HOUSE LABOR AND COMMERCE STANDING COMMITTEE January 21, 2000 3:21 p.m. MEMBERS PRESENT Representative Norman Rokeberg, Chairman Representative Lisa Murkowski Representative John Harris Representative Sharon Cissna MEMBERS ABSENT Representative Andrew Halcro, Vice Chairman Representative Jerry Sanders Representative Tom Brice COMMITTEE CALENDAR HOUSE BILL NO. 105 "An Act providing for the licensing of speech-language pathologists; and providing for an effective date." - MOVED CSHB 105(L&C) OUT OF COMMITTEE PREVIOUS ACTION BILL: HB 105 SHORT TITLE: LICENSING SPEECH PATHOLOGY/AUDIOLOGY Jrn-Date Jrn-Page Action 2/19/99 260 (H) READ THE FIRST TIME - REFERRAL(S) 2/19/99 260 (H) L&C, FIN 1/21/00 (H) L&C AT 3:15 PM CAPITOL 17 WITNESS REGISTER REPRESENTATIVE CON BUNDE Alaska State Legislature Capitol Building, Room 501 Juneau, Alaska 99801 POSITION STATEMENT: Sponsor of HB 105. KIT ROBERTS, Representative Alaska Speech-Language-Hearing Association (Address not provided) POSITION STATEMENT: Testified in favor of HB 105. CATHERINE REARDON, Director Division of Occupational Licensing Department of Community & Economic Development PO Box 110806 Juneau, Alaska 99811-0806 POSITION STATEMENT: Testified on HB 105. JANET SEITZ, Staff to House Labor and Commerce Standing Committee Alaska State Legislature Capitol Building, Room 24 Juneau, Alaska 99801 POSITION STATEMENT: Testified on transitional regulation language as it relates to HB 105. PATTI SWENSEN, Staff to Representative Con Bunde Alaska State Legislature Capitol Building, Room 501 Juneau, Alaska 99801 POSITION STATEMENT: Answered questions regarding the issue of a temporary license as it relates to HB 105. ACTION NARRATIVE TAPE 00-3, SIDE A Number 0001 CHAIRMAN NORMAN ROKEBERG called the House Labor and Commerce Standing Committee meeting to order at 3:21 p.m. Members present at the call to order were Representatives Rokeberg, Murkowski, Harris and Cissna. HB 105 - LICENSING SPEECH PATHOLOGY/AUDIOLOGY Number 0040 CHAIRMAN ROKEBERG announced the first and only item of business would be House Bill No. 105, "An Act providing for the licensing of speech-language pathologists; and providing for an effective date." [NOTE: THE COMMITTEE WILL BE DISCUSSING WORK DRAFT VERSION 1-LS0340\H, LAUTERBACH, 1/20/00] CHAIRMAN ROKEBERG commented that the bill appears to be an excellent piece of draftsmanship in that it does not develop a new board or commission and therefore, presumably, would be a very cost-effective way to bring needed regulation and control of speech pathology and audiology in the state. Number 0073 REPRESENTATIVE CON BUNDE, Alaska State Legislature, sponsor of the bill, began by disclosing that when he first came to Alaska he worked as a speech and hearing therapist so he has some personal knowledge of this area. At that time, the American Speech-Language-Hearing Association's [ASHA] certification was just beginning to grow as a professional goal for speech and hearing therapists. Although it would not have been required for their employment, he said many people aspired to the certification because it establishes ethical and clinical competencies and gives the public a bit of assurance. He is pleased to bring this bill before the committee. It is another illustration of folks who want to create certification upon themselves to reassure members of the public that they are getting the best service possible rather than having the state presume to place a certification on an occupation. REPRESENTATIVE BUNDE further stated that Alaska is one of only six states that does not require this license or certification. Therefore, the goal of HB 105 is to set out the requirements for licensure. He noted that the legislation was requested by the Alaska Speech-Language-Hearing Association to allow speech and language professionals to follow more stringent clinical and ethical competency standards. The bill would - in essence - take what is being done already on a voluntary basis and put it into statute. Number 0286 REPRESENTATIVE BUNDE acknowledged that there has been some discussion about the fee, which he described as "pretty substantial" - about $700 biennially or $350 per person per year. He noted that about a dozen speech/language pathologists are anticipated to be licensed, and suggested combining them with the audiologists, whose licensing fee is substantially less, thereby spreading the cost over greater numbers. REPRESENTATIVE BUNDE announced that Ms. Kit Roberts is online [to testify]. She is a member of the Alaska Speech-Language-Hearing Association and is able to give a personal point of view as a requester of this type of certification as well as answer any clinical questions. Number 0383 KIT ROBERTS, testifying via teleconference from Anchorage, introduced herself as a speech/language pathologist. She mentioned that she is the director of Emerald Speech & Learning Clinic in Anchorage, but she is testifying today as a representative of the Alaska Speech-Language-Hearing Association. She also thanked Representative Bunde for his help. She has been in private practice since 1976 in the state. For many years speech/language pathologists have gotten along pretty well with the honor system. However, a few years ago a gentleman started advertising himself as a speech/language pathologist who had a bachelors degree that wasn't even in speech therapy. There were complaints made, but there was nothing that could be done. There is nothing to protect consumers. She also noted that reimbursements have become an issue because medical insurance companies are looking at state licensing to determine if a speech/language pathologist is a qualified provider. As a result, some have been denied payments by medical insurance companies. She cited the profession has a very low incidence rate: only 5 to 10 percent of the population will ever need to see a speech/language pathologist. There are no training programs in the state, yet all have worked for and received a Certificate of Clinical Competence [CCC], the minimum certification needed to work in private practice nationally, which is why it was chosen as the entry level for state licensing. She remarked that there is a shortage of speech/language pathologists in the state, but all are concerned about maintaining a high standard for the profession. She said, "We're kind of a picky lot, and we like things done right. We like things done well so we're ready for this." MS. ROBERTS further stated, in regards to the fiscal note, there are an estimated 25 audiologists who are licensed and practicing now, and an estimated 25 to 30 speech/language pathologists would be licensed. She explained that both audiologists and speech/language pathologists are certified under the same parent organization - the American Speech-Language-Hearing Association - and both receive the same testing and certification. Therefore, a fee similar to audiologists would be fair and reasonable, which is $190 biennially. Number 0715 REPRESENTATIVE JOHN HARRIS asked Ms. Roberts whether she is looking for uniformity amongst the professions. MS. ROBERTS replied, "Yes." CHAIRMAN ROKEBERG asked Ms. Roberts to explain the difference between an audiologist and a speech/language pathologist. MS. ROBERTS replied both professions start with the same course work and share similar core courses at school. At some point, however, a decision is made as to what path to pursue. She explained that an audiologist deals mostly with hearing and hearing impairments, while a speech/language pathologist deals mostly with speech, language and voice. Both can have clients in common; for example, they both work with deaf children. A speech/language pathologist works with deaf children in ways to improve their speech or to teach them sign language, while an audiologist tests and prescribes hearing aids. She also noted that speech/language pathologists work with stroke victims, stutters, individuals who have had surgery for a cleft palate, and individuals who have had a head injury. She called it a very broad field. Number 0836 CHAIRMAN ROKEBERG noted that when his Mother had a stroke she worked with a speech/language pathologist to learn how to swallow and eat. MS. ROBERTS confirmed that speech/language pathologists also treat swallowing disorders. CHAIRMAN ROKEBERG noted that his Mother's care was covered by Medicare. Is that typical? he asked. MS. ROBERTS replied, "Yes." Swallowing is a good example of an area in which a person can get injured if treated by someone who is not trained or thinks they know what they are doing. CHAIRMAN ROKEBERG asked Ms. Roberts to explain the education requirements for certification for a speech/language pathologist. MS. ROBERTS replied, in order to qualify for a CCC, a person must have a masters degree from a qualified institution; undergo a supervised year of training; and pass a national examination. Number 0992 REPRESENTATIVE BUNDE expressed that the bill would not present any difficult barriers. There are hundreds if not thousands of colleges and universities that offer programs in speech/language therapy. Number 1011 REPRESENTATIVE LISA MURKOWSKI asked Ms. Roberts whether the requirements for an audiologist are similar to the requirements for a speech/language pathologist. MS. ROBERTS replied, "Yes." According to her understanding, it's exactly the same thing - a masters degree and a CCC. She noted that a person can be dually certified as an audiologist and as a speech/language pathologist. REPRESENTATIVE MURKOWSKI asked Ms. Roberts how would a dual certification be handled in regards to licensing. In other words, would a person have to pay both fees? MS. ROBERTS replied that's a decision the committee will have to consider. She is thinking that a person would have to get two licenses. REPRESENTATIVE SHARON CISSNA requested that the committee hear from the Division of Occupational Licensing [Department of Community & Economic Development] on that issue. CHAIRMAN ROKEBERG asked Representative Bunde whether a person who is certified and licensed in another state would just have to pay a licensing fee. REPRESENTATIVE BUNDE replied the CCC is a national certification. He suspects, therefore, that a person would just have to apply for a license upon entering the state, if that person already has a CCC. He called it a transfer of paper. Number 1175 REPRESENTATIVE MURKOWSKI referred to Section 13, "Exemptions," of the work draft, and wondered whether those who teach speech/language pathology would have to be licensed. REPRESENTATIVE BUNDE replied a person working as such in a school district is not really teaching speech pathology but acting as a speech/language pathologist. REPRESENTATIVE MURKOWSKI said she would hope that a person who is teaching speech/language pathology would be licensed, which is not how subsection (c) reads [Section 13]. MS. ROBERTS explained that a license is for those who are practicing and treating clients. However, if at some point she wanted to become a professor for example, then she wouldn't need a license. She doesn't have a problem with that as long as the person is not treating any clients. Number 1266 REPRESENTATIVE BUNDE stated, according to personal experience, professors typically work with clients as well and in those cases they would have to be licensed. However, a person teaching a class in semantics, which leads to a degree in speech/language pathology, wouldn't have to be certified [licensed]. REPRESENTATIVE MURKOWSKI replied she is concerned because she wouldn't like to see a person - who had never been licensed - elevated through the speech department who is now training students of speech/language pathology. REPRESENTATIVE BUNDE replied that is a hypothetical scenario; there are no training programs in the state and he doubts that there ever would be. The language that Representative Murkowski is concerned about refers to those who are licensed to deal with clients/patients as opposed to those who deal with theory. In reality, he can't imagine that those who are teaching would not have had a clinical practice. Number 1401 REPRESENTATIVE CISSNA referred to Section 3, paragraph (5), of the work draft, and wondered whether the language would cover the issue at hand. The American Speech-Language-Hearing Association would have a fairly rigorous screening process for those applying for a CCC. Similarly, an instructor would not be able to teach unless he/she has a fairly rigorous background. REPRESENTATIVE BUNDE replied there are individuals who are not licensed in the state yet they teach theory. In addition, he wants to stay away from telling the university who they can or cannot hire. Number 1489 CHAIRMAN ROKEBERG referred to Section 13, paragraph (2), of the work draft, and asked Representative Bunde to explain why a school district employee should be exempt from this type of licensing. REPRESENTATIVE BUNDE replied the bill is addressing those individuals who are practicing and calling themselves speech/language pathologists. A school district can set up its own criteria as to who it can or cannot hire. CHAIRMAN ROKEBERG wondered whether this would cause "violence" to those with a bachelors degree who don't have a CCC but who are employed in the field. REPRESENTATIVE BUNDE stated, according to his own experience, he didn't hurt anybody while working in the public schools with a bachelors degree. MS. ROBERTS explained the minimum requirements for those who work as a speech/language pathologist in the public schools is a masters degree. School districts stop short of requiring a CCC, but they are starting to recognize it as a way to give pay increases. REPRESENTATIVE BUNDE noted that the requirements vary from school district to school district, but that nothing less than a bachelors [degree] is required. CHAIRMAN ROKEBERG asked whether there are practitioners outside the realm of education who don't have a certificate that would be harmed by this. REPRESENTATIVE BUNDE replied he would reverse the question; is it wise to protect the public from someone who hangs up a shingle and calls himself a speech/language pathologist according to his own definition? He doesn't know of anybody - specifically - who would be driven out of business because of this certification [licensing]; it's a consumer protection issue. CHAIRMAN ROKEBERG stated the point of the bill is to create another occupation guild with prohibitions of practice to set a minimum standard. Number 1733 CHAIRMAN ROKEBERG referred to page 7, line 7, of the work draft, and wondered whether referring to a code of ethics in statute is "running afoul." There is no code of ethics either memorialized in statute or regulation. Furthermore, what code of ethics is the bill talking about? REPRESENTATIVE BUNDE replied it refers to the code of ethics of the individual's profession. The language refers to the exemption of a licensed physician who chooses to practice some speech/language pathology such as swallowing exercises. CHAIRMAN ROKEBERG asked: What code of ethics exists for a speech/language pathologist? REPRESENTATIVE BUNDE replied the American Speech-Language-Hearing Association's code of ethics applies to them. CHAIRMAN ROKEBERG exclaimed this is a classic occupational licensing "thing." Each profession may or may not have adopted a code of ethics, but in certain instances a code is codified... REPRESENTATIVE BUNDE interjected and stated the bill refers to a code of ethics and clinical competency... CHAIRMAN ROKEBERG interjected and stated that once a person has been certified - presumably - he/she would have to be incompliance with that code of ethics or stand a chance of being decertified. In other words, there would be two enforcement agencies - the Division of Occupational Licensing and the certification agency. REPRESENTATIVE BUNDE noted that the public would also act as an enforcement as they would be the ones complaining. CHAIRMAN ROKEBERG wondered whether the American Speech-Language-Hearing Association would indicate to the Division of Occupational Licensing [Department of Community & Economic Development] that there had been a breach in the code of ethics. REPRESENTATIVE BUNDE said there would have to be another step because the association would remove that person's certification which would automatically make him/her incompliant for a state license. CHAIRMAN ROKEBERG asked Ms. Roberts whether she is aware of any actions against a person based on a code of ethics violation. MS. ROBERTS replied, "Yes." There have been a few cases related to insurance fraud of which the state licensing agencies were notified. She offered to make available to the committee members a copy of the code. Number 1930 CHAIRMAN ROKEBERG stated he is concerned because there are different levels of a breach; therefore, would a person automatically be decertified for a breach? REPRESENTATIVE BUNDE pointed out that, if a person loses his/her CCC, then... CHAIRMAN ROKEBERG interjected and stated the language in the work draft doesn't say that. MS. ROBERTS said she thought the exemption language meant a person didn't have to get a license; there's nothing to lose, right? CHAIRMAN ROKEBERG replied, "That's true." MS. ROBERTS further noted that the language is included because sometimes a doctor will give hearing tests. CHAIRMAN ROKEBERG said he is troubled by this section because it sets up a standard on top of a laundry list of exemptions. He asked: What does the code of ethics have to do with an exemption? Is a person not exempt if unethical? REPRESENTATIVE BUNDE pointed out that the language reads, "...this chapter does not apply to an individual who practices speech-language pathology consistent with the accepted standards and code of ethics of the individual's profession..." He noted that physicians take an Hippocratic oath and that the employees of a school district and interns follow professional standards. CHAIRMAN ROKEBERG referred to the issue as a drafting "thing." If a person is exempt from overview, why is that person's code of ethics mentioned? REPRESENTATIVE BUNDE interjected and stated - obviously - the drafter of the bill is comfortable with the language. "But, legally, are we going to say some doctor who practices speech therapy and breaches -- he does it poorly and breaches his own ethics -- he does harm first. We don't want to then exempt that behavior. We want to say that he's exempted as long as he or she is doing this in an acceptable manner." Number 2062 CHAIRMAN ROKEBERG asked: If a school district employee is acting unethically as a speech/language pathologist, what does the Division of Occupational Licensing [Department of Community & Economic Development] have to do with that? REPRESENTATIVE BUNDE pointed out that the individuals in the exemptions section are not covered by a license... CHAIRMAN ROKEBERG interjected and stated that is his point; why is the bill talking about a code of ethics? Number 2075 REPRESENTATIVE BUNDE avowed, if this is a major problem with the Chairman, then the language should be deleted. CHAIRMAN ROKEBERG reiterated that he is confused about what the language, "accepted standards and code of ethics," has to do with an exemption. REPRESENTATIVE BUNDE explained that the language was borrowed from other states and is part of the current statute for audiologists. Number 2142 REPRESENTATIVE HARRIS said it's clear to him. The section just says that those in other professions have their own accepted standards and code of ethics and that they must follow them, if they are to be allowed to practice speech/language pathology. They wouldn't be able to practice their own profession if they didn't follow their own code of ethics. CHAIRMAN ROKEBERG pointed out that the language refers to the exemptions which are not under the purview of the Division of Occupational Licensing [Department of Community & Economic Development]. Number 2180 CATHERINE REARDON, Director, Division of Occupational Licensing, Department of Community & Economic Development, came before the committee to help clarify the issue. She stated, if the division was to prove that a person was not following his/her own accepted standards and code of ethics, then that person would no longer be eligible for an exemption and, therefore, practicing without a license, which is a misdemeanor. CHAIRMAN ROKEBERG interjected and said: "So, somebody could be doing something and not have a license, know they don't have to have a license, and then if they do something wrong then all of a sudden you [Division of Occupational Licensing] claim that they should have a license so you can exempt them. That's nonsense." MS. REARDON replied it appears that is what is permitted in the bill, but it wouldn't be wise for the division to pursue something like that because those in question are not regulated and they haven't paid anything into the system. She noted that the language is the same for the audiologists and the division has not had to pursue a complaint. She suggested either taking the language out for both [occupations] or leaving it in for both. Number 2257 REPRESENTATIVE CISSNA asked whether the profession itself feels that this is an important way to police itself. CHAIRMAN ROKEBERG replied, he thinks, it's a drafting "thing." REPRESENTATIVE BUNDE suggested, in the interest of time, deleting the language, "consistent with the accepted standards and code of ethics of the individual's profession" [page 7, lines 7-8]. Number 2329 MS. REARDON continued testifying on HB 105. She explained that the bill is modeled after the audiology statute, and that the fiscal note is a feature of what the division spends on the profession. MS. REARDON stated, in response to earlier concerns, she's not certain as to whether or not those who have a CCC are reputable, but she pointed out that the effective date of the bill is July 1, 2000, which if passed into law would hit the profession quite soon. CHAIRMAN ROKEBERG asked Ms. Reardon whether she would have to draft any regulations against the statute. MS. REARDON replied she would draft regulations to put limits around the temporary license, which would take longer than July 1, 2000. Until such time, however, the division would probably give out temporary licenses without a termination date. CHAIRMAN ROKEBERG asked Representative Bunde to comment on the effective date; it's not very "clean." REPRESENTATIVE BUNDE replied, in regards to the state's need for time, he can't comment on that. But, in regards to a practitioner's need for time, he/she certainly has the option of applying for a CCC. He clarified with Ms. Roberts that all of the 25 members of the Alaska Speech-Language-Hearing Association have their CCC and Ms Roberts replied in the affirmative. CHAIRMAN ROKEBERG said: "So, but, but given the nature here we may only have 30 to 45 days to 60 days to get geared up at occ[upational] licencing. Is that sufficient time for these people not to...I mean..." MS. REARDON stated she would prefer a longer time because often legislation like this is passed near the end of a session then off to the Governor. There may not be very much time... [TAPE CHANGE] TAPE 00-3, SIDE B Number 0001 REPRESENTATIVE BUNDE asked Ms. Roberts whether an additional 90 days would be an inconvenience or danger to the public's safety. MS. ROBERTS replied, "No." REPRESENTATIVE BUNDE asked Ms. Reardon whether an additional 90 days would take care of her concern. MS. REARDON replied it would take care of her concern regarding licensing, but regulations take a year. Number 0027 CHAIRMAN ROKEBERG referred to boiler plate language for transitional regulations and asserted that the committee should give Ms. Reardon the authority to write regulations prior to the effective date. MS. REARDON stated her dream date would be January 1, 2001. Number 0052 JANET SEITZ, Staff to House Labor and Commerce Standing Committee, came before the committee to testify on transitional regulation language. She noted that the language for transitional regulations says something to the effect of, "notwithstanding the effective date of a piece of legislation the department can go ahead and start developing regulations." REPRESENTATIVE MURKOWSKI noted that the language says "developing" not "implementing." MS. REARDON noted that the language would allow her to adopt regulations and present them to the public. CHAIRMAN ROKEBERG said adding the language would cover both concerns of delaying the implementation of the regulations and giving the division more time. MS. REARDON asserted that she needs to know the amount of the licensing fee so that she can start drafting regulations and informing those who apply for a license. MS. REARDON continued her testimony on HB 105. She referred to page 3, paragraphs (1) and (2), and noted that a temporary license is good for 60 days or less in a calendar year which, according to her understanding, are not consecutive days. She is concerned about how the division would track that information. As written, it would probably be left to the licensee to stick to the limit. She doesn't want people to think that the division is going to clock them in and out every time they enter the state. REPRESENTATIVE BUNDE noted that those who are not incompliant with the laws and regulations of their licensing would lose their CCC. There has to be some expectation of professional responsibility. MS. REARDON noted that the division advocated for the language to read "consecutive [days]," but the supporters didn't want that. She is concerned how it would work. Number 0217 PATTI SWENSEN, Staff to Representative Con Bunde, came before the committee to answer questions regarding the issue of the temporary license. She noted, according to discussions with individuals in the profession, that those who commute with a temporary license have a contract with a certain amount of days attached, which is how it could be measured. Number 0242 MS. ROBERTS explained - as an analogy - when there is a nursing shortage a hospital will hire a temporary nurse from outside for a certain amount of time. That happens in Alaska as well for speech/language pathologists. She cited that usually a speech/language pathologist is hired from the state of Washington or Oregon as a consultant for a school district in a small community when the rest are booked up. She doesn't want to penalize a therapist or a school district for a temporary visit, but if it turns out to be a consistent visit then that therapist would need to get a full license. MS. REARDON stated, according to her read on the bill, a therapist could get a temporary license every year. MS. ROBERTS replied there should be something in the bill that indicates a temporary license is good for only one year, after which, a person would have to get a regular license. MS. SWENSEN replied the language reads, "60 days or less in a calendar year," which could be used 5 days at a time or 60 days straight. MS. ROBERTS said a person should get a temporary license once. REPRESENTATIVE MURKOWSKI wondered whether the issue could be addressed under Section 4, subsection (d), which reads as follows: (d) The department may impose by regulation additional limitations that it determines appropriate on a temporary license issued under this section. MS. REARDON indicated to Ms. Roberts that she can address the issue through the regulations. She doesn't see a limit in statute. It's helpful to know the intent, however. She stated - for the record - that since a temporary license would be issued for only one year rather than two she is assuming that the cost would be half of the regular license. CHAIRMAN ROKEBERG wondered whether the fee for a temporary license should be in statute. MS. REARDON replied she prefers that it not be in statute. She would prefer that no fees be in statute. CHAIRMAN ROKEBERG asked Ms. Reardon what she would contemplate charging for a license. MS. REARDON replied, according to the fiscal note, the division is proposing to spend $7,500 a year, which comes out to $700 for approximately 25 people. If it doesn't cost $7,500 a year then the fees would not be as high, and similarly if it costs more than $7,500 a year then the fees would be higher. The fiscal note indicates what the division thinks it would cost for a license, but that doesn't govern it absolutely. It's the actual experience that in the end determines what the fee would be; for example, enforcement money for an appeals process can cost $100 an hour for legal time, which is billed to the profession. That is the downside of having a self-sufficiency statute. But, as pointed out by the sponsor, there are professions which are also very small and since no legal monies have been expended the fees are running anywhere from $200 to $300. MS. REARDON further stated, in regards to the issue of the temporary license, the division would not track the days, otherwise it would start costing money in terms of staff time. MS. REARDON further stated she would like to see the loss of a person's CCC as a ground for disciplinary action stated clearly in the bill. As written it says that a person has to have a CCC to get a license; it doesn't say that a loss is grounds for revocation. MS. ROBERTS indicated that that is reasonable language to add to the bill. Where would it be added? she asked. MS. REARDON replied she would recommend including it in Section 9, "Grounds for imposition of disciplinary sanctions on a speech-language pathologist." She noted that the bill drafter would probably make it a separate subsection because it would be an automatic [revocation]. She pointed out that the other grounds are actions for which the department "may" impose a sanction. She further pointed out that there is similar language in statute for hunting crimes. CHAIRMAN ROKEBERG closed the meeting to public testimony. Number 0669 REPRESENTATIVE MURKOWSKI noted that the suggested changes apply towards audiologists, yet the title of the bill does not include them. REPRESENTATIVE BUNDE replied it is not his intent to include these requirements for audiologists. REPRESENTATIVE MURKOWSKI noted that there is a section for disciplinary sanctions and prohibited acts for audiologists, which leads her to believe that they might need to be reflected in the title of the bill as well. MS. SWENSEN replied the speech/language pathologists are being added to the audiologist statute. It doesn't affect the audiologists. Furthermore, as indicated earlier, many therapists are dually certified. Number 0758 CHAIRMAN ROKEBERG pointed out that Sections 8 and 9, of the work draft, are different; therefore, the bill drafter could argue a title change is not necessary. REPRESENTATIVE CISSNA asked whether there is any place in the bill that makes for inconsistencies since a person can be dually licensed. REPRESENTATIVE BUNDE replied, "No." A person needs to meet the requirements for licensure in each area. REPRESENTATIVE CISSNA asked whether they would pay a double fee. MS. REARDON replied, "Yes." They would be treated separately; they would have to pay both fees. Number 0822 REPRESENTATIVE MURKOWSKI asked why there is a difference between the grounds for dismissal for audiologists and speech/language pathologists. She specifically referred to the inclusion of paragraphs (2), (3) and (4) [Section 9], of the work draft. REPRESENTATIVE BUNDE replied the bill simply amends speech/language pathologists into the audiologist statute. He has not investigated into whether or not there should be changes made to the audiologist statute as well. REPRESENTATIVE MURKOWSKI noted that she is simply wondering whether there would be a problem within the industry since they "swap" licenses. MS. SWENSEN reiterated that the bill is simply adding speech/language pathologists into the audiologist statute, and from what she has heard from the association it wouldn't create a conflict... MS. REARDON interjected and stated the language probably came from a national organization. She has never heard of a license being bartered in Alaska before. CHAIRMAN ROKEBERG asked Ms. Reardon whether she has an amendment to combine the audiologists and pathologists to help lower their licensing fees. MS. REARDON replied licensing fees are less volatile if there is a larger number of licensees. At this point in time, the division expects about 25 individuals to be licensed as a speech/language pathologist, while currently there are 68 individuals licensed as audiologists. Although it wouldn't solve the problem entirely, it would be better financially for the division to track 100 licensees in one program; it helps to spread the cost in the "spiked" years. CHAIRMAN ROKEBERG asked Ms. Reardon whether anything needs to be done in statute to accomplish that goal. MS. REARDON replied yes, but there is an interest to do that in the [House] Finance Committee. REPRESENTATIVE BUNDE asserted that he would prefer to do that in the [House] Finance [Committee]; it would give him a chance to spend more time on it. MS. REARDON further stated that something similar was done when the landscape architects were licensed a few years ago. She cited that there were only going to be about 50 landscape architects so language was included in statute to pool their licensing fees with the architects, engineers and landscape surveyors. Number 1015 CHAIRMAN ROKEBERG said it's the purview of this committee to make that type of change and to inquire as to whether the audiologists want to be put in that type of position since there is risk involved in the "spiked" years. REPRESENTATIVE BUNDE noted that the audiologists have not been consulted, which is why he needs more time. Representative Bunde asked Ms. Roberts whether there is a state audiologist society. MS. ROBERTS replied the audiologists and speech/language pathologists are part of the same association. CHAIRMAN ROKEBERG asked Ms. Roberts whether she believes combining the licensing fee amongst the two professions would create a problem. MS. ROBERTS replied she would have to take that issue back to the association and notify the audiologists before she could reply. CHAIRMAN ROKEBERG indicated that is what Representative Bunde would like her to do. MS. ROBERTS said she would like to have some information to present to the audiologists as it relates to money. MS. SWENSEN pointed out that she received the fiscal note only a few days ago at which time she learned how high the fees were projected, which is another reason more time is needed to notify those involved. CHAIRMAN ROKEBERG stated that since this is a financial issue he is willing to move the bill on to the [House] Finance Committee with the provision that the bill sponsor does the right thing, and that the committee members concur with that right thing. Number 1215 REPRESENTATIVE MURKOWSKI asked whether an individual who is working for a school district can use the title speech/language pathologist. REPRESENTATIVE BUNDE replied they are often hired as speech-language-hearing pathologists. Number 1255 CHAIRMAN ROKEBERG announced that there are four amendments to be discussed. CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 1 that would clarify the loss of one's CCC as grounds for mandatory revocation. There being no objection, it was so ordered. CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 2 that would change the effective date to October 1, 2000, thereby adding 90 days. There being no objection, it was so ordered. CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 3 that would give permission to the department to begin developing regulations prior to the effective date of the bill. There being no objection, it was so ordered. CHAIRMAN ROKEBERG made a motion to adopt conceptual Amendment 4 that would delete the language, "consistent with the accepted standards and code of ethics of the individual's profession," on page 7, lines 7-8, of the work draft. There being no objection, it was so ordered. Number 1430 REPRESENTATIVE HARRIS made a motion to move CSHB 105, Version 1-LS0340\H, Lauterbach, 1/20/00, as amended, from the committee with individual recommendations and the attached fiscal note. There being no objection, CSHB 105(L&C) so moved from the House Labor and Commerce Standing Committee. ADJOURNMENT There being no further business before the committee, Chairman Rokeberg adjourned the House Labor and Commerce Standing Committee meeting at 4:42 p.m.