Bill Summary for Bill Number Sunset Review of Psychiatric Technicians Licensure

Date: 01/14/2009

Final
Sunset Review of Psychiatric Technicians Licensure

SENATE COMMITTEE ON HEALTH AND HUMAN SERVICES

Votes: View-->	Action Taken:
Amend the draft bill (Attachment C) to change the Continue the licensing of psychiatric technicians Introduce the draft bill (Attachment C) as drafted	FAIL FAIL PASS

10:09 AM -- Sunset Review of Psychiatric Technicians Licensure

Brian Tobias, Department of Regulatory Agencies (DORA), introduced himself and gave the committee an overview of the sunset review process. The sunset review process is intended to ensure that the General Assembly has an opportunity to review the programs it creates. A sunset review is triggered when a sunset clause is included in a bill, specifying the date by which the report must be conducted. The sunset process requires the General Assembly to take affirmative action to ensure the programs are continued. State statute specifies nine criteria used to evaluate programs in a sunset review, and Mr. Tobias reviewed the criteria. He noted that DORA makes an effort to contact individuals who are part of the profession subject to the sunset review. He noted that the recommendations of DORA are included in reports, and are ultimately become part of a draft bill which is considered by a committee of reference.

10:15 AM

Senator Boyd asked Mr. Tobias to begin his comments related to the Sunset Review of the Psychiatric Technicians Licensure Program (Attachment B). He referred to a draft bill containing the recommendations of the report (Attachment C). He described the professional responsibilities of psychiatric technicians, noting that such technicians may administer medications. Psychiatric technicians may only practice under the supervision of a physician or registered nurse. Psychiatric technicians work with the developmentally disabled or the mentally ill, are employed in large part by the Department of Human Services, and work primarily in state-operated facilities, including the mental health institutions and Fort Logan and Pueblo and the regional centers for individuals with developmental disabilities at Wheat Ridge, Pueblo, and Grand Junction. Psychiatric Technicians are regulated by the Board of Nursing.

10:18 AM

Mr. Tobias described DORA's recommendations with regard to the regulation of psychiatric technicians. The first recommendation is that the licensing and regulation of psychiatric technicians should continue for five more years, at which time, the licensing of the profession should be permitted to sunset. The second recommendation is that the statutory prohibition against nurses delegating the selection of medication to someone not authorized by law to do so be repealed. He discussed the reasons why DORA is recommending that the regulation of psychiatric technicians ultimately sunset. Mr. Tobias noted DORA's position that the only portion of psychiatric technicians' practice that requires regulation is the administration of medication. He noted that DORA's recommendation is to sunset the regulation of psychiatric technicians, not to sunset the profession. He stated that Colorado is only one of two states that currently licenses psychiatric technicians. Mr. Tobias responded to questions from Senator Mitchell regarding regulation of psychiatric technicians in other states. Mr. Tobias listed the states that have the highest number of psychiatric technicians, noting that none of those states license psychiatric technicians. He noted that most psychiatric technicians work for the Department of Human Services, and sunsetting the licensing of psychiatric technicians would permit the Department of Human Services to develop training programs for technicians specific to their work with the department. He stated that the five year time period prior to sunset would permit the Board of Nursing to develop a training program for certified nurse aides (CNAs) with medication authority to meet the needs of psychiatric technicians who dispense medications.

10:31 AM

Mr. Tobias responded to questions from Senator Carroll regarding complaints against psychiatric technicians. Mr. Tobias responded to questions from Senator Morse regarded the recommended five year wind down period, stating that the medication administration authority for CNAs will be a complicated issue, and that the five year time period was intended to allow sufficient time to allow rule making on the issue to occur. Senator Morse asked if three years would be sufficient, and Mr. Tobias stated that he believed it would be. Senator Tochtrop expressed concern regarding eliminating licensure of psychiatric technicians. Mr. Tobias responded to questions from Senator Newell regarding consistency of training for psychiatric technicians, and whether training programs may be eliminated as a result of the sunset recommendations. Senator Tochtrop commented on the need for specialty care for vulnerable populations and expressed concern that without licensure the standards for the profession of psychiatric technicians will be lowered.

10:51 AM

Mr. Tobias responded to a question from Senator Mitchell regarding whether the lack licensure for the profession of psychiatric technicians has affected public safety in other states. Senator Newell asked for more information about California, which is the only other state that licenses psychiatric technicians.

10:54 AM

Jocelyn Gay, Department of Human Services, stated that the department participated in the review and had input into the report. She stated that the department is neutral on the report, and that the department respects the work of licensed psychiatric technicians. She described the training program for psychiatric technicians at Pueblo Community College, which trains technicians for employment at the Colorado Mental Health Institute (CMHI) at Pueblo. She stated that the department believes the five-year time period for the sunset of licensure of psychiatric technicians is appropriate and will allow the department to transition to a different model of care. She stated that if psychiatric technicians are not licensed, they would still continue to do much of what they current do, but that nurses would administer medications. Ms. Gay responded to questions from Senator Mitchell regarding the changes that would occur in the staffing of the CMHI at Pueblo if the licensure of psychiatric technicians were to end. She stated that the CMHI at Pueblo would likely not employ CNAs with medication authority to administer medications in lieu of administration by psychiatric technicians. She further noted that the CMHI at Fort Logan currently uses a model where nurses administer medications. Ms. Gay responded to questions from Senator Carroll regarding how patient complaints would be handled, noting that there are mechanisms in place currently for complaints related to other unlicensed professionals who work at the institutes. Ms. Gay further responded to questions from Senator Carroll regarding whether that complaint data is made public.

11:08 AM

Ms. Gay responded to comments from Senator Tochtrop regarding medication administration by nurses rather than psychiatric technicians. Ms. Gay responded to questions from Senator Boyd regarding whether the department would be comfortable with a three year rather than five year sunset period.

The following witnesses testified:

11:14 AM -- Bill Ortiz, Psychiatric Technician, testified regarding the difficulty of the work of physiatric technicians in the CMHI at Pueblo. He stated that CNAs will not be a good fit for CMHI at Pueblo and that the current system of licensure for psychiatric technicians works well. He distributed a comparison document of the recommendations of the 1994 sunset review of the licensure of psychiatric technicians and the current review (Attachment D). Senator Mitchell commented on the profession of psychiatric technicians. Mr. Ortiz responded to questions from Senator Morse, stating that he believed if licensure was ended, the training program for psychiatric technicians at Pueblo Community College would be eliminated. He responded to questions from Senator Morse regarding the lack of licensure of psychiatric technicians in other states. Mr. Ortiz responded to questions from Senator Newell regarding turnover in the profession.

11:30 AM -- Paul Barela, Psychiatric Technician, described the differences in the practice of psychiatric technicians and CNAs. He testified in opposition to the recommendations of the DORA report.

11:33 AM -- John Ramos, Psychiatric Technician, testified that there is a need in the public and private sectors for psychiatric technicians. He testified regarding the work of psychiatric technicians at the CMHI at Pueblo. Mr. Ramos responded to questions from Senator Carroll, noting his believe that licensing the profession gives it credibility and that sunsetting licensing will result in a loss of jobs. He described the demand for psychiatric technician services.


BILL:	Sunset Review of Psychiatric Technicians Licensure
TIME:	11:40:05 AM
MOVED:	Carroll M.
MOTION:	Continue the licensing of psychiatric technicians for five years. The motion failed on a 3-4 roll call vote.
SECONDED:
		VOTE
	Carroll M.	Yes
	Mitchell	No
	Morse	No
	Newell	Yes
	Schultheis	No
	Tochtrop	Yes
	Boyd	No
Not Final YES: 3 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	Sunset Review of Psychiatric Technicians Licensure
TIME:	11:41:43 AM
MOVED:	Schultheis
MOTION:	Amend the draft bill (Attachment C) to change the five year sunset period to a three year sunset period. The motion failed on a 3-4 roll call vote.
SECONDED:
		VOTE
	Carroll M.	No
	Mitchell	Yes
	Morse	Yes
	Newell	No
	Schultheis	Yes
	Tochtrop	No
	Boyd	No
Not Final YES: 3 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	Sunset Review of Psychiatric Technicians Licensure
TIME:	11:43:05 AM
MOVED:	Mitchell
MOTION:	Introduce the draft bill (Attachment C) as drafted. The motion passed on a 4-3 roll call vote.
SECONDED:
		VOTE
	Carroll M.	No
	Mitchell	Yes
	Morse	Yes
	Newell	No
	Schultheis	Yes
	Tochtrop	No
	Boyd	Yes
Final YES: 4 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS

11:44 AM

Senator Mitchell was designated as the prime Senator sponsor and Senator Schultheis was added as a cosponsor. Senator Boyd explained that the draft bill will be introduced and will be referred back to the Senate Health and Human Services Committee later in the session.