Legislature(1999 - 2000)

01/21/2000 03:21 PM House L&C

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
    HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                                 
                  January 21, 2000                                                                                              
                     3:21 p.m.                                                                                                  
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                                 
                                                                                                                                
Representative Norman Rokeberg, Chairman                                                                                        
Representative Lisa Murkowski                                                                                                   
Representative John Harris                                                                                                      
Representative Sharon Cissna                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                  
                                                                                                                                
Representative Andrew Halcro, Vice Chairman                                                                                     
Representative Jerry Sanders                                                                                                    
Representative Tom Brice                                                                                                        
                                                                                                                                
COMMITTEE CALENDAR                                                                                                              
                                                                                                                                
HOUSE BILL NO. 105                                                                                                              
"An Act providing for the licensing of speech-language                                                                          
pathologists; and providing for an effective date."                                                                             
                                                                                                                                
     - MOVED CSHB 105(L&C) OUT OF COMMITTEE                                                                                     
                                                                                                                                
PREVIOUS ACTION                                                                                                                 
                                                                                                                                
BILL: HB 105                                                                                                                    
SHORT TITLE: LICENSING SPEECH PATHOLOGY/AUDIOLOGY                                                                               
                                                                                                                                
Jrn-Date    Jrn-Page           Action                                                                                           
 2/19/99       260     (H)  READ THE FIRST TIME - REFERRAL(S)                                                                   
 2/19/99       260     (H)  L&C, FIN                                                                                            
 1/21/00               (H)  L&C AT  3:15 PM CAPITOL 17                                                                          
                                                                                                                                
WITNESS REGISTER                                                                                                                
                                                                                                                                
REPRESENTATIVE CON BUNDE                                                                                                        
Alaska State Legislature                                                                                                        
Capitol Building, Room 501                                                                                                      
Juneau, Alaska  99801                                                                                                           
POSITION STATEMENT: Sponsor of HB 105.                                                                                          
                                                                                                                                
KIT ROBERTS, Representative                                                                                                     
Alaska Speech-Language-Hearing Association                                                                                      
(Address not provided)                                                                                                          
POSITION STATEMENT: Testified in favor of HB 105.                                                                               
                                                                                                                                
                                                                                                                                
CATHERINE REARDON, Director                                                                                                     
Division of Occupational Licensing                                                                                              
Department of Community & Economic Development                                                                                  
PO Box 110806                                                                                                                   
Juneau, Alaska 99811-0806                                                                                                       
POSITION STATEMENT: Testified on HB 105.                                                                                        
                                                                                                                                
JANET SEITZ, Staff                                                                                                              
   to House Labor and Commerce Standing Committee                                                                               
Alaska State Legislature                                                                                                        
Capitol Building, Room 24                                                                                                       
Juneau, Alaska  99801                                                                                                           
POSITION STATEMENT: Testified on transitional regulation language                                                               
as it relates to HB 105.                                                                                                        
                                                                                                                                
PATTI SWENSEN, Staff                                                                                                            
   to Representative Con Bunde                                                                                                  
Alaska State Legislature                                                                                                        
Capitol Building, Room 501                                                                                                      
Juneau, Alaska  99801                                                                                                           
POSITION STATEMENT: Answered questions regarding the issue of a                                                                 
temporary license as it relates to HB 105.                                                                                      
                                                                                                                                
ACTION NARRATIVE                                                                                                                
                                                                                                                                
TAPE 00-3, SIDE A                                                                                                               
Number 0001                                                                                                                     
                                                                                                                                
CHAIRMAN NORMAN ROKEBERG called the House Labor and Commerce                                                                    
Standing Committee meeting to order at 3:21 p.m.  Members present                                                               
at the call to order were Representatives Rokeberg, Murkowski,                                                                  
Harris and Cissna.                                                                                                              
                                                                                                                                
HB 105 - LICENSING SPEECH PATHOLOGY/AUDIOLOGY                                                                                   
                                                                                                                                
Number 0040                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG announced the first and only item of business                                                                 
would be House Bill No. 105, "An Act providing for the licensing of                                                             
speech-language pathologists; and providing for an effective date."                                                             
                                                                                                                                
[NOTE:  THE COMMITTEE WILL BE DISCUSSING WORK DRAFT VERSION                                                                     
1-LS0340\H, LAUTERBACH, 1/20/00]                                                                                                
                                                                                                                                
                                                                                                                                
CHAIRMAN ROKEBERG commented that the bill appears to be an                                                                      
excellent piece of draftsmanship in that it does not develop a new                                                              
board or commission and therefore, presumably, would be a very                                                                  
cost-effective way to bring needed regulation and control of speech                                                             
pathology and audiology in the state.                                                                                           
                                                                                                                                
Number 0073                                                                                                                     
                                                                                                                                
REPRESENTATIVE CON BUNDE, Alaska State Legislature, sponsor of the                                                              
bill, began by disclosing that when he first came to Alaska he                                                                  
worked as a speech and hearing therapist so he has some personal                                                                
knowledge of this area.  At that time, the American                                                                             
Speech-Language-Hearing Association's [ASHA] certification was just                                                             
beginning to grow as a professional goal for speech and hearing                                                                 
therapists.  Although it would not have been required for their                                                                 
employment, he said many people aspired to the certification                                                                    
because it establishes ethical and clinical competencies and gives                                                              
the public a bit of assurance.  He is pleased to bring this bill                                                                
before the committee.  It is another illustration of folks who want                                                             
to create certification upon themselves to reassure members of the                                                              
public that they are getting the best service possible rather than                                                              
having the state presume to place a certification on an occupation.                                                             
                                                                                                                                
REPRESENTATIVE BUNDE further stated that Alaska is one of only six                                                              
states that does not require this license or certification.                                                                     
Therefore, the goal of HB 105 is to set out the requirements for                                                                
licensure.  He noted that the legislation was requested by the                                                                  
Alaska Speech-Language-Hearing Association to allow speech and                                                                  
language professionals to follow more stringent clinical and                                                                    
ethical competency standards.   The bill would - in essence - take                                                              
what is being done already on a voluntary basis and put it into                                                                 
statute.                                                                                                                        
                                                                                                                                
Number 0286                                                                                                                     
                                                                                                                                
REPRESENTATIVE BUNDE acknowledged that there has been some                                                                      
discussion about the fee, which he described as "pretty                                                                         
substantial" - about $700 biennially or $350 per person per year.                                                               
He noted that about a dozen speech/language pathologists are                                                                    
anticipated to be licensed, and suggested combining them with the                                                               
audiologists, whose licensing fee is substantially less, thereby                                                                
spreading the cost over greater numbers.                                                                                        
                                                                                                                                
REPRESENTATIVE BUNDE announced that Ms. Kit Roberts is online [to                                                               
testify].  She is a member of the Alaska Speech-Language-Hearing                                                                
Association and is able to give a personal point of view as a                                                                   
requester of this type of certification as well as answer any                                                                   
clinical questions.                                                                                                             
                                                                                                                                
Number 0383                                                                                                                     
                                                                                                                                
KIT ROBERTS, testifying via teleconference from Anchorage,                                                                      
introduced herself as a speech/language pathologist.  She mentioned                                                             
that she is the director of Emerald Speech & Learning Clinic in                                                                 
Anchorage, but she is testifying today as a representative of the                                                               
Alaska Speech-Language-Hearing Association.  She also thanked                                                                   
Representative Bunde for his help.  She has been in private                                                                     
practice since 1976 in the state.  For many years speech/language                                                               
pathologists have gotten along pretty well with the honor system.                                                               
However, a few years ago a gentleman started advertising himself as                                                             
a speech/language pathologist who had a bachelors degree that                                                                   
wasn't even in speech therapy.  There were complaints made, but                                                                 
there was nothing that could be done.  There is nothing to protect                                                              
consumers.  She also noted that reimbursements have become an issue                                                             
because medical insurance companies are looking at state licensing                                                              
to determine if a speech/language pathologist is a qualified                                                                    
provider.  As a result, some have been denied payments by medical                                                               
insurance companies.  She cited the profession has a very low                                                                   
incidence rate:  only 5 to 10 percent of the population will ever                                                               
need to see a speech/language pathologist.  There are no training                                                               
programs in the state, yet all have worked for and received a                                                                   
Certificate of Clinical Competence [CCC], the minimum certification                                                             
needed to work in private practice nationally, which is why it was                                                              
chosen as the entry level for state licensing.  She remarked that                                                               
there is a shortage of speech/language pathologists in the state,                                                               
but all are concerned about maintaining a high standard for the                                                                 
profession.  She said, "We're kind of a picky lot, and we like                                                                  
things done right.  We like things done well so we're ready for                                                                 
this."                                                                                                                          
                                                                                                                                
MS. ROBERTS further stated, in regards to the fiscal note, there                                                                
are an estimated 25 audiologists who are licensed and practicing                                                                
now, and an estimated 25 to 30 speech/language pathologists would                                                               
be licensed.  She explained that both audiologists and                                                                          
speech/language pathologists are certified under the same parent                                                                
organization - the American Speech-Language-Hearing Association -                                                               
and both receive the same testing and certification.  Therefore, a                                                              
fee similar to audiologists would be fair and reasonable, which is                                                              
$190 biennially.                                                                                                                
                                                                                                                                
Number 0715                                                                                                                     
                                                                                                                                
REPRESENTATIVE JOHN HARRIS asked Ms. Roberts whether she is looking                                                             
for uniformity amongst the professions.                                                                                         
                                                                                                                                
MS. ROBERTS replied, "Yes."                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Roberts to explain the difference                                                                   
between an audiologist and a speech/language pathologist.                                                                       
                                                                                                                                
MS. ROBERTS replied both professions start with the same course                                                                 
work and share similar core courses at school.  At some point,                                                                  
however, a decision is made as to what path to pursue.  She                                                                     
explained that an audiologist deals mostly with hearing and hearing                                                             
impairments, while a speech/language pathologist deals mostly with                                                              
speech, language and voice.  Both can have clients in common; for                                                               
example, they both work with deaf children.  A speech/language                                                                  
pathologist works with deaf children in ways to improve their                                                                   
speech or to teach them sign language, while an audiologist tests                                                               
and prescribes hearing aids.  She also noted that speech/language                                                               
pathologists work with stroke victims, stutters, individuals who                                                                
have had surgery for a cleft palate, and individuals who have had                                                               
a head injury.  She called it a very broad field.                                                                               
                                                                                                                                
Number 0836                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG noted that when his Mother had a stroke she                                                                   
worked with a speech/language pathologist to learn how to swallow                                                               
and eat.                                                                                                                        
                                                                                                                                
MS. ROBERTS confirmed that speech/language pathologists also treat                                                              
swallowing disorders.                                                                                                           
                                                                                                                                
CHAIRMAN ROKEBERG noted that his Mother's care was covered by                                                                   
Medicare.  Is that typical? he asked.                                                                                           
                                                                                                                                
MS. ROBERTS replied, "Yes."  Swallowing is a good example of an                                                                 
area in which a person can get injured if treated by someone who is                                                             
not trained or thinks they know what they are doing.                                                                            
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Roberts to explain the education                                                                    
requirements for certification for a speech/language pathologist.                                                               
                                                                                                                                
MS. ROBERTS replied, in order to qualify for a CCC, a person must                                                               
have a masters degree from a qualified institution; undergo a                                                                   
supervised year of training; and pass a national examination.                                                                   
                                                                                                                                
Number 0992                                                                                                                     
                                                                                                                                
REPRESENTATIVE BUNDE expressed that the bill would not present any                                                              
difficult barriers.  There are hundreds if not thousands of                                                                     
colleges and universities that offer programs in speech/language                                                                
therapy.                                                                                                                        
                                                                                                                                
Number 1011                                                                                                                     
                                                                                                                                
REPRESENTATIVE LISA MURKOWSKI asked Ms. Roberts whether the                                                                     
requirements for an audiologist are similar to the requirements for                                                             
a speech/language pathologist.                                                                                                  
                                                                                                                                
MS. ROBERTS replied, "Yes."  According to her understanding, it's                                                               
exactly the same thing - a masters degree and a CCC.  She noted                                                                 
that a person can be dually certified as an audiologist and as a                                                                
speech/language pathologist.                                                                                                    
                                                                                                                                
REPRESENTATIVE MURKOWSKI asked Ms. Roberts how would a dual                                                                     
certification be handled in regards to licensing.  In other words,                                                              
would a person have to pay both fees?                                                                                           
                                                                                                                                
MS. ROBERTS replied that's a decision the committee will have to                                                                
consider.  She is thinking that a person would have to get two                                                                  
licenses.                                                                                                                       
                                                                                                                                
REPRESENTATIVE SHARON CISSNA requested that the committee hear from                                                             
the Division of Occupational Licensing [Department of Community &                                                               
Economic Development] on that issue.                                                                                            
                                                                                                                                
CHAIRMAN ROKEBERG asked Representative Bunde whether a person who                                                               
is certified and licensed in another state would just have to pay                                                               
a licensing fee.                                                                                                                
                                                                                                                                
REPRESENTATIVE BUNDE replied the CCC is a national certification.                                                               
He suspects, therefore, that a person would just have to apply for                                                              
a license upon entering the state, if that person already has a                                                                 
CCC.  He called it a transfer of paper.                                                                                         
                                                                                                                                
Number 1175                                                                                                                     
                                                                                                                                
REPRESENTATIVE MURKOWSKI referred to Section 13, "Exemptions," of                                                               
the work draft, and wondered whether those who teach                                                                            
speech/language pathology would have to be licensed.                                                                            
                                                                                                                                
REPRESENTATIVE BUNDE replied a person working as such in a school                                                               
district is not really teaching speech pathology but acting as a                                                                
speech/language pathologist.                                                                                                    
                                                                                                                                
REPRESENTATIVE MURKOWSKI said she would hope that a person who is                                                               
teaching speech/language pathology would be licensed, which is not                                                              
how subsection (c) reads [Section 13].                                                                                          
                                                                                                                                
                                                                                                                                
MS. ROBERTS explained that a license is for those who are                                                                       
practicing and treating clients.  However, if at some point she                                                                 
wanted to become a professor for example, then she wouldn't need a                                                              
license.  She doesn't have a problem with that as long as the                                                                   
person is not treating any clients.                                                                                             
                                                                                                                                
Number 1266                                                                                                                     
                                                                                                                                
REPRESENTATIVE BUNDE stated, according to personal experience,                                                                  
professors typically work with clients as well and in those cases                                                               
they would have to be licensed.  However, a person teaching a class                                                             
in semantics, which leads to a degree in speech/language pathology,                                                             
wouldn't have to be certified [licensed].                                                                                       
                                                                                                                                
REPRESENTATIVE MURKOWSKI replied she is concerned because she                                                                   
wouldn't like to see a person - who had never been licensed -                                                                   
elevated through the speech department who is now training students                                                             
of speech/language pathology.                                                                                                   
                                                                                                                                
REPRESENTATIVE BUNDE replied that is a hypothetical scenario; there                                                             
are no training programs in the state and he doubts that there ever                                                             
would be.  The language that Representative Murkowski is concerned                                                              
about refers to those who are licensed to deal with                                                                             
clients/patients as opposed to those who deal with theory.  In                                                                  
reality, he can't imagine that those who are teaching would not                                                                 
have had a clinical practice.                                                                                                   
                                                                                                                                
Number 1401                                                                                                                     
                                                                                                                                
REPRESENTATIVE CISSNA referred to Section 3, paragraph (5), of the                                                              
work draft, and wondered whether the language would cover the issue                                                             
at hand.  The American Speech-Language-Hearing Association would                                                                
have a fairly rigorous screening process for those applying for a                                                               
CCC.  Similarly, an instructor would not be able to teach unless                                                                
he/she has a fairly rigorous background.                                                                                        
                                                                                                                                
REPRESENTATIVE BUNDE replied there are individuals who are not                                                                  
licensed in the state yet they teach theory.  In addition, he wants                                                             
to stay away from telling the university who they can or cannot                                                                 
hire.                                                                                                                           
                                                                                                                                
Number 1489                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG referred to Section 13, paragraph (2), of the                                                                 
work draft, and asked Representative Bunde to explain why a school                                                              
district employee should be exempt from this type of licensing.                                                                 
                                                                                                                                
                                                                                                                                
REPRESENTATIVE BUNDE replied the bill is addressing those                                                                       
individuals who are practicing and calling themselves                                                                           
speech/language pathologists.  A school district can set up its own                                                             
criteria as to who it can or cannot hire.                                                                                       
                                                                                                                                
CHAIRMAN ROKEBERG wondered whether this would cause "violence" to                                                               
those with a bachelors degree who don't have a CCC but who are                                                                  
employed in the field.                                                                                                          
                                                                                                                                
REPRESENTATIVE BUNDE stated, according to his own experience, he                                                                
didn't hurt anybody while working in the public schools with a                                                                  
bachelors degree.                                                                                                               
                                                                                                                                
MS. ROBERTS explained the minimum requirements for those who work                                                               
as a speech/language pathologist in the public schools is a masters                                                             
degree.  School districts stop short of requiring a CCC, but they                                                               
are starting to recognize it as a way to give pay increases.                                                                    
                                                                                                                                
REPRESENTATIVE BUNDE noted that the requirements vary from school                                                               
district to school district, but that nothing less than a bachelors                                                             
[degree] is required.                                                                                                           
                                                                                                                                
CHAIRMAN ROKEBERG asked whether there are practitioners outside the                                                             
realm of education who don't have a certificate that would be                                                                   
harmed by this.                                                                                                                 
                                                                                                                                
REPRESENTATIVE BUNDE replied he would reverse the question; is it                                                               
wise to protect the public from someone who hangs up a shingle and                                                              
calls himself a speech/language pathologist according to his own                                                                
definition?  He doesn't know of anybody - specifically - who would                                                              
be driven out of business because of this certification                                                                         
[licensing]; it's a consumer protection issue.                                                                                  
                                                                                                                                
CHAIRMAN ROKEBERG stated the point of the bill is to create another                                                             
occupation guild with prohibitions of practice to set a minimum                                                                 
standard.                                                                                                                       
                                                                                                                                
Number 1733                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG referred to page 7, line 7, of the work draft,                                                                
and wondered whether referring to a code of ethics in statute is                                                                
"running afoul."  There is no code of ethics either memorialized in                                                             
statute or regulation.  Furthermore, what code of ethics is the                                                                 
bill talking about?                                                                                                             
                                                                                                                                
                                                                                                                                
REPRESENTATIVE BUNDE replied it refers to the code of ethics of the                                                             
individual's profession.  The language refers to the exemption of                                                               
a licensed physician who chooses to practice some speech/language                                                               
pathology such as swallowing exercises.                                                                                         
                                                                                                                                
CHAIRMAN ROKEBERG asked:  What code of ethics exists for a                                                                      
speech/language pathologist?                                                                                                    
                                                                                                                                
REPRESENTATIVE BUNDE replied the American Speech-Language-Hearing                                                               
Association's code of ethics applies to them.                                                                                   
                                                                                                                                
CHAIRMAN ROKEBERG exclaimed this is a classic occupational                                                                      
licensing "thing."  Each profession may or may not have adopted a                                                               
code of ethics, but in certain instances a code is codified...                                                                  
                                                                                                                                
REPRESENTATIVE BUNDE interjected and stated the bill refers to a                                                                
code of ethics and clinical competency...                                                                                       
                                                                                                                                
CHAIRMAN ROKEBERG interjected and stated that once a person has                                                                 
been certified - presumably - he/she would have to be incompliance                                                              
with that code of ethics or stand a chance of being decertified.                                                                
In other words, there would be two enforcement agencies - the                                                                   
Division of Occupational Licensing and the certification agency.                                                                
                                                                                                                                
REPRESENTATIVE BUNDE noted that the public would also act as an                                                                 
enforcement as they would be the ones complaining.                                                                              
                                                                                                                                
CHAIRMAN ROKEBERG wondered whether the American                                                                                 
Speech-Language-Hearing Association would indicate to the Division                                                              
of Occupational Licensing [Department of Community & Economic                                                                   
Development] that there had been a breach in the code of ethics.                                                                
                                                                                                                                
REPRESENTATIVE BUNDE said there would have to be another step                                                                   
because the association would remove that person's certification                                                                
which would automatically make him/her incompliant for a state                                                                  
license.                                                                                                                        
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Roberts whether she is aware of any                                                                 
actions against a person based on a code of ethics violation.                                                                   
                                                                                                                                
MS. ROBERTS replied, "Yes."  There have been a few cases related to                                                             
insurance fraud of which the state licensing agencies were                                                                      
notified.  She offered to make available to the committee members                                                               
a copy of the code.                                                                                                             
                                                                                                                                
                                                                                                                                
Number 1930                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG stated he is concerned because there are                                                                      
different levels of a breach; therefore, would a person                                                                         
automatically be decertified for a breach?                                                                                      
                                                                                                                                
REPRESENTATIVE BUNDE pointed out that, if a person loses his/her                                                                
CCC, then...                                                                                                                    
                                                                                                                                
CHAIRMAN ROKEBERG interjected and stated the language in the work                                                               
draft doesn't say that.                                                                                                         
                                                                                                                                
MS. ROBERTS said she thought the exemption language meant a person                                                              
didn't have to get a license; there's nothing to lose, right?                                                                   
                                                                                                                                
CHAIRMAN ROKEBERG replied, "That's true."                                                                                       
                                                                                                                                
MS. ROBERTS further noted that the language is included because                                                                 
sometimes a doctor will give hearing tests.                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG said he is troubled by this section because it                                                                
sets up a standard on top of a laundry list of exemptions.  He                                                                  
asked:  What does the code of ethics have to do with an exemption?                                                              
Is a person not exempt if unethical?                                                                                            
                                                                                                                                
REPRESENTATIVE BUNDE pointed out that the language reads, "...this                                                              
chapter does not apply to an individual who practices                                                                           
speech-language pathology consistent with the accepted standards                                                                
and code of ethics of the individual's profession..."  He noted                                                                 
that physicians take an Hippocratic oath and that the employees of                                                              
a school district and interns follow professional standards.                                                                    
                                                                                                                                
CHAIRMAN ROKEBERG referred to the issue as a drafting "thing."  If                                                              
a person is exempt from overview, why is that person's code of                                                                  
ethics mentioned?                                                                                                               
                                                                                                                                
REPRESENTATIVE BUNDE interjected and stated - obviously - the                                                                   
drafter of the bill is comfortable with the language.  "But,                                                                    
legally, are we going to say some doctor who practices speech                                                                   
therapy and breaches -- he does it poorly and breaches his own                                                                  
ethics -- he does harm first.  We don't want to then exempt that                                                                
behavior.  We want to say that he's exempted as long as he or she                                                               
is doing this in an acceptable manner."                                                                                         
                                                                                                                                
                                                                                                                                
Number 2062                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG asked:  If a school district employee is acting                                                               
unethically as a speech/language pathologist, what does the                                                                     
Division of Occupational Licensing [Department of Community &                                                                   
Economic Development] have to do with that?                                                                                     
                                                                                                                                
REPRESENTATIVE BUNDE pointed out that the individuals in the                                                                    
exemptions section are not covered by a license...                                                                              
                                                                                                                                
CHAIRMAN ROKEBERG interjected and stated that is his point; why is                                                              
the bill talking about a code of ethics?                                                                                        
                                                                                                                                
Number 2075                                                                                                                     
                                                                                                                                
REPRESENTATIVE BUNDE avowed, if this is a major problem with the                                                                
Chairman, then the language should be deleted.                                                                                  
                                                                                                                                
CHAIRMAN ROKEBERG reiterated that he is confused about what the                                                                 
language, "accepted standards and code of ethics," has to do with                                                               
an exemption.                                                                                                                   
                                                                                                                                
REPRESENTATIVE BUNDE explained that the language was borrowed from                                                              
other states and is part of the current statute for audiologists.                                                               
                                                                                                                                
Number 2142                                                                                                                     
                                                                                                                                
REPRESENTATIVE HARRIS said it's clear to him.  The section just                                                                 
says that those in other professions have their own accepted                                                                    
standards and code of ethics and that they must follow them, if                                                                 
they are to be allowed to practice speech/language pathology.  They                                                             
wouldn't be able to practice their own profession if they didn't                                                                
follow their own code of ethics.                                                                                                
                                                                                                                                
CHAIRMAN ROKEBERG pointed out that the language refers to the                                                                   
exemptions which are not under the purview of the Division of                                                                   
Occupational Licensing [Department of Community & Economic                                                                      
Development].                                                                                                                   
                                                                                                                                
Number 2180                                                                                                                     
                                                                                                                                
CATHERINE REARDON, Director, Division of Occupational Licensing,                                                                
Department of Community & Economic Development, came before the                                                                 
committee to help clarify the issue.  She stated, if the division                                                               
was to prove that a person was not following his/her own accepted                                                               
standards and code of ethics, then that person would no longer be                                                               
eligible for an exemption and, therefore, practicing without a                                                                  
license, which is a misdemeanor.                                                                                                
                                                                                                                                
CHAIRMAN ROKEBERG interjected and said:  "So, somebody could be                                                                 
doing something and not have a license, know they don't have to                                                                 
have a license, and then if they do something wrong then all of a                                                               
sudden you [Division of Occupational Licensing] claim that they                                                                 
should have a license so you can exempt them.  That's nonsense."                                                                
                                                                                                                                
MS. REARDON replied it appears that is what is permitted in the                                                                 
bill, but it wouldn't be wise for the division to pursue something                                                              
like that because those in question are not regulated and they                                                                  
haven't paid anything into the system.  She noted that the language                                                             
is the same for the audiologists and the division has not had to                                                                
pursue a complaint.  She suggested either taking the language out                                                               
for both [occupations] or leaving it in for both.                                                                               
                                                                                                                                
Number 2257                                                                                                                     
                                                                                                                                
REPRESENTATIVE CISSNA asked whether the profession itself feels                                                                 
that this is an important way to police itself.                                                                                 
                                                                                                                                
CHAIRMAN ROKEBERG replied, he thinks, it's a drafting "thing."                                                                  
                                                                                                                                
REPRESENTATIVE BUNDE suggested, in the interest of time, deleting                                                               
the language, "consistent with the accepted standards and code of                                                               
ethics of the individual's profession" [page 7, lines 7-8].                                                                     
                                                                                                                                
Number 2329                                                                                                                     
                                                                                                                                
MS. REARDON continued testifying on HB 105.  She explained that the                                                             
bill is modeled after the audiology statute, and that the fiscal                                                                
note is a feature of what the division spends on the profession.                                                                
                                                                                                                                
MS. REARDON stated, in response to earlier concerns, she's not                                                                  
certain as to whether or not those who have a CCC are reputable,                                                                
but she pointed out that the effective date of the bill is July 1,                                                              
2000, which if passed into law would hit the profession quite soon.                                                             
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Reardon whether she would have to draft                                                             
any regulations against the statute.                                                                                            
                                                                                                                                
MS. REARDON replied she would draft regulations to put limits                                                                   
around the temporary license, which would take longer than July 1,                                                              
2000.  Until such time, however, the division would probably give                                                               
out temporary licenses without a termination date.                                                                              
                                                                                                                                
CHAIRMAN ROKEBERG asked Representative Bunde to comment on the                                                                  
effective date; it's not very "clean."                                                                                          
                                                                                                                                
                                                                                                                                
REPRESENTATIVE BUNDE replied, in regards to the state's need for                                                                
time, he can't comment on that.  But, in regards to a                                                                           
practitioner's need for time, he/she certainly has the option of                                                                
applying for a CCC.  He clarified with Ms. Roberts that all of the                                                              
25 members of the Alaska Speech-Language-Hearing Association have                                                               
their CCC and Ms Roberts replied in the affirmative.                                                                            
                                                                                                                                
CHAIRMAN ROKEBERG said:  "So, but, but given the nature here we may                                                             
only have 30 to 45 days to 60 days to get geared up at                                                                          
occ[upational] licencing.  Is that sufficient time for these people                                                             
not to...I mean..."                                                                                                             
                                                                                                                                
MS. REARDON stated she would prefer a longer time because often                                                                 
legislation like this is passed near the end of a session then off                                                              
to the Governor.  There may not be very much time... [TAPE CHANGE]                                                              
                                                                                                                                
TAPE 00-3, SIDE B                                                                                                               
Number 0001                                                                                                                     
                                                                                                                                
REPRESENTATIVE BUNDE asked Ms. Roberts whether an additional 90                                                                 
days would be an inconvenience or danger to the public's safety.                                                                
                                                                                                                                
MS. ROBERTS replied, "No."                                                                                                      
                                                                                                                                
REPRESENTATIVE BUNDE asked Ms. Reardon whether an additional 90                                                                 
days would take care of her concern.                                                                                            
                                                                                                                                
MS. REARDON replied it would take care of her concern regarding                                                                 
licensing, but regulations take a year.                                                                                         
                                                                                                                                
Number 0027                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG referred to boiler plate language for                                                                         
transitional regulations and asserted that the committee should                                                                 
give Ms. Reardon the authority to write regulations prior to the                                                                
effective date.                                                                                                                 
                                                                                                                                
MS. REARDON stated her dream date would be January 1, 2001.                                                                     
                                                                                                                                
Number 0052                                                                                                                     
                                                                                                                                
JANET SEITZ, Staff to House Labor and Commerce Standing Committee,                                                              
came before the committee to testify on transitional regulation                                                                 
language.  She noted that the language for transitional regulations                                                             
says something to the effect of, "notwithstanding the effective                                                                 
date of a piece of legislation the department can go ahead and                                                                  
start developing regulations."                                                                                                  
                                                                                                                                
REPRESENTATIVE MURKOWSKI noted that the language says "developing"                                                              
not "implementing."                                                                                                             
                                                                                                                                
MS. REARDON noted that the language would allow her to adopt                                                                    
regulations and present them to the public.                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG said adding the language would cover both                                                                     
concerns of delaying the implementation of the regulations and                                                                  
giving the division more time.                                                                                                  
                                                                                                                                
MS. REARDON asserted that she needs to know the amount of the                                                                   
licensing fee so that she can start drafting regulations and                                                                    
informing those who apply for a license.                                                                                        
                                                                                                                                
MS. REARDON continued her testimony on HB 105.  She referred to                                                                 
page 3, paragraphs (1) and (2), and noted that a temporary license                                                              
is good for 60 days or less in a calendar year which, according to                                                              
her understanding, are not consecutive days.  She is concerned                                                                  
about how the division would track that information.  As written,                                                               
it would probably be left to the licensee to stick to the limit.                                                                
She doesn't want people to think that the division is going to                                                                  
clock them in and out every time they enter the state.                                                                          
                                                                                                                                
REPRESENTATIVE BUNDE noted that those who are not incompliant with                                                              
the laws and regulations of their licensing would lose their CCC.                                                               
There has to be some expectation of professional responsibility.                                                                
                                                                                                                                
MS. REARDON noted that the division advocated for the language to                                                               
read "consecutive [days]," but the supporters didn't want that.                                                                 
She is concerned how it would work.                                                                                             
                                                                                                                                
Number 0217                                                                                                                     
                                                                                                                                
PATTI SWENSEN, Staff to Representative Con Bunde, came before the                                                               
committee to answer questions regarding the issue of the temporary                                                              
license.  She noted, according to discussions with individuals in                                                               
the profession, that those who commute with a temporary license                                                                 
have a contract with a certain amount of days attached, which is                                                                
how it could be measured.                                                                                                       
                                                                                                                                
Number 0242                                                                                                                     
                                                                                                                                
MS. ROBERTS explained - as an analogy - when there is a nursing                                                                 
shortage a hospital will hire a temporary nurse from outside for a                                                              
certain amount of time.  That happens in Alaska as well for                                                                     
speech/language pathologists.  She cited that usually a                                                                         
speech/language pathologist is hired from the state of Washington                                                               
or Oregon as a consultant for a school district in a small                                                                      
community when the rest are booked up.  She doesn't want to                                                                     
penalize a therapist or a school district for a temporary visit,                                                                
but if it turns out to be a consistent visit then that therapist                                                                
would need to get a full license.                                                                                               
                                                                                                                                
MS. REARDON stated, according to her read on the bill, a therapist                                                              
could get a temporary license every year.                                                                                       
                                                                                                                                
MS. ROBERTS replied there should be something in the bill that                                                                  
indicates a temporary license is good for only one year, after                                                                  
which, a person would have to get a regular license.                                                                            
                                                                                                                                
MS. SWENSEN replied the language reads, "60 days or less in a                                                                   
calendar year," which could be used 5 days at a time or 60 days                                                                 
straight.                                                                                                                       
                                                                                                                                
MS. ROBERTS said a person should get a temporary license once.                                                                  
                                                                                                                                
REPRESENTATIVE MURKOWSKI wondered whether the issue could be                                                                    
addressed under Section 4, subsection (d), which reads as follows:                                                              
                                                                                                                                
     (d)  The department may impose by regulation additional                                                                    
     limitations that it determines appropriate on a temporary                                                                  
     license issued under this section.                                                                                         
                                                                                                                                
MS. REARDON indicated to Ms. Roberts that she can address the issue                                                             
through the regulations.  She doesn't see a limit in statute.  It's                                                             
helpful to know the intent, however.  She stated - for the record                                                               
- that since a temporary license would be issued for only one year                                                              
rather than two she is assuming that the cost would be half of the                                                              
regular license.                                                                                                                
                                                                                                                                
CHAIRMAN ROKEBERG wondered whether the fee for a temporary license                                                              
should be in statute.                                                                                                           
                                                                                                                                
MS. REARDON replied she prefers that it not be in statute.  She                                                                 
would prefer that no fees be in statute.                                                                                        
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Reardon what she would contemplate                                                                  
charging for a license.                                                                                                         
                                                                                                                                
MS. REARDON replied, according to the fiscal note, the division is                                                              
proposing to spend $7,500 a year, which comes out to $700 for                                                                   
approximately 25 people.  If it doesn't cost $7,500 a year then the                                                             
fees would not be as high, and similarly if it costs more than                                                                  
$7,500 a year then the fees would be higher.  The fiscal note                                                                   
indicates what the division thinks it would cost for a license, but                                                             
that doesn't govern it absolutely.  It's the actual experience that                                                             
in the end determines what the fee would be; for example,                                                                       
enforcement money for an appeals process can cost $100 an hour for                                                              
legal time, which is billed to the profession.  That is the                                                                     
downside of having a self-sufficiency statute.  But, as pointed out                                                             
by the sponsor, there are professions which are also very small and                                                             
since no legal monies have been expended the fees are running                                                                   
anywhere from $200 to $300.                                                                                                     
                                                                                                                                
MS. REARDON further stated, in regards to the issue of the                                                                      
temporary license, the division would not track the days, otherwise                                                             
it would start costing money in terms of staff time.                                                                            
                                                                                                                                
MS. REARDON further stated she would like to see the loss of a                                                                  
person's CCC as a ground for disciplinary action stated clearly in                                                              
the bill.  As written it says that a person has to have a CCC to                                                                
get a license; it doesn't say that a loss is grounds for                                                                        
revocation.                                                                                                                     
                                                                                                                                
MS. ROBERTS indicated that that is reasonable language to add to                                                                
the bill.  Where would it be added? she asked.                                                                                  
                                                                                                                                
MS. REARDON replied she would recommend including it in Section 9,                                                              
"Grounds for imposition of disciplinary sanctions on a                                                                          
speech-language pathologist."  She noted that the bill drafter                                                                  
would probably make it a separate subsection because it would be an                                                             
automatic [revocation].  She pointed out that the other grounds are                                                             
actions for which the department "may" impose a sanction.  She                                                                  
further pointed out that there is similar language in statute for                                                               
hunting crimes.                                                                                                                 
                                                                                                                                
CHAIRMAN ROKEBERG closed the meeting to public testimony.                                                                       
                                                                                                                                
Number 0669                                                                                                                     
                                                                                                                                
REPRESENTATIVE MURKOWSKI noted that the suggested changes apply                                                                 
towards audiologists, yet the title of the bill does not include                                                                
them.                                                                                                                           
                                                                                                                                
REPRESENTATIVE BUNDE replied it is not his intent to include these                                                              
requirements for audiologists.                                                                                                  
                                                                                                                                
REPRESENTATIVE MURKOWSKI noted that there is a section for                                                                      
disciplinary sanctions and prohibited acts for audiologists, which                                                              
leads her to believe that they might need to be reflected in the                                                                
title of the bill as well.                                                                                                      
                                                                                                                                
                                                                                                                                
MS. SWENSEN replied the speech/language pathologists are being                                                                  
added to the audiologist statute.  It doesn't affect the                                                                        
audiologists.  Furthermore, as indicated earlier, many therapists                                                               
are dually certified.                                                                                                           
                                                                                                                                
Number 0758                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG pointed out that Sections 8 and 9, of the work                                                                
draft, are different; therefore, the bill drafter could argue a                                                                 
title change is not necessary.                                                                                                  
                                                                                                                                
REPRESENTATIVE CISSNA asked whether there is any place in the bill                                                              
that makes for inconsistencies since a person can be dually                                                                     
licensed.                                                                                                                       
                                                                                                                                
REPRESENTATIVE BUNDE replied, "No."  A person needs to meet the                                                                 
requirements for licensure in each area.                                                                                        
                                                                                                                                
REPRESENTATIVE CISSNA asked whether they would pay a double fee.                                                                
                                                                                                                                
MS. REARDON replied, "Yes."  They would be treated separately; they                                                             
would have to pay both fees.                                                                                                    
                                                                                                                                
Number 0822                                                                                                                     
                                                                                                                                
REPRESENTATIVE MURKOWSKI asked why there is a difference between                                                                
the grounds for dismissal for audiologists and speech/language                                                                  
pathologists.  She specifically referred to the inclusion of                                                                    
paragraphs (2), (3) and (4) [Section 9], of the work draft.                                                                     
                                                                                                                                
REPRESENTATIVE BUNDE replied the bill simply amends speech/language                                                             
pathologists into the audiologist statute.  He has not investigated                                                             
into whether or not there should be changes made to the audiologist                                                             
statute as well.                                                                                                                
                                                                                                                                
REPRESENTATIVE MURKOWSKI noted that she is simply wondering whether                                                             
there would be a problem within the industry since they "swap"                                                                  
licenses.                                                                                                                       
                                                                                                                                
MS. SWENSEN reiterated that the bill is simply adding                                                                           
speech/language pathologists into the audiologist statute, and from                                                             
what she has heard from the association it wouldn't create a                                                                    
conflict...                                                                                                                     
                                                                                                                                
MS. REARDON interjected and stated the language probably came from                                                              
a national organization.  She has never heard of a license being                                                                
bartered in Alaska before.                                                                                                      
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Reardon whether she has an amendment to                                                             
combine the audiologists and pathologists to help lower their                                                                   
licensing fees.                                                                                                                 
                                                                                                                                
MS. REARDON replied licensing fees are less volatile if there is a                                                              
larger number of licensees.  At this point in time, the division                                                                
expects about 25 individuals to be licensed as a speech/language                                                                
pathologist, while currently there are 68 individuals licensed as                                                               
audiologists.  Although it wouldn't solve the problem entirely, it                                                              
would be better financially for the division to track 100 licensees                                                             
in one program; it helps to spread the cost in the "spiked" years.                                                              
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Reardon whether anything needs to be                                                                
done in statute to accomplish that goal.                                                                                        
                                                                                                                                
MS. REARDON replied yes, but there is an interest to do that in the                                                             
[House] Finance Committee.                                                                                                      
                                                                                                                                
REPRESENTATIVE BUNDE asserted that he would prefer to do that in                                                                
the [House] Finance [Committee]; it would give him a chance to                                                                  
spend more time on it.                                                                                                          
                                                                                                                                
MS. REARDON further stated that something similar was done when                                                                 
the landscape architects were licensed a few years ago.  She cited                                                              
that there were only going to be about 50 landscape architects so                                                               
language was included in statute to pool their licensing fees with                                                              
the architects, engineers and landscape surveyors.                                                                              
                                                                                                                                
Number 1015                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG said it's the purview of this committee to make                                                               
that type of change and to inquire as to whether the audiologists                                                               
want to be put in that type of position since there is risk                                                                     
involved in the "spiked" years.                                                                                                 
                                                                                                                                
REPRESENTATIVE BUNDE noted that the audiologists have not been                                                                  
consulted, which is why he needs more time.  Representative Bunde                                                               
asked Ms. Roberts whether there is a state audiologist society.                                                                 
                                                                                                                                
MS. ROBERTS replied the audiologists and speech/language                                                                        
pathologists are part of the same association.                                                                                  
                                                                                                                                
CHAIRMAN ROKEBERG asked Ms. Roberts whether she believes combining                                                              
the licensing fee amongst the two professions would create a                                                                    
problem.                                                                                                                        
                                                                                                                                
MS. ROBERTS replied she would have to take that issue back to the                                                               
association and notify the audiologists before she could reply.                                                                 
                                                                                                                                
CHAIRMAN ROKEBERG indicated that is what Representative Bunde would                                                             
like her to do.                                                                                                                 
                                                                                                                                
MS. ROBERTS said she would like to have some information to present                                                             
to the audiologists as it relates to money.                                                                                     
                                                                                                                                
MS. SWENSEN pointed out that she received the fiscal note only a                                                                
few days ago at which time she learned how high the fees were                                                                   
projected, which is another reason more time is needed to notify                                                                
those involved.                                                                                                                 
                                                                                                                                
CHAIRMAN ROKEBERG stated that since this is a financial issue he is                                                             
willing to move the bill on to the [House] Finance Committee with                                                               
the provision that the bill sponsor does the right thing, and that                                                              
the committee members concur with that right thing.                                                                             
                                                                                                                                
Number 1215                                                                                                                     
                                                                                                                                
REPRESENTATIVE MURKOWSKI asked whether an individual who is working                                                             
for a school district can use the title speech/language                                                                         
pathologist.                                                                                                                    
                                                                                                                                
REPRESENTATIVE BUNDE replied they are often hired as                                                                            
speech-language-hearing pathologists.                                                                                           
                                                                                                                                
Number 1255                                                                                                                     
                                                                                                                                
CHAIRMAN ROKEBERG announced that there are four amendments to be                                                                
discussed.                                                                                                                      
                                                                                                                                
CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 1                                                                 
that would clarify the loss of one's CCC as grounds for mandatory                                                               
revocation.  There being no objection, it was so ordered.                                                                       
                                                                                                                                
CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 2                                                                 
that would change the effective date to October 1, 2000, thereby                                                                
adding 90 days.  There being no objection, it was so ordered.                                                                   
                                                                                                                                
CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 3                                                                 
that would give permission to the department to begin developing                                                                
regulations prior to the effective date of the bill.  There being                                                               
no objection, it was so ordered.                                                                                                
                                                                                                                                
CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 4                                                                 
that would delete the language, "consistent with the accepted                                                                   
standards and code of ethics of the individual's profession," on                                                                
page 7, lines 7-8, of the work draft.  There being no objection, it                                                             
was so ordered.                                                                                                                 
                                                                                                                                
Number 1430                                                                                                                     
                                                                                                                                
REPRESENTATIVE HARRIS made a motion to move CSHB 105, Version                                                                   
1-LS0340\H, Lauterbach, 1/20/00, as amended, from the committee                                                                 
with individual recommendations and the attached fiscal note.                                                                   
There being no objection, CSHB 105(L&C) so moved from the House                                                                 
Labor and Commerce Standing Committee.                                                                                          
                                                                                                                                
ADJOURNMENT                                                                                                                     
                                                                                                                                
There being no further business before the committee, Chairman                                                                  
Rokeberg adjourned the House Labor and Commerce Standing Committee                                                              
meeting at 4:42 p.m.                                                                                                            

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