03/05/2024 09:00 AM House FINANCE

HOUSE BILL NO. 126                                                                                                            
                                                                                                                                
     "An Act relating to the Board of Professional                                                                              
     Counselors; and relating to licensing of associate                                                                         
     counselors."                                                                                                               
                                                                                                                                
9:12:00 AM                                                                                                                    
                                                                                                                                
Co-Chair  Foster   relayed  that  no  amendments   had  been                                                                    
received for HB 126. He  intended to review the fiscal notes                                                                    
and move the  bill from committee if it was  the will of the                                                                    
committee. He  asked to  hear a review  of the  fiscal notes                                                                    
from the Department of Health (DOH).                                                                                            
                                                                                                                                
RENEE GAYHART,  DIRECTOR, DIVISION OF HEALTH  CARE SERVICES,                                                                    
DEPARTMENT  OF  HEALTH,  reviewed  the  department's  fiscal                                                                    
notes for  the Medicaid component and  Health Care Services.                                                                    
The fiscal impact  was zero and there was  no revenue change                                                                    
in cost to DOH; the  department intended to absorb the cost.                                                                    
The first fiscal  note for Medicaid was  OMB component 3234.                                                                    
She relayed that the  associate professional counselors that                                                                    
would  be  coming on  board  were  already included  in  the                                                                    
budget.  The second  fiscal note  for Health  Care Services,                                                                    
OMB component 242,  would result in an  uptick in enrollment                                                                    
and additional  work for the department's  Quality Assurance                                                                    
Unit, which was responsible  for enrollment and post payment                                                                    
reviews.  She  stated  there  would  be  a  limited  systems                                                                    
configuration,  but  the  division would  absorb  the  cost,                                                                    
resulting in a zero fiscal note.                                                                                                
                                                                                                                                
9:13:31 AM                                                                                                                    
                                                                                                                                
Representative  Stapp  asked  if  there  needed  to  be  any                                                                    
language in  the operating budget  or bill  referencing that                                                                    
the funding  for the positions  was already included  in the                                                                    
budget. He  remarked that  there was not  a fiscal  note for                                                                    
the cost because the positions were already in the budget.                                                                      
                                                                                                                                
Co-Chair Johnson  noted that even though  the positions were                                                                    
not referenced  in the fiscal note,  she did not see  how it                                                                    
could be  put in the budget  when it was part  of the fiscal                                                                    
note even though  it was zero. She would take  a look at the                                                                    
issue with  her staff. She  suggested that may be  done when                                                                    
the  fiscal notes  were all  integrated  at the  end of  the                                                                    
[budget] process.                                                                                                               
                                                                                                                                
Ms. Gayhart commented that  the department contemplated that                                                                    
the funding was  already in the budget. She  relayed that it                                                                    
was included with the existing  staffing pattern that was in                                                                    
FY 24 and would go forward in FY 25.                                                                                            
                                                                                                                                
9:15:41 AM                                                                                                                    
                                                                                                                                
Representative  Hannan asked  if the  bill would  allow more                                                                    
Alaskans  to  get  coverage for  mental  health  counseling.                                                                    
Additionally, she  asked if the  services would  be Medicaid                                                                    
reimbursable once the licensure was in place.                                                                                   
                                                                                                                                
Ms.  Gayhart  responded that  the  bill  would increase  the                                                                    
mental health  services capacity  and the services  would be                                                                    
covered through Medicaid.                                                                                                       
                                                                                                                                
Co-Chair Foster asked for a review of the next fiscal note.                                                                     
                                                                                                                                
TRACY  DOMPELING, DIRECTOR,  DIVISION OF  BEHAVIORAL HEALTH,                                                                    
DEPARTMENT  OF HEALTH,  reviewed fiscal  note OMB  component                                                                    
2665. The zero note showed no  revenue change or cost to the                                                                    
department.  She detailed  that the  Division of  Behavioral                                                                    
Health was involved with enrollment  of individuals who were                                                                    
1115  providers. The  division would  use existing  staff to                                                                    
perform any additional requirements  needed to bring the new                                                                    
professional counselors on board.                                                                                               
                                                                                                                                
9:17:10 AM                                                                                                                    
                                                                                                                                
Co-Chair Foster asked  for a review of fiscal  note from the                                                                    
Department of  Commerce, Community and  Economic Development                                                                    
(DCCED).                                                                                                                        
                                                                                                                                
SYLVAN ROBB,  DIRECTOR, DIVISION OF  CORPORATIONS, BUSINESS,                                                                    
AND   PROFESSIONAL   LICENSING,  DEPARTMENT   OF   COMMERCE,                                                                    
COMMUNITY  AND ECONOMIC  DEVELOPMENT,  addressed the  fiscal                                                                    
impact note, OMB component 2360.  The fiscal note included a                                                                    
request   in  FY   25  for   $131,000   for  an   additional                                                                    
occupational licensing  examiner to handle the  licensing of                                                                    
the new  associate counselors.  The only  cost that  did not                                                                    
continue  into the  outyears was  $2,900  for a  regulations                                                                    
project.  The rest  of  the costs  that  continued into  the                                                                    
outyears were  all related to  the new position.  The fiscal                                                                    
note reflected a  change in revenue because  the fund source                                                                    
for    the   position    was    1156,   receipt    supported                                                                    
services/designated general funds.  She explained that DCCED                                                                    
was  required through  statute to  have  its licensing  fees                                                                    
cover the cost of operations for professional licensing.                                                                        
                                                                                                                                
Representative Galvin asked if  the one DCCED position would                                                                    
oversee all  of the  associate counselors. She  believed the                                                                    
position would  keep track of  counselors' hours.  She asked                                                                    
how many counselors one person would keep track of.                                                                             
                                                                                                                                
Ms. Robb  replied that  the position would  be added  to the                                                                    
staff that  currently licensed professional  counselors. The                                                                    
team would  license professional and  associate professional                                                                    
counselors. She  explained that  because the  department did                                                                    
not currently license  associate professional counselors, it                                                                    
did not  have an accurate  estimate of how many  there were.                                                                    
There  were 993  professional counselors  in FY  23 and  577                                                                    
board   approved   supervisors   who   would   oversee   the                                                                    
individuals   who  would   become  the   licensed  associate                                                                    
counselors.                                                                                                                     
                                                                                                                                
Representative  Galvin  assumed   the  number  of  associate                                                                    
counselors  would  be   in  the  100s  if   there  were  577                                                                    
supervisor counselors.                                                                                                          
                                                                                                                                
Ms. Robb replied that there was  not a count of how many the                                                                    
individuals  there  were.  She  explained  that  each  board                                                                    
approved supervisor  may supervise  more than one  person or                                                                    
may currently not be supervising anyone.                                                                                        
                                                                                                                                
Representative Galvin asked  for verification the department                                                                    
had confidence that the one position would be sufficient.                                                                       
                                                                                                                                
Ms. Robb responded affirmatively.                                                                                               
                                                                                                                                
9:20:49 AM                                                                                                                    
                                                                                                                                
Co-Chair  Foster asked  the bill  sponsor and  his staff  to                                                                    
provide a quick summary of the bill.                                                                                            
                                                                                                                                
REPRESENTATIVE  STANLEY  WRIGHT,  SPONSOR, deferred  to  his                                                                    
staff to provide a brief overview of the bill.                                                                                  
                                                                                                                                
RACHEL GUNN,  STAFF, REPRESENTATIVE STANLEY  WRIGHT, relayed                                                                    
that  the  bill  created  a   tier  designation  within  the                                                                    
counseling profession  in Alaska. She detailed  that after a                                                                    
person  completed their  graduate degree  and prior  to full                                                                    
licensure, the  bill offered more supporting  guidance along                                                                    
their   professional   pathway  and   supported   supervisor                                                                    
supporting  associate counselors.  She shared  that a  local                                                                    
Juneau therapist  had testified that they  have four interns                                                                    
currently.  She  stated  that  supervisors  were  overseeing                                                                    
anywhere from one person to a handful of people.                                                                                
                                                                                                                                
Representative Ortiz  asked what  was currently  required in                                                                    
order for a person to gain full licensure.                                                                                      
                                                                                                                                
Ms.  Gunn   replied  that  there  were   federal  guidelines                                                                    
governing  the  counseling  profession that  included  3,000                                                                    
hours  of  training,  passing a  national  exam,  and  other                                                                    
rigorous standards.  The bill would give  counseling interns                                                                    
a   licensure  to   report  their   hours  more   often  and                                                                    
supervisors could  keep everything together. The  bill would                                                                    
make  sure that  everyone  graduating  with a  postsecondary                                                                    
degree in  behavioral health would  have the  opportunity to                                                                    
become a licensed professional counselor.                                                                                       
                                                                                                                                
Representative  Ortiz the  bill was  intended to  streamline                                                                    
the licensing process.                                                                                                          
                                                                                                                                
Ms. Gunn  responded affirmatively.  She added that  the bill                                                                    
had the  additional benefit of offering  billable hours. She                                                                    
explained that  currently counseling interns could  not bill                                                                    
many  insurances  including   Medicaid.  She  detailed  that                                                                    
supervisors  were overloaded  with clients  with only  a few                                                                    
billable  self-pay  clients.  For example,  a  counselor  in                                                                    
Juneau  with four  interns only  had  two billable  self-pay                                                                    
clients to share between the interns.                                                                                           
                                                                                                                                
9:24:14 AM                                                                                                                    
                                                                                                                                
Co-Chair Johnson  MOVED to  REPORT HB  126 out  of committee                                                                    
with individual recommendations  and the accompanying fiscal                                                                    
notes.                                                                                                                          
                                                                                                                                
There being NO OBJECTION, it was so ordered.                                                                                    
                                                                                                                                
HB  126 was  REPORTED out  of committee  with six  "do pass"                                                                    
recommendations     and     three    "no     recommendation"                                                                    
recommendations  and with  one new  fiscal impact  note from                                                                    
the   Department  of   Commerce,   Community  and   Economic                                                                    
Development,  and three  new zero  fiscal impact  notes from                                                                    
the Department of Health.                                                                                                       
                                                                                                                                
9:24:53 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:26:30 AM                                                                                                                    
RECONVENED