Legislature(1995 - 1996)
04/04/1996 03:04 PM House HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= 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.