HOUSE BILL NO 105 "An Act providing for the licensing of speech-language pathologists; and providing for an effective date." Vice Chair Bunde spoke in support of HB 105. The legislation was introduced at the request of speech-language therapists. He disclosed that he has practiced as a speech therapist, but is not currently practicing and would not be affected by the legislation. The legislation would require speech- language pathologists to obtain a license to practice in Alaska. Licensure would be dependent on certification by the American Speech-Language Hearing Association. He explained that there are about 25 private practitioners in Alaska that would be affected by the legislation. Alaska is one of only 6 states that do not require this protection. Vice Chair Bunde provided members with Amendment 1: Page 1, following line 6: Insert new bill sections to read: Sec. 2. AS 08.01.065(c) is amended to read: (c) Except as provided in (1) and (g) of this section, the department shall establish fee levels under (a) of this section so that the total amount of fees collected for an occupation approximately equals the actual regulatory costs for the occupation. The department shall annually review each fee level to determine whether the regulatory costs of each occupation are approximately equal to fee collections related to that occupation. If the review indicates that an occupation's fee collections and regulatory costs are not approximately equal, the department shall calculate fee adjustments and adopt regulations under (a) of this section to implement the revisions for the previous year under this subsection to the office of management and budget. If a board regulates an occupation covered by this chapter, the department shall consider the board's recommendations concerning the occupation's fee levels and regulatory costs before revising fee schedules to comply with this subsection. In this subsection, "regulatory costs" means costs of the department that are attributable to regulation of an occupation plus (1) all expenses of the board that regulates the occupation if the board regulates only one occupation; (2) the expenses of a board that are attributable to the occupation if the board regulates more than one occupation. Sec. 3. As 08.01.065 is amended by adding a new subsection to read: (g) Notwithstanding (c) of this section, the department shall establish fee levels under (a) of this section so that the total amount of fees collected by the department for all occupations regulated under AS 08.11 approximately equals the total regulatory costs of the department for all occupations regulated by the department under AS 08.11. The department shall set the fee levels for the issuance and renewal of licenses issued under AS 08.11 so that the fee levels are the same for all occupations regulated by the department under AS 08.11 . Renumber the following bill sections accordingly. Vice Chair Bunde noted that the fiscal note would be changed with the adoption of the amendment. Representative Grussendorf questioned why the profession should be regulated. Vice Chair Bunde responded that the level of competency is in question. He pointed out that individuals recovering from strokes could suffer from inappropriate services. Co-Chair Therriault asked if the legislation is proactive or reactive. Vice Chair Bunde noted that the providers requested the legislation. He referred to an instance where an individual was practicing without any experience or training in the field. The legislation is both proactive and reactive. People who need the services need assurance that quality service will be provided. Co-Chair Therriault asked how the legislation would impact current practitioners. Vice Chair Bunde observed that all of the 25 private practitioners would met the requirements. CATHERINE REARDON, DIRECTOR, DIVISION OF OCCUPATIONAL LICENSING, DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT provided information regarding the legislation. The Division of Occupational Licensing would administer the program without a licensing board. She thought that there might be one person in Homer practicing with a bachelor's degree that would be affected by the legislation. Representative Austerman asked if the legislation provided sufficient guidelines to administer the program. Ms. Reardon stated that the legislation is similar to the Audiology Licensing Program, administered by the Division. The Division would not have general regulation authority. The Division would have to administer the program from the direct language of the bill, except for in the temporary licensing sections. Representative Grussendorf asked if there have been problems with patients or clients. Ms. Reardon replied that she had not been approached by any clients or patients. She noted that other states license speech pathologists. The Division has received inquiries regarding licensing requirements from people entering the state. Co-Chair Therriault noted that the 25 practicing speech- language pathologists make a small pool. He noted that the amendment would broaden the field by adding 45 audiologists. Ms. Reardon spoke in support of merging the two groups. She noted that there is still a danger of volatile fees. Co-Chair Therriault questioned if the audiologists were aware that one legal action could drive the fees up substantially. Ms. Reardon stated that the fee structure was explained to Ms. Bunting. She acknowledged that increased fee costs could be difficult in the case of a serious legal action. Vices Chair Bunde stressed that the more people in the pool the lower the cost but the higher the risk. Ms. Reardon noted that the Division separated audiologists from hearing aide dealers due to their liability. Audiologists have not been difficult to regulate. She felt that a license denial appeal would be the most serious legal challenge. Co-Chair Therriault noted that speech pathologists working for school districts were exempted. Ms. Reardon clarified that employees of school districts are exempt. The majority of pathologists work for school districts. Co-Chair Therriault questioned if employees under contract would need to be licensed. Ms. Reardon affirmed that contract pathologists would need temporary or full licenses under the law. A temporary license would allow them to work for 60 days. Representative Austerman noted that the Division does not have the authority to do regulation. Their authority would come from statute. Ms. Reardon pointed out that "has not engaged in conduct that is a ground for imposing disciplinary sanctions under AS 08.11.085" would allow the Division to make a subjective decision. The Division could accuse a pathologist of performing incompetently in violation of one of the activities listed on page 5 of the legislation. The accused would have a due process right to a hearing. Any costs would be charged against the fee. She detailed costs that could incur. In response to a question by Representative Austerman, Ms. Reardon clarified that the 25 individuals that would be affected by the legislation are not practicing in school districts. Co-Chair Therriault reiterated questions for Ms. Bunting. SUSAN BUNTING, PRESIDENT, ALASKA SPEECH AND HEARING ASSOCIATION, HOMER testified via teleconference in support of HB 105. She stated that the Association is aware that fees will be charged and that there is a risk that additional costs could be incurred through litigation. She explained that the procedure for licensure of audiologists was started in 1986. Speech-language was not added at that time due to other concerns. There are only two other states that do not have requirements for speech-language pathologists in private practice. The legislation would be proactive. Representative G. Davis clarified that state regulations will not be drawn up because standards of the American Speech-Language Association would be adopted. He noted that adherence to the American Speech-Language Association standards is voluntary. Vice Chair Bunde clarified that certification in the American Speech-Language Association voluntary. Once an individual is certified they must comply with the standards. The legislation would make compliance mandatory. Vice Chair Bunde MOVED to ADOPT Amendment 1. Representative G. Davis OBJECTED for the purpose of discussion. Vice Chair Bunde explained that the amendment allows the Division of Occupational Licensing to combine audiologists and speech- language pathologists in their calculations for financial purposes. Ms. Reardon noted that "the department may impose by regulation additional limitations that it determines appropriate on a temporary license issued under this section." The Division only has regulation writing authority to govern temporary licenses. She explained that the Division could not write regulation to define grounds for sanctions under page 5. She added that fee setting is a regulation process. The Division has the general authority to set fees through regulation under other statutes. In response to a question by Representative Foster, Vice Chair Bunde noted that fees would be approximately $200 hundred dollars for the first year. In response to a question by Representative Austerman, Ms. Reardon interpreted the Division's regulation authority under the legislation to address only the contents of the bill and the fees that go with the bill. Representative Austerman expressed concern that there could be a broader interpretation. Co-Chair Therriault agreed with a narrow interpretation. Ms. Reardon recalled that the intent of the House Labor and Commerce Committee was to allow the Division to provide public notice fee regulations before the legislation takes effect. Vice Chair Bunde maintained that the regulation writing authority only applies to HB 105. Representative G. Davis WITHREW his objection. In response to a question by Representative Foster, Ms. Reardon explained that licenses would have to be renewed every two years. National certification would have to be demonstrated. Ms. Bunting discussed certification requirements. Continuing education is needed to maintain certification. Alaska does not require continuing education. She noted that classes are not available in Alaska. In response to a question by Representative Foster, Ms. Reardon stated that the state is not involved in maintaining standards. Ms. Bunting explained that examinations are offered two times a year in various places in the continental United States. Conference attendance is voluntary and is generated by the interests of the membership. Representative Foster questioned why the legislation does not cover speech-language practitioners working in school districts. Ms. Bunting noted that most individuals working in schools have masters' degree. Master degrees have on going education requirements. Ms. Reardon added that since the Department of Education and Early Development has master level requirements their addition to the legislation would amount to double regulation. In response to a question by Representative Foster, Ms. Bunting noted that private hospitals and Native Corporations generally pay the fee for their employees. Some of the 25 in question would fall into this category. Representative Austerman questioned if Amendment 1 was discussed with audiologists. Vice Chair Bunde noted that Ms. Bunting has carried the message to the audiologists. There being NO OBJECTION, Amendment 1 was adopted. Ms. Reardon discussed the fiscal note. She observed that the fiscal cost would be $7.5 hundred dollars for the first year and $3.7 hundred dollars for each additional year. She explained that the fiscal note was based on actual costs of the audiology program in FY99. More money is needed in the first year to cover attorney fees to review regulations and postage related to advertising. Representative J. Davies questioned if steps have been taken to look at lumping adjudication costs into one category. Ms. Reardon stated that discussions have occurred but that there is dissention among the groups. (Tape Change, HFC 00-20, Side 2) Ms. Reardon continued to discuss the possibility of merging licensing groups. Representative Foster questioned the cost of the fee. Ms. Reardon emphasized that the fee would be $315 dollars in combination with audiologists. There would be an initial application fee of $150 dollars. She observed that this is a medium level fee. She noted that fees could be increased in the future. Representative Grussendorf questioned the need for regulation. He indicated that he has additional questions regarding the legislation. Vice Chair Bunde noted that under the current law a person with no training could call themselves a speech and hearing pathologist. Vice Chair Bunde MOVED to report CSHB 105 (FIN) out of Committee with the accompanying amended fiscal note. Representative J. Davies did not object, but voiced concern with the legislation. Representative G. Davis pointed out that the public did not request the legislation. Representative Foster asked for clarification regarding individuals practicing with Native nonprofit groups. Ms. Reardon stated that they would need a license. He questioned if there was support for the legislation in rural areas. Vice Chair Bunde clarified that those working in public schools would be required to have a master degree. Those in private practice would have to have certification at the national level. He thought that those currently practicing in Alaska already have their certification. There being NO OBJECTION, CSHB 105 (FIN) was Moved from Committee. CSHB 105 (FIN) was REPORTED out of Committee with "no recommendation" and a new fiscal note by the Community and Economic Development.