Legislature(2013 - 2014)BARNES 124

01/29/2014 03:15 PM House LABOR & COMMERCE


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 239 EXTEND BOARD OF EXAMINERS IN OPTOMETRY TELECONFERENCED
Moved Out of Committee
*+ HB 240 EXTEND BOARD OF CHIROPRACTIC EXAMINERS TELECONFERENCED
Moved Out of Committee
*+ HB 241 EXTEND BOARD OF MARITAL & FAMILY THERAPY TELECONFERENCED
Moved Out of Committee
        HB 241-EXTEND BOARD OF MARITAL & FAMILY THERAPY                                                                     
                                                                                                                                
3:49:27 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON announced  that the final order of  business would be                                                               
HOUSE BILL  NO. 241,  "An Act extending  the termination  date of                                                               
the Board  of Marital  and Family Therapy;  and providing  for an                                                               
effective date."                                                                                                                
                                                                                                                                
3:49:41 PM                                                                                                                    
                                                                                                                                
CRYSTAL  KOENEMAN, Staff,  Representative  Lora Reinbold,  Alaska                                                               
State Legislature, stated that the  bill will extend the Board of                                                               
Marital and Family  Therapy (BMFT) until June 30,  2018, based on                                                               
a  previous audit.   Auditors  recommended a  four-year extension                                                               
based  on two  prior audit  recommendations from  the 2009  audit                                                               
that had not  been fully resolved.  First,  the audit recommended                                                               
that the  Board of  Marital and Family  Therapy (BMFT)  develop a                                                               
strategy  for distance  therapy  and distance  supervision.   She                                                               
said  she  discussed this  with  the  BMFT's  chair.   The  chair                                                               
advised  that  the  board  worked   with  the  division  and  the                                                               
Department  of Law  and concluded  that the  matter will  require                                                               
statutory language to  implement changes.  She said  the board is                                                               
moving forward  for proposed  language for  possible introduction                                                               
next legislative session.                                                                                                       
                                                                                                                                
3:51:01 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON asked whether the small  size of the BMFT adds to the                                                               
present challenges.                                                                                                             
                                                                                                                                
MS. KOENEMAN  answered yes.   Auditors also recommended  that the                                                               
Office  of the  Governor  and  the board  work  together to  fill                                                               
vacant board  seats timely.   She recalled  the BMFT  consists of                                                               
almost 100  licensees, although the  board or the  division could                                                               
confirm the figures.   She advised that the  board member vacancy                                                               
has since  been filled.   Finally, the auditors  recommended that                                                               
the  BCBPL's investigative  case management  system be  improved,                                                               
but as  previously mentioned the  division has  made improvements                                                               
in this area.   The sponsor agrees with  the legislative auditors                                                               
on the recommended four-year extension, she said.                                                                               
                                                                                                                                
3:52:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON was  surprised by  the small  number of                                                               
licensees.                                                                                                                      
                                                                                                                                
MS.  KOENEMAN  explained that  by  statute,  one requirement  for                                                               
marital  and family  therapist licensures  is the  therapist must                                                               
have  1,500  hours  of  practice,  of which  200  hours  must  be                                                               
supervised.  In response to a  question on whether the clients or                                                               
the professional  needs distance supervision she  deferred to the                                                               
division.                                                                                                                       
                                                                                                                                
3:54:11 PM                                                                                                                    
                                                                                                                                
KRIS CURTIS, Legislative Auditor,  Division of Legislative Audit,                                                               
Legislative   Agencies  and   Offices,  explained   the  division                                                               
conducted  a sunset  audit dated  June  19, 2013,  with the  main                                                               
objective to determine whether the  board is serving the public's                                                               
interest and if it should  be extended.  The legislative auditors                                                               
recommended only  a four-year extension  since the board  had not                                                               
fully addressed  the prior sunset audit  recommendation to pursue                                                               
regulation  changes that  are necessary  to protect  the public's                                                               
interest.  The prior audit's  reasoning on the recommendation was                                                               
slightly different.  Although the  board initiated one regulation                                                               
change,  the  board  has  not addressed  the  need  for  distance                                                               
supervision and  distance therapy.   She explained  that distance                                                               
supervision pertains  to licensure,  such that an  applicant must                                                               
have a certain  number of supervised hours to  become licensed as                                                               
a marital  and family therapist.   Distance supervision  would be                                                               
provided electronically,  possibly through the Internet,  or from                                                               
other  technology.   Currently,  BMFT's services  are not  widely                                                               
available in  some areas of  the state and distance  delivery has                                                               
been viewed as being a means to address this disparity.                                                                         
                                                                                                                                
MS. CURTIS  said that during  the current audit period  the board                                                               
extensively researched and discussed  the topic; however, it made                                                               
little progress in developing regulations  and the board does not                                                               
have a strategy  to move past the discussion phase.   The auditor                                                               
recommended the board develop a  strategy to address the need for                                                               
distance services, and the board  and division concurred with the                                                               
recommendation.    She  reported  that   as  of  March  2013,  91                                                               
applicants  applied   for  licensure.    Additionally   the  BMFT                                                               
licenses associates,  although she did  not have the  figures for                                                               
that  category  of  license.     In  response  to  Representative                                                               
Josephson, Ms.  Curtis replied that  the BMFT offers one  type of                                                               
license, but people  can obtain services in other  areas, such as                                                               
social   worker    examiners,   professional    counselors,   and                                                               
psychologists.                                                                                                                  
                                                                                                                                
3:57:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  asked  for   the  historical  counts  on                                                               
licensees.                                                                                                                      
                                                                                                                                
MS. CURTIS  referred to page 17  of the audit that  shows a count                                                               
by year on  the number of new licenses issued,  which varies from                                                               
three to nine licenses.                                                                                                         
                                                                                                                                
3:57:54 PM                                                                                                                    
                                                                                                                                
DON HABEGER,  Director, Division  of Corporations,  Business, and                                                               
Professional   Licensing   (DCBPL),   Department   of   Commerce,                                                               
Community,  &  Economic  Development  (DCCED),  deferred  to  Mr.                                                               
Webber, Chair, Board of Marital & Family Therapy (BMFT).                                                                        
                                                                                                                                
3:58:46 PM                                                                                                                    
                                                                                                                                
LEON  WEBBER,  D.Mn., LMFT;  Chair,  Board  of Marital  &  Family                                                               
Therapy  (BMFT), Department  of  Commerce,  Community &  Economic                                                               
Development  (DCCED), related  his understanding  that the  board                                                               
previously   faced   financial    difficulties,   stemming   from                                                               
investigative  expense,  with fees  increasing  to  $1,000 for  a                                                               
biennial  license, resulting  in some  licensees transferring  to                                                               
larger boards  with lower  fees.   Currently, the  board licenses                                                               
118  "marriage and  family therapists"  and "marriage  and family                                                               
therapy  associates."   Although  marital  and family  therapists                                                               
practice  in   the  specific  field,  as   previously  mentioned,                                                               
services  are also  being provided  other  professionals such  as                                                               
those  providing  couples therapy.    The  field of  marital  and                                                               
family  therapy  specifically  requires licensees  to  achieve  a                                                               
masters'  level  or  doctorate   level  in  marriage  and  family                                                               
therapy.                                                                                                                        
                                                                                                                                
REPRESENTATIVE JOSEPHSON acknowledged the  fields have all become                                                               
very sophisticated and complicated.                                                                                             
                                                                                                                                
4:01:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER wondered  about  the  quality of  service                                                               
provided  by the  other professionals  when the  BMFT's licensees                                                               
shift to other boards.                                                                                                          
                                                                                                                                
MR. WEBBER  answered that he  couldn't answer that question.   He                                                               
said the  BMFT's responsibility is  to ensure that those  who are                                                               
licensed  by the  board provide  quality services  and for  other                                                               
professions to monitor and oversee  services provided under other                                                               
licenses  to  ensure their  licensees  are  qualified to  perform                                                               
them.   He lauded  DCBPL's director,  Mr. Habeger,  for providing                                                               
financial assistance  to the  board.  He  said the  sunset review                                                               
was very thorough and he  reported that the BFMT has subsequently                                                               
contacted 49 states to obtain  research and has worked with other                                                               
boards  and  health  care  agencies  on  tele-therapy  and  tele-                                                               
supervision.   For  example, tele-therapy  might mean  a licensed                                                               
therapist  in  Alaska is  providing  therapy  to an  out-of-state                                                               
client  in Idaho  or it  may mean  a therapist  in a  residential                                                               
treatment center in Idaho is  providing family therapy to someone                                                               
in  Alaska.     Thus  far,  the  board   hasn't  established  any                                                               
guidelines to address  those issues or any  competency issues for                                                               
tele-therapy services,  noting that an average  therapist may not                                                               
feel   as  competent   providing  distance   therapy,  he   said.                                                               
Additionally,  confidentiality issues  have arisen,  for example,                                                               
whether   encrypted  communications   are  needed.     The   BMFT                                                               
considered these matters at its  last board meeting, and plans to                                                               
address  proposed statutes,  regulations, and  ethical guidelines                                                               
at its next meeting, which he said has been a huge challenge.                                                                   
                                                                                                                                
4:03:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  asked whether the division's  remedies on                                                               
investigation costs  will stabilize  the number of  licensees and                                                               
curtail the drift of BMFT's licensees to other boards.                                                                          
                                                                                                                                
MR. WEBBER thought  it would do so.  He  anticipated that license                                                               
fees  will  drop  to  within several  hundred  dollars  of  other                                                               
similar professional fees.   He did not  envision more therapists                                                               
would leave  the field.   He characterized  the total  clarity on                                                               
finances as being a relief.                                                                                                     
                                                                                                                                
4:04:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER asked whether  he envisioned other changes                                                               
in the field that will need to be addressed.                                                                                    
                                                                                                                                
MR.  WEBBER answered  that it  will be  important to  monitor how                                                               
well tele-therapy  is handled.   For example, he related  that he                                                               
is   participating   in   this   hearing   from   Hawaii,   while                                                               
simultaneously  his  friend  is   at  a  military  base  hospital                                                               
conducting tele-therapy  with five  members of  a family  who are                                                               
located in Iraq, North Carolina, and  Honolulu.  He said that his                                                               
board  recognizes  that this  type  of  service is  beginning  to                                                               
become predominant  in the field.   He looked forward  to working                                                               
with the  legislature on  statutory and  regulation changes.   In                                                               
further response to a question, he  said the BMFT hopes to have a                                                               
bill introduced next year.                                                                                                      
                                                                                                                                
CHAIR OLSON  said appreciated  the work Mr.  Habeger has  done to                                                               
address  the  investigative costs  and  level  the fees  for  all                                                               
boards.                                                                                                                         
                                                                                                                                
4:07:02 PM                                                                                                                    
                                                                                                                                
KENNITH MCCARTY, Board Member, Board  of Marital & Family Therapy                                                               
(BMFT), Department of Commerce,  Community & Economic Development                                                               
(DCCED),  stated  he   also  serves  as  the   president  of  the                                                               
Association for  Marriage and Family  Therapists.  He  provided a                                                               
brief background of  his service and the board  issues that arose                                                               
from  an investigation.  He explained  that  the BMFT's  statutes                                                               
have title  protection, but  not practice  protection.   In other                                                               
words, unless a person is  licensed by the BMFT, the professional                                                               
cannot  call themselves  a family  therapist on  his/her business                                                               
card, but the person could  offer other services such as "couples                                                               
counseling."  In  response to a question  on practice protection,                                                               
he said  the board  was unsure  of how  to proceed  with practice                                                               
protection.  For example, in  the instance of couples counseling,                                                               
the  board could  examine  the  type of  experience  in terms  of                                                               
education  and training;  however, the  board is  holding ongoing                                                               
discussions.                                                                                                                    
                                                                                                                                
CHAIR  OLSON   suggested  members  could   contemplate  statutory                                                               
remedies to assist the board.                                                                                                   
                                                                                                                                
4:10:46 PM                                                                                                                    
                                                                                                                                
MR.  MCCARTY,  in  response  to  the comment  on  the  number  of                                                               
licensees,  agreed  that higher  license  fees  has affected  the                                                               
number of  overall practitioners,  but the division's  efforts to                                                               
reduce license fees have helped remedy  this and may lead to some                                                               
professionals applying for dual licenses.                                                                                       
                                                                                                                                
REPRESENTATIVE REINBOLD  lauded Mr. McCarty.   She encouraged him                                                               
working with Mr.  Webber, and her staff and  congratulated him on                                                               
his wedding.                                                                                                                    
                                                                                                                                
4:12:21 PM                                                                                                                    
                                                                                                                                
CHAIR  OLSON,  after first  determining  no  one else  wished  to                                                               
testify, closed public testimony on HB 241.                                                                                     
                                                                                                                                
4:12:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  moved to report  HB 241 out  of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.   There being no objection,  HB 241 was reported  from the                                                               
House Labor and Commerce Standing Committee.                                                                                    

Document Name Date/Time Subjects
HB239 ver A.pdf HL&C 1/29/2014 3:15:00 PM
HB 239
HB239 Sponsor Statement.pdf HL&C 1/29/2014 3:15:00 PM
HB 239
HB239 Supporting Documents-Legislative Audit Recommendations.pdf HL&C 1/29/2014 3:15:00 PM
HB 239
HB239 Fiscal Note-DCCED-CBPL-01-24-14.pdf HL&C 1/29/2014 3:15:00 PM
HB 239
HB239 Fiscal Note-REVISED-DCCED-CBPL-01-27-14.pdf HL&C 1/29/2014 3:15:00 PM
HB 239
HB240 ver A.pdf HL&C 1/29/2014 3:15:00 PM
HB 240
HB240 Sponsor Statement.pdf HL&C 1/29/2014 3:15:00 PM
HB 240
HB240 Supporting Documents-Legislative Audit Recommendations.pdf HL&C 1/29/2014 3:15:00 PM
HB 240
HB240 Fiscal Note-DCCED-CBPL-01-24-14.pdf HL&C 1/29/2014 3:15:00 PM
HB 240
HB240 Fiscal Note-REVISED-DCCED-CBPL-01-27-14.pdf HL&C 1/29/2014 3:15:00 PM
HB 240
HB241 ver A.pdf HL&C 1/29/2014 3:15:00 PM
HB 241
HB241 Sponsor Statement.pdf HL&C 1/29/2014 3:15:00 PM
HB 241
HB241 Supporting Documents-Legislative Audit Recommendations.pdf HL&C 1/29/2014 3:15:00 PM
HB 241
HB241 Fiscal Note-DCCED-CBPL-01-24-14 (1).pdf HL&C 1/29/2014 3:15:00 PM
HB 241
HB241 Fiscal Note-REVISED-DCCED-CBPL-01-27-14.pdf HL&C 1/29/2014 3:15:00 PM
HB 241