about the lack of specific educational course work requirements. MS. HAGEVIG said the bill is fairly consistent with other statutes in place for social workers and associate psychologists. She said the degree requirement is in the bill, but the course work for that degree is not specified. MS. HENRY indicated that the organizations that accredit these programs are national organizations that are very particular in the programs they accredit. SENATOR PARNELL asked about the confidentiality provision and what it is meant to protect. Number 261 MS. HENRY replied that rule 504 is fairly standard and mandates the confidentiality of information provided to a counselor unless there is a threat of harm to the client themselves or to others. MS. HAGEVIG said much of the language in this bill was borrowed from the legislation enabling the licensure of marriage and family therapists. SENATOR PARNELL noted that those counselors who are not licenced must divulge information if they are subpoenaed. MS. HENRY replied this was correct and specified that the privilege belongs to the client and can be waived if they so desire. Number 306 CHAIRMAN TAYLOR said the file indicates there is concern from the Alaska Psychological Association (APA) about the use of assessment techniques. AMA would like to see the use of assessment techniques limited to those "consistent with each counselor's formal education and training, licensed professional counselors may administer and utilize appropriate assessment instruments which measure and/or diagnose problems and/or dysfunctions within the course of human growth and development . . . appraisal techniques shall not include the use of projective techniques . . . nor the use of psychological or clinical tests designed to identify or classify abnormal or pathological human behavior, nor the use of individually administered intelligence tests." MS. HENRY said counselors do not do these types of tests and she believes the prohibition on projective testing already exists in the bill. MS. HENRY again referred to the limitation of practice provision. MR. CLEMENT explained that deciphering the subtleties of tests like the Rorschach (ink blot) test was more of an art than a science, and if he wanted to use a Rorschach he had evaluated, he would get his psychologist to "sign off on it." CHAIRMAN TAYLOR noted the issue seemed to be a turf battle of some sort. MS. HENRY said it was not the intent of the bill to allow anyone to do anything they are not trained to do and the bill allows a person to complain if they believe this is happening. CHAIRMAN TAYLOR said it seems that existing counselors don't have to comply with the provisions in the bill. MS. HAGEVIG said the bill does contain a grandfathering provision for people currently practicing who have either a MA or a Ph.D. CHAIRMAN TAYLOR asked if the degree has to be in counseling and MS. HENRY said counseling or a related field. CHAIRMAN TAYLOR announced his intent to take up the confirmation hearing at this time. SB 331 - PROFESSIONAL COUNSELOR LICENSING Resuming the discussion of SB 331, CHAIRMAN TAYLOR again noted that there seemed to be a turf battle over the bill between psychologists and counselors. CHAIRMAN TAYLOR thought he heard someone say that if these counselors had the appropriate post graduate work and training they could be psychologists themselves. MR. CLEMENT stated the name of the program is precisely what prevents this. He said they do in fact have the same training, just under another name. MS. HENRY agreed, saying the name on your degree must match the name on your license. MR. CLEMENT specified that a degree in "community psychology" might not be treated the same as a degree in "psychology." Number 444 SENATOR WILKEN thanked the committee for hearing the bill, saying it originated from a constituent who had been wronged by someone who claimed to be a counselor. He said he approached this issue from a consumer protection standpoint but he's happy if it happens to benefit counselors as well. MS. SHEILA CLARSON Ph.D., representing the Alaska Psychological Association (APA), testified via teleconference from Anchorage and said the language of the bill is too broad, though she does support counselor licensing. MS. CLARSON said the training of counselors differs from that of a psychologist or a psychological associate and the bill does not accurately reflect that. MS. CLARSON said course work is generally specified for different types of licences by regulation. She said MR. CLEMENT's comments about testing illustrated APA's concern about testing. She said appropriate use of testing and accurate diagnoses are important issues that keep her from supporting the bill at this time. CHAIRMAN TAYLOR asked if there had been an amendment contemplated to deal with the testing issue. SENATOR WILKEN said he also thinks it is a turf battle and the sides have compromised all they can. He thinks the bill has reached a workable point at which the public interest is served. CHAIRMAN TAYLOR asked MS. CLARSON if she was aware of the changes that had been made to the bill and she replied she was. MS. CLARSON maintained her concern about the use of testing by counselors due to the fact that the results of such a test can make a big impact on a person's life. She concluded that she recognizes there is room for both psychologists and counselors, she just wants the bill to reflect the difference between the two. Number 400 MS. ANNE HENRY said the scope of counselors practice is defined in the bill and was modeled after the statute which licences marriage and family therapists. She said the bill has been changed to accommodate the concerns of psychologists. MS. HAGEVIG made the point that psychologists have regulations defining who can do what and this same thing will happen for counselors under this bill. She indicated if there is a board of counselors set up, they will set the regulations to flesh out what is allowed in statute. She said the original licensure state for psychologists was no more specific than this bill. Number 387 CHAIRMAN TAYLOR commented that a board of counselors defining what counselors can do would understandably want to define those limits broadly. MS. CATHERINE SIMON, a member of the American Counseling Association, testified via teleconference from Anchorage to her support of the bill. Number 360 MR. ALLEN MOROTTI commented that the bill will allow a board of counselors to be set up. Currently, there is no board and no type of oversight at all over people who call themselves "counselors." MR. LLOYD CARY supported the bill due to a case he was aware of in which a pastor falsely claimed to be a psychologist and was practicing counseling. He supported licensure for the protection of the public. SENATOR PARNELL moved SB 331 with individual recommendation. Without objection, the bill moved from committee and they were adjourned.