HB 136 - PHYSICAL THERAPY AND OCCUPATIONAL THERAPY Number 425 CHAIRMAN ROKEBERG announced the next order of business would be HB 136, "An Act relating to the regulation of physical therapists and physical therapy assistants; extending the termination date of the State Physical Therapy and Occupational Therapy Board; and providing for an effective date." Number 456 RANDY WELKER, Legislative Auditor, Legislative Audit Division, explained HB 136 addresses two elements of statute. The first is the sunset extension date in Section 1. He explained Section 2 is a provision that requires applicants to pass an oral examination administered by the board. When this was put into place, it was put in to basically demonstrate an ability to speak English. He said we were often times being mandated to give an oral examination to Canadians who were very capable of speaking English. Mr. Welker said at a minimum it has been changed to, "at the discretion of the board." An option would be to simply delete this requirement as we don't require doctors and others to demonstrate that they have the ability to speak English, but we are requiring it of the physical therapists and occupational therapists. He sat they felt at a minimum, it would be best left to the discretion of the board on the various applicants. Number 539 PAULINE BENNETT-GANNON, President, Alaska Occupational Therapy Association, testified via teleconference from Fairbanks. She said she is testifying to amend HB 136 and has also testified earlier in the week to amend the Senate's version of the bill. She said she believes the Senate has a committee substitute which incorporates her suggestions. Ms. Bennett-Gannon said the suggestions that she will make are in addition to the changes that the committee already has made. She said the word "or" would be changed to "and" when speaking of the agency that approves curriculum for occupational therapists. Ms. Bennett-Gannon said the statute relating to occupational therapists in this area had "and," whereas statutes relating to physical therapists, which has very similar wording had "or." She said, "The reason for this is that in the past, say when I went to school, the AMA (American Medical Association) was involved in certifying all their (indisc.) professional curriculums and it is no longer that professional agencies dealing with (indisc.) professions has -- part of their organization that does that credentialing and so we really aren't doing `and' because `and' really isn't available." MS. BENNETT-GANNON explained that under AS 08.84.030, section (b)(1), "and" should be changed to "or." She noted on the committee substitute there is something left off. CHAIRMAN ROKEBERG indicated the committee doesn't have the Senate version of the bill and asked Ms. Bennett-Gannon to address the House bill. Number 584 MS. BENNETT-GANNON said her suggestion was that the wording about the discretion of the board that foreign trade therapists demonstrate the ability to speak effective English during an interview also be included for occupational therapists. Currently, it is only located in the language of the statute that refers to physical therapists. She referred to discussion earlier in the meeting about another board and said they have a lot of physical and occupational therapy foreign schools that do send people to the United States and they have concerns about whether or not training is adequate. Ms. Bennett-Gannon said in the past when she served on the Physical Therapists and Occupational Therapist Licensing Board they had a case where a foreign-trained therapist was doing her interview that we require and did not have that ability to understand an English prescription written by a doctor, etc., and wasn't able to finish her internship. That (indisc.) would require some renumbering on that page. She suggested the wording "under this chapter" be added where it speaks of being licensed as an occupational therapist. There was a case where someone licensed in a different health profession decided that what they were doing could be constituted as occupational therapy. The new wording would help clarify that situation. MS. BENNETT-GANNON said, "I also believe that in addition to this (indisc.) of the board by the (indisc.) trained therapists for English that perhaps wording to the effect that "testing could be done if necessary" might be useful. Again, when I served on the board, it was sometimes frustrating not to adopt a regulation and not be able to because there wasn't a place to hook it on in the language in the state." Number 852 MARY MELISSA ROBINSON, Therapist, Committee Chair, Licensing Committee, Alaska Occupational Therapy Association, testified via teleconference from Anchorage. She indicated she is in favor of the extension of the Licensing Board. The present copy of HB 136 states that the extension would be 2003 and she prefers that date. She said her organization would be in favor of extending the board even if it was changed to 2001. Ms. Robinson said she also supports the change in the language for the effective speaking of English which is very important when you're relating to a patient's need when they are describing symptoms. They need to relate not only to other medical personnel, but to the client and that is an important piece of being competent in a profession. She said she would also like to support some of the items outlined in SB 91 (B). The additional language indicates that a person may not provide occupational therapy services without being licensed under this chapter seems self explanatory, but perhaps it is not without the addition of that under this chapter. She said it couldn't be a driver's license, they have to be licensed as an occupational therapist. She said she would like to support the change that would identify that the American Medical Association no longer is part of the curriculum approval with the American Occupational Therapy Association. Although that was in the past, it no longer is and hasn't been for a few years. She thanked the committee for listening to her. CHAIRMAN ROKEBERG asked Ms. Robinson to explain the difference between physical therapists and occupational therapists. MS. ROBINSON explained physical therapists treat physical disabilities differently than occupational therapists do. The philosophy of an occupational therapist requires they use adaptation. She they look at what a person is occupied with during the day. Ms. Robinson said, "The word `occupational therapy' comes from the things which occupy their day and looks specifically at what it is in their day that they need assistance to be modified, to be remediated, to be relieved, to be more functional. We take a very very functional approach rather than total exercise or (indisc.) who work with the person of need is one reason why it's very critical to be able to (indisc.) the receiver of the services to know what his needs are and how that applies to his life, not what our goals are, but what the client's needs are." Number 1159 MARY VAIL, Physical Therapist, Legislative Liaison for the Alaska Chapter of the American Physical Therapy Association, came before the committee to testify on HB 136. She said she would like to endorse the extension of the termination date which she believes will be 2001 in the final version of the bill. Ms. Vail said she would also like to support the proposed changes by the occupational therapists. She said so much of what she does is education as she needs to educate people on how to take care of themselves and she does feel that English is a strong part of their communication to teach patients in what they need to do. Ms. Vail said she agrees to the changes in the Senate bill. Number 1224 CHAIRMAN ROKEBERG indicated HB 136 would be held to await the adoption of changes from the occupational therapists.