COMMONWEALTH OF PENNSYLVANIA HOUSE OF REPRESENTATIVES
PROFESSIONAL LICENSURE COMMITTEE PUBLIC HEARING
STATE CAPITOL HARRISBURG, PA
RYAN OFFICE BUILDING ROOM 2 05
TUESDAY, MARCH 22, 2016 9:00 A.M.
PRESENTATION ON HOUSE BILL 1438 STATE LICENSURE OF MUSIC THERAPISTS
BEFORE: HONORABLE JULIE HARHART, MAJORITY CHAIR HONORABLE ROSEMARY BROWN HONORABLE GARY DAY HONORABLE JOE EMRICK HONORABLE KEITH GILLESPIE HONORABLE DAVID HICKERNELL HONORABLE JERRY KNOWLES HONORABLE STEVEN MENTZER HONORABLE DAVID MILLARD HONORABLE MARK MUSTIO HONORABLE JAMES SANTORA HONORABLE CURTIS SONNEY HONORABLE MARCY TOEPEL HONORABLE HARRY READSHAW, DEMOCRATIC CHAIRMAN HONORABLE TINA DAVIS HONORABLE DANIEL DEASY HONORABLE DANIEL MCNEILL
* * * * * Pennsylvania House of Representatives Commonwealth of Pennsylvania 2
ALSO IN ATTENDANCE: REPRESENTATIVE EDDIE DAY PASHINSKI
COMMITTEE STAFF PRESENT: WAYNE CRAWFORD MAJORITY EXECUTIVE DIRECTOR MAUREEN BEREZNAK MAJORITY RESEARCH ANALYST ANGIE KELLY MAJORITY LEGISLATIVE ADMINISTRATIVE ASSISTANT
MARGARET TRICARICO DEMOCRATIC RESEARCH ANALYST KEONTAY HODGE DEMOCRATIC LEGISLATIVE ASSISTANT 3 D D E E 1—1 1—1 X N
TESTIFIERS
~k k k NAME PAGE
REPRESENTATIVE EDDIE DAY PASHINSKI PRIME SPONSOR OF HOUSE BILL 1438 ...... 7
JUDY SIMPSON DIRECTOR OF GOVERNMENT RELATIONS, AMERICAN MUSIC THERAPY ASSOCIATION...... 10
NICOLE HAHNA PROFESSOR OF MUSIC THERAPY, SLIPPERY ROCK UNIVERSITY...... 19
MELANIE WALBORN CO-CHAIR, PA STATE TASK FORCE FOR MUSIC THERAPY...... 21
TONY ELHAJJ PARENT OF A CHILD WITH RETT SYNDROME...... 25
KRISTIE DIONNE PARA-EDUCATOR, CAMP HILL SCHOOL DISTRICT; BOARD DIRECTOR, AUTISM SOCIETY OF GREATER HARRISBURG...... 27
RITA PORRECA, LMFT LEGISLATIVE CHAIR, PA ASSOCIATION FOR MARRIAGE AND FAMILY THERAPY... 49 ACCOMPANIED BY: AMY TIELEMANS, MBA, LMFT PRESIDENT SUZANNE MORANO, EXECUTIVE DIRECTOR
ANNE GILBERTSON, MS/CCC-SLP PRESIDENT, PA SPEECH-LANGUAGE-HEARING ASSOCIATION; DIRECTOR OF REHAB, HCR MANORCARE...... 58
SUBMITTED WRITTEN TESTIMONY
~k ~k ~k (See submitted written testimony and handouts online.) 1 P R O C E E D I N G S
2 ~k ~k ~k
3 MAJORITY CHAIR HARHART: Good morning, everybody.
4 ALL: Good morning.
5 MAJORITY CHAIR HARHART: And welcome, welcome. I
6 believe it is nine o ’clock at this time. Is it?
7 DEMOCRATIC CHAIRMAN READSHAW: Yes.
8 MAJORITY CHAIR HARHART: Okay. It is nine
9 o ’clock, and having arrived at, I would like to call this
10 meeting of the House Professional Licensure to order.
11 But the first order of business I would like to
12 ask each Member of the Professional Licensure Committee to
13 introduce themselves and to state where they are from. So
14 if you could start down at that end.
15 REPRESENTATIVE HICKERNELL: Mike is not working.
16 Dave Hickernell, Lancaster and Dauphin Counties.
17 REPRESENTATIVE TOEPEL: Marcy Toepel, Montgomery
18 County.
19 REPRESENTATIVE MCNEILL: I think they’re all
20 broken. Dan McNeill, Lehigh County.
21 MAJORITY CHAIR HARHART: Julie Harhart, Lehigh,
22 Northampton County and Chair of Professional Licensure.
23 DEMOCRATIC CHAIRMAN READSHAW: Harry Readshaw,
24 Democratic Chair of the Committee, and I ’m from Allegheny
25 County. 5
1 REPRESENTATIVE DAVIS: Good morning, Tina Davis,
2 Bucks County.
3 REPRESENTATIVE SANTORA: Good morning, Jamie
4 Santora -- sorry about that. Good morning, Jamie Santora,
5 Delaware County.
6 REPRESENTATIVE SONNEY: Good morning, Curt
7 Sonney, Erie County.
8 REPRESENTATIVE MILLARD: David Millard, Columbia
9 County.
10 MAJORITY CHAIR HARHART: Now, before we begin,
11 Representative Readshaw, would you like to say anything?
12 DEMOCRATIC CHAIRMAN READSHAW: Yes, thank you
13 Madam Chair.
14 Very briefly, I'd just like to welcome everyone
15 here. This is a subject which I have spoken to
16 Representative Pashinski about and we hope to gain more
17 knowledge about the subject matter this morning. So thank
18 you very much for being here.
19 MAJORITY CHAIR HARHART: Thank you.
20 We are holding this public hearing to take
21 testimony on House Bill 1438, legislation which establishes
22 a statewide requirement for musical therapists.
23 In addition to the testimony included in your
24 folders, everybody's folders, we have received
25 approximately 130 plus emails in support of House Bill 6
1 1438, which will be emailed to all the Committee Members,
2 and it will also be included as part of the record of this
3 hearing. I have to say I ’ve never seen so many emails on
4 one particular piece of legislation flood my email box.
5 So I have to say you really have a passion for it
6 and a belief for it, and I ’m very interested in it, so this
7 is why I’m holding the hearing because I really want, you
8 know, to hear why you feel it’s important to be licensed.
9 But let me tell you, it’s not something that’s just a
10 given. W e ’re going to have the public hearing, and if the
11 bill needs to be worked on, then you can work on that bill.
12 And if everybody is in agreement to it, then w e ’ll see if
13 we could get them moving. But at least this is opening the
14 dialogue.
15 So before we begin the testimony, I certainly
16 would like to recognize the prime sponsor of the bill,
17 Representative Pashinski. Would you like to give some
18 opening comments?
19 REPRESENTATIVE PASHINSKI: Thank you very, very
20 much.
21 Chairlady Harhart, Chair Readshaw, Members of the
22 Professional Licensure Committee, I appreciate you taking
23 the time to find out about this very, very important and
24 very misunderstood position in our society, music
25 therapists. 7
1 I think that all of us have recognized the idea
2 that music is a universal language, and I think each and
3 every one of us has been touched by a particular kind of
4 music. It could be a symphony, it could be a marching band
5 playing a patriotic song, it could be a blues B.B. King, it
6 could be some rap that Chairman Readshaw is into.
7 REPRESENTATIVE PASHINSKI: The bottom line is I
8 think -- you’ve got to picture that now. You got to
9 picture it.
10 DEMOCRATIC CHAIRMAN READSHAW: Who’s to testify
11 next?
12 MAJORITY CHAIR HARHART: Can we have a little bit
13 of display of that or what do you think?
14 REPRESENTATIVE PASHINSKI: That’s going to be at
15 another time.
16 But I think all of us agree that, you know, music
17 plays some role in all our lives, and maybe you also
18 remember that time that you happened to dance on a special
19 song with a special person, you know, that really touches
20 your heart.
21 Now, the question is how do these music
22 therapists take this magnificent thing, this universal
23 language of music, and how do they then relate that to
24 physical or mental disabilities within patients? And this
25 is the major difference between someone who performs music, 8
1 someone who teaches music, and someone now who takes that
2 particular art and uses it to stimulate their mind, to help
3 them physically, to stimulate them either to suppress, you
4 know, certain emotions or to ignite a certain part of their
5 brain to help them overcome their disability.
6 So today, it will be very exciting for all of us
7 to understand, you know, over 2,000 clinical hours in
8 internship, in learning about physical problems and mental
9 problems that people face and how, through the form of
10 music, they can help them.
11 So I thank you very, very much, and I look
12 forward to the testimony. Thank you.
13 MAJORITY CHAIR HARHART: Thank you,
14 Representative.
15 Okay. I think we will call now the panelist Judy
16 Simpson, who is Director of Government Relations, American
17 Music Therapy Association; Nicole Hahna, Professor of Music
18 Therapy, Slippery Rock University; Melanie Walborn, co
19 Chair, PA Task Force for Music Therapy; parent Tony -- is
20 that -
21 MR. ELHAJJ: Elhajj.
22 MAJORITY CHAIR HARHART: Elhajj, parent of a
23 child with Rett syndrome; and Kristie Dionne, and you are a
24 para-educator, Camp Hill School District, Board of
25 Directors, Autism Society, greater Harrisburg. 9
1 So if you all would please come to the table.
2 And I know there is one that you have missing, but she has
3 put in written testimony, okay. And that would be Jennifer
4 Keener, so she’s not here. Okay. All right. You may
5 begin. Do you want to begin?
6 MS. SIMPSON: Thank you.
7 MAJORITY CHAIR HARHART: Okay. Thank you.
8 MS. SIMPSON: Madam Chair Harhart and Members of
9 the House Professional Licensure Committee, thank you so
10 much for this opportunity to speak in support of House Bill
11 1438. My name is Judy Simpson, and I ’m a board-certified
12 music therapist and the Director of Government Relations
13 for the American Music Therapy Association.
14 The profession music therapy actually got its
15 start in the Veterans Administration system after World
16 Wars I and II treating soldiers who were diagnosed with
17 what we now know as posttraumatic stress disorder. And our
18 national association was actually founded in 1950. Our
19 Association, AMTA, is responsible for maintaining all of
20 the educational and clinical training standards, standards
21 of clinical practice, our code of ethics, as well as
22 competencies for the profession.
23 And I think a lot of times people don’t realize
24 how long music therapy has been around and how well-
25 established it is nationally. It is a nationally 10
1 recognized allied health profession, and it’s obviously had
2 over 70 years of clinical history in the United States, and
3 along with that, quite a bit of research. The United
4 States Code actually includes music therapy as a support
5 service and a health promotion service. If the part of the
6 Older Americans Act and has been that way since 1992.
7 It’s also listed as a program that can be
8 included under the General Services Administration, some
9 music therapists who are Federal or State contractors can
10 use the GSA schedule to contract with different government
11 agencies to provide music therapy services, and they’re
12 recognized as a professional or allied health service.
13 Music therapists are also eligible to be national
14 provider identifier owners. As a part of the HIPAA
15 requirements from CMS, all healthcare providers have to
16 have a national provider identifier, and music therapy is
17 listed in that taxonomy with the government.
18 The Centers for Medicare and Medicaid Services
19 recognize music therapy. W e ’ve actually had direct
20 reimbursement for partial hospitalization since 1994, and
21 we ’re included in the prospective payment system, so w e ’re
22 not billing separately for Medicare but we’re included in
23 the daily package rate for inpatient psych, inpatient
24 rehab, hospice, and skilled nursing.
25 CMS also recognizes music therapy on the Minimum 11
1 Data Set assessment tool that’s used in nursing homes, so
2 we ’re specifically listed on that national assessment.
3 And then to move over into the Department of
4 Education, we are also recognized as a related service
5 under the Individuals with Disabilities Education Act.
6 We ’ve been on students IEPs, their individual education
7 programs and plans, since 1975 and continue to see growth
8 in that area of clinical practice.
9 Despite these examples, though, of national
10 recognition, what w e ’re finding is that consumers continue
11 to have problems. They encounter misrepresentation from
12 individuals who are not qualified to provide music therapy,
13 I think, because the public sometimes has a
14 misunderstanding of what skill level it takes and that it’s
15 not just simply going in and taking your guitar and playing
16 for folks. There really is the science and the research
17 behind the profession.
18 And also the fact that State regulations often
19 require that a healthcare professional have a State-
20 recognized credential, that oftentimes prevents individuals
21 in the community from accessing services because the
22 facility doesn’t know that they can hire a music therapist,
23 that we are qualified, that we have met national board
24 certification requirements. And this creates barriers to
25 service access. 12
1 In particular in Pennsylvania what we have found
2 is that individuals in one county can receive music
3 therapy, and if they moved to another part of the State,
4 then they’re not able to access it because that county
5 doesn’t recognize the profession and its credential. And a
6 State license would help alleviate that misunderstanding.
7 It would be a statewide recognition of the profession and
8 its credential.
9 We understand that with any proposed change in
10 occupational regulation that there are going to be peers in
11 our rehabilitation professions that have questions, and we
12 acknowledge that you may hear opposition statements today
13 -- they’re in your packet as well -- from representatives
14 of those professions.
15 And I would like to take the opportunity to
16 alleviate any concerns and demonstrate the good-faith
17 efforts that we have made over the past four years in other
18 States to reach compromises with bill language so that
19 consumers are the ones who benefit. The consumers need to
20 benefit from the collaborative and interdisciplinary
21 treatment team approach that we have in clinical settings.
22 It’s very common to see music therapists, physical
23 therapists, speech therapists, marriage and family
24 therapists, occupational therapists all working side-by-
25 side either in a school setting working with a child with a 13
1 disability or working in a rehabilitation hospital and
2 treating those individuals. We are part of a team, and we
3 each bring something different to the table, and that’s
4 what we would like to see maintained through this license.
5 I do have some specific issues that I know have
6 been raised from our opposition within their written
7 testimony, and I ’d like to address some of those now to
8 help you have a better understanding of the situation.
9 I think there’s some concern with other
10 professionals that they will not be allowed to use music in
11 their treatment, and that is not our intent. The bill
12 clearly has exemption language that states other
13 professionals are able to use music as long as they do not
14 represent it as music therapy or claim to be music
15 therapists. We understand that everybody uses music to a
16 certain extent, and w e ’re not preventing that process.
17 We also do not claim to own music, just as other
18 professions cannot claim to own certain disabilities or
19 disorders. Consumers in Pennsylvania have the right to
20 seek the healthcare services that meets their needs and the
21 services that are ordered by their physicians because music
22 therapists go in after an order has been received or a
23 referral has been received from another healthcare
24 professional. So it’s not taking over for another therapy.
25 It’s in addition to or after the other therapy is 14
1 concluded.
2 There are some concerns, I think, that our
3 mission is about reimbursement and it is not. As I clearly
4 stated earlier, we really have an access issue in
5 Pennsylvania of people not being able to get the service
6 because the State doesn’t recognize the profession
7 formally, and so our main goals are, one, to protect the
8 public from the misrepresentation, to improve the access,
9 and to avoid confusion, just even understanding the
10 difference between a music volunteer and a music therapist
11 and the dramatic difference in training that it involves.
12 As far as CPT codes, if you’re familiar with that
13 terminology from the American Medical Association and the
14 codes that they use for billing, w e ’ve actually talked with
15 the American Medical Association. We actually put in an
16 application for specific music therapy codes, and we were
17 directed by them to utilize existing codes, that the
18 existing codes are not discipline-specific but they’re
19 procedure-specific and so they gave us that permission to
20 use those codes.
21 We do recommend to our members that they don’t
22 use the same codes as other professions on the same day,
23 and that they communicate with our peers in OT, PT, and
24 speech so that they don’t double-bill. We don’t want that
25 problem with the insurance companies. And ultimately, it 15
1 is the insurance companies that decide what services
2 they’re going to cover and what requirements they have for
3 each particular code. So in some States it’s not possible
4 for a music therapist to apply for or to actually bill for
5 a speech therapy, the code the talks about treatment of
6 speech, but that doesn’t mean that music therapists cannot
7 use other CPT codes. And very few music therapists
8 actually use that particular code that the speech
9 therapists are concerned about.
10 I think another issue that has been raised is
11 that music therapists are not qualified, that we don’t have
12 the clinical training or the education to provide the
13 services that we do. And I know that my peer Nicole is
14 going to talk a bit about the education part, but just to
15 say that we do have a very comprehensive and rigorous
16 program, and it actually takes close to five years to
17 complete the program as it stands now. The profession is
18 considering moving to a master’s level entry at this time.
19 But even prior to that, even with the coursework
20 that we have and the 1,200 hours of clinical training that
21 we do, music therapists are specifically trained to
22 independently analyze nonverbal, verbal, psychological, and
23 physiological responses to music. We don’t assess the
24 disorders themselves; we assess the patient’s response to
25 music. And I think that’s the biggest difference that 16
1 needs to be clarified.
2 Our profession’s board certification domains and
3 our scope of practice do not state that we diagnose. We do
4 not claim to diagnose any disorders. We don’t assess the
5 disorders themselves. We do provide treatment, though, to
6 help alleviate the issues that are our clients are dealing
7 with.
8 I think in the realization that in Pennsylvania
9 there are 450 music therapists, when you compare that to
10 the numbers of other peers in rehab therapies w e ’re very
11 small. W e ’re not a threat. And in fact we work quite well
12 together in a clinical setting. And I ’m hopeful and I ’m
13 very positive that w e ’ll be able to, you know, work out any
14 concerns that might be raised today.
15 I think just a reminder that House Bill 1438
16 already includes language within the music therapy
17 definition that has been adopted in other States. We
18 actually have six States that have licensure across the
19 country, one State with State certification and one State
20 with a registry.
21 And in fact, since a formal meeting between our
22 associations back in 2012, AMTA has consistently followed
23 suggestions from the American Speech-Language-Hearing
24 Association regarding State licensure communication. ASHA
25 recommended that music therapists reach out to individual 17
1 State’s speech-language-hearing associations as we
2 introduce our legislation in each State, and we have done
3 so. And in the process we have been very successful in
4 other States, and w e ’re confident that any concerns in
5 Pennsylvania can also be addressed in this manner.
6 So thank you so much for your consideration of
7 1438. Thank you.
8 MAJORITY CHAIR HARHART: Thank you very much for
9 your testimony.
10 Before we begin, I have had Members that have
11 joined us, and I would like the Members to please give your
12 name and where you’re from.
13 REPRESENTATIVE MUSTIO: Mark Mustio, 44th
14 District, Allegheny County.
15 REPRESENTATIVE DAY: Gary Day, Lehigh and Berks
16 Counties, 187th District.
17 REPRESENTATIVE BROWN: Rosemary Brown, 189th
18 District, Monroe and Pike County.
19 REPRESENTATIVE DEASY: Dan Deasy, 27th District,
20 Allegheny County.
21 REPRESENTATIVE MENTZER: Steve Mentzer, 97th
22 District, Lancaster County.
23 MAJORITY CHAIR HARHART: Okay. Okay. Thank you.
24 Thank you for being here.
25 You may begin. 18
1 MS. HAHNA: Thank you, Madam Chair Harhart and
2 the Members of the Professional Licensure House Committee.
3 My name is Dr. Nicole Hahna. I teach in the music therapy
4 program at Slippery Rock. I ’m going to be briefly talking
5 about the education requirements of music therapy students
6 in our Commonwealth.
7 So currently, music therapists require a four-
8 year degree to practice. At Slippery Rock University, that
9 includes six semesters of clinical placements prior to an
10 internship. We are blessed to have an on-campus music
11 therapy clinic. Each of those sessions are videotaped, and
12 we have a board-certified music therapist that provides
13 individual and group supervision to each of our students.
14 We have a very closely monitored education and clinical
15 training.
16 After completing coursework that includes
17 coursework in music, music therapy, things like the
18 psychology of music, understanding how music affects the
19 brain and our body, taking courses such as anatomy and
20 physiology, introduction to special education, students are
21 eligible to take a six-month 1,040-hour internship. Again,
22 that is under the supervision of a board-certified music
23 therapist.
24 After successful completion of this internship
25 and all pre-internship clinical hours, they take a national 19
1 board certification exam, and upon successful completion of
2 that, the credential MTBC or Music Therapist Board-
3 Certified is issued.
4 One of the amazing things in our Commonwealth is
5 the number of music therapy schools that we have.
6 Currently, we have nine universities in the Commonwealth
7 that provide music therapy. In my written testimony I do
8 indicate which universities those are. And starting in the
9 fall, Edinboro will be added. That gives us 10
10 universities in our Commonwealth, which is the highest
11 number in any State in this country.
12 If we imagine we have 450 music therapists now in
13 this State, if every one of those States graduates between
14 5 and 10, which are very conservative numbers, we have
15 between 50 and 100 music therapists each year becoming
16 board-certified.
17 And the issue w e ’re having right now in
18 Pennsylvania is brain drain. As an educator in the State
19 system, I work very hard to produce and train students that
20 are very qualified, and they’re having to leave the
21 Commonwealth due to lack of licensure.
22 I live in Allegheny. One of the major
23 stakeholders in Allegheny is Allegheny Health Network. I ’m
24 sure you guys have heard the fun times w e ’re having over in
25 Pittsburgh. And just last week Allegheny Health Network 20
1 posted a job position for music therapist upon which no
2 Pennsylvania music therapists can apply because it requires
3 licensure.
4 I am encouraging us to support House Bill 1438 to
5 stop the brain drain that’s happening, to keep Pennsylvania
6 jobs here in Pennsylvania, and we recognize the strength,
7 the clinical training, and the amazing work that music
8 therapists are doing here in our Commonwealth with 10
9 universities in our Pennsylvania State.
10 MAJORITY CHAIR HARHART: Thank you, Nicole.
11 MS. WALBORN: Good morning. My name’s Melanie
12 Walborn. Thank you, Chairlady Harhart and the Members of
13 the Professional Licensure Committee.
14 I’m a board-certified music therapist, co-Chair
15 of the Pennsylvania State Task Force for occupational
16 regulation of music therapy, and I ’m a small business owner
17 of WB Music Therapy. We provide services in Dauphin,
18 Lancaster, and Lebanon Counties.
19 I’m among at least 10 other woman-owned small
20 businesses in our State that serve counties like Lehigh,
21 Delaware, Tioga, Lackawanna, Luzerne, Wyoming, Susquehanna,
22 Beaver, Allegheny, Bedford, Somerset, Cambria, and Blair
23 counties. I ’m going to share information today that will
24 focus on the benefits of licensing the music therapy
25 profession in our great Commonwealth. 21
1 First, w e ’ll talk about restricting practice in
2 Pennsylvania. When we talk about music therapy in creating
3 this license, the passage of this bill will actually likely
4 increase opportunities for State agencies, facilities, and
5 employers to include music therapy, as Judy mentioned, as a
6 treatment option for the consumers.
7 Currently, the inconsistency in State regulations
8 has prevented music therapists from working in this State.
9 For example, residents of York County are not eligible to
10 receive music therapy through their managed care
11 organization because Community Care Behavioral Health
12 network does not recognize music therapy as an eligible
13 service option. However, individuals living in the
14 neighboring county like Lancaster and Cumberland, they are
15 eligible to receive music therapy through their MCO
16 PerformCare because PerformCare recognizes music therapy as
17 a valid healthcare profession.
18 Thinking about licensure and restricting the
19 supply of practitioners into the entry of our profession,
20 licensure would likely increase the number of practitioners
21 in our State. It would create a mechanism for public and
22 facility awareness, advocacy for the profession, and
23 improved access to services. Music therapists who relocate
24 from another State would be eligible to work as board-
25 certified music therapists in Pennsylvania, as we are 22
1 seeking State recognition of the same national education,
2 clinical training, and board-certification requirements.
3 Hundreds of graduates each year from the nine university
4 music therapy degree programs will have the confidence to
5 stay in Pennsylvania, seeking work in a place that formally
6 identifies and values the practice of music therapy.
7 Now, undoubtedly, the cost of creating a State
8 license is a concern of your Committee and the individuals
9 that oversee the finances of our State. Fortunately, State
10 recognition of the MTBC, as structured according to the
11 proposed plan in our current bill language, is cost-
12 neutral. Our startup and maintenance costs can be covered
13 through our licensing fees, which are nominal for our
14 practitioners.
15 The current bill proposes the creation of a board
16 that’s comprised of volunteers in order to provide
17 oversight at a minimal cost to the State. Additionally,
18 there’s no foreseeable increases in costs of services to
19 consumers as a result of regulating music therapy through a
20 State license.
21 There is potential for economic growth as a
22 result of regulating the profession that is more likely to
23 occur. Thinking about cost, music therapy is a proven
24 cost-effective treatment option. The potential for job
25 growth due to attracting or retaining current and newly 23
1 trained music therapists will increase with the addition of
2 this licensure.
3 State facilities supported by the people of
4 Pennsylvania that provide music therapy services by an MTBC
5 can often experience cost-savings. This is evidenced by
6 the impact of selected music therapy interventions on
7 important cost drivers such as the length of stay in a
8 neonatal intensive care unit or use of medical procedural
9 efficiencies in the perioperative environment. All these
10 factors have a positive impact on constituents.
11 The benefit of increased governmental
12 intervention in the marketplace will be improved consumer
13 protection and streamlined access to quality services in
14 healthcare and education settings for Pennsylvania
15 residents. The potential for decreased out-of-pocket
16 expenses for those receiving services as facilities
17 confidently identify and employ therapists who have met
18 State requirements for professional practice, this could
19 lead to favorable economic outcomes for Pennsylvania.
20 Thank you for your consideration of House Bill
21 1438.
22 We are going to listen to a video now if that’s
23 okay, Chairlady.
24 MAJORITY CHAIR HARHART: Yes.
25 24
1 (A video was played back.)
2
3 MAJORITY CHAIR HARHART: Okay. The next
4 testifier is Tony.
5 MR. ELHAJJ: Madam Chair and Members of the
6 Pennsylvania House Licensure Committee, my name is Tony
7 Elhajj. I ’m the father of a daughter with Rett syndrome.
8 Rett syndrome is a mutation of the X chromosome on the
9 MECP2 gene. One in 10,000 girls gets this disease, and for
10 my daughter it’s stolen her ability to walk and talk. And
11 she has seizures every day, and she is fed through a G-tube
12 due to her inability to swallow correctly.
13 However, her brain functions normally. Imagine
14 the symptoms of autism and cerebral palsy, Parkinson’s,
15 epilepsy, and anxiety disorders all wrapped up in one
16 little girl. So I ’m writing to give my support to House
17 Bill 1438 seeking to create a State board of professional
18 music therapy licensure that will recognize the MTBC
19 national credential in Pennsylvania.
20 This bill is important because it will allow
21 Pennsylvania citizens to more easily access music therapy
22 services, and it will protect the public by ensuring that
23 these services are provided by trained and qualified
24 practitioners.
25 My daughter Caroline has received music therapy 25
1 for the past eight years. Music therapy has been
2 instrumental in our long and painful road of providing care
3 for our daughter. The music therapist would come and
4 interact with Caroline and maintain her attention through
5 rhythm and melody as they played the music for her.
6 Once we realized how well my daughter responded
7 to music, we incorporated it into her other therapies such
8 as speech and occupational and physical therapy, and even
9 her regular teacher has used it. On the advice from the
10 music therapist, we played various tunes for my daughter to
11 help her focus on the task at hand. Our music therapist
12 also made recordings of some relaxing guitar music for her
13 anxiety and for her sleep.
14 We found that when the music therapist co-treated
15 with the other therapists that the session became very
16 productive. At one point about two years ago, funding
17 became an issue with our musical therapist, and changes to
18 their funding dictated that the therapist could no longer
19 come to the house to treat Caroline. So we went to the
20 school district and asked them to put it in my daughter’s
21 IEP, which they did. Not only that, they attained music
22 therapy for the entire school district, which meets once a
23 week throughout the school year for all the children with
24 disabilities.
25 My daughter has specialized medical needs. 26
1 Musical therapists are trained and nationally certified
2 professionals that are educated in a way that can meet my
3 daughter’s needs. No other provider should be trusted to
4 work with the intricate needs of my daughter and all the
5 people who have complex diagnoses.
6 Please support efforts to establish a State board
7 of professional music therapy licensure by voting "yes" on
8 House Bill 1438.
9 MAJORITY CHAIR HARHART: Thank you.
10 Next? That would be Kristine.
11 MS. DIONNE: Kristie. Good morning. I ’d also
12 like to state for the record that I am here this morning as
13 a parent, and while my other credentials are an important
14 part of my daily life, I am here today as a parent.
15 So with that, good morning, Madam Chair Harhart
16 and ladies and gentlemen of the Pennsylvania House
17 Professional Licensure Committee. My name is Kristie
18 Dionne. I am the mother of Michael Abraham, an 11-year-old
19 boy with low-functioning autism, an intellectual and
20 development disability, along with major impulsivity and
21 anxiety.
22 I am here today to lend my support in favor of
23 House Bill 1438 seeking to create a State board of
24 professional music therapy licensure that will recognize
25 the music therapist board-certified national credential in 27
1 Pennsylvania.
2 To understand the extent to which music therapy
3 has had an impact on our lives, it’s helpful to know a bit
4 of Michael’s history. When he was officially diagnosed at
5 three years old, Michael’s prognosis was grim. We were
6 told Michael would never talk, never be able to learn,
7 never read, or never do anything independently, in short,
8 never really amount to anything unless we infused intense
9 intervention on a daily basis. So we did.
10 Music therapy has been one of those
11 interventions, and it’s made a huge difference for him, in
12 concert with the other interventions that we take.
13 Michael’s autistic brain has a padlock of the most secure
14 variety on every lobe. Since he was two years old, we have
15 tried so many keys to unlock those lobes that our key ring
16 holds more keys than a school janitor’s. There have been
17 few golden keys that have fit and clicked during Michael’s
18 life. One of the keys is music therapy.
19 Before he would respond to his spoken name, as a
20 toddler, Michael responded to his name sung in tune. He
21 responded to music in a variety of settings when spoken
22 interaction fell flat. When we learned about music therapy
23 as an accepted intervention for autism, we quickly applied
24 for an evaluation, knowing instinctually that Michael would
25 benefit from it. And benefit he has indeed. 28
1 Michael has been receiving music therapy through
2 Living Unlimited for almost six years. His current music
3 therapy plan addresses some of Michael’s challenges: self-
4 injurious behavior, physical aggression, noncompliance,
5 frustration tolerance, safety regarding elopement, and
6 impulsivity.
7 Music therapy has helped improve Michael’s
8 ability to attend to an activity for increased spans of
9 time, scan a field of choices and make a selection, follow
10 multistep directions, regulate his body using rhythm to
11 perform repetitive movements that help with skills for
12 daily living, and develop coping skills to express and
13 regulate his emotions.
14 We use techniques learned from Michael’s music
15 therapist to continue skill development and prevent
16 undesirable behaviors. Michael is able to participate in
17 his school choir and attend concerts, even playing a
18 percussion instrument during his fall concert last
19 December. Standing on a stage surrounded by many sensory
20 stimuli while being expected to stand still, sing songs,
21 and make hand motions would have once seemed impossible,
22 perhaps horrifying, to us all. But with music therapy,
23 accomplishing this feat, as well as mundane daily
24 activities, is much more tolerable for Michael.
25 Over the years, Michael has also participated in 29
1 music listening therapy prescribed by an occupational
2 therapist. In addition, he receives adapted music led by
3 his outstanding music teacher at his elementary school.
4 But make no mistake, neither listening therapy nor adapted
5 music come close to competing with the positive behavioral
6 and functional outcomes that music therapy provides.
7 Just as our speech therapists, occupational
8 therapists, and recently, behavioral specialist consultants
9 (BSCs) are required to hold licenses to practice in
10 Pennsylvania, so too should our music therapists. This is
11 a serious business, equal to any other therapy our loved
12 ones receive, and the care of our disabled children should
13 be taken very seriously.
14 We are an extremely vulnerable population, fully
15 dependant on those who care for our children, as well as
16 disabled adults. As parents, when we take our children for
17 care and therapy, we expect that those caregivers are fully
18 trained, vetted, and approved by the therapeutic community.
19 Without such checks in place, unexpected consequences, or
20 perhaps no results at all, may occur at a huge expense.
21 Today, with the help of phenomenal therapists and
22 teachers over the years, Michael can talk, can learn, can
23 read, and is on a course to be a contributing member of
24 society as an adult, rather than being a burden, which was
25 once prognosticated. 30
1 I ask that you support the efforts to establish a
2 State board of professional music therapy licensure by
3 voting "yes" on House Bill 1438. Thank you.
4 MAJORITY CHAIR HARHART: Thank you. Okay. I am
5 going to open it up to questions right now, and if I may,
6 since I am the Chair, can I ask one?
7 I had heard I believe it was you say that not
8 every county recognizes -- why not? I mean, this is a
9 diverse State, I understand, but you would think that
10 something like this would be recognized throughout the
11 State of Pennsylvania.
12 MS. SIMPSON: Since there is no official
13 recognition at the State level of the profession, it’s not
14 listed anywhere within the State regulations, or our
15 credential is not listed. Then when counties go to see
16 who’s qualified to provide services, they don’t see the
17 music therapy on the list.
18 MAJORITY CHAIR HARHART: Oh, so —
19 MS. SIMPSON: And as a result, then they deny
20 those services. I guess maybe perhaps Melanie could speak
21 to how some counties do include it and how that has been
22 able to be achieved.
23 MS. WALBORN: I can speak knowing about the
24 capital area, Dauphin, Lebanon, Perry, Lancaster,
25 Cumberland Counties. The managed care overseas the members 31
1 that choose to be members of their insurance company, but
2 it comes ultimately from the Department of Human Services.
3 So w e ’ve been in good communication with that company, and
4 their psychologist has decided that that’s what they want
5 for their members.
6 However, not every -- there’s about 13 managed
7 care organizations in the State who recognize music
8 therapy, and that is their choice at this point without a
9 State recognition.
10 MAJORITY CHAIR HARHART: That’s interesting. And
11 how do they define it? I heard you say your musical
12 therapist ran out of funds. Was she funded from the county
13 or how was the funding distributed to her?
14 MR. ELHAJJ: Not knowing exactly, but our music
15 therapist comes from Living Unlimited, which is Living
16 Unlimited in our area, and -
17 MAJORITY CHAIR HARHART: Is that a private
18 organization?
19 MR. ELHAJJ: (Nonverbal response).
20 MAJORITY CHAIR HARHART: Okay.
21 MR. ELHAJJ: So the funds from there but then I
22 guess -- and I don’t know the details of it. I just know
23 that we got the phone call and they no longer could come to
24 the House. And we can still have it. We just have to
25 transport my daughter once or twice a week up to 32
1 Harrisburg, wherever.
2 So we stopped right there. I called the school
3 district. We had some communication. In Middletown Area
4 School District, the Director of special ed, very helpful,
5 very knowledgeable about music therapy, not only did she
6 approve it for us but she got it for the entire school
7 district, which the past two years now they've been having
8 music therapy in the classroom for kids with disabilities.
9 MAJORITY CHAIR HARHART: Interesting.
10 MS. WALBORN: I also could speak on that. The
11 managed care organization had to do some backpedaling let's
12 say. Music therapy wasn’t always in the record for them.
13 They had been using some different terminology to, let’s
14 say, we can’t call it music therapy; w e ’re going to call it
15 something else. And now they officially recognize it so
16 there are medical necessity criteria to receive music
17 therapy, but it is an outpatient service. So under the
18 State regulations, anything that’s an outpatient mental
19 health service must be provided in an office location. So
20 that’s where that change came from where people were
21 getting services in the school, in their home, in a non
22 approved office location and then the paperwork came in
23 that made it all situated.
24 MAJORITY CHAIR HARHART: Is that a good thing?
25 MS. WALBORN: It is a good thing because it does 33
1 show that the managed care organization was taking it very
2 seriously, and there’s hundreds of their members receiving
3 music therapy as a behavioral health service. So they
4 needed to make their regulations follow through with the
5 State through the office of Mental Health and Substance
6 Abuse Services, who oversees performed care.
7 MAJORITY CHAIR HARHART: Okay. Thank you. Thank
8 you very much.
9 Before we go on to the Members for questions, I
10 know we have two Members that have joined us. You have to
11 understand that our schedules are very, very -- we have
12 very busy schedules, so there’s a lot of meetings going on
13 and overlapping. So, you know, we all try to get to where
14 we need to go. And I appreciate the Members that have been
15 here to listen to some of your testimony. But they did
16 have to leave. It’s not because of you. It’s because of
17 their schedule.
18 And would you mind introducing yourself and where
19 you’re from?
20 REPRESENTATIVE GILLESPIE: Thank you, Madam
21 Chair. Keith Gillespie, 47th District, York County.
22 REPRESENTATIVE KNOWLES: Thank you, Madam Chair.
23 Jerry Knowles, the 124th Legislative District, which
24 includes portion of Berks, Schuylkill, and Carbon County.
25 MAJORITY CHAIR HARHART: Thank you. 34
1 We also have a question from Representative
2 Readshaw, Chair Readshaw.
3 DEMOCRATIC CHAIRMAN READSHAW: Thank you, Madam
4 Chair.
5 Judy, with your permission, I ’m going to address
6 this question to you. Anyone may join in. But I need some
7 practical help here. You had mentioned residential nursing
8 facilities in your testimony. Could you give me a
9 practical example? Are you on staff? Are you called in in
10 a nursing facility where there might be X number of
11 patients, a practical example of what you do and how this
12 works?
13 MS. SIMPSON: I would definitely give it over to
14 someone who’s doing clinical work at this time to give you
15 a specific example. But as far as the hiring position, it
16 could be a full-time position. It might be a contract
17 position where a music therapist goes in. Because there’s
18 not many of us, oftentimes, they’ll contract with several
19 nursing homes in particular. And they might either see
20 individuals at the bedside or they’ll do group programming,
21 especially for those with dementia and Alzheimer’s. It’s a
22 very effective treatment for that population and that
23 diagnostic group.
24 And does someone want to address the actual -
25 MS. HAHNA: Madam Chair, if we could bring up 35
1 Michelle Muth, who is a music therapist in Beaver County
2 and Allegheny County to answer the Representative’s
3 question.
4 MAJORITY CHAIR HARHART: On video?
5 MS. MUTH: No, I ’m using this microphone if
6 that’s okay.
7 MAJORITY CHAIR HARHART: Oh, you’re Michelle?
8 MS. MUTH: Yes, I am.
9 MAJORITY CHAIR HARHART: Oh, okay. I ’m sorry.
10 MS. MUTH: I ’m Michelle Muth, so I own M3 Music
11 Therapy in Beaver County. I ’m also a female-owned business
12 and practicing with this client base. So a practical
13 application, in a skilled nursing facility, sometimes they
14 contract with a music therapist to come in, sometimes they
15 have them on staff. In Beaver County at St. Joseph’s in
16 Baden they have a full-time music therapist on staff.
17 And the music therapist -- so I ’m going to paint
18 two pictures for you. You might come into a skilled
19 nursing facility and you might come in and see in a group
20 there is somebody with an accordion performing music or
21 singing music to a group of residents. And the residents
22 all look like they’re enjoying it and they feel better.
23 But this is an entertainment scenario where somebody is
24 entertaining and that’s somebody they hire in.
25 In another situation you might see a group of 36
1 people sitting in a small group with somebody who looks
2 like they might be doing the same thing. However, what
3 might be different is you might see somebody, a music
4 therapist, holding a drum in front of a resident. Perhaps
5 this is a group that is all recovering from stroke is their
6 primary diagnosis. So there with stroke recovery you’re
7 trying to work on strengthening the affected side or trying
8 to help restore some language abilities.
9 So a music therapist might have a drum that
10 they’re holding in front of somebody that might have a
11 mallet strapped and w e ’re aiming for gross motor movement
12 to hit that drum. And the music therapist is also
13 supporting the arm to make sure there’s no injury done to
14 that arm while at the same time the whole group might be
15 sharing in the song "Oh, What a Beautiful Mornin’" where
16 the music therapist is doing strategic places for prompts
17 in the music.
18 You know how you hear music and you always get to
19 this point you have to finish it. In a sense that’s what
20 we do. W e ’re prompting through that music. Oh what a
21 beautiful -- morning. So the rest of the group -- so by
22 prompting through that music they’re starting to regain
23 some of their language. That’s what you saw with Gabby
24 Giffords. As they were doing a song, it’s cadential points
25 in music and understanding those points. And then you’re 37
1 doing the tempo according to what that individual can
2 actually do with their arm.
3 If a non-music therapist were in this position
4 and held the drum out and expected them to go like this,
5 they might be able to lift their arm but they have no
6 control to put it down and they could cause injury to their
7 arm coming down with stroke. So you need to have somebody
8 who understands the physiology that’s going on.
9 So that’s sort of two images you might see.
10 Sometimes a music therapist is on staff. Sometimes they’re
11 contracted in. Did that help answer your question?
12 DEMOCRATIC CHAIRMAN READSHAW: Yes, thank you
13 very much.
14 MS. MUTH: Okay.
15 DEMOCRATIC CHAIRMAN READSHAW: Not to be
16 critical, but I think that component was not stressed in
17 your testimony, the practical application so we can better
18 understand exactly what you do. Thank you very much.
19 Thank you, Madam Chair.
20 MAJORITY CHAIR HARHART: Thank you.
21 Representative Mustio.
22 REPRESENTATIVE MUSTIO: Thank you. I want to
23 thank you for holding this hearing today. It’s been very
24 informative. And you certainly have the right House
25 Member, being the great vocalist that he is, sponsoring 38
1 your legislation.
2 I do have a couple questions. You know, I ’ve had
3 a similar bill for a naturopath that has been struggling to
4 get passed, so I ’m very sympathetic to your cause here.
5 And, Judy -
6 MS. SIMPSON: Yes.
7 REPRESENTATIVE MUSTIO: — Ms. Simpson —
8 MS. SIMPSON: Ms. Simpson.
9 REPRESENTATIVE MUSTIO: — the letter that we
10 received from the Pennsylvania Occupational Therapy
11 Association outlined some objections, which I really don’t
12 see that many of them, if any, aren’t able to be satisfied.
13 But the next-to-last paragraph if I could just read it and
14 get your comment on whether you think this is able to be
15 taken care of.
16 "On the issue of infringement, since House Bill
17 1438 would make it illegal for anyone to use music for
18 therapeutic purposes without a license, it is imperative
19 that any legislation establishing licensure for music
20 therapists include explicit, unambiguous provisions stating
21 that the act would not prevent an occupational therapist
22 from performing therapy services involving music.
23 We oppose the general savings clause contained in
24 House Bill 1438 and would only support legislative language
25 that explicitly references the Occupational Therapy 39
1 Practice Act and exempts the services of licensed
2 occupational therapists.”
3 MS. SIMPSON: There is exemption language within
4 the bill currently, and I guess that’s what they’re taking
5 -- they don’t like that from that statement. But it does
6 state that if someone is already licensed in another
7 profession within Pennsylvania, they are -- w e ’re not
8 preventing the use of music within their scope of practice
9 as long as they do not call it music therapy or claim to be
10 a music therapist because we understand they do use music
11 sometimes, oftentimes recorded, but they’ll use music in
12 relation or in coordination with the treatments that they
13 have as OTs.
14 What we have done another State is we actually
15 have listed the other professions.
16 REPRESENTATIVE MUSTIO: Okay.
17 MS. SIMPSON: W e ’ve been able to come to that
18 agreement. In fact, the Georgia bill that passed, we did
19 list OT/PT speech within the exemption language so that
20 they were satisfied. So that is an option -
21 REPRESENTATIVE MUSTIO: Okay.
22 MS. SIMPSON: -- if they want to propose that.
23 REPRESENTATIVE MUSTIO: And then, Melanie, you
24 had indicated that you felt that the licensing fees or the
25 cost to license the board would be nominal. I don’t know 40
1 that we’ve necessarily seen that. How many potential
2 licensees are there for this?
3 MS. WALBORN: Currently, there would be
4 potentially 450 or so on the first year of licensing and
5 about 50 to 100 licensees each year after.
6 REPRESENTATIVE MUSTIO: Oh, okay. So you’ve gone
7 from 450 to 5,200? Am I hearing that right?
8 MS. HAHNA: From 50 to 1-0-0, 100. There’s 10
9 music therapy schools in the Commonwealth, so a
10 conservative estimate of 5 to 10 graduates each year.
11 REPRESENTATIVE MUSTIO: Oh, 50 to 100, not —
12 MS. HAHNA: Yes.
13 REPRESENTATIVE MUSTIO: — 5,200?
14 MS. HAHNA: No, no, no, 5-0 —
15 REPRESENTATIVE MUSTIO: We have the same problems
16 with -
17 MS. HAHNA: — or 1-0-0.
18 REPRESENTATIVE MUSTIO: — our budgets here, too,
19 so -- all right.
20 And Kristie, you were talking about the various
21 professionals that were part of the team for your child.
22 Of those, is the music therapist the only one that’s not
23 licensed? I think there was a teacher, there was an
24 occupational therapist.
25 MS. DIONNE: Right, the treatment he received 41
1 through occupational therapy is called music listening
2 therapy. There are two I ’m familiar with. One is Tomatis
3 and the one we used is Vital Sounds. And it is listening
4 to music through headphones that is -- and I can’t speak of
5 it scientifically, so pardon me for that, but it’s infused
6 with pitches that vary in obviously pitch and duration, and
7 those sounds stimulate different parts of the brain.
8 And perhaps an occupational therapist or anyone
9 on the panel could maybe -
10 REPRESENTATIVE MUSTIO: But those —
11 MS. DIONNE: -- describe it better, but that was
12 what he received through the occupational therapist.
13 REPRESENTATIVE MUSTIO: Okay.
14 MS. DIONNE: And then at school his music
15 teacher, the music teacher at the school provides adapted
16 music once a week for the children with low-functioning
17 special needs.
18 REPRESENTATIVE MUSTIO: So the only person that’s
19 not licensed the part of the team is the musical therapist
20 at this point?
21 MS. DIONNE: Right.
22 REPRESENTATIVE MUSTIO: Okay. Thank you, Chair.
23 MAJORITY CHAIR HARHART: Representative Knowles.
24 Oh, okay, sorry.
25 Representative Day. 42
1 REPRESENTATIVE DAY: Thank you. I have a lot of
2 questions about just providing information for the
3 Committee, so I just want to -- for time purposes I want to
4 get the understanding -- and you don’t have to answer
5 today, maybe just send an email later about the educational
6 requirements. You touched on them and -- but how they
7 compare to other people in this space. There are other
8 therapists. And the information about other States also
9 and what are their degrees. I think we had that there was
10 six with licensure, one with certification and one with -
11 MS. SIMPSON: Registry.
12 REPRESENTATIVE DAY: -- registration. But who
13 are they, and just whatever information you can provide
14 helps us start to build which way to go with this.
15 One of my questions that maybe you can answer and
16 also provide if you have this later -- I don’t expect you
17 to have it all right now -- but is there anything that any
18 particular diagnosis that there are studies that say music
19 therapy was a breakthrough? You know, you have your
20 anecdotal information -- by the way, you did a great job
21 today.
22 MS. DIONNE: Thank you.
23 REPRESENTATIVE DAY: I just want to tell you.
24 Everybody did, but my sister is visiting with her autistic
25 son at my house, so it’s just really -- your story is very 43
1 close to home today. So I appreciate what you did today,
2 and it’s great that you have become such a great advocate
3 for your child.
4 What I ’m looking for is are there any studies
5 that say music therapy has unlocked something that other
6 therapies have not? And if you have that information, that
7 would be great if you could answer that question today.
8 MS. HAHNA: Yes, we would be happy to provide
9 that information. If there’s a specific clinical
10 population of interest, for instance, autism spectrum
11 disorders, if you’d like for us to send that information.
12 We have two journals of music therapy, the Journal of Music
13 Therapy -- they’re peer-reviewed -- and the Music Therapy
14 Perspectives. We also have Cochrane reviews demonstrating
15 -- those are meta-analysis of meta-analysis. It’s the gold
16 standard of looking at research. And w e ’d be happy to send
17 you both individual studies, examples of Cochrane reviews.
18 But we don’t have for the entire field. It would
19 have to be based on a specific population, but we could
20 certainly send you for autism spectrum if that’s an
21 interest.
22 REPRESENTATIVE DAY: I would be interested in
23 that myself, and that would be something that I ’m very,
24 very small amount exposed to. You know, I don’t live it
25 like my sister does. But I do as her brother. And the way 44
1 we operate is if you could provide that information to the
2 Chairman, her and her staff will make sure that everyone
3 will have answers to the questions today.
4 Did you have something else that -
5 MS. SIMPSON: I just wanted to say that -
6 REPRESENTATIVE DAY: Yes.
7 MS. SIMPSON: -- the National Institutes of
8 Health also recognize music therapy as a valid allied
9 health profession, and they have funded multiple studies
10 over the years, so we can provide those, an outline of all
11 of those.
12 REPRESENTATIVE DAY: You had mentioned in the
13 legislation that as long as they don’t call it music
14 therapy, so if someone else would use it, what would you
15 want them to call it?
16 MS. SIMPSON: They are just using it within their
17 own scope. So in other words, OTs use music, PTs might use
18 music, speech therapists use music, and that’s fine because
19 it’s within their scope of practice already, but it’s not
20 music therapy techniques. It’s a difference.
21 And a lot of times the difference is when you
22 physically see it or watch it is that music therapists do
23 live music and change it in the moment reacting to the
24 individual and responding to their response to the music.
25 W e ’re able to facilitate changes in the moment, changing in 45
1 the music whether it’s tempo, melody, rhythm. And so as
2 opposed to a prerecorded set of headphones or a prerecorded
3 just a simple -- just singing along, which we encourage
4 everyone to do. So it’s just a different application.
5 REPRESENTATIVE DAY: Thank you. And thank you
6 for your testimony today.
7 Madam Chair, I just want to make one final
8 comment and just for the record for this Committee, we all
9 know that we just recently passed as a Legislature the use
10 of medical marijuana, a psychotropic drug, and you guys are
11 here offering other types of treatments that don’t have
12 that type of effect on the human body, and I just want to
13 thank you for being here.
14 And, you know, in light of us passing that as a
15 Legislature, I don’t know why we wouldn’t consider the good
16 gentleman’s legislation. I still have a lot to learn about
17 it, but I just wanted to make that comment on the record.
18 Thank you very much.
19 MS. HAHNA: And if I could point out, Madam
20 Chair, where the exemption language is. If you’re in the
21 packet, it is on page 4, Section 301(b). It says that
22 "this act does not apply” -- does not apply -- "to a person
23 licensed certified regulated under the State including the
24 use of music so long as a person does not represent himself
25 as a licensed professional music therapist." I encourage 46
1 speech therapists, I encourage occupational therapists, I
2 encourage physical therapists to use music. I know that
3 it’s healing. I want everyone -- I hope you use music in
4 your personal lives as well. And the exemption language is
5 very clear and quite broad.
6 MAJORITY CHAIR HARHART: Thank you. Thank you
7 all for your testimony.
8 And I ’ll tell you, I do use music. When I want
9 to cry, I listen to music. When I want to laugh and be
10 joyful, I listened to happy music. And it does work for
11 me.
12 But I do thank you for your testimony, and I
13 think I learned a little bit, still have a lot to learn
14 about this, but I do appreciate you testifying. Thank you
15 very much.
16 MS. HAHNA: Thank you.
17 MAJORITY CHAIR HARHART: Oh, and we also have
18 another Member that joined us. Would you like to state
19 your name and where you’re from?
20 MR. CRAWFORD: You must.
21 REPRESENTATIVE EMRICK: Thank you, Madam Chair.
22 Representative Joe Emrick from Northampton County.
23 MAJORITY CHAIR HARHART: He is the Vice Chair of
24 Professional Licensure.
25 Okay. Our next testifier had a conflict and was 47
1 not able to come. Her name was Christine Achenbach. And
2 we do have testimony here for her. The testimony, though,
3 was written by Mary Muhlenhaupt, and she is the President
4 of the Pennsylvania Occupational Therapy Association. So
5 your testimony is in your packets.
6 Now, the next testifier will be Rita Porreca.
7 Okay. Would you please come to the mike? And then I
8 believe you have Suzanne Morano with you and Amy Tielemans.
9 MS. TIELEMANS: Tielemans.
10 MAJORITY CHAIR HARHART: Tielemans?
11 MS. TIELEMANS: Tielemans.
12 MAJORITY CHAIR HARHART: Tielemans. Now, I
13 believe you’re giving the testimony, and both of you are
14 kind of there to answer questions?
15 MS. PORRECA: Yes.
16 MAJORITY CHAIR HARHART: Okay. Great. You may
17 begin.
18 MS. PORRECA: Good morning, Madam Chair, Chairman
19 Readshaw, Committee Members. We thank you for this
20 opportunity to be able to speak to this issue today. My
21 name is Rita Porreca. I am the Legislative Director of the
22 Pennsylvania Association for Marriage and Family
23 Therapists, and with me today is Amy Tielemans, our current
24 President, and Sue Morano, who is our Executive Director.
25 I invite all of you to read the testimony that we 48
1 submitted, but to expedite time, I will say that I want to
2 make it perfectly clear that in the State of Pennsylvania
3 today a music therapist can be licensed under the State
4 Board of Social Workers licensed professional counselors
5 and marriage and family therapists. However, it’s required
6 that they have a master’s degree and 3,000 clinical hours
7 under clinical supervision.
8 This law was passed in 1998 when marriage and
9 family therapists and professional counselors joined the
10 Social Work Board to be able to get licensed, and it was
11 you, the State of Pennsylvania, that required that we have
12 master’s degrees. You can find this in Act 136 in 1998.
13 Our section specifically is Section 49.2 where it states
14 the educational and clinical hours required to become
15 licensed.
16 So it long has been recognized that the creative
17 arts, which includes music and music therapists, are needed
18 for people who are institutionalized, marginalized,
19 traumatized, the elderly, the children with a wide variety
20 of issues, and they were all included in that bill or in
21 that law in 1998. However, the music therapists did not
22 join with that, although there are some currently licensed
23 at the master’s level in Pennsylvania. So we want to make
24 it perfectly clear there is no need for another board. We
25 already have all of that mechanism in place for them to 49
1 become licensed.
2 One other point I would like to make, which is at
3 the end of my testimony, is that it’s required in
4 Pennsylvania that prior to the creation of a new licensing
5 board that the sunrise evaluation take place, which we did
6 back in the ’90s, and to date the proponents of this
7 legislation have failed to demonstrate a public need for
8 the creation of an additional licensing board. And so I
9 would expect that that also be taken into consideration.
10 So we oppose this bill because, as they talked
11 about in their testimony, they are one of a team that works
12 with people, and everyone else on that team, that clinical
13 team, have master’s degree or above, and they would be the
14 only clinical people at a bachelor’s level, and we feel
15 that that would start or set a bad precedent for the State
16 of Pennsylvania since, prior to this, it’s always been
17 required to be at a master’s level.
18 Thank you. I ’d address any questions that you
19 have.
20 MAJORITY CHAIR HARHART: Well, thank you.
21 Can I just ask the last panel? You are aware
22 that you need to have a master’s in order to be licensed?
23 MS. HAHNA: So the licensure that this bill is
24 referring to -- my husband is both a music therapist and an
25 LPC, a licensed professional counselor, but that is not 50
1 licensure of music therapy. It’s a completely separate
2 field. So music therapists with a master’s degree in
3 Pennsylvania specifically may apply to the social work LPC
4 [inaudible], but it does not include a music therapist’s
5 scope of practice. We work not only in behavioral health.
6 We work in medical settings and in educational. So
7 barriers to access would restrict -- if we went under only
8 LPC, a very small percentage of music therapists
9 [inaudible]. The testimonies you’ve heard from parents
10 [inaudible] would not be able to access music therapy under
11 the LPC social work and marriage and [inaudible].
12 MAJORITY CHAIR HARHART: You are going to have to
13 come and speak into a mike because otherwise it won’t get
14 into the record. Plus, we all can’t hear either. Thank
15 you.
16 MS. HAHNA: Thank you, Madam Chair, for the
17 opportunity to respond. My husband is a music therapist
18 and a licensed professional counselor in the Commonwealth
19 of Pennsylvania so I can speak to this issue personally.
20 The scope of practice for an MFT, a social worker, or a
21 licensed professional counselor specific to behavioral
22 health or mental health, the scope of practice for music
23 therapists, we work in the hospital setting, we work with
24 NICU, we work in hospice, we work with children with down
25 syndrome and autism spectrum, in addition to many of the 51
1 things that our behavioral health that would be related to
2 this board.
3 So we are currently seeking licensure of music
4 therapy to include the scope of practice of music
5 therapists. It would be very restrictive for us to go
6 under a board of social work, LPC, or marriage family
7 therapy. Currently, only 11 percent of music therapists in
8 this State practice just in mental health. Our scope of
9 practice is very diverse.
10 MAJORITY CHAIR HARHART: Okay. Did you want to
11 add something? Representative -
12 MS. PORRECA: Yes.
13 MAJORITY CHAIR HARHART: That’s okay. Did you
14 want to add something, Representative Pashinski?
15 REPRESENTATIVE PASHINSKI: I just wanted to make
16 sure she was on a mike so the record would pick her up.
17 MAJORITY CHAIR HARHART: Okay. Thank you.
18 Yes, did you want to add something?
19 MS. PORRECA: To that point, again, I would say
20 that all of those other practices, all those people on the
21 team are master’s level. This would be the only one that
22 would be at a bachelor’s level, master’s level or above.
23 MAJORITY CHAIR HARHART: Okay. Is there anything
24 further that you want to add to this or -
25 MS. PORRECA: We invite you to read our testimony 52
1 in the detail.
2 MAJORITY CHAIR HARHART: Oh, yes, it will be
3 read, and all the testimony, all the letters, we will
4 review all of that, absolutely. So -- okay. If you ladies
5 don’t have anything to add -- oh, I ’m sorry.
6 Representative Mustio, do you have a question?
7 REPRESENTATIVE MUSTIO: Yes. I think she makes a
8 valid point that we need to address, so I want to make sure
9 I’m understanding what you’re saying, and I ’ll say it in my
10 words and you can tell me how wrong I am and correct me.
11 Are you telling me that factually the act that was passed
12 by this Legislature years ago in 1998 required a master’s
13 degree as a minimum to become certified under the board
14 where you’re certified -
15 MS. PORRECA: Yes.
16 REPRESENTATIVE MUSTIO: — and as part of the
17 group that is currently able to be licensed, music
18 therapists are specifically delineated in that legislation?
19 MS. PORRECA: They are.
20 REPRESENTATIVE MUSTIO: And to become licensed —
21 MS. PORRECA: It’s called the creative arts, and
22 music is one of the creative arts that is included in that.
23 REPRESENTATIVE MUSTIO: Would the music
24 therapists agree that -- I ’m seeing heads shaking back
25 there -- that’s why I love what you just did, Chairman, by 53
1 bringing somebody up so we can get this going at the same
2 time so we don’t have to wait another month to get answers.
3 So it’s your interpretation that the music
4 therapists are included under what you just said?
5 MS. PORRECA: Yes, sir.
6 REPRESENTATIVE MUSTIO: So in order to be
7 licensed under that board they would have to have a
8 master’s degree?
9 MS. PORRECA: Yes.
10 REPRESENTATIVE MUSTIO: Now —
11 MS. PORRECA: And 3,000 hours of clinical
12 experience -
13 REPRESENTATIVE MUSTIO: Right.
14 MS. PORRECA: -- under supervision.
15 REPRESENTATIVE MUSTIO: Right. And Nicole just
16 came up and said that, as a musical therapist, we do a lot
17 of other things than what marriage counselors do. So this
18 is kind of like the Solomon thing, right? W e ’re dividing
19 the baby. There’s a significant value, my personal
20 opinion, of what they testified to. And there’s a
21 tremendous amount of expense to set up a separate board,
22 right? But are you telling me that it sort of diminishes
23 your license if we start licensing bachelor’s -
24 MS. PORRECA: Correct.
25 REPRESENTATIVE MUSTIO: Okay. That’s all I 54
1 wanted to -- thank you.
2 MAJORITY CHAIR HARHART: Thank you,
3 Representative Mustio.
4 Anyone else?
5 Representative Mentzer.
6 REPRESENTATIVE MENTZER: For either side of this
7 -- thank you, Madam Chairwoman.
8 For either side of this, how do you charge -- is
9 there a set charge to an insurance company for this? I
10 mean, is there a different charge for -- whether it be a
11 different charge for services that you provide and if they
12 set up a different licensure for music therapists alone,
13 would that be a different charge or is it all one charge?
14 MS. PORRECA: I can’t speak for music therapists.
15 I know the CPT codes that marriage and family therapists
16 use. They’re mental health codes and diagnosis codes that
17 come out of the DSM-V, which is our diagnostic manual.
18 REPRESENTATIVE MENTZER: Okay. So each insurance
19 provider would have a different payment schedule for that
20 code?
21 MS. PORRECA: Well, under our licensing board,
22 clinical social workers, LPCs, and marriage and family
23 therapists may use the same codes. They’re not specific
24 for individual mental health therapy. There is a CPT code.
25 REPRESENTATIVE MENTZER: Okay. So music 55
1 therapists that are not currently licensed because there is
2 no licensure board, how do you charge? And do insurance
3 companies recognize you?
4 MS. SIMPSON: Music therapists are not allowed to
5 use the mental health charges because w e ’re not qualified.
6 We recognize that that’s -- and we don’t support that. But
7 because our -- the difference between the -- and the
8 insurance companies don’t necessarily always pay for music
9 therapy. It is case-by-case approval, and oftentimes, it’s
10 private pay. So that’s not our intent, and having the
11 license is not going to ensure, unfortunately -- but it
12 won’t ensure reimbursement. That’s not -- because you
13 still have to show medical or behavioral necessity before
14 they would pay, and that’s what we do. So we present the
15 information to the insurance company, and they make the
16 decision case-by-case at this point. But we don’t use the
17 mental health codes unless they have a master’s in mental
18 health.
19 I think the difference that needs to be stressed
20 is that, yes, music therapists with master’s in mental
21 health can sit and have the license through your board.
22 However, if they have a master’s in music therapy, they are
23 not eligible. So if they’re truly just doing music
24 therapy, they can’t get a license, but if they have a
25 master’s in mental health like they decide, oh, I did my 56
1 bachelor’s in music therapy, I ’m going to get my master’s
2 in counseling, then I can be an LPC in Pennsylvania, that’s
3 great, but that’s not music therapy.
4 MS. PORRECA: I believe our law says that it is
5 an allied field, and music therapy is an allied field that
6 would be considered under our board.
7 MS. SIMPSON: But it does restrict them to mental
8 health. It doesn’t recognize music therapy. It calls them
9 an LPC so they’re actually a counselor. They’re not
10 providing music therapy when they use that title is what
11 I ’m saying. So in order to do music therapy, that’s not
12 recognized, but they could be LPCs. I do recognize that.
13 Does that make sense? So they can be licensed as another
14 profession but not as music therapist.
15 MS. PORRECA: They can be licensed as an LPC.
16 It’s a broad license, and the creative arts, drama, music,
17 and other things are all considered. They’re all LPCs but
18 they all have different flavors of it.
19 MAJORITY CHAIR HARHART: Right now, I ’m a little
20 confused with all of this.
21 MS. PORRECA: Yes.
22 MAJORITY CHAIR HARHART: Representative
23 Pashinski, I think you have your work cut out for you
24 because I think if you sit down with these groups and make
25 sure that everybody’s on the same page and understands 57
1 exactly what w e ’re doing because I move no bills unless
2 everything is ironed out and all i ’s are dotted and t ’s are
3 crossed. So you will have your work cut out for you there.
4 I thank you very much for your testimony.
5 And I think we have one more testifier, which is
6 Anne Gilbertson. Come on down. Anne is the President, PA
7 Speech-Language-Hearing Association, and Director of Rehab
8 HCR ManorCare. You may begin.
9 Are you her support?
10 UNIDENTIFIED SPEAKER: The view is better from up
11 here.
12 MAJORITY CHAIR HARHART: Oh, I see. Okay.
13 MS. GILBERTSON: Good morning, all. Madam Chair
14 Harhart, thank you for allowing me to come and talk to you
15 all of you today. I ’ve appreciated listening to all the
16 testimony already today. I ’ve learned some new things
17 myself, too, so thanks to all of you and the time that
18 you’ve spent.
19 Again, I ’m Anne Gilbertson. I do have a master’s
20 degree from Penn State a long time ago in speech-language
21 pathology. I have a Certificate of Clinical Competence
22 from American Speech-Language-Hearing Association, and we
23 call that the CCC. I have been practicing for 30 years as
24 a speech-language pathologist and, like you had mentioned,
25 I work for HCR ManorCare, which is a skilled nursing 58
1 facility. I have worked there for 30 years now.
2 I ’ve also worked in the arenas of home health and
3 also in the hospital setting, so I have a little bit of a
4 diverse experience level there. I have not worked with
5 children, so I will be up front with that because my whole
6 focus has always been adult rehab for my time I was at Penn
7 State.
8 I’m the President of the Pennsylvania Speech and
9 Hearing Association, and I ’m here to represent our
10 membership today in opposition of House Bill 1438, as it
11 directly impinges on our scope of practice. And as w e ’ve
12 talked about already this morning, it does create some
13 billing conflicts when a music therapist and a speech-
14 language pathologist are billing the same code on the same
15 day. And I ’ll get into that a little bit more when we get
16 through here.
17 We have speech-language pathologists that have
18 been licensed as healthcare providers in Pennsylvania for
19 over 30 years. Many of you may remember that just in the
20 past year or two we have updated our license to reflect
21 changes in our profession. We are uniquely educated and
22 trained to assess speech, language, hearing, swallowing,
23 balance, and cognitive communication disorders in children
24 and adults. These services help children acquire language,
25 speech, and enable individuals to recover essential skills 59
1 to communicate about their health and safety and to safely
2 swallow, as well to have sufficient attention, memory,
3 organizational skills to function in their environment and
4 to become an independent person.
5 I ’ll go over a little bit about the education
6 components that we go through. A speech-language
7 pathologist completes a comprehensive education program
8 that meets rigorous standards of practice based on
9 objective methodology. We have a master’s degree, and some
10 people do have a doctorate with 75 semester credit hours in
11 course of study addressing the knowledge and skills
12 pertinent to the speech-language pathology field. And
13 that’s during our master’s degree. So we have a bachelor’s
14 as well, but then in our master’s degree it’s a 75-credit
15 program.
16 Of that, a minimum of 400 clock hours of
17 supervised clinical experience in the practice of speech-
18 language pathology -- an audiologist would have 400 in
19 audiology just so you know -- with the supervision provided
20 by individuals holding the ASHA Certificate of Clinical
21 Competence. Now, of those 400 hours, just so you know, 25
22 of the 400 hours are during our bachelor level where w e ’re
23 doing observation, and then another 50 of those clinical
24 hours would be typically done in our clinics at our
25 university settings in the bachelor’s level. The other 325 60
1 are all done during our master’s level of training.
2 We have to have a passing score on a national
3 examination administered and validated by the Educational
4 Testing Service.
5 Another area that we have to do which is very
6 unique to speech-language pathologists is we have to
7 complete a supervised clinical fellowship year. We call it
8 a year. It’s actually 9 to 10 months. It’s approximately
9 1,600 hours of supervised direct work experience. We can
10 be paid during this time, but we are directly supervised by
11 someone who has a CCC from ASHA during that time. That
12 supervision is provided directly and indirectly. I ’ve
13 worked with over 20 to 25 CFs as we call them, clinical
14 fellows, and I typically spend a lot more than the required
15 amount of time supervising them so that I ’m giving them the
16 mentorship that they deserve to be able to care for the
17 people that they’re caring for.
18 And then we have State licensure. Right now, all
19 50 States require State licensure for speech-language
20 pathologists, including the District of Columbia.
21 Also, we have continuing education. And I have
22 been in the past the ASHA CEU Administrator for the
23 Pennsylvania Speech and Hearing Association, so continuing
24 education is very, very important to me. I don’t know how
25 people would not be able to continue doing their career if 61
1 they’re not ongoing learning.
2 Pennsylvania requires 20 hours of continuing
3 education every two years to maintain their licensure. All
4 20 hours has to be directly related to speech-language
5 pathology. ASHA requires 30 hours every three years. Some
6 of these hours may be the same hours, it’s okay, but ASHA
7 requires 30 years every three year to maintain their CCC
8 for ASHA.
9 And also, I want to make note of the Pennsylvania
10 Department of Education that requires 180 hours every five
11 years for speech-language pathologists to maintain their
12 teacher’s certificate.
13 A couple points that I ’d also like to bring up,
14 one is related to the scope of practice that I mentioned.
15 Music therapists’ scope of practice, as proposed in House
16 Bill 1438, is extremely vague and broad and indicates that
17 music therapists can assess cognitive and communication
18 abilities. Their scope of practice doesn’t actually
19 mention this, but their standards do mention that they can
20 include the assessment of cognitive, communication, and
21 social domains and implementing treatment in the areas of
22 executive functions, language, speech, communication
23 skills, neurological and cognitive function, and nonverbal
24 communication. And some of this was discussed today.
25 We believe that the protection for the persons in 62
1 need of the therapeutic treatment provided by a speech-
2 language pathologist needs to be within a scope of practice
3 limited to the specific competencies acquired through
4 extensive education, training, and practical experience.
5 And that’s one of my major points that I wanted to make
6 there is regarding our education, our training, and our
7 practical experience that we have.
8 Unlike SLPs, music therapists are not subject to
9 the same rigorous qualifications and standards and do not
10 acquire the skills necessary to assess and treat disorders
11 in the prescribed programs and subsequent clinical
12 training. Speech-language pathologists are the only
13 professionals who can appropriately assess and plan
14 treatment for individuals with communication disorders.
15 The bottom line is that House Bill 1438 would
16 allow music therapists to treat some conditions that
17 speech-language pathologists treat but do not have the same
18 level of education and practice that we do.
19 Just like music therapists pointed out, we do
20 have 15 universities and colleges in Pennsylvania that
21 actually engage in the preparation of speech-language
22 pathologists. Their teachings draw upon the huge body of
23 evidence-based practice developed over decades. Much of
24 this rigorous research has been supported and recognized by
25 National Institute of Health, U.S. Department of Education, 63
1 and the Veterans Administration. Music therapy is not
2 based upon as big a body of research.
3 I just wanted to point out a picture that I -- a
4 graph that I have, which I will also make sure that you
5 get, and I ’m going to also work to incorporate it including
6 Pennsylvania schools. But this is a graph -- see the
7 yellow versus the black, different columns? Each column
8 represents -- and then I have another page of it as well.
9 And, like I said, I will get this -- each column represents
10 an area that we actually study in school. One could be on
11 articulation, phonological disorders, it could be on
12 aphasia, it can be on different types of disabilities and
13 on and on and on and on. The yellow columns represent the
14 coursework that we actually have to take in order to become
15 a speech-language pathologist.
16 And we studied and looked at the universities.
17 This is Iowa, for instance, and they looked at three
18 universities in Iowa versus universities that have speech-
19 language pathology. The black columns are the coursework
20 for articulation or language or some other disability that
21 speech language pathologists would be working with, what
22 kind of coursework they’re getting as compared to what we
23 are for that particular disorder. So it just goes to show
24 that we have the education, the training, and expertise to
25 provide that level of care. 64
1 Back to my thing. Next point, reimbursement,
2 talking to you about the CPT codes, as mentioned before.
3 If music therapists become licensed, the Current Procedural
4 Terminology, otherwise known as CPT codes can be used to be
5 billing for the same services in the same day, and that’s
6 not allowable. If a patient received a service from a
7 music therapist and the CPT code 92507 was billed, a
8 speech-language pathologist could not typically bill that
9 day on the same day. The code 92507 is defined as
10 "treatment of speech, language, voice, communication and/or
11 auditory processing disorders." And in their CPT code
12 language, they have that as one of the codes that they
13 would be billing.
14 Again, music therapists’ scope of practice is
15 infringing upon the long-established and recognized scope
16 of practice of speech-language pathologists. This would
17 result in Pennsylvanians not receiving services from
18 specialists with the education and the training in the area
19 of communication disorders.
20 My final point is regarding consumer protection.
21 I am not aware that music therapists have documented any
22 reason why there is a need to license them in Pennsylvania.
23 The primary purpose of State licensure is and always has
24 been the protection of the healthcare-consuming public.
25 Have there been any independent studies to show that the 65
1 lack of music therapy licensing is causing harm to our
2 citizens? If not, why is the bill necessary?
3 In my handout that I gave you that you have, I do
4 have the websites of the scope of practices for music
5 therapists, as well as speech pathologists attached there
6 for your reference. I urge you to please go take a look at
7 them and read them. Upon review, I am confident that you
8 will also agree that speech-language pathologists are the
9 only professionals that should provide necessary services
10 to help our Pennsylvanian children and others to acquire
11 the language and recover as needed.
12 We oppose legislation for licensure of music
13 therapists in Pennsylvania. Thank you for this time and
14 I ’ll take questions now.
15 MAJORITY CHAIR HARHART: Thank you.
16 Any questions from anyone?
17 Representative Mustio.
18 REPRESENTATIVE MUSTIO: Thank you. Thank you for
19 your testimony.
20 On the chart that you held up -
21 MS. GILBERTSON: Yes.
22 REPRESENTATIVE MUSTIO: — those couple of pages
23 of charts, where is the music therapy training that the
24 speech-language -- what is it, SLPs, how about I do that -
25 receive? How does your color code of the training that you 66
1 receive in music therapy compare to what the music
2 therapists receive?
3 MS. GILBERTSON: I ’ll look at this page because
4 this page is a little bit bigger print for me. Okay. For
5 instance, for cognitive assessment, for a speech-language
6 pathologist at the particular universities that were
7 referenced, that were looked at, this particular -- they
8 would get training in basic neuroscience of the speech and
9 hearing, developmental language disorders, developmental
10 speech and language disorders, neurogenic things,
11 understanding communication disorders -
12 REPRESENTATIVE MUSTIO: Right. Rather than read
13 that -
14 MS. GILBERTSON: Yes.
15 REPRESENTATIVE MUSTIO: — if you could provide
16 it to the Chair -
17 MS. GILBERTSON: Yes.
18 REPRESENTATIVE MUSTIO: — in color-coded
19 fashion.
20 MS. GILBERTSON: Sure.
21 REPRESENTATIVE MUSTIO: My question — what I was
22 trying to say was how much training does the SLP receive in
23 music therapy? That’s my question.
24 MS. GILBERTSON: Oh, I misunderstood you.
25 REPRESENTATIVE MUSTIO: Right. 67
1 MS. GILBERTSON: Very little unless it —
2 REPRESENTATIVE MUSTIO: And then if you could
3 provide that in a highlighted chart for the Committee, too,
4 compared to what the music therapists receive, that would
5 be beneficial for us -
6 MS. GILBERTSON: Okay.
7 REPRESENTATIVE MUSTIO: — to receive as well.
8 And you did make a comment, and I agree 100
9 percent, that licensing is to protect the consumer. But as
10 we move into this integrated medicine, and w e ’ve seen it on
11 this Committee on multiple turf wars, that licensing
12 sometimes is used by those that currently hold it to
13 prevent others from helping those in society. And that’s
14 the job that we have to watch and make sure that we judge.
15 So I appreciate very much your testimony, and I ’m
16 very much a facts-based person, but I want to make sure we
17 get all the facts and they’re presented in the same fair
18 way as well.
19 MS. GILBERTSON: I certainly have no issue with
20 music therapy in the areas. How it impinges on
21 communication disorders, that’s the point w e ’re trying to
22 make.
23 REPRESENTATIVE MUSTIO: Right.
24 MS. GILBERTSON: I -
25 REPRESENTATIVE MUSTIO: And I appreciate that. 68
1 MS. GILBERTSON: Yes.
2 REPRESENTATIVE MUSTIO: And we could change the
3 name of this hearing to multiple other ones that w e ’ve
4 heard -
5 MS. GILBERTSON: Yes.
6 REPRESENTATIVE MUSTIO: — and it’s the same
7 thing w e ’ve heard. For me to make the right decisions in
8 my votes I need to get the information presented in a way
9 that I understand it and best can make the arguments either
10 way. Thank you.
11 MS. GILBERTSON: Sure thing.
12 REPRESENTATIVE MUSTIO: Thank you, Chairlady.
13 MAJORITY CHAIR HARHART: Thank you,
14 Representative.
15 Okay. I thank you very much -
16 MS. GILBERTSON: Thank you.
17 MAJORITY CHAIR HARHART: — for your
18 presentation, and I thank every one of you for taking the
19 time and coming out and giving your testimony.
20 I do believe that this bill does need work, and
21 Representative Pashinski being the prime sponsor of this,
22 of course, will be bringing all the powers to be and
23 hopefully will be able to iron on some of these problems
24 that we have heard here today.
25 REPRESENTATIVE PASHINSKI: W e ’re amenable to 69
1 that.
2 MAJORITY CHAIR HARHART: Pardon?
3 REPRESENTATIVE PASHINSKI: I said w e ’re amenable
4 to that.
5 MAJORITY CHAIR HARHART: Okay.
6 REPRESENTATIVE PASHINSKI: The challenge has been
7 put forth. W e ’ll work on it.
8 MAJORITY CHAIR HARHART: Okay, great.
9 And again, I thank all the Members for attending
10 as well. We did have a lot of Members here, but as I said,
11 we do have very hectic schedules, and sometimes they
12 overlap. Our meetings overlap. But again, thank you very
13 much, and I hope you have a happy holiday. Thanks.
14 MS. GILBERTSON: Thank you.
15
16 (The hearing concluded at 10:30 a.m.) 70
1 I hereby certify that the foregoing proceedings
2 are a true and accurate transcription produced from audio
3 on the said proceedings and that this is a correct
4 transcript of the same.
5
6
7 Christy Snyder
8 Transcriptionist
9 Diaz Transcription Services