Legislature(2009 - 2010)BELTZ 105 (TSBldg)
02/09/2010 02:00 PM LABOR & COMMERCE
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SB 248-EXTEND BD OF MARITAL & FAMILY THERAPY 2:41:44 PM CHAIR PASKVAN announced SB 248 to be up for consideration. 2:41:49 PM TIM BENINTENDI, staff to Senator Olson, sponsor of SB 248, said the extension of the Board of Marriage and Family Therapy shows June 30, 2015 in the bill, but the recommendation was for 2014. He ordered up copies of the bill before doing the homework and when he read the audit he found the recommendation was for 2014. The sponsor supports the audit and has asked them to amend SB 248 to reflect its recommendation. He said the board is composed of three therapists and two public members; the cost of a license is currently at $775 and in FY09 had 84 licensees. According to the audit that figure may be declining. Also according to the audit, the board's deficit has gone down fairly dramatically from $75,400 in FY05 to $29,200 in FY09. The deficit has existed for over 10 years. MR. BENINTENDI said the board needs to make regulatory changes, however preparations and processing for such are charged to it and members want to eliminate its deficit before they move to make significant regulatory changes. He said the legislative audit recognizes this and further observed that the board support from the department could be more substantial and that the governor could be making appointments in a more timely fashion. CHAIR PASKVAN asked about the APOC issue if there is a concern that either the applicant pool is extremely small or that the appointments haven't been completed from the available applicants. MR. BENINTENDI answered that he didn't have any thoughts beyond what has been stated in the audit. Frankly, he said, department personnel may have more current figures, but a decline in numbers seems to have been the trend for the last several years, and it is a small pool of people from which to draw fees. 2:44:46 PM CHAIR PASKVAN remarked that he has a draft committee substitute (CS) that reflects the recommended-2014 sunset date that would be brought up in the next meeting. 2:45:11 PM PAT DAVIDSON, Division of Legislative Audit, Alaska State Legislature, said the audit recommended extending the Board of Marital and Family Therapy to June 30, 2014. She explained that a four-year extension is half of what is allowed by statute, and the reason for the four-year recommendation is because she found the board is holding off on regulation projects because of the estimated associated costs along with the fact that the board is currently trying to work off its deficit. She said that a main advantage to having professional boards is they keep regulations up to date instead of the legislature or an administrative body having to do it. However, if the board is holding off on doing the regulatory changes that are necessary to keep that professional occupation to its professional standards, it isn't really aren't serving its licensing purpose. This is why the audit recommended a limited extension. They also found the same administrative difficulties with the board - lack of timely appointments by the governor for new board members. CHAIR PASKVAN said page 7, findings and recommendations, references that chairs of both the boards objected to her recommendation of combining them into one single board. What was the basis for the objection? 2:48:06 PM MS. DAVIDSON replied that the last time mental health professionals were looked at - the Boards of Social Workers, Marital and Family Therapists, Professional Counselors, Psychologists, Psychological Associates, and one other group - they were all up for sunset in the same year (by design). One of the things she looked at is if they should be combined and her recommendation is that they could be combined. But when it comes down to it, the boards are financially self supporting and so is each occupation. So there was no overriding budgetary need for the combination; and probably the best way to create failure is to try to "stick people together who do not want to be there." Her office thought a combined board would be larger than any one of the individual boards, but in total would be a little bit smaller. Again, they had a real concern that if the boards didn't want to join or there was more than an initial reluctance to it, they would end up with a couple of very dysfunctional boards. About four or five years ago the legislature decided to individually license the boards. MS. DAVIDSON said the Board of Marital and Family Therapists thought combining would be okay, but it was in financial difficulty and continuing to be challenged; and it has pretty high fees. The only other board that has a small group with high fees is the Board of Direct Entry Midwives. Their group is relatively small; the fees go up and down and they never hear complaints from the practitioners about getting rid of their board. CHAIR PASKVAN asked if given the objection to joining together, would it be appropriate to do a two-year sunset to see how successful their financial efforts are. Or are they forever separated and not going to try to achieve those efficiencies? MS. DAVIDSON said the legislature could designate whatever extension it would like. Since the statute requires each occupation to be self sufficient, combining the boards would make any economies of financial scale. Choosing to make a two- year extension to drive the point home is up to the legislature. CHAIR PASKVAN found no further questions on recommendation 1 and went on to recommendation 2, the issue of unqualified staff and lack of documented procedures. SENATOR THOMAS interrupted to say he had trouble understanding how delaying regulations has an impact on revenue. MS. DAVIDSON answered that regulation projects involve the Department of Law (DOL) and it bills the board for its services. If they start to incur legal and regulation specialist costs, then the costs would go up and then the fees have to go up. This board is already seeing a decline in the number of people who are seeking licensure. She reminded them that this is one of the boards that has a title restriction. You cannot call yourself a licensed marital and family therapist unless you are licensed by the state, but it doesn't really prohibit one from offering those services in a different name. So, while practitioners find value in licensing, by being able to bill insurance companies for instance, it's a title restriction, not a practice restriction. If the fees get to be too much to bear, people could decide to just not be licensed. 2:55:01 PM CHAIR PASKVAN asked if the state has a minimum qualification standard for someone calling himself a counselor or a therapist. MS. DAVIDSON replied yes; there are Boards of Professional Counselors, Social Work Examiners, and Psychologist and Psychological Associates. Each of those boards are going to have educational requirements associated with them - possibly a certain level of experience requirements and clinical or non clinical settings to meet licensure. CHAIR PASKVAN asked if that included the Board of Marital and Family Therapy. MS. DAVIDSON replied "yes." 2:56:18 PM CHAIR PASKVAN went on to recommendation 2 on the unqualified staff and lack of documented procedures. MS. DAVIDSON said those are the same issues as with the previous bill. CHAIR PASKVAN went to recommendation 3. MS. DAVIDSON said that is the same as the previous bill. CHAIR PASKVAN found no further questions on any of the recommendations. 2:57:00 PM JENNIFER STRICKLER, Operations Manager, Division of Corporations, Business and Professional Licensing, Department of Commerce, Community and Economic Development (DCCED), reported that the Board of Marital and Family Therapy is about $2000 shy of making up its deficit. The division's fee analysis is based on a two-year period and as with the other board, they had gone back and corrected its figures. CHAIR PASKVAN asked her "gut feeling" about combining this board with other boards once their monetary deficiency is brought up to date. MS. STRICKLER answered that her gut feeling is that the potential would be there if they were all operating in the positive, but she didn't necessarily see any huge benefits. For example, the Board of Architects, Engineers, Surveyors, and Landscape Architects has 11 or 12 members. Central licensing has a law that says for whatever reason, they all pay the same amount of fees. The same thing could happen here, but if the Board of Marital and Family Therapy currently has 84 licensees and if they are added to a larger group, like the Board of Psychologists and Psychological Associates, even if they all pay the same fees, a majority of the revenue would be coming from the psychology area. The boards might not consider that "equal." 2:59:56 PM PATRICIA WHITE, Chair, Board of Marriage and Family Therapists, introduced herself. CHAIR PASKVAN asked her thoughts regarding the audit's findings and recommendations and sunset extension. MS. WHITE said she wrote a letter in response to the audit and it said that the responsibility spread over three sections was fair and not just all the board's fault. The deficit has been a problem, but it happened earlier on in the board's creation around 1992. The board has made changes in the way investigations are carried out before passing them on to the DOL, which eliminates the problem that happened many years ago. The investigation centered on actions on the part of a licensed marriage and family therapist who is no longer in the profession. It was a good thing, but procedures have been changes so that these kinds of costs won't happen to the board again. MS. WHITE stated that the audit said their main function is protecting the public interest and that their inability to look at changing regulations was challenging in that light. While that is true in theory, after the audit came out the board decided to review all of its minutes to see if it should have gone ahead with regulations but were thwarted because of associated costs. She didn't think they would find that any public interest had been challenged, but they were going to make sure. 3:03:18 PM CHAIR PASKVAN asked if she found the APOC reporting requirements of board members was unduly limiting the field of potential applicants. MS. WHITE answered that she didn't realize there was an APOC reporting requirement. CHAIR PASKVAN asked if anyone else wanted to comment on the APOC issue. Finding no further questions, he said SB 248 would be held for further work.