"The public is well served"
Dept. of Regulatory Agencies Sunset Report Summation on the State Grievance Board
Confrontation is certain when the House Health Committee meets Wednesday, Dec. 3rd in the State Capitol Bldg. The 10 a.m. debate in room 112 over the State Grievance Board (SGB) will be decided by an otherwise trite phrase, "In or Out?"
The Grievance Board has been in operation since July of 1988. It has sole authority from the legislature to discipline licensed and non-licensed psychotherapists. (Psychiatrists are under the Medical Board.) There are four separate licensing boards for psychologists, social workers, marriage/family therapists, and professional counselors under the SGB law.
Two associations of licensed groups definitely want "out" from under control of the SGB: The Colorado Psychologists Assn., represented by lobbyist Freda Poundstone, and the Colorado Society For Clinical Social Work, represented by lobbyist Beth Minahan. The Dept. of Regulatory Agencies (DORA), in its 1997 Sunset report on the grievance board, believes the psychologists and social workers should stay "in".
Until passage of the Grievance Board law in 1988, professional counselors and marriage/family therapists were not licensed in Colorado. Spokespersons for professional counselors will also try to get those licensees "out" from under SGB jurisdiction.
The SGB was initiated in 1986 by a joint House-Senate Sunrise-Sunset committee composed of four Republicans and two Democrats. That committee heard evidence the psychology and social work boards then in operation had failed to discipline licensees who violated the laws, and appeared more interested in protecting their "titled" professionals.
Then-Sen. Steve Durham, R-Colo. Springs, carried the initial bill in 1987. I carried the 1988 law in the House with then-Sens. Harold McCormick, R-Canon City and Durham carrying the measure in the Senate. After reviewing six years of effective SGB performance, the Council of State Governments made Colorado's grievance board "model legislation" in their 1994 volume, page 138, entitled "Psychotherpy Grievance Board."
In reviewing past histories and present performance, the DORA report in 1997 stated: The state grievance board has met the burden of proof required by the sunset criteria for the General Assembly to continue the board. The service to Colorado citizens by this regulatory board -- discipline of offenders who have harmed the public -- is unquestionably greater than pre-1988 actions by combined licensing/enforcement boards."
There are 13 regulatory boards under Sunset review for 1998, including the SGB. Do any of these laws HAVE to pass in 1998? The answer is "No", even though each statute seems to indicate repeal as of July l, 1998 if nothing happens. CRS 24-34-104 (5) (b) and (12) make it clear each statute continues until July l, 1999 if no continuation occurs in 1998. That allows the new legislature in 1999 to make the final decision.
The Grievance Board has jurisdiction as of July 16, 1997 over 8,425 psychotherapists broken down into: 1749 psychologists, 371 marriage and family therapists, 1574 professional counselors, 2339 clinical social workers, and 2392 unlicensed psychotherapists.
While there will be confrontation at the Health Committee hearing, there won't be drama. Lobbyists for the associations already have the votes of the majority of the committee, for a replay of what happened earlier in 1997.
At that time, Rep. Mark Paschall, R-Arvada introduced HB 1317 to remove discipline of psychologists from under the SGB. Rep. Kay Alexander, R-Montrose introduced HB 1283 to do the same for social work licenses. Sen. Dottie Wham, R-Denver was senate sponsor of the two bills. Both bills passed the Health Committee and died in Appropriations.
Those who want "out" from under SGB jurisdiction assert all other Colorado boards that regulate occupations have control over both licensing and disciplines, and why shouldn't they?
While several boards, such as Medical, Dental, and Real Estate have done decent work regarding discipline, none have matched the SGB in ferreting out those who harm consumers of services. If you have or can get a copy of the DORA Sunset report, turn to Appendix B, page 82 through 98. There you will find the names, practice, offenses, punishment and date decided.
From Jan. 1980 through June 30, 1988, there were 13 psychologists and 11 social workers who were disciplined by boards that had both licensing and discipline authority. Final disposition of some of those cases didn't occur until later, but totals were placed as if they had happened earlier.
From July l, 1988 through April 30th, 1997, 28 social workers and 55 psychologists were disciplined by the SGB. That was in addition to SGB discipline of 100 non-licensed psychotherapists, five marriage/family therapists, and 18 professional counselors for a total of 216 individuals. The number given on page 17 of the Sunset report of "233" is of total disciplinary decisions, rather than the number of individuals disciplined.
Lobbyists for the psychologists and social workers can accurately claim the pre-1988 boards didn't have as large a list of violations to choose from in order to discipline. What they will NOT point out is that their professional associations played a major role in drafting language that determined what constituted a violation of the laws.
Of the 216 names in the appendix of the Sunset report, 47 of the disciplined therapists either voluntarily gave up their right to practice, or no longer practiced after the disciplinary decisions.
After several years, 24 of the 47 were permitted to return to practice. Another 44 therapists, mostly in the non-licensed category, are under orders to stop practicing.
So 31 percent of the therapists disciplined are no longer in a position to harm consumers of services. No other state regulatory board comes close to that percentage. When psychotherapists who endanger patients are no longer practicing, that cuts heavily into insurance losses incurred by companies that cover the occupation.
The DORA report on page 55 sums up the reasons given by the psychologists and social work associations as to why they want out from under the grievance board:
"Many psychologists and social workers simply do not believe that complaints against members of their profession should be reviewed by marriage and family therapists or licensed professional counselors. (They) argue...psychology and social work are significantly different from other professions, and that the judgments of other mental health professionals are possibly uninformed and inappropriate."
The original HB 1317 by Rep. Paschall to move psychologists out from under the SGB in 1997 required the governor to appoint psychologists to the new board "from a list of nominees submitted by the Colorado Psychological Association." That approach goes back to pre-1976, with regulatory scandals resulting from private associations running state boards, leading to the adoption in 1976 of the "Sunset" law.
What happens to the non-licensed remaining under jurisdiction of the SGB? A "deal" has allegedly been reached with the associations promising not to "go after" the non-licensed. Of course, that's not binding on the legislature, which could break the "deal" in 1999.
And the legislature should expect the kind of "turf wars" starting in 1999 between the four groups of licensed psychotherapists, similar to what occurred when the Soviet Union broke up into separate states.
The one group that will be most detrimentally affected by what happens in Health Committee won't show up for the hearings and won't know about the result until too late: The future consumers of psychotherapy services.
Jerry Kopel writes a column for the Statesman based on 22 years past experience as a state legislator.
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