Legislature(2021 - 2022)BELTZ 105 (TSBldg)
01/26/2022 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB99 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 127 | TELECONFERENCED | |
| *+ | HB 99 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
January 26, 2022
1:33 p.m.
MEMBERS PRESENT
Senator Mia Costello, Chair
Senator Joshua Revak, Vice Chair
Senator Peter Micciche
Senator Gary Stevens
Senator Elvi Gray-Jackson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 99
"An Act relating to the State Physical Therapy and Occupational
Therapy Board; relating to the practice of physical therapy; and
relating to the practice of occupational therapy."
- MOVED HB 99 OUT OF COMMITTEE
SENATE BILL NO. 127
"An Act establishing a private cause of action for unfair claim
settlement practices; and amending Rules 79 and 82, Alaska Rules
of Civil Procedure."
- BILL HEARING CANCELED
PREVIOUS COMMITTEE ACTION
BILL: HB 99
SHORT TITLE: PHYSICAL/OCCUPATIONAL THERAPY BD/PRACTICE
SPONSOR(s): REPRESENTATIVE(s) CLAMAN
02/18/21 (H) READ THE FIRST TIME - REFERRALS
02/18/21 (H) HSS, L&C
02/19/21 (H) HSS REFERRAL REMOVED
02/19/21 (H) FIN REFERRAL ADDED AFTER L&C
02/19/21 (H) BILL REPRINTED
03/05/21 (H) L&C AT 3:15 PM BARNES 124
03/05/21 (H) Heard & Held
03/05/21 (H) MINUTE(L&C)
03/12/21 (H) L&C AT 3:15 PM BARNES 124
03/12/21 (H) Moved HB 99 Out of Committee
03/12/21 (H) MINUTE(L&C)
03/15/21 (H) L&C RPT 6DP
03/15/21 (H) DP: SNYDER, NELSON, MCCARTY, SCHRAGE,
KAUFMAN, SPOHNHOLZ
03/26/21 (H) FIN AT 2:00 PM ADAMS 519
03/26/21 (H) <Bill Hearing Canceled>
04/09/21 (H) FIN AT 9:00 AM ADAMS 519
04/09/21 (H) Heard & Held
04/09/21 (H) MINUTE(FIN)
04/12/21 (H) FIN RPT 6DP 2NR
04/12/21 (H) DP: ORTIZ, EDGMON, LEBON, THOMPSON,
MERRICK, FOSTER
04/12/21 (H) NR: WOOL, JOSEPHSON
04/12/21 (H) FIN AT 9:00 AM ADAMS 519
04/12/21 (H) Moved HB 99 Out of Committee
04/12/21 (H) MINUTE(FIN)
05/18/21 (H) TRANSMITTED TO (S)
05/18/21 (H) VERSION: HB 99
05/19/21 (S) READ THE FIRST TIME - REFERRALS
05/19/21 (S) L&C, FIN
01/26/22 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
WITNESS REGISTER
REPRESENTATIVE MATT CLAMAN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 99.
LIZZIE KUBITZ, Staff
Representative Matt Claman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sectional analysis for HB 99
on behalf of the sponsor.
ALEC G. KAY, Alaska President
American Physical Therapy Association;
President, United Physical Therapy
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 99.
LEEANNE CARROTHERS, Director
Allied Health at UAA;
Alaska Government Affairs Liaison
Alaska Physical Therapy Association
Anchorage, Alaska
POSITION STATEMENT: Answered questions and provided supporting
information during the hearing on HB 99.
SARA CHAMBERS, Director
Division of Corporations, Business, and Professional Licensing
Department of Commerce, Community and Economic Development
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
99.
KEITH POORBAUGH PT, ScD, Chair
State Physical Therapy and Operational Therapy Board
Wasilla, Alaska
POSITION STATEMENT: Testified in support of HB 99.
ACTION NARRATIVE
1:33:23 PM
CHAIR MIA COSTELLO called the Senate Labor and Commerce Standing
Committee meeting to order at 1:33 p.m. Present at the call to
order were Senators Gray Jackson, Revak, Stevens, and Chair
Costello. Senator Micciche arrived during the course of the
meeting.
HB 99-PHYSICAL/OCCUPATIONAL THERAPY BD/PRACTICE
1:34:00 PM
CHAIR COSTELLO announced the consideration of HOUSE BILL NO. 99
"An Act relating to the State Physical Therapy and Occupational
Therapy Board; relating to the practice of physical therapy; and
relating to the practice of occupational therapy."
1:34:43 PM
REPRESENTATIVE MATT CLAMAN, Alaska State Legislature, Juneau,
Alaska, Sponsor of HB 99, read the following prepared testimony
to introduce the legislation:
Good afternoon members of the Committee, for the
record, my name is Matt Claman, and I am the State
Representative for House District 21 in West
Anchorage. First, I would like to thank you for
hearing House Bill 99. We often talk of making Alaska
open and ready for business. House Bill 99 makes sure
we're open and ready for the business of providing
physical and occupational therapy.
My office introduced House Bill 99 at the request of
the Alaska Physical and Occupational Therapy
Associations. House Bill 99 amends the governing
statutes for physical therapists, physical therapy
assistants, occupational therapists and occupational
therapy assistants practicing in Alaska. These changes
are designed to bring Alaska statutes in line with
national standards and terminology, and overall make
the administrative experience of these professionals
smoother and up to date.
1:35:39 PM
House Bill 99 is supported by the State Physical
Therapy and Occupational Therapy Board, which believes
HB 99 will help the Board in its work to protect the
public. A letter stating that support is in your bill
packet.
Currently, physical therapists, physical therapy
assistants, occupational therapists, and occupational
therapy assistants, are represented by the State
Physical Therapy and Occupational Therapy Board. This
board is made up of one physician, three Physical
Therapists, two Occupational Therapists, and one
member of the public. House Bill 99 removes the
physician from this board, and replaces them with
another occupational therapist, thereby balancing the
representation of the professions on the board. There
is good reason for this. When this statute was
originally written, the work of Physical and
Occupational therapists required referral by a
physician. This has not been the case in Alaska for
more than thirty years.
House Bill 99 also enables the board to discipline a
therapist who commits infractions under AS 08.84.120,
such as conviction of a felony, gross negligence, or
abuse of alcohol. Currently the board has the ability
to revoke or deny a license based on infractions, but
has no ability to discipline.
Additionally, House Bill 99 clarifies the language in
the requirements for those therapists who received
their training outside of the U.S., ensuring that
their training is equivalent to a U.S professional
Physical Therapy Training program, and also exempting
therapists trained in an English language program from
having to take an English proficiency test.
Furthermore, this bill updates language in Alaska
Statute that references an accrediting entity that no
longer exists, and makes the language more general,
allowing the state board to designate the appropriate
accrediting entity as needed. Several other updates to
terminology are made to update the language.
House Bill 99 does not constitute a restructuring of
the relevant statute, but it contains a number of
long-awaited changes that will make it easier for
professionals to do business in Alaska. I'll pass you
off now to Lizzie Kubitz, who can walk you through the
sectional analysis.
1:37:47 PM
LIZZIE KUBITZ, Staff, Representative Matt Claman, Alaska State
Legislature, Juneau, Alaska, presented the sectional analysis
for HB 99 on behalf of the sponsor. It read as follows:
[Original punctuation provided.]
Section 1
AS 08.84.010. Creation and membership of the board.
Removes the seat for a physician and balances out the
board with 3 physical therapists or physical therapy
assistants and 3 occupational therapists or
occupational therapy assistants along with one public
member, to make up the 7-member board. It also changes
the term "physical therapy assistant" to "physical
therapist assistant" in this section and throughout
the entire statute. This change is to conform to the
industry title used nationally.
Section 2
AS 08.84.030. Qualifications for licensing.
Allows the board to have broader authority over what
entities will have accreditation oversight over
physical therapy & occupational therapy education
programs. Some of the accrediting entities listed in
statute are now either renamed or no longer exist,
making that statute obsolete.
Section 2 removes language from the statute relating
to additional supervised field work that occupational
therapists must complete as these requirements are
covered by the accrediting bodies.
Section 3
AS 08.84.032. Foreign-educated applicants.
Changes the section headline from "trained" to
ducated." New language is added that requires
foreign-educated physical therapist or physical
therapy assistant students to have attended a
"substantially" equivalent educational program that is
accredited by a U.S. accreditation entity that has
been approved by the board. Outdated and obsolete
language is removed that can be found on page 4, lines
3 -9 of this bill.
Added to subsection (3) of this section is language
that would require that a physical therapist or
physical therapist assistant pass a test demonstrating
competency of the English language only if their
program was taught in a foreign language. Subsection
(4) requires that a foreign-educated applicant is a
legal alien or a U.S. citizen. Subsection (7) requires
them to pay the required fee and meet any other
qualifications for licensure set by the board under
08.84.010(b).
All the above changes in Section 3 are replicated for
occupational therapists or occupational therapy
assistants on page 4, lines 27-31 and over to page 5,
lines 1-22.
1:39:36 PM
Section 4
AS 08.84.060. Licensure by acceptance of credentials.
Makes conforming terminology changes.
Section 5
AS 08.84.065(c). Temporary changes.
Makes conforming terminology changes.
Section 6
AS 08.84.075(b). Limited permit.
Makes conforming terminology changes.
Section 7
AS 08.84.075(c). Limited permit.
Changes language that would now require that a limited
permit is valid for 120 consecutive days.
Section 8
AS 08.84.075(d). Limited permit.
Allows only one limited permit per 12-month period.
Section 9
AS 08.84.090. Licensure.
Updates licensure terminology.
1:40:01 PM
Section 10
AS 08.84.120(a). Refusal, revocation, and suspension
of license. Adds disciplinary action as a possibility
to actions a board might consider for an infraction of
their licensure and updates terminology in item (7)
and states in (9) that failure to comply with the law
or regulations or order of the board might result in
disciplinary action or suspension of a license.
Section 11
AS 08.04.130(a). False claim of license prohibited.
Adds updated credentialing and terminology.
Section 12
AS 08.84.130(b). False claim of license prohibited.
Updates terminology.
Section 13
AS 08.84.190. Definitions.
Adds a new paragraph defining the updated term
"physical therapist assistant."
1:40:31 PM
Section 14
AS 11.41.470(1). Definitions.
Updates definitions in criminal law/sexual assault
statute.
Section 15
AS 47.17.290(14). Definitions.
Updates terminology under definitions in child
protection statute. 3
Section 16
AS 08.84.190(7). Definitions.
Repeals subsection (7), which is the definition using
outdated term of physical therapy assistant; according
to Leg. Legal, when the actual "term" used for the
definition is being changed, the entire citing must be
repealed. The new definition is set out on page 8,
Section 13, lines 11-14.
Section 17
Applicability
Sets out the applicability clauses for licensure for
sections 2 and 3 of this Act and for sections 7 and 8.
Section 18
Uncodified law
Transition language for the board vacancy and
appointments for the PT/OT board, and states that the
changes do not apply to current licensees until it is
time for their licensure renewal and then all changes
to the law will apply
1:41:39 PM
CHAIR COSTELLO asked if the physician seat would fall open
immediately if the bill were to pass, so an occupational
therapist could be appointed or if the physician in that seat
would fill out their term.
REPRESENTATIVE CLAMAN deferred to Ms. Kubitz.
MS. KUBITZ said she would defer to either Alec Kay or Sara
Chambers, or she would follow up with the information.
1:42:38 PM
SENATOR GRAY-JACKSON asked the sponsor if he said that referrals
from a doctor have not been required for 30 years.
REPRESENTATIVE CLAMAN replied that is correct.
SENATOR GRAY-JACKSON asked if it is insurance companies that
require referrals.
REPRESENTATIVE CLAMAN related a personal experience to answer
the question. His chiropractor suggested he see a physical
therapist and that he could schedule an appointment directly
because insurance companies do not require a referral. He made
the appointment and the insurance company paid the claim without
question.
SENATOR GRAY-JACKSON related that she was told she needed a
doctor's referral to make a PT appointment.
REPRESENTATIVE CLAMAN said that for many years he was under the
impression that a doctor's referral was necessary to make an
appointment with a physical therapist, but it is not necessary.
SENATOR GRAY-JACKSON commented that now she knows the rules.
1:44:34 PM
SENATOR STEVENS commented that he visited a physical therapist
yesterday with a note from his doctor. He asked if that is the
only rationale for removing the physician seat from the board or
if there has been a problem having a physician on the board.
REPRESENTATIVE CLAMAN replied the rationale is to create balance
on the board between occupational and physical therapists. Also,
the level of training for physical therapists has increased to
the Ph.D. level, which was not the case when the statute was
written. He deferred to Mr. Kay for more detail.
SENATOR STEVENS asked for an explanation of the difference
between occupational and physical therapy.
REPRESENTATIVE CLAMAN replied they are separate fields, and he
would defer to Mr. Kay for the distinction.
CHAIR COSTELLO turned to invited testimony. She asked Mr. Kay to
respond to the questions he heard and explain the medical
training needed to become a physical therapist and occupational
therapist.
1:46:56 PM
ALEC G. KAY, Alaska President, American Physical Therapy
Association; President, United Physical Therapy, Anchorage,
Alaska, explained that when the practice act was established
about 50 years ago, the profession of physical therapy was under
the supervision of the American Medical Association. Since then
PT has evolved into its own profession. He agreed with the
sponsor that the education requirements have also evolved such
that all physical therapists now must hold a doctoral degree.
The profession is practicing more autonomously now as evidenced
by the direct access the committee was discussing.
To Senator Gray Jackson's question, he explained that some
government sponsored insurance such as Medicare and Medicaid,
some unions, and some others require a doctor's referral to see
a physical therapist, but the law does not require a referral.
He posited that some physical therapy offices may blanket ask
patients to bring a referral to make sure they are paid timely.
He related his experience that in the 30 years he has been
practicing, the licensing board either has not had a physician
in the physician seat or the physician in the seat was not
engaged. He acknowledged he was not familiar with the physician
in the seat currently. He opined that replacing the physician
seat with an occupational therapist or occupational therapist
assistant would be more useful to the board's mission.
1:49:47 PM
SENATOR STEVENS asked for an explanation of the difference
between an occupational therapist and a physical therapist.
MR. KAY deferred to Dr. Carrothers. He added that another reason
to support the bill is that it gives the board some disciplinary
control. This will be helpful because there are many levels of
potential infraction and not all warrant taking the license
away.
CHAIR COSTELLO asked how many patients he sees who do not have a
doctor's referral.
MR. KAY replied 60 percent arrive without a referral from a
doctor; 35 percent are Medicare or Medicaid and 5 percent of
people with insurance have a doctor's referral.
CHAIR COSTELLO asked if he is allowed to offer sports physicals.
MR. KAY replied that he can do functional assessments but it is
not within the purview of a physical therapist to assess for
underlying cardiac issues. He acknowledged that school districts
have different policies.
1:52:37 PM
LEEANNE CARROTHERS, Director, Allied Health at UAA; Alaska
Government Affairs Liaison for the Alaska Physical Therapy
Association, Anchorage, Alaska, stated that her testimony is
related to her role in the Physical Therapy Association, not the
university.
1:53:33 PM
SENATOR MICCICHE joined the committee.
MS. CARROTHERS responded to the question about the difference
between the professions by explaining that the paths are
different but both professions work to help people regain skills
to return to daily living. Physical therapists work on gross
motor skills such as standing up and walking from point to
point, whereas occupational therapists focus on fine motor
skills involved in activities such as dressing, grooming, and
bathing. OTs also work on cognitive rehabilitation after an
illness or injury when people have difficulty with such things
as thinking and problem solving. She acknowledged that PTs work
on cognitive rehabilitation as well but more so for OTs.
SENATOR STEVENS asked if OTs primarily focus on getting people
back to work.
MS. CARROTHERS explained that in the definition of "occupational
therapy" occupation refers to activities and chores that people
need to do in their lives, whether it is paid or unpaid.
Activities of daily living include things like getting up,
getting dressed, and getting groomed and chores of daily living
include things like cooking and feeding. She said there is a lot
of overlap between the professions but two distinct bodies of
knowledge are required.
CHAIR COSTELLO asked Sara Chambers, if the bill were to pass,
whether the governor would be able to immediately appoint an
occupational therapist to what is now the physician seat or if
the physician's term would have to run its course.
1:57:21 PM
SARA CHAMBERS, Director, Division of Corporations, Business, and
Professional Licensing, Department of Commerce, Community and
Economic Development, Juneau, Alaska, stated that Section 18 on
page 9 has transition language that allows the current physician
to continue to serve his term. She relayed that the physician
currently on the board is very active and engaged.
CHAIR COSTELLO asked when the term for the physician seat
expires. She also noted that the language on page 9, line 17,
says, "may serve," which provides some flexibility.
1:59:07 PM
MS. CHAMBERS answered that the physician was reappointed last
year so his current term ends March 2025.
1:59:23 PM
CHAIR COSTELLO opened public testimony on HB 99.
1:59:37 PM
KEITH POORBAUGH PT, ScD, Chair, State Physical Therapy and
Operational Therapy Board, Wasilla, Alaska, said the physician
currently serving will be missed, but it is important to have
equal PT and OT representation on the board. He agreed with
previous testimony that the training, education, and expertise
for these professions has increased since the statute was
written. These advances warrant having a board that is
representative of the professions, he said. The proposed changes
will align with other states and allow direct access to PTs and
OTs without a physician referral. He noted that the provision to
allow the board broader scope to address disciplinary action
also reflects the advances in the professions. On behalf of the
board, he stated support for HB 99.
2:01:45 PM
SENATOR STEVENS asked for the difference in education and
training requirements between PT and OT professions.
DR. POORBAUGH answered that there has been a developing
separation of the two professions over last 30 years. He said
the greatest distinction is that PTs are focused on movement and
function, and OTs are focused on activities and fine motor
skills. The training is similar for basic anatomy and physiology
but diverse for aspects of treatment. He acknowledged that the
professions work hand in hand.
SENATOR STEVENS said he appreciated the explanations.
2:03:57 PM
CHAIR COSTELLO found no one else wished to comment and closed
public testimony on HB 99.
2:04:09 PM
At ease
2:05:26 PM
CHAIR COSTELLO reconvened the meeting.
2:05:34 PM
SENATOR GRAY-JACKSON asked Ms. Chambers if there was a way to
appoint an [OT] now to achieve balance, and when the physician
term expires that seat goes away.
MS. CHAMBERS replied that adding a seat to the board would
require an amendment to the bill. As the chair noted, she said
the physician could resign and that position could be filled by
a person qualified under the bill. She suggested that is
probably the easiest way to move forward.
SENATOR GRAY-JACKSON said she raised the question because the
physician currently serving has been described as such an asset,
but she would defer to the committee.
CHAIR COSTELLO asked if this issue came up in the other body.
REPRESENTATIVE CLAMAN said no, and his sense is that if the bill
passes the physician will likely resign.
CHAIR COSTELLO said the state has over 200 boards and
commissions and she is always amazed at how much personal time
Alaskans devote to serving on these boards and commissions. She
thanked all the people who serve and said her support for the
legislation in no way reflects on the physician who is currently
serving. She publicly thanked that member.
SENATOR GRAY-JACKSON thanked that member and the members of all
the boards and commissions.
2:10:10 PM
SENATOR REVAK moved to report HB 99, work order 32-LS0506\A,
from committee with individual recommendations and attached
fiscal note(s).
CHAIR COSTELLO found no objection and HB 99 was reported from
the Senate Labor and Commerce Standing Committee.
2:10:52 PM
There being no further business to come before the committee,
Chair Costello adjourned the Senate Labor and Commerce Standing
Committee meeting at 2:10 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 99 Sponsor Statement v. A - 1.26.22.pdf |
SL&C 1/26/2022 1:30:00 PM |
HB 99 |
| HB 99 Sectional Analysis v. A - 1.26.22.pdf |
SL&C 1/26/2022 1:30:00 PM |
HB 99 |
| HB 99 Fiscal Note 2360 - DCCED.pdf |
SL&C 1/26/2022 1:30:00 PM |
HB 99 |
| HB 99 Testimony - Received as of 1.25.22.pdf |
SL&C 1/26/2022 1:30:00 PM |
HB 99 |