Legislature(1995 - 1996)
04/04/1996 03:04 PM House HES
| Audio | Topic |
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
April 4, 1996
3:04 p.m.
MEMBERS PRESENT
Representative Cynthia Toohey, Co-Chair
Representative Con Bunde, Co-Chair
Representative Norman Rokeberg
Representative Caren Robinson
Representative Tom Brice
Representative Al Vezey
MEMBERS ABSENT
Representative Gary Davis
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 165(L&C)
"An Act relating to psychologists and psychological associates."
- HEARD AND HELD
* HOUSE JOINT RESOLUTION NO. 50
Proposing an amendment to the Constitution of the State of Alaska
relating to freedom of conscience.
- SCHEDULED BUT NOT HEARD
(* First public hearing)
PREVIOUS ACTION
BILL: SB 165
SHORT TITLE: PSYCHOLOGISTS & PSYCHOLOGICAL ASSOCIATES
SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES BY REQUEST
JRN-DATE JRN-PG ACTION
04/25/95 1230 (S) READ THE FIRST TIME - REFERRAL(S)
04/25/95 1230 (S) HES, L&C
01/17/96 (S) HES AT 9:00 AM BUTROVICH ROOM 205
01/17/96 (S) MINUTE(HES)
01/18/96 2166 (S) HES RPT CS 4DP SAME TITLE
01/18/96 2166 (S) ZERO FISCAL NOTE TO SB & CS (DCED)
01/30/96 (S) L&C AT 1:30 PM FAHRENKAMP RM 203
01/30/96 (S) MINUTE(L&C)
01/31/96 2262 (S) L&C RPT CS 2DP 2NR SAME TITLE
01/31/96 2262 (S) PREVIOUS ZERO FISCAL NOTE (DCED)
02/02/96 (S) RLS AT 10:15 AM FAHRENKAMP RM 203
02/02/96 (S) MINUTE(RLS)
02/07/96 2324 (S) RULES TO CALENDAR 2/9/96
02/09/96 2359 (S) READ THE SECOND TIME
02/09/96 2359 (S) L&C CS ADOPTED UNAN CONSENT
02/09/96 2359 (S) ADVANCED TO THIRD READING UNAN
CONSENT
02/09/96 2359 (S) READ THE THIRD TIME CSSB 165(L&C)
02/09/96 2360 (S) PASSED Y19 N0 E1
02/09/96 2363 (S) TRANSMITTED TO (H)
02/12/96 2718 (H) READ THE FIRST TIME - REFERRAL(S)
02/12/96 2718 (H) HEALTH,EDUCATION AND SOCIAL SERVICES
04/02/96 (H) HES AT 3:00 PM CAPITOL 106
04/02/96 (H) MINUTE(HES)
04/04/96 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
MIKE TIBBLES, Legislative Assistant
to Senator Lyda Green
Alaska State Legislature
Capitol Building, Room 423
Juneau, Alaska 99801-1182
Telephone: (907) 465-3762
POSITION STATEMENT: Gave sponsor statement for CSSB 165(L&C)
JERRY REINWAND, Lobbyist
Blue Cross
2 Marine Way, Number 219
Juneau, Alaska 99801
Telephone: (907) 586-8966
POSITION STATEMENT: Testified on CSSB 165(L&C)
DR. ROBB STOKES, Vice-Chair
Alaska Psychology Board
P.O. Box 20949
Juneau, Alaska 99802
Telephone: Not Available
POSITION STATEMENT: Testified in opposition to CSSB 165(L&C)
ALLEN MOMA
P.O. Box 231453
Anchorage, Alaska 99523
Telephone: (907) 562-1846
POSITION STATEMENT: Testified on CSSB 165(L&C)
KATHRYN CARSSOW
1335 O Street
Anchorage, Alaska 99501
Telephone: (907) 274-7909
POSITION STATEMENT: Testified on CSSB 165(L&C)
KAREN GIBSON
P.O. Box 110623
Anchorage, Alaska 99511
Telephone: (907) 346-3738
POSITION STATEMENT: Testified in support of CSSB 165(L&C)
JENNIFER HALL-JONES
2453 West 27th Street
Anchorage, Alaska 99517
Telephone: Not Available
POSITION STATEMENT: Testified on CSSB 165(L&C)
ACTION NARRATIVE
TAPE 96-36, SIDE A
Number 001
The House Health, Education and Social Services Standing Committee
was called to order by Co-Chair Con Bunde at 3:04 p.m. Members
present at the call to order were Representatives Bunde, Toohey,
Brice and Vezey. Members absent were Representatives Davis,
Robinson and Rokeberg.
CSSB 165(L&C) - PSYCHOLOGISTS & PSYCHOLOGICAL ASSOCIATES
CO-CHAIR BUNDE announced the calendar for the meeting was CSSB
165(L&C), an act relating to psychologists and psychological
associates and HJR 50, proposing an amendment to the Constitution
of the State of Alaska relating to freedom of conscience. He asked
Mike Tibbles, Senate HESS Committee Aide to present SB 165.
Number 082
MIKE TIBBLES, Legislative Assistant to Senator Lyda Green, read to
following sponsor statement: "Currently under Alaska law,
psychological associates are held to a more stringent standard in
the licensure process than other masters-level mental health
practitioners. For example, psychological associates are now the
only mental health practitioners required to have three years of
supervision by a Ph.D. psychologist prior to examination, followed
by five years of supervision before they are eligible for
independent practice. These provisions are too restrictive and
often dissuade or prohibit individuals from entering into this
particular profession.
"The goal of this legislation is to bring the psychological
associates into conformity with other masters-level programs; i.e.,
social workers, marriage and family therapists. It also insures
the quality of these professionals by maintaining the examination,
education, and ethical standards prior to licensure.
"This bill has a zero fiscal note from the Department of Commerce
and Economic Development."
REPRESENTATIVE CAREN ROBINSON arrived at 3:05 p.m.
CO-CHAIR BUNDE asked if the intent of the legislation was to allow
people who have master's degrees full licensure, as opposed to
other states where a person must have a Ph.D. to achieve full
licensure.
MR. TIBBLES explained there are two different levels of
individuals; psychologists and psychological associates. The
psychological associates are the masters-level and this legislation
changes the existing practice of a three year supervision period
and an additional five years before an individual can practice on
their own to a two-year period of supervision and considering the
fact they meet all the requirements under regulation with their
academics, they would be subject to licensure.
Number 237
CO-CHAIR BUNDE referred to the psychological associates as opposed
to psychologists who have a Ph.D. and asked what procedure they
would follow for licensure.
MR. TIBBLES said a psychologist would be required to have one year
of post doctoral supervised experience approved by the board.
CO-CHAIR TOOHEY said a psychologist is a doctorate and a
psychological assistant can never become a psychologist without two
additional years of education.
CO-CHAIR BUNDE said he understood that, but he wanted the record to
reflect what the procedure was for licensure.
MR. TIBBLES added that after the one year of post doctoral
supervised experience, the individual would be required to pass an
examination for licensure.
CO-CHAIR BUNDE said inasmuch as there were three people on
teleconference wishing to testify as well as people in Juneau, he
would rotate between Juneau and Anchorage. He asked Jerry Reinwand
to come forward.
Number 338
JERRY REINWAND, Lobbyist for Blue Cross of Washington & Alaska,
said he had just been alerted to a potential problem in that
Section 10 seems to change the scope of services of a psychological
associate, making it broader in scope. He said it may not be a big
issue, but he wanted committee members to be aware that it could
add to the cost of health care. He provided the committee with a
copy of the unfair discrimination statute, AS 21.36.090(d) and said
the Division of Insurance is reexamining to determine what all that
statute does because there has always been some question about it.
His interpretation, as a lay person, is that if a provider is on
this list, the insurance company has to reimburse for services.
There has been a progression of people wanting to get licensed by
the state, and once they are licensed the next move is to get on
the list. He pointed out that in the last hours of the 1993
legislature, psychologist, psychological associate and licensed
clinical social workers were added to a bill that was a NAIC model
and basically, Mr. Reinwand thinks the net effect of that is to
potentially add to the cost of health insurance. Based on Section
10, does it mean that virtually anything a psychological associate
does under this definition is reimbursable under an insurance
policy and is it an expansion of the scope of services? If so, is
it an additional cost? He apologized for not talking with the
sponsor about this, but it had just been brought to his attention.
CO-CHAIR TOOHEY said this was the exact problem she had with the
licensure of physician assistants who are very much needed, but
they should not be paid the same amount of money as a physician.
Psychological associates are not psychologists and should be paid
at a lower level than a psychologist.
Number 564
CO-CHAIR BUNDE asked Mr. Tibbles to comment on the rationale for
deleting "in association with a licensed psychologist" in Section
10, line 16 and added he would give Mr. Tibbles time to ponder the
question while the committee received testimony from Anchorage.
Number 619
REPRESENTATIVE AL VEZEY said he appreciated the debate on Section
10, but didn't understand the connection between it and the handout
on AS 21.36.090.
REPRESENTATIVE NORM ROKEBERG arrived at 3:13 p.m.
MR. REINWAND said his question is: Does the definition of
psychological associate contained in Section 10 expand the scope of
service that a psychological associate provides? If that's the
case, does it mean that anything a psychological associate bills to
an insurance company therefore is payable, which could be an
expansion of cost. He commented said that history has shown that
people get the state to license them and jump on this section of
the law, because then the insurance companies have to pay.
REPRESENTATIVE VEZEY asked if this would be the appropriate time
for the legislature to consider removing the changes made in 1993?
MR. REINWAND commented he had an amendment that would accomplish
that.
REPRESENTATIVE VEZEY asked if Mr. Reinwand believed that the change
in definition in Section 10 would expand the number of people that
insurance companies are obligated to reimburse and would also
require they be reimbursed at the same rate as a more highly
trained professional?
MR. REINWAND said he was raising the question, but to him that's
exactly what it appears to do; however, he could be wrong.
CO-CHAIR BUNDE asked with the psychological associate being on the
list now, isn't it a foregone conclusion that they are now on the
approved list and insurance companies will have to pay for their
services?
MR. REINWAND replied that's right, unless they are removed from the
list.
CO-CHAIR TOOHEY said she was not suggesting they be removed from
the list; however, she was suggesting that a criteria be
established for their payment of services and not lumped in with
services for a psychologist.
MR. TIBBLES said he believed that in Section 10, the change stems
from the fact that psychological associates who wished to go into
rural communities where there was no psychologist would be unable
to do that. He said, "We have set up a two year requirement that
they serve under a psychologist after they meet those requirements
and the licensing requirements, they would be able to go into rural
communities. But the way the current law is set up, it is
dissuading psychological associates from going into those areas."
CO-CHAIR BUNDE asked if the services for a psychological associate
working under a psychologist during the two year period are billed
at the same rate as a psychologist or at a reduced rate.
MR. TIBBLES said the bill didn't specifically address that question
and he didn't know the answer.
Number 862
ALLEN MOMA testified via teleconference from Anchorage. He
addressed to the issue of expansion of services under Section 10
and said the regulations as currently written are cumbersome. The
reason for the rewrite of the section was to bring it in line with
specific training and educational background. He referred to
Section 5, AS 08.86.164(a) and said this addresses psychological
associates practicing within the scope of their training and
education; thus, the services are not being expanded, but rather
they were attempting to address language that was awkward
initially.
CO-CHAIR BUNDE asked Mr. Moma if he would be comfortable addressing
Co-Chair Toohey's concern about how the services of a psychological
associate are billed as opposed to a psychologist.
Number 922
MR. MOMA said currently, psychologists are typically reimbursed at
a rate of between $110 and $130 per hour and psychological
associates are reimbursed at between $70 and $90 per hour. He did
not envision psychological associates raising their rate up to the
higher rate. As a professional, he recognized the difference
between the training of a psychological associate and the training
of a Ph.D. He is aware of psychological associates who have
practicing for 10 years and their rates are still below that of a
psychologist.
CO-CHAIR BUNDE asked if the committee could assume that based on
his testimony Mr. Moma was a psychologist associate and currently
employed in that field?
MR. MOMA responded that he is the co-chair of the organization that
introduced this legislation - the Alaska Psychological Association,
which is a professional organization within the state that
represents psychologists and psychological associates. He added
that he is actually in the training phase; he doesn't have a
psychological associate license, but is working through the
training phase with the goal of acquiring his license in the near
future.
Number 1005
CO-CHAIR TOOHEY referred to a situation where psychological
associates are working for a psychologist and asked if the
psychologist bills the insurance company for his/her work or for
the psychological associates' work.
MR. MOMA said ethically, as he understands it, the psychologist has
to bill for the psychological associates' work which would be at
the reduced rate.
CO-CHAIR TOOHEY asked if a qualified psychological associate
working on his/her own in a rural community has a specific code
used to bill the insurance company that would automatically trigger
a lesser fee than that of a psychologist.
MR. MOMA said Co-Chair Toohey would need to check with the
insurance companies, but he thought it was market economics at some
point. He added there are standards, but no guidelines that
specifically state how much money can be charged and in a smaller
community, the psychological associate would probably charge
whatever the market would bear.
CO-CHAIR TOOHEY asked if it was correct that a psychological
associate would not be lumped under a fee for service when it was
covered by a psychologist.
MR. MOMA said that was his understanding of how the American
Psychological Association ethic guidelines would address that
issue.
CO-CHAIR BUNDE said there were additional people to testify in
Juneau and asked Dr. Robb Stokes to come forward.
Number 1122
DR. ROBB STOKES, Vice-Chair, Alaska Psychology Board, said the
opinions he was going to express were the unanimous opinions of the
Alaska Psychology Board. The Alaska Psychology Board opposes the
legislation, but not the spirit of the bill. He said he is a
psychological associate, has done the eight years and earned a
Ph.D. He pointed out the flaw in this legislation is there is an
assumption that the scope of practice by a marriage and family
therapist, by a social worker, and a psychological associate are
all the same. According to Alaska Statute that is not true. He
pointed out the mission of the Psychology Board is protection of
the public and it is their feeling this particular bill will not
protect the public.
Number 1183
DR. STOKES referred to AS 08.63.900 and said that marriage and
family therapists and licensed clinical social workers' scope of
practice is limited considerably more than that of a psychological
associate. A psychological associate has a much broader scope of
practice that requires considerably more training and ethical
responsibility and, the board feels, supervision before that person
should be independent. It is the board's position, however that
five years is too long, but two years is too short.
CO-CHAIR BUNDE asked if Dr. Stokes was saying that even though
marital and family counselors are on the list, they serve a
narrower function than a psychological associate and the board's
problem with the bill is they want something less than five years
but more than two years of supervision.
DR. STOKES stated that marriage and family therapists and clinical
social workers are licensed to provide counseling and
psychotherapy, that's all. However, the scope of practice of a
psychological associate or what is called the practice of
psychology, which includes both psychological associates and
psychologists is as follows: "To practice psychology means to
render or offer to render for a fee to individuals, groups,
organizations, or the public for the diagnosis, prevention,
treatment, or amelioration of psychological problems and emotional
mental disorders of individuals or groups or for conducting
research on human behavior, a psychological service involving the
application of psychological principles, methods, and procedures of
understanding, predicting, and influencing behavior, including..."
Dr. Stokes said the prior portion would be similar to the marriage
and family and social work, but this is where the differences come
in. He continued "...(A) the principles pertaining to learning,
perception, motivation, emotions, and interpersonal relationships;
(B) the methods and procedures of interviewing, counseling,
psychotherapy, biofeedback, behavior modification, and hypnosis."
He added that only psychological associates and psychologists are
licensed in the state to provide biofeedback, to provide behavior
modification and to provide hypnosis. He went on to cite
subsection (C) "constructing, administering and interpreting tests
of mental abilities, aptitudes, interests, attitudes, personality
characteristics, emotions, and motivations." That is psychological
testing which is a very broad part of the profession of psychology
and requires considerable preparation. Psychological testing
requires an educational background in statistics, test
construction, research design methodology and a training in the
administration, scoring and interpretation in the scoring in each
of these psychological tests, and there are many. The Board's
concern is that a psychological associate needs additional
supervision in order to provide a quality service to the public and
to protect the public by providing psychological testing, hypnosis,
biofeedback and behavior modifications.
Number 1400
CO-CHAIR BUNDE commented less than eight years, but more than two;
what does that leave?
DR. STOKES said the board hasn't discussed it. He commented that
as the senior member of the board, this board is very flexible,
very pro psychological associate and it has been very accommodating
in facilitating people getting licensure as psychological
associates. He added that he is the representative of the
psychological associates on this board. The board is held to the
statutes that were in place before they came on board.
CO-CHAIR TOOHEY said if she were a psychological associate she
would be very upset with Dr. Stokes in that the legislation was
introduced at the request of psychological associates and he was
speaking against the bill.
DR. STOKES said that was correct.
CO-CHAIR TOOHEY asked if he was a doctorate?
DR. STOKES responded yes, but he was licensed as a psychological
associate.
CO-CHAIR TOOHEY stated he was not billing as a psychological
associate, he was billing as a doctorate, as a psychologist. She
asked if this was a turf battle?
DR. STOKES replied no. He explained that with respect to scope of
practice the only difference between an independent psychological
associate and a psychologist is titular.
CO-CHAIR TOOHEY asked Dr. Stokes to explain titular.
DR. STOKES explained that it's title. He went on to say an
independent psychological associate is able to do everything that
a psychologist can do according to state statute.
CO-CHAIR BUNDE verified that Dr. Stokes' role on the Alaska
Psychology Board was as the representative of psychological
associates, and his work was that of a psychological associate in
Juneau.
DR. STOKES said he is licensed as an independent clinical
psychological associate.
CO-CHAIR TOOHEY asked if he was a psychologist?
DR. STOKES replied no, he earned his Ph.D., but did not go back and
get licensed as a psychologist, he stayed licensed as a
psychological associate.
CO-CHAIR BUNDE asked if Dr. Stokes was implying that the work he
does would not change with a title change, but possibly the billing
would change.
DR. STOKES said he didn't know and added the board does not address
billing issues.
CO-CHAIR BUNDE stated the committee needs to know what the board
would recommend with respect to less than eight years, but more
than two years.
Number 1556
REPRESENTATIVE ROKEBERG asked Dr. Stokes if he could provide a
breakdown of the rates billed for a pre-psychologist associate, a
psychologist associate and a psychologist.
DR. STOKES thought the rates that Mr. Moma gave were quite
accurate; a psychologist would bill at $100 - $120 per hour and a
psychologist associate would bill at $75 - $90 per hour.
REPRESENTATIVE ROKEBERG inquired about the title and the rate
billed of the person who is in the training period and works under
supervision.
DR. STOKES replied the same as the psychological associate. He
explained that after the individual passes the examination, they
are licensed as a psychologist associate, but are required to be
under the supervision of a psychologist for three years. If that
person desires to work independently, it requires an additional
five years, for a total of eight years. He reiterated the board
feels the eight years is too much, but two years which is
equivalent to the marriage and family, and social workers, is not
enough because psychological associates have much greater
responsibility and are licensed to do additional things.
CO-CHAIR BUNDE asked if some people view the eight years as an
attempt to keep them off the job market?
DR. STOKES replied yes, and that was his view also. He said when
he was pursuing licensure, he wrote letters to the Governor and was
very militant in what he felt was discrimination. He felt there
was an attempt by the previous board of which he was a member, to
get rid of psychological associates. The current board is very
supportive of psychological associates.
REPRESENTATIVE ROKEBERG asked what the typical length of time for
a master's degree to qualify under the licensure requirements for
a psychological associate.
DR. STOKES responded two to three years. He added the board gets
applications from all over the country.
REPRESENTATIVE ROKEBERG asked if it depended on the institution and
the type of specialty.
DR. STOKES responded yes.
REPRESENTATIVE ROKEBERG asked if the next step after the two to
three years was for an individual to become a supervised
psychological associate by licensure and examination?
DR. STOKES explained that if the board approves an individual's
application, he/she can then sit for the national and state
examinations. If the individual passes those exams, then he/she
must be supervised by a psychologist for five years. He further
explained that three years of post master's supervision is required
in order to be eligible to take the exam; under the current
statutes, if the exams are passed, then the individual is required
to be supervised for five years before he/she can be independent.
REPRESENTATIVE ROKEBERG noted there was three years academic
training at the university level, followed by three years of
supervised activity under a psychologist.
DR. STOKES interjected the supervision could be under a
psychologist or a person with a Ph.D. in psychology.
REPRESENTATIVE ROKEBERG inquired if at the point, assuming the
individual passed the examinations, the person would then be a
fully accredited psychological associate.
DR. STOKES added under the supervision of a psychologist.
REPRESENTATIVE ROKEBERG inquired if there would be an additional
five years under supervision, following the three years, in order
to "put out your own shingle."
DR. STOKES said no, an individual could "put out their own shingle"
but the psychological associate would have to meet with a
psychologist, he believed once a month.
REPRESENTATIVE ROKEBERG verified that a person could be
independently employed after the three year level.
DR. STOKES responded affirmatively.
Number 1767
REPRESENTATIVE ROBINSON asked Dr. Stokes if the reason for his
opposition to the bill was the two year period and if he believed
that somewhere between eight years and two years would be a more
appropriate length of time.
DR. STOKES replied yes. He added the board agrees with the spirit
of the bill.
REPRESENTATIVE ROBINSON asked how quickly the board could make a
recommendation as to an appropriate length of time.
DR. STOKES said it would depend on how many board members were
available, but he thought it could be done pretty quickly.
CO-CHAIR BUNDE advised Dr. Stokes the committee would need to know
next week.
CO-CHAIR TOOHEY commented that Dr. Stokes had spoken of a national
and a state exam and asked Dr. Stokes to explain the difference
between the two tests.
DR. STOKES said the national test is called the "E Triple P;" the
examination for the professional practice of psychology and is
given in all 50 states. The state test is composed by the board
and is on ethics only.
CO-CHAIR TOOHEY asked if she could see a copy of the state exam?
DR. STOKES suggested she talk to the Division of Occupational
Licensing regarding that request.
REPRESENTATIVE VEZEY submitted that making copies of a test could
compromise the integrity of the exam.
Number 1863
REPRESENTATIVE ROKEBERG referred to Section 4, subsection (b), and
asked Dr. Stokes if he understood what that meant.
DR. STOKES explained that a number of years ago, the only degrees
that were accepted were those degrees approved by the American
Psychological Association. That was contested and the Attorney
General's Office found that it could not be held, so the
professional organization referenced in Section 4, subsection (b)
is referring to the American Psychological Association.
REPRESENTATIVE ROKEBERG maintained there could be universities with
curriculum that is not accredited by that particular group.
DR. STOKES said that was correct, but they could be fully
accredited by regional accreditation.
CO-CHAIR TOOHEY asked if a state board is considered a regional
(indisc.).
DR. STOKES interjected no. He believed there were six large
regional accrediting bodies and added it's the highest level of
true, formal accreditation in the United States.
Number 1924
KATHRYN CARSSOW testified via teleconference that she is a resident
of downtown Anchorage and a 20-year resident of Alaska. She said
just last spring she earned her master's degree in clinical
psychology from the University of Alaska and is looking forward to
licensure. She noted the university has an impressive clinical
psychology program and through that training she spent over 1 1/2
years in supervision doing clinical work with children, couples,
families and the elderly. As a master's level person, she does not
feel the master's level point of view is represented at all on the
board of examiners. She thought Co-Chair Toohey hit the nail on
the head when she pointed out that the person who is representing
the psychological associates has a Ph.D. and is practicing as a
person with a Ph.D. regardless of what his license says. She said
prior to going back to school to get her master's in clinical
psychological, she had been a practicing community and resources
planner for the state. She is very much aware of the need for
mental health providers in the rural communities and cost
effectiveness is an important consideration. The current
requirement for eight years of supervision for master's level
people is an expensive acquisition; that supervision isn't free
unless the person is working for an agency. If a master's level
person is working in private practice, they are paying for that
supervision and that cost is passed on to the consumer. She felt
that was keeping the cost of mental health services higher than
necessary, especially in consideration of the investment that
citizens of Alaska have put into providing a master's level
clinical psychology program in Alaska. She believed in order to
get the maximum return on that investment, the length of time it
takes to get master's level people out in the field and practicing
without the expense of supervision needed to be restructured. She
noted there are indeed specialties such as behavior modification,
biofeedback and hypnosis which are provided by people in the
psychology profession, but by law those can't be provided unless
the person has specific training in those specialty areas.
CO-CHAIR BUNDE said the previous testifier felt that eight years
was too long, but two years was too short and asked if Ms. Carssow
had an opinion about the length of time of supervision.
MS. CARSSOW responded that she helped draft this legislation, so of
course she felt two years was appropriate, which puts the
psychological associates in parity with the other professions that
are practicing at a master's level. She pointed out that each
board member was approached individually last fall with this
legislation and they never mentioned any problem with the change in
years. She was upset about the manner in which this was handled
and felt it was very consistent with the way this board has
approached the master's level practitioner.
CO-CHAIR TOOHEY asked if the eight year requirement falls in line
with the requirement of other states.
MS. CARSSOW responded that eight years is far beyond what other
states require. She added that in drafting this legislation, they
reviewed the requirements of other states and found a range between
one year and five years, at the very most.
CO-CHAIR TOOHEY said she wanted to find out when the eight year
requirement came into effect. She reiterated this sounded like a
turf battle to her and the psychologists don't want the
psychological associates practicing in the field. She asked if
person is trained for a specific field such as marital therapist or
child psychologist, is that specified on their license?
MS. CARSSOW said it doesn't show up, but the American Psychological
Association has a very strict code of ethics they have to abide by
or have the threat of losing their license and practice. It is
very specific that a person doesn't practice outside their field of
training. Also, Alaska Statutes require that a person provide
support for any specialty areas being practiced.
CO-CHAIR TOOHEY asked if Ms. Carssow felt that was covered
sufficiently?
MS. CARSSOW replied yes, she did. She also wanted to point out in
terms of the supervised experience in other states that about eight
states require two years. The Alaska Psychological Association has
endorsed the two year requirement and fully supports this
legislation.
CO-CHAIR BUNDE noted that Representative Brice had just made the
observation that if teacher tenure takes three years, a
psychological associate should take at least that long.
REPRESENTATIVE BRICE remarked it was actually Representative
Robinson who had made the observation.
Number 2262
KAREN GIBSON testified that she is in the master's program of
clinical psychology at the University of Alaska, Anchorage. She
noted that much of her testimony had already been addressed by
previous speakers, but she does support SB 165 and observed that it
had received two hearings in the Senate where there was no
objection made to the content of the bill. This bill does more
than revise the amount of time it takes a psychological associate
to achieve independent practice; it allows for a temporary license
of a psychological associate. She said that Representative
Rokeberg had referred to it as the pre-psychological associate
period - that three year period before a person can sit for
licensure. She noted those people are not under the purview of the
licensing board because they aren't eligible for a license. This
bill corrects that so as soon as the board approves the education
and the years of supervision, the person can sit for the exam. If
the person passes the exam, a temporary license can be granted
while meeting the time frame to gain the eligibility to become a
fully licensed psychological associate. The legislation also
tightens up the language for temporary licenses of psychologists
for their one year post doctoral supervision. Also, SB 165
clarifies sexual misconduct and makes the definition tighter and
easier for the board to implement sanctions.
CO-CHAIR BUNDE asked if that would apply to both psychologists and
psychological associates?
MS. GIBSON replied yes it does.
REPRESENTATIVE BRICE said that Ms. Gibson had mentioned sexual
misconduct and asked if that two year time period after therapy or
counseling with the patient...
TAPE 96-36, SIDE B
Number 001
REPRESENTATIVE BRICE continued... had been terminated was based on
anything specific?
MS. GIBSON said she didn't know, but based on APA ethics, there
should never be sexual contact with a patient or a former patient;
this legislation provides a minimum of two years.
Number 026
JENNIFER HALL-JONES testified that she is in the process of getting
her degree from the University of Alaska Anchorage. She is also
the co-chair of the licensing equity committee for the Alaska
Psychological Association and helped draft SB 165. She pointed out
the state has a wonderful institution, yet it is virtually
impossible to get licensed in Alaska. As of this date, there are
37 licensed psychological associates in the state, 144 Ph.D.
licensed people in the state and there has been about 400 graduates
of the combined master's level program in both psychology or the
various kinds of psychology in the last four or five years and yet
these people are not going for licensure. She pointed out the
reason for that is the current statutes are (indisc.-coughing).
Another point that has been raised several times has to do with the
kinds of people served by the Ph.D. level versus the master's level
individuals; they are indeed different by statute. For instance,
a Ph.D. is the only one who is able to work within the court system
which is often the criminal population and the master's level
individuals don't even have access to that population. In reality,
the practices can be quite different. She concluded that the
University of Alaska Anchorage, Life Quest Comprehensive Mental
Health Services in the Mat-Su Valley, Anchorage Center for Families
and the Alaska Pacific University are all supportive of SB 165.
Number 122
CO-CHAIR TOOHEY recalled the 400 graduates mentioned by Ms. Hall-
Jones who are not going for their license and asked if that was
because they didn't have the proper training or was it because of
the time restraints?
MS. HALL-JONES responded that a lot of people end up getting out of
the profession because it is too difficult to earn a living. She
noted that Co-Chair Toohey had talked about it being a turf battle
and she felt there were Ph.D. folks in the state who do view it
that way. She reiterated that eight years is too prohibitive.
CO-CHAIR TOOHEY asked if the time frame was pared down to two
years, were the educational requirements sufficient in the state
between UAA and APU to graduate, certify and license graduates?
MS. CARSSOW replied she believed so.
CO-CHAIR BUNDE asked Ms. Hall-Jones if she was a member of the
Psychological Association?
MS. HALL-JONES said that was correct.
CO-CHAIR BUNDE asked if the membership consisted of master's degree
level individuals, Ph.D. level individuals or both.
MS. HALL-JONES said it was predominately Ph.D., there are very few
master's level people within that organization.
CO-CHAIR BUNDE addressed the people who were not going for
licensure. He asked Ms. Hall-Jones, "Do you mean that they were
not putting in the eight years to become independently licensed or
are they -- you know currently work three years under supervision
and then you have a license to work in association with a
psychologist. At what point are people....
MS. HALL-JONES interjected the reason she quoted the 37 is because
that is the number of people who have gone through the three years;
she does not have the figures for beyond that. She added there are
only 37 people licensed at the master's level in the state.
CO-CHAIR BUNDE confirmed those would be the individuals working
under the supervision of a psychologist.
MS. HALL-JONES said that was correct. She added the reality of the
market place is such that insurance companies will not reimburse
unless a Ph.D. level individual has signed off on the services
rendered.
Number 280
CO-CHAIR TOOHEY inquired if it was Ms. Carssow's or Ms. Hall-Jones'
understanding that when they bill an insurance company through a
clinic it would be at a lesser fee than that of a psychologist.
MS. HALL-JONES said that was correct. She added there are many
agencies who will not hire an individual unless he/she is licensed
or is in the process of becoming licensed.
CO-CHAIR TOOHEY asked Ms. Hall-Jones if adding M.A. at the end of
name for billing purposes automatically triggers a different pay
scale?
MS. HALL-JONES said that was her understanding of how it works;
however, she's not in that position yet so she really can't speak
with authority on that.
CO-CHAIR BUNDE said he would like Mr. Reinwand to get together with
the sponsor of SB 165 regarding the insurance questions. Also, he
asked Dr. Stokes to have a recommendation from the board regarding
a length of time of supervised experience. He announced that SB
165 would be heard again on Tuesday, April 9.
REPRESENTATIVE ROKEBERG referenced AS 08.18.062 relating to the
three years of supervised experience as a qualification for the
associate's examination and said he didn't see that specific
section mentioned in the bill for revision.
CO-CHAIR BUNDE said that question could be addressed at the next
hearing on CSSB 165(L&C).
CO-CHAIR BUNDE called an at-ease at 4:01 p.m.
CO-CHAIR BUNDE called the HESS Committee back to order at 4:02 p.m.
and announced the sponsor of HJR 50 was not available. There being
no further business to come before the committee, Co-Chair Bunde
adjourned the meeting of the House HESS Committee at 4:04 p.m.
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