HB 241-EXTEND BOARD OF MARITAL & FAMILY THERAPY  3:49:27 PM CHAIR OLSON announced that the final order of business would be HOUSE BILL NO. 241, "An Act extending the termination date of the Board of Marital and Family Therapy; and providing for an effective date." 3:49:41 PM CRYSTAL KOENEMAN, Staff, Representative Lora Reinbold, Alaska State Legislature, stated that the bill will extend the Board of Marital and Family Therapy (BMFT) until June 30, 2018, based on a previous audit. Auditors recommended a four-year extension based on two prior audit recommendations from the 2009 audit that had not been fully resolved. First, the audit recommended that the Board of Marital and Family Therapy (BMFT) develop a strategy for distance therapy and distance supervision. She said she discussed this with the BMFT's chair. The chair advised that the board worked with the division and the Department of Law and concluded that the matter will require statutory language to implement changes. She said the board is moving forward for proposed language for possible introduction next legislative session. 3:51:01 PM CHAIR OLSON asked whether the small size of the BMFT adds to the present challenges. MS. KOENEMAN answered yes. Auditors also recommended that the Office of the Governor and the board work together to fill vacant board seats timely. She recalled the BMFT consists of almost 100 licensees, although the board or the division could confirm the figures. She advised that the board member vacancy has since been filled. Finally, the auditors recommended that the BCBPL's investigative case management system be improved, but as previously mentioned the division has made improvements in this area. The sponsor agrees with the legislative auditors on the recommended four-year extension, she said. 3:52:25 PM REPRESENTATIVE JOSEPHSON was surprised by the small number of licensees. MS. KOENEMAN explained that by statute, one requirement for marital and family therapist licensures is the therapist must have 1,500 hours of practice, of which 200 hours must be supervised. In response to a question on whether the clients or the professional needs distance supervision she deferred to the division. 3:54:11 PM KRIS CURTIS, Legislative Auditor, Division of Legislative Audit, Legislative Agencies and Offices, explained the division conducted a sunset audit dated June 19, 2013, with the main objective to determine whether the board is serving the public's interest and if it should be extended. The legislative auditors recommended only a four-year extension since the board had not fully addressed the prior sunset audit recommendation to pursue regulation changes that are necessary to protect the public's interest. The prior audit's reasoning on the recommendation was slightly different. Although the board initiated one regulation change, the board has not addressed the need for distance supervision and distance therapy. She explained that distance supervision pertains to licensure, such that an applicant must have a certain number of supervised hours to become licensed as a marital and family therapist. Distance supervision would be provided electronically, possibly through the Internet, or from other technology. Currently, BMFT's services are not widely available in some areas of the state and distance delivery has been viewed as being a means to address this disparity. MS. CURTIS said that during the current audit period the board extensively researched and discussed the topic; however, it made little progress in developing regulations and the board does not have a strategy to move past the discussion phase. The auditor recommended the board develop a strategy to address the need for distance services, and the board and division concurred with the recommendation. She reported that as of March 2013, 91 applicants applied for licensure. Additionally the BMFT licenses associates, although she did not have the figures for that category of license. In response to Representative Josephson, Ms. Curtis replied that the BMFT offers one type of license, but people can obtain services in other areas, such as social worker examiners, professional counselors, and psychologists. 3:57:17 PM REPRESENTATIVE SADDLER asked for the historical counts on licensees. MS. CURTIS referred to page 17 of the audit that shows a count by year on the number of new licenses issued, which varies from three to nine licenses. 3:57:54 PM DON HABEGER, Director, Division of Corporations, Business, and Professional Licensing (DCBPL), Department of Commerce, Community, & Economic Development (DCCED), deferred to Mr. Webber, Chair, Board of Marital & Family Therapy (BMFT). 3:58:46 PM LEON WEBBER, D.Mn., LMFT; Chair, Board of Marital & Family Therapy (BMFT), Department of Commerce, Community & Economic Development (DCCED), related his understanding that the board previously faced financial difficulties, stemming from investigative expense, with fees increasing to $1,000 for a biennial license, resulting in some licensees transferring to larger boards with lower fees. Currently, the board licenses 118 "marriage and family therapists" and "marriage and family therapy associates." Although marital and family therapists practice in the specific field, as previously mentioned, services are also being provided other professionals such as those providing couples therapy. The field of marital and family therapy specifically requires licensees to achieve a masters' level or doctorate level in marriage and family therapy. REPRESENTATIVE JOSEPHSON acknowledged the fields have all become very sophisticated and complicated. 4:01:18 PM REPRESENTATIVE SADDLER wondered about the quality of service provided by the other professionals when the BMFT's licensees shift to other boards. MR. WEBBER answered that he couldn't answer that question. He said the BMFT's responsibility is to ensure that those who are licensed by the board provide quality services and for other professions to monitor and oversee services provided under other licenses to ensure their licensees are qualified to perform them. He lauded DCBPL's director, Mr. Habeger, for providing financial assistance to the board. He said the sunset review was very thorough and he reported that the BFMT has subsequently contacted 49 states to obtain research and has worked with other boards and health care agencies on tele-therapy and tele- supervision. For example, tele-therapy might mean a licensed therapist in Alaska is providing therapy to an out-of-state client in Idaho or it may mean a therapist in a residential treatment center in Idaho is providing family therapy to someone in Alaska. Thus far, the board hasn't established any guidelines to address those issues or any competency issues for tele-therapy services, noting that an average therapist may not feel as competent providing distance therapy, he said. Additionally, confidentiality issues have arisen, for example, whether encrypted communications are needed. The BMFT considered these matters at its last board meeting, and plans to address proposed statutes, regulations, and ethical guidelines at its next meeting, which he said has been a huge challenge. 4:03:48 PM REPRESENTATIVE SADDLER asked whether the division's remedies on investigation costs will stabilize the number of licensees and curtail the drift of BMFT's licensees to other boards. MR. WEBBER thought it would do so. He anticipated that license fees will drop to within several hundred dollars of other similar professional fees. He did not envision more therapists would leave the field. He characterized the total clarity on finances as being a relief. 4:04:52 PM REPRESENTATIVE SADDLER asked whether he envisioned other changes in the field that will need to be addressed. MR. WEBBER answered that it will be important to monitor how well tele-therapy is handled. For example, he related that he is participating in this hearing from Hawaii, while simultaneously his friend is at a military base hospital conducting tele-therapy with five members of a family who are located in Iraq, North Carolina, and Honolulu. He said that his board recognizes that this type of service is beginning to become predominant in the field. He looked forward to working with the legislature on statutory and regulation changes. In further response to a question, he said the BMFT hopes to have a bill introduced next year. CHAIR OLSON said appreciated the work Mr. Habeger has done to address the investigative costs and level the fees for all boards. 4:07:02 PM KENNITH MCCARTY, Board Member, Board of Marital & Family Therapy (BMFT), Department of Commerce, Community & Economic Development (DCCED), stated he also serves as the president of the Association for Marriage and Family Therapists. He provided a brief background of his service and the board issues that arose from an investigation. He explained that the BMFT's statutes have title protection, but not practice protection. In other words, unless a person is licensed by the BMFT, the professional cannot call themselves a family therapist on his/her business card, but the person could offer other services such as "couples counseling." In response to a question on practice protection, he said the board was unsure of how to proceed with practice protection. For example, in the instance of couples counseling, the board could examine the type of experience in terms of education and training; however, the board is holding ongoing discussions. CHAIR OLSON suggested members could contemplate statutory remedies to assist the board. 4:10:46 PM MR. MCCARTY, in response to the comment on the number of licensees, agreed that higher license fees has affected the number of overall practitioners, but the division's efforts to reduce license fees have helped remedy this and may lead to some professionals applying for dual licenses. REPRESENTATIVE REINBOLD lauded Mr. McCarty. She encouraged him working with Mr. Webber, and her staff and congratulated him on his wedding. 4:12:21 PM CHAIR OLSON, after first determining no one else wished to testify, closed public testimony on HB 241. 4:12:40 PM REPRESENTATIVE SADDLER moved to report HB 241 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 241 was reported from the House Labor and Commerce Standing Committee.