HOUSE BILL NO. 126 "An Act relating to the Board of Professional Counselors; and relating to licensing of associate counselors." 10:04:35 AM REPRESENTATIVE STANLEY WRIGHT, SPONSOR, introduced HB 126 and appreciated the committee for hearing the bill. He explained that every year, the University of Alaska (UA) behavioral health programs graduated a high number of qualified and knowledgeable students ready to begin careers in the behavioral health field. The current system lacked the structure and clarity necessary for individuals to make a smooth transition from post-graduate student to fully licensed professional counselor. The obstacles not only delayed the entry of qualified professionals into the workforce, but also perpetuated a long-standing waitlist of Alaskans in dire need of mental health services. By introducing the role of Associate Counselor, the bill would create a clear and structured pathway for graduates to enter the field, receive the necessary supervision, and progress towards becoming fully licensed. The tiered approach proposed in the bill would align the state with the national standards and would demonstrate that the state's professionals were well-trained as well as ethically bound and effective in the practice of counseling. He asked his staff to provide her comments. 10:06:51 AM RACHAEL GUNN, STAFF, REPRESENTATIVE STANLEY WRIGHT, relayed that the legislation was crafted with a dual focus: to enrich the full licensure of post-graduate counseling interns who were already serving Alaskans, and to elevate the support system for interns during the training phase. There was currently limited guidance and support available to students who had finished their education in behavioral health but had not yet completed all necessary requirements to become fully licensed professional counselors. Ms. Gunn relayed that HB 126 would introduce the Associate Counselor program which would be developed by the Board of Professional Counselors in addition to criteria for supervisor certification. By establishing clear and streamlined pathways from completion of the graduate program in the mental health field to full licensure, the bill would remove unnecessary barriers that often delayed the professional development of aspiring counselors. The bill would uphold the training and supervision requirements already in place and ensure that every professional entering the field was well-prepared and qualified. The bill would also address access to health care, which was one of the most pressing issues in the health care field. She added that HB 126 would bring the state in line with over 65 percent of states that had already adopted a tiered system for licensure. The alignment would standardize the approach to mental health care as well as enforce the state's commitment to adopting best practices that had been recognized and implemented across the country. Representative Josephson asked whether the bill defined the term "Associate Counselor." He asked if it was under the board's purview to define the term. Ms. Gunn deferred the question to an invited testifier representing the board. 10:09:31 AM RACHEL BUDDIN-YOUNG, MEMBER, ALASKA STATE BOARD FOR LICENSED PROFESSIONAL COUNSELORS, EAGLE RIVER (via teleconference), asked for the question to be repeated. Representative Josephson repeated his question. Ms. Buddin-Young responded that there would be pre- requisites in order to apply to become an associate counselor. The definition would be in regulation if it was not in statute and would apply to individuals who were considered "pre-independent licensed." Representative Josephson noted the bill called for the repealing of the supervisory certification statute. He asked what the reason was for the repeal. Ms. Buddin-Young responded that currently, there was no requirement for continuing education or reapplication after an individual received a supervisory license. The board would prefer the license to be renewable instead of a "one- and-done" license in order to be in line with the rest of the nation. During the preliminary discussions around the legislation, a recommendation was made to the board that the requirement be moved to regulation rather than statute. Co-Chair Foster suggested that Ms. Buddin-Young provide her invited testimony. 10:11:54 AM Ms. Buddin-Young stated that the bill would provide necessary assistance and support for new mental health counselors. Currently, post-graduate counselors were in a "no man's land" because there was a lack of structure and support following graduation. All of the responsibilities fell on the supervisors of the new counselors. The bill would provide more support to the supervisor, including support from the board and a more streamlined process. As a result, individuals would receive faster mental health care because intern counselors would have more support during the process of becoming licensed. The bill would also increase quality of care because the board would provide more support and guidance to prospective counselors. Representative Hannan asked Ms. Buddin-Young what the academic preparations were for intern counselors. She asked for more information on the timeline and training requirements before an individual could become fully licensed. Ms. Buddin-Young responded that the requirement for licensure would not change. The requirements for full licensure included obtaining a master's degree in a field related to counseling, passing a national certification exam, and completing 3,000 hours of work experience under a qualified supervisor. An individual could not apply for full licensure before all of the requirements were met. The associate license proposed by the bill would provide post- graduate intern counselors assistance and governance during the required 3,000 hours of work experience. There was presently no support for counselors in training. The bill would add to the current requirements and allow for more structure and guidance. Representative Hannan asked how long it typically took for an individual to accumulate the required 3,000 hours. Ms. Buddin-Young replied that the minimum amount of time was two years, which was a standard time frame to complete the hours. Students typically took between two and four years depending on availability. Representative Hannan asked if the bill would allow the associate counselors to bill services through insurance, Medicare, and Medicaid, or if there would be a need for separate legislation. Ms. Buddin-Young replied that insurance billing practices were different from company to company. There were some insurance companies that would allow associate counselors to bill insurance. Some companies required that the supervisor's license be included in the billing process. Each agency had its own rules and regulations, but there would be some insurance companies that would accept billing from counselors in training. Representative Hannan asked for clarification that some insurance companies would not accept billing from associate counselors. Ms. Buddin-Young responded in the affirmative. She reiterated that some insurance agencies would accept it and others would not. 10:16:24 AM Representative Josephson asked if there was confidence that the statute repealing the certification would be largely replaced. For example, the statute required that a supervisor would have at least five years of counseling experience. He asked for clarification that there would be similar requirements and regulations in lieu of the statute. Ms. Buddin-Young responded in the affirmative. She added that the board would likely change the requirement to five years post-license experience. Currently, the time period during which post-graduate counselors in training were acquiring the 3,000 hours of work experience was counted towards the five years of counseling experience. Nationally, the five years of experience were required to be post-licensure in order to qualify to become a supervisor. The requirements would be similar apart from the aforementioned change to a renewable license. She explained that the requirements would be fine-tuned but not changed in a significant way. Representative Josephson noted that the bill repealed language that would allow supervision to occur via telephonic or electronic means if an individual was in a remote location. He asked why it would be prudent to repeal the language. Ms. Buddin-Young replied that the board wanted to encourage individuals to engage supervisors through electronic means; however, the board wanted to prevent situations in which a supervisor and trainee would never meet face-to-face. The goal was to implement safeguards to ensure that individuals in remote locations were getting the best possible supervisory experience. 10:19:29 AM Co-Chair Foster asked the sponsor if he had any closing comments. Representative Wright shared that coming back from military service was difficult, and the bill was personal to him. The bill would help people receive necessary mental health care quickly. Co-Chair Foster set an amendment deadline for Tuesday, February 13, 2024, at 5:00 p.m. HB 126 was HEARD and HELD in committee for further consideration. 10:21:06 AM AT EASE 10:23:25 AM RECONVENED