Legislature(2009 - 2010)BELTZ 105 (TSBldg)

02/09/2010 02:00 PM LABOR & COMMERCE

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Heard & Held
Heard & Held
Heard & Held
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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                                                               
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                                                               
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                                                               
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                                                               
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                                                               
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                                                               
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                                                               
3:03:18 PM                                                                                                                    
CHAIR PASKVAN asked if she  found the APOC reporting requirements                                                               
of  board members  was  unduly limiting  the  field of  potential                                                               
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.                                                                                                          

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