SB 118-MEDICAID REIMBURSEMENT FOR FAMILY THERAPY  2:05:21 PM CHAIR DAVIS stated that SB 118 was before the committee. CELESTE HODGE, staff, Senator Bettye Davis, sponsor of SB 118, introduced the bill. She read from the following sponsor statement: SB 118 is a simple bill that adds counseling services provided by a licensed marital and family therapist to the list of optional services covered by the Medical Assistance Program in the state of Alaska. Under current Alaska law, licensed marital and family therapists are not eligible to receive direct reimbursement for services provided to Medicaid- eligible clients. Community behavioral health service providers and mental health physicians' clinics that are enrolled with the Medicaid program and employ or contract with licensed family and medical therapists may receive Medicaid reimbursement for those services. The Department of Health and Social Services will pay for behavioral health services provided by a mental health physician's clinic, only if the services are for treatment and a diagnosable mental health disorder and the services are provided by a psychiatrist or by one of the following licensed professionals who work under the direct supervision of the psychiatrist. Those professional individuals include psychologists, psychological associates, clinical social workers, physician assistants, advanced nurse practitioners, psychiatric nursing clinical specialists, marital and family therapist, or professional counselors. For community behavior health service providers, clinic services must be provided by a member of the community behavior health service provider's staff who is a physician, a physician's assistant, advanced nurse practitioner, or mental health professional clinician under the general direction of a physician. Otherwise, the only independent providers who are eligible to bill directly for Medicaid behavioral health services are licensed psychologists and physicians. According to the Kaiser Family Foundation, about 47 percent of Alaska's population, or 334,975 are living in mental health professional shortage areas. Of that group, Kaiser estimates that over 38 percent are under served. In September of 2011, the Alaska Primary Care Association issued a resolution supporting Medicaid licensed marriage and family therapists, among others, in order to address the shortage of mental health providers and to improve access to behavioral health services in the state. SENATOR DAVIS opened public testimony. 2:08:35 PM KEN MCCARTY, Marriage and Family Therapist, spoke in favor of SB 118. He discussed the lack of family therapists in the state. He described some of the frustrations from this issue and shared examples in Kodiak, Barrow, and Nome. He explained that American Family Therapists can provide mental health work and substance abuse treatment. Adding them to the list under Title 47 would give the state more resources to provide for community needs. 2:11:20 PM MICHAEL WEINGARTEN, Marriage and Family Therapist, testified in support of SB 118. He shared his experience with all types of clients. He related that very few Medicaid clients show up for counseling without a referral from some agency, person, or court. Many children in residential treatment are required to have family treatment. Most Medicaid patients show up for treatment because they must. He spoke in favor of independent therapists being included on the list of providers, as included in this bill. 2:17:16 PM JANA MINER-COLLINS, Marriage and Family Therapist, testified in support of SB 118. She spoke of the possibility of having to turn Medicaid clients away because of the loss of a physician who provided those services. Those clients will not be able to receive services because therapists are not currently listed as Medicaid providers. LINDA KING, President, Alaska Association of Marriage and Family Therapy, testified in support of SB 118. She related her experience in a clinic that turns away Medicaid clients because therapists are not currently considered providers. She reported that Alaska has a high number of child neglect and abuse cases, and there is a problem with lack of therapy services for these children, leading to a cycle of abuse. She reported that most states allow licensed marital and family therapists to be included as Medicaid providers. 2:22:52 PM CHAIR DAVIS requested someone from the Department of Health and Social Services to testify on the bill. JON SHERWOOD, Medicaid Special Projects, Office of the Commissioner, Department of Health and Social Services, provided information about a fiscal note for SB 118 regarding medical assistance administration. He related information about the changes to the claims payment system. He estimated a one-time cost of $275,000 of which $68,800 would be general funds. CHAIR DAVIS asked if family therapists would be an asset to the state under Medicaid. 2:25:17 PM TERI KEKLAK, Section Manager, Program Integrity Section Division, Department of Behavioral Health, Department of Health and Social Services, provided information related to SB 118. She reported that the division is neutral on the bill. She explained that when a new provider is added to the Medicaid system, there are issues to work on before implementation of a new service category can be added. She stated that adding a new provider to Medicaid improves access to clients. CHAIR DAVIS said the bill would be going to Senate Finance next. She opined that the bill was needed. She asked committee members for their opinions. 2:27:36 PM SENATOR DYSON shared that he did not have a conflict of interest now that his wife has retired as a licensed marital and family therapist. DIXIE HOOD, Marriage and Family Therapist, urged the committee to support SB 118. She said she the bill would allow for more options for patients seeking counseling services, especially in areas with limited mental health providers. She opined that including therapists under Medicaid would save money from no longer having psychiatrists and psychologists travel to provide those services. Passage of SB 118 would also provide fair reimbursement to therapists. She shared her experience of providing a sliding fee scale for Medicaid patients in order to serve them. She spoke of the qualifications to be a licensed therapist, her wide range of experience, and the unfairness of not being able to be reimbursed for Medicaid. 2:35:12 PM CHAIR DAVIS thanked Ms. Hood for her work. She closed public testimony. CHAIR DAVIS stated that she felt the bill was needed. SENATOR EGAN moved to report SB 118 from committee with individual recommendations and the accompanying fiscal notes. There being no objection, SB 118 was reported from the Senate Health and Social Services Standing Committee.