02/26/2024 01:30 PM Senate LABOR & COMMERCE

           SB 228-EXTEND BOARD OF MASSAGE THERAPISTS                                                                        
                                                                                                                                
2:06:11 PM                                                                                                                    
CHAIR  BJORKMAN   reconvened  the   meeting  and   announced  the                                                               
consideration  of SENATE  BILL  NO. 228,  "An  Act extending  the                                                               
termination  date  of  the  Board   of  Massage  Therapists;  and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
2:06:34 PM                                                                                                                    
KONRAD  JACKSON,  Staff,  Senator Jesse  Bjorkman,  Alaska  State                                                               
Legislature, Juneau,  Alaska, presented SB  228 on behalf  of the                                                               
Senate Labor  and Commerce Standing Committee.  He explained that                                                               
SB  228 would  extend the  sunset date  of the  Board of  Massage                                                               
Therapists by six  years, to 2030. He noted that  an audit of the                                                               
board  found  four  issues  that  need to  be  addressed  by  the                                                               
department  and the  board.  He acknowledged  that  EO 127  would                                                               
eliminate the Board  of Massage Therapists and  explained that if                                                               
EO  127 is  disapproved,  this  board extension  needs  to be  in                                                               
place.                                                                                                                          
                                                                                                                                
2:08:12 PM                                                                                                                    
KRIS  CURTIS, Legislative  Auditor,  Legislative Audit  Division,                                                               
Legislative  Affairs Agency,  Alaska  State Legislature,  Juneau,                                                               
Alaska, testified by  invitation on SB 228.  She paraphrased from                                                               
the following statement:                                                                                                        
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
     The Division  of Legislative  Audit conducted  a sunset                                                                    
     audit  of the  Board of  Massage Therapists.  I believe                                                                    
     you  all have  a copy  of  the report  in your  meeting                                                                    
     packets.  This   audit  is   dated  August   2023.  The                                                                    
     objectives of  a sunset audit are  to determine whether                                                                    
     a board or commission  is serving the public's interest                                                                    
     and whether it should be extended.                                                                                         
                                                                                                                                
     Overall, the  audit concluded  that the  board operated                                                                    
     in the public's interest  by conducting its meetings in                                                                    
     an effective  manner and actively  amending regulations                                                                    
     to  address statutory  changes,  improve the  licensing                                                                    
     process,  and enhance  public  safety.  The audit  also                                                                    
     concluded  that licenses  were not  consistently issued                                                                    
     in compliance with state law,  board related cases were                                                                    
     not  consistently  investigated  in  a  timely  manner,                                                                    
     continuing  education audits  were  not completed,  and                                                                    
     licensing  fees did  not cover  the cost  of regulating                                                                    
     the profession.                                                                                                            
                                                                                                                                
     We  recommend   the  legislature  extend   the  board's                                                                    
     termination date six years, to  June 30, 2030, which is                                                                    
     two  years less  than the  maximum allowed  by statute.                                                                    
     The  reduced  extension  reflects  the  need  for  more                                                                    
     routine   oversight  in   recognition   of  the   audit                                                                    
     findings.                                                                                                                  
                                                                                                                                
     On  page   6  you  will  find   the  board's  licensing                                                                    
     statistics. As of  December 2022, the board  had 1, 157                                                                    
     active licenses and registrations.                                                                                         
                                                                                                                                
     On  Page 9  of the  report  you will  find the  board's                                                                    
     schedule  of revenues  and  expenditures.  As of  March                                                                    
     2023, the board had  a surplus of approximately 36,000.                                                                    
     You can see that during  FY 22, the board was allocated                                                                    
     just over $289,000 of general  funds to replace revenue                                                                    
     lost  due to  the license  fee freeze  mandated by  the                                                                    
     governor to  help mitigate the financial  impact of the                                                                    
     COVID-19  pandemic. General  fund  allocations are  not                                                                    
     expected in the  future. And the board  was expected to                                                                    
     have  a  deficit  at  the  end  of  FY  23.  Exhibit  3                                                                    
     indicates that  a fee increase  is needed to  prevent a                                                                    
     continuing  deficit.  DCBPL  did not  recommend  a  fee                                                                    
     increase for  the 2023  licensure renewal  period based                                                                    
     on  DCCED's  FY  24   proposed  operating  budget  that                                                                    
     requested general  funds be  used for  all occupational                                                                    
     board   investigative  costs.   The  request   was  not                                                                    
     approved  by  the   legislature  and  DCBPL  management                                                                    
     stated that there was insufficient  time to update fees                                                                    
     once  the   request  was  denied.   Consequently,  this                                                                    
     board's deficit is expected to grow.                                                                                       
                                                                                                                                
2:10:51 PM                                                                                                                    
MS. CURTIS continued:                                                                                                           
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
     The audit  includes four recommendations that  begin on                                                                    
     page  12.  First  we  recommend  the  DCBPL's  director                                                                    
     develop procedures to ensure  licenses are not approved                                                                    
     based on outdated documentation.  We tested 32 licenses                                                                    
     and registrations  found three  had been  approved with                                                                    
     stale documentation. Regs  say that licensing documents                                                                    
     older  than  six  months  must  be  resubmitted.  Staff                                                                    
     turnover  and a  lack of  procedures was  the cause  of                                                                    
     this error.                                                                                                                
                                                                                                                                
     Second   recommendation        we   recommend   DCCED's                                                                    
     commissioner  work with  policy makers  to improve  the                                                                    
     recruitment and retention of investigators.                                                                                
                                                                                                                                
     Recommendation  3   is  similar     we   recommend  the                                                                    
     commissioner  work with  policy makers  to improve  the                                                                    
     recruitment and  retention of  licensing staff.   These                                                                    
     recs  are  the  result  of our  testing  timeliness  of                                                                    
     investigations  and continuing  education audits.  Both                                                                    
     of these  functions had deficiencies which  were caused                                                                    
     by vacancies.                                                                                                              
                                                                                                                                
     Rec 4 is  on page 14, We recommend the  board and DCBPL                                                                    
     director  consider increasing  licensing fees.  Statues                                                                    
     require that the  fees be set at a level  to covers the                                                                    
     regulatory cost  of the  occupation. This  board's fees                                                                    
     are not sufficient.                                                                                                        
                                                                                                                                
     Management's response  to the  audit begin on  page 23.                                                                    
     The  commissioner concurred  with  the conclusions  and                                                                    
     recommendations. The audit does  not include a response                                                                    
     form the  board chair. The  board did not have  a chair                                                                    
     at the time we requested response.                                                                                         
                                                                                                                                
2:12:34 PM                                                                                                                    
SENATOR MERRICK  asked how many investigations  or complaints are                                                               
filed per year.                                                                                                                 
                                                                                                                                
2:12:46 PM                                                                                                                    
MS. CURTIS replied  that they do not summarize  by year. However,                                                               
155 cases were open or opened between FY 21 and December 2022.                                                                  
                                                                                                                                
2:13:18 PM                                                                                                                    
SENATOR  GRAY-JACKSON referred  to  the schedule  of revenue  and                                                               
expenditures  and  asked  for  clarification  of  the  "personnel                                                               
services."                                                                                                                      
                                                                                                                                
2:13:33 PM                                                                                                                    
MS.  CURTIS  replied  that  this  includes  licensing  staff  and                                                               
investigators. It  would also include any  legal assistance would                                                               
fall under "services."                                                                                                          
                                                                                                                                
2:14:15 PM                                                                                                                    
SYLVAN ROBB,  Director, Division  of Corporations,  Business, and                                                               
Professional   Licensing   (DCBPL),   Department   of   Commerce,                                                               
Community  and  Economic  Development  (DCCED),  Juneau,  Alaska,                                                               
testified by invitation on SB 228.  She said that there were four                                                               
recommendations  contained  in  the  audit. One  was  related  to                                                               
outdated documentation,  and she  explained that this  was partly                                                               
due to  staffing issues  during the  COVID-19 pandemic.  She said                                                               
that this has  since improved and added that  some positions have                                                               
been restructured  to provide greater oversight.  She stated that                                                               
the  next two  recommendations  are related  to recruitment.  She                                                               
acknowledged that  this is  an issue and  said the  department is                                                               
taking steps to improve recruitment.  However, she said that this                                                               
is  a statewide  issue that  may need  a statewide  solution. The                                                               
division  is in  the middle  of  a classification  study for  all                                                               
licensing  examiners and  records and  licensing supervisors  (50                                                               
personnel  within the  division). She  expressed hope  that, once                                                               
concluded, this will help to  make positions more attractive. She                                                               
explained that currently, occupational  licensing examiners are a                                                               
single position  type. The study  would create  multiple examiner                                                               
positions  based   on  varying  degrees  of   responsibility  and                                                               
oversight.                                                                                                                      
                                                                                                                                
2:16:58 PM                                                                                                                    
MS.  ROBB stated  that the  final recommendation  was related  to                                                               
fees.  She   explained  that  in  2023,   the  Governor  proposed                                                               
switching the  investigation fund  source from licensing  fees to                                                               
the general fund.  However, this change did not make  it into the                                                               
final  budget  and there  was  not  enough  time to  implement  a                                                               
licensing  fee  change.  She  explained  that  massage  therapist                                                               
licenses are  renewed every two  years on  odd years (2023  was a                                                               
renewal  year) and  changing the  fee during  the renewal  period                                                               
would be problematic. She said that  the division will be doing a                                                               
fee analysis and adjusting the fee as necessary.                                                                                
                                                                                                                                
2:18:18 PM                                                                                                                    
ANNETTA  ATWELL,  Chair,  Board of  Massage  Therapy,  Anchorage,                                                               
Alaska,  testified by  invitation on  SB 228.  She said  that the                                                               
board has  done a  great deal of  work over the  past 9  years to                                                               
improve the status  of the massage therapy  profession in Alaska.                                                               
This work  has included the establishment  of licensing, revising                                                               
regulations, professional input  on investigations concerning the                                                               
scope of  practice, and the development  of disciplinary matrices                                                               
over  the  diverse  range  of  definable  negligence  or  illegal                                                               
activity.  She   said  that  the  board   continues  to  maintain                                                               
connections  with  national  massage  therapy  organizations  and                                                               
state boards  which allows the  board to gather information  on a                                                               
variety of  issues. She stated that  one goal of the  board is to                                                               
ensure  that  members  are  knowledgeable  about  human  and  sex                                                               
trafficking  in  order  to   identify  perpetrators  and  briefly                                                               
explained   how  these   individuals  can   be  identified.   She                                                               
emphasized the importance of communication  between the board and                                                               
licensees. She  said that  licensees are  currently able  to bill                                                               
insurance  - which  would change  if  the board  were allowed  to                                                               
expire.                                                                                                                         
                                                                                                                                
2:21:50 PM                                                                                                                    
JILL MOTZ,  Government Relations Chair, American  Massage Therapy                                                               
Association   Alaska  Chapter,   Palmer,  Alaska,   testified  by                                                               
invitation on  SB 228. She  said the board ensures  public safety                                                               
by  providing expert  oversight when  reviewing applications  and                                                               
consulting  on  investigations,  and  keeping  up  with  industry                                                               
standards, among others. She opined  that the board helps to keep                                                               
DCBPL honest  and focused.  She shared a  variety of  issues that                                                               
she  observed  within  DCBPL  which  then  impacted  the  board's                                                               
ability to  perform its work.  She said  that the board  plays an                                                               
important  role  in  combating  human  and  sex  trafficking  and                                                               
emphasized the  importance of experts who  understand the massage                                                               
therapy  profession  and  can  watch   for  the  signs  of  these                                                               
occurring. She  detailed the myriad  ways massage  therapists are                                                               
able to identify  these individuals. She pointed out  that all of                                                               
the  board members  are  volunteers who  give  of their  personal                                                               
time.  The current  structure  ensures that  both  DCBPL and  the                                                               
board are held  accountable. She stated that the  board has grown                                                               
a great  deal since its  inception and  opined that it  should be                                                               
allowed  to  continue   to  grow.  She  detailed   the  ways  the                                                               
profession has grown as a result of work done by the board.                                                                     
                                                                                                                                
2:26:43 PM                                                                                                                    
VOLKER   HRUBY,   Representative,    American   Massage   Therapy                                                               
Association  (AMTA), Anchorage,  Alaska, testified  by invitation                                                               
on SB 228. He said that  he has been a licensed massage therapist                                                               
since 2005  and has served on  AMTA at both a  state and national                                                               
level.  He stated  that continuing  the board  is crucial  to the                                                               
profession of massage  therapy. He pointed out that  the board is                                                               
primarily made up of licensed  volunteer massage therapists, thus                                                               
giving  massage  therapists  a voice  in  the  various  processes                                                               
governing the  profession. He  stated that  massage therapy  is a                                                               
healthcare  profession,  and   therapists  work  with  vulnerable                                                               
populations.  He   stated  that  the  expertise   of  members  is                                                               
beneficial when dealing  with the myriad issues  that come before                                                               
the board. In  addition, the board has worked  to minimize board-                                                               
related  expenses  and  increase   efficiency  of  the  licensing                                                               
process.  He noted  that the  recent audit  recommended that  the                                                               
board continue and shared his belief  that the board has and will                                                               
continue to  work hard to improve  all aspects of their  work. He                                                               
said  that allowing  the board  to  lapse would  create a  public                                                               
safety  issue. He  stated that  the  board increases  efficiency,                                                               
helps keep costs down, helps  protect the profession from illegal                                                               
entities,   and  helps   maintain  the   respectability  of   the                                                               
profession in Alaska.                                                                                                           
                                                                                                                                
2:29:17 PM                                                                                                                    
SENATOR  GRAY-JACKSON asked  for clarification  regarding massage                                                               
therapists' ability to bill insurance.                                                                                          
                                                                                                                                
2:29:49 PM                                                                                                                    
MR. HRUBY deferred to Ms. Motz.                                                                                                 
                                                                                                                                
2:30:07 PM                                                                                                                    
MS.  MOTZ answered  that currently  massage  therapists can  bill                                                               
insurance  companies  directly.  While some  insurance  companies                                                               
require a  prescription from a  medical doctor,  chiropractor, or                                                               
physical therapist,  the massage therapist no  longer needs their                                                               
direct oversight in order to bill insurance.                                                                                    
                                                                                                                                
2:30:53 PM                                                                                                                    
CHAIR BJORKMAN opened  public testimony on SB  228; finding none,                                                               
he closed public testimony.                                                                                                     
                                                                                                                                
2:31:30 PM                                                                                                                    
CHAIR BJORKMAN solicited the will of the committee.                                                                             
                                                                                                                                
2:31:37 PM                                                                                                                    
SENATOR BISHOP  moved to report  SB 228, work  order 33-LS1311\A,                                                               
from  committee  with  individual  recommendations  and  attached                                                               
fiscal note(s).                                                                                                                 
                                                                                                                                
2:31:51 PM                                                                                                                    
CHAIR BJORKMAN  found no objection  and SB 228 was  reported from                                                               
the Senate Labor and Commerce Standing Committee.