Legislature(2017 - 2018)BELTZ 105 (TSBldg)
02/08/2018 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB105 | |
| SB155 | |
| SB116 | |
| HB126 | |
| SJR12 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 155 | TELECONFERENCED | |
| *+ | SB 116 | TELECONFERENCED | |
| + | HB 126 | TELECONFERENCED | |
| *+ | SJR 12 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 105 | TELECONFERENCED | |
SB 105-MARITAL & FAMILY THERAPY LIC. & SERVICES
1:33:38 PM
CHAIR COSTELLO announced the consideration of SB 105. She noted
the proposed amendment and stated her intention to take public
testimony and move the bill from committee.
SENATOR DAVID WILSON, Alaska State Legislature Juneau, Alaska
sponsor of SB 105, introduced the legislation paraphrasing the
following sponsor statement:
If enacted, Senate Bill 105 would add licensed marital
and family therapists to the list of independent
licensed practitioners, in order to address the
shortage of Medicaid-eligible behavioral health
providers in the state, afford more options for
beneficiaries, and increase access to care.
Currently, licensed marital and family therapists
(MFTs) are only allowed to provide services in
community health clinics or physician mental health
clinics, which limits the number of willing providers
in the mental health care arena. SB 105 expands
medical assistance reimbursement services to cover
those services provided by MFTs.
Specifically, SB 105
• Designates LMFTs as providers eligible to render
and bill for Medicaid-funded services as
independent practitioners under Alaska Statute
47.07.030(b)
• Clarifies supervisory requirements for marital
family therapist licensees
• Requires marital family therapist licensees to
carry liability insurance for regulatory
investigation fees of at least $30,000.
In 2016, the Alaska Board of Marital and Family
Therapy unanimously recommended the statute changes
contained in SB 105.
SENATOR WILSON said his understanding is that the foregoing
recommendations were discussed during the hearings for Senate
Bill 74 but weren't included in the final bill. The board has
requested these changes and the regulations have been written
but won't be promulgated until SB 105 is enacted.
1:36:43 PM
GARY ZEPP, Staff, Senator Wilson, Alaska State Legislature,
Juneau, Alaska, reviewed the two fiscal notes attached to SB
105. The fiscal note from the Department of Commerce, Community
and Economic Development (DCCED) appropriation is for
Corporations, Business and Professional Licensing. The total is
$1,300 for the services line in FY 2019 and with no expenditures
in outlying years. The revenue collection is receipt supported
and totals $1,300 for FY 2019 with no revenues reflected in the
outlying years. The summary states that the funding is needed
for regulation review, advertising, printing, and postage.
The fiscal note from the Department of Health and Social
Services (DHSS) appropriation is for Medicaid services. The
total is $50 thousand for the services line in FY 2019 and $1.8
million in the grants & benefits line for FY 2020 and beyond.
The revenue supporting the fiscal note is a blend of 66 percent
federal receipts and general fund match of 34 percent. The FY
2019 revenue shows $25 thousand of federal receipts and $25
thousand of general fund match totaling $50 thousand. Annual
revenue thereafter shows $660.5 thousand in federal receipts and
$340.3 thousand in general fund match totaling $1.8 million. The
summary states that in FY 2019 the $50 thousand general fund
match is for the development of business rules in the Medicaid
Management Information System detailing the parameters for
services and reimbursement. FY 2020 and annually thereafter
reflect $1.8 million. It's the average annual per recipient cost
times the estimated number of recipients. DHSS estimates $1,581
annually per recipient times 6,330 recipients for a total of
$1,000,773.
1:39:28 PM
MR. ZEPP provided the following sectional analysis for SB 105.
Section 1: Amends AS 08.63.100(a). Provides that 1,500
hours of clinical contact with couples, individuals,
and families required for licensure of marital and
family therapy must be supervised. Clarifies that
1,500 hours of clinical contact must include at least
100 hours of individual supervision and 100 hours of
group supervision. Provides that the required hours of
individual and group supervision may be conducted by
one or more supervisors. Requires that an applicant
for a license to practice marital and family therapy
must have professional liability insurance including
coverage of at least $30,000 for the applicant's
regulatory investigation fees.
Section 2: Provides the qualification for a person to
perform individual supervision of a licensee under AS
08.63 and the qualifications for a person to perform
group supervision of a licensee under AS 08.63.
Section 3: Adds marital and family therapy services to
the optional services that the Department of Health
and Social Services may provide medical assistance for
under AS 40.07.030(b).
Section 4: Adds a new subsection (g) that defines
"direct supervision," "mental health [physician
clinic]," and "psychiatrist" for AS 47.07.030.
Section 5 Adds a new subsection (h) that provides that
the department may reimburse a mental health physician
clinic for certain services if the services are
provided by a psychiatrist or an individual who works
under the direct supervision of a psychiatrist and is
licensed to practice as a professional counselor, a
marital and family therapist, a physician assistant,
an adult or family psychiatric mental health nurse
practitioner, psychologist, psychological associate,
or clinical social worker.
Section 6: Authorizes the department and the Board of
Marital and Family Therapy to adopt regulations
necessary to implement this act.
Section 7: Provides an immediate effective date for
Section 6 of this act.
Section 8: Provides a January 1, 2018 effective date
for Sections 1-5 of this act.
1:43:12 PM
CHAIR COSTELLO informed members of a friendly amendment to
change the effective date to January 1, 2019.
SENATOR MEYER moved Amendment 1.
AMENDMENT 1
OFFERED IN THE SENATE
Page 5, line 9:
Delete "2018"
Insert "2019"
CHAIR COSTELLO asked if there was objection to Amendment 1.
SENATOR GARDNER asked if the amendment addresses the DHSS fiscal
note that twice references a July 1, 2018 effective date in the
analysis.
CHAIR COSTELLO asked if the sponsor or staff could answer
1:45:14 PM
At ease
1:45:41 PM
CHAIR COSTELLO reconvened the meeting and clarified that the
fiscal note was updated to reflect the legislation.
SENATOR GARDNER withdrew her objection.
CHAIR COSTELLO found no further objection and Amendment 1 was
adopted. She noted who was available to answer questions.
SENATOR GARDNER asked if the bill would allow LMFTs to bill
Medicaid directly as an independent provider if they choose to
do so.
SENATOR WILSON clarified that the bill would allow LMFTs to bill
Medicaid both under supervision and as a private entity.
SENATOR GARDNER questioned the statement on the bottom of page 2
of the DHSS fiscal note that says:
Therefore, we are unsure of the number of LMFTs who
will be interested in beginning to independently bill
Medicaid, subjecting their practices to the
documentation and audit requirements that follow on
enrollment in Medicaid as an independent provider.
She said she was trying to anticipate the beneficial impact of
being able to bill independently when there are just under 100
LMFTs in the state with an active license.
SENATOR WILSON said that's their decision; this is intended more
for the nonprofit agencies or grantees that didn't benefit as
intended from the Medicaid expansion. The bill also seeks to
increase capacity to meet the demand for behavioral health
services.
CHAIR COSTELLO asked if marital and family therapist services
could be delivered through telemedicine.
SENATOR WILSON deferred to Ms. McCarthy.
CHAIR COSTELLO asked if there was any opposition to the bill.
SENATOR WILSON said no.
1:51:01 PM
CHAIR COSTELLO determined no one wished to comment and close
public testimony on SB 105.
1:51:31 PM
SENATOR MEYER moved to report SB 105, as amended, from committee
with individual recommendations and attached fiscal note(s).
1:51:49 PM
CHAIR COSTELLO announced that without objection, CSSB 105(L&C)
moves from the Senate Labor and Commerce Standing Committee.