BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                                 THIRD READING


          Bill No:  AB 1113
          Author:   Lowenthal (D) and Anderson (R) 
          Amended:  5/14/09 in Assembly
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON. DEVELOP. COM.  :  10-0,  
            6/22/09
          AYES: Negrete McLeod, Wyland, Aanestad, Corbett, Correa,  
            Florez, Oropeza, Romero, Walters, Yee

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  71-0, 5/18/09 - See last page for vote


           SUBJECT  :    Prisoners:  professional mental health  
          providers:  marriage
                        and family therapists

           SOURCE  :     California Association of Marriage and Family  
          Therapists


           DIGEST  :    This bill allows a marriage and family therapist  
          intern to gain qualifying experience for licensure as a  
          marriage and family therapist while working in a state  
          correctional facility.

           ANALYSIS  :    Existing law, the Business and Professions  
          Code:

          1.Licenses and regulates marriage and family therapists  
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            (MFTs), marriage and family therapy interns (MFT  
            Interns), licensed clinical social workers (LCSWs) and  
            associate social workers (ASWs) by the Board of  
            Behavioral Sciences (Board) within the Department of  
            Consumer Affairs.

          2.Provides that a person who wishes to gain experience  
            toward licensure as an LCSW shall register with the Board  
            as an ASW prior to obtaining that experience.  The ASW  
            shall gain experience under the supervision of a LCSW,  
            licensed psychologist, MFT or psychiatrist, as specified.  


          3.Provides that a person who wishes to gain experience  
            toward licensure as an MFT shall register with the Board  
            as an MFT Intern prior to obtaining that experience.  The  
            MFT Intern shall gain experience under the supervision of  
            an, MFT, LCSW, licensed psychologist or psychiatrist, as  
            specified.

          This bill:

          1.Adds a person gaining qualifying experience for licensure  
            as an MFT (i.e., an MFT Intern) to the list of those for  
            whom the license requirement may be waived. 

          2.Specifies that an MFT Intern is limited to working within  
            his or her scope of practice.

          3.Makes technical and clarifying changes.

           Background
           
          The Business and Professions Code provides for the  
          licensing and regulation of more than 28,000 MFTs, 10,000  
          MFT interns, 16,000 LCSWs, and 7,200 ASWs by the Board.  In  
          order to qualify for MFT licensure, an individual must have  
          at least a master's level degree and 3,000 hours of  
          supervised experience as a MFT Intern over a period of at  
          least 104 weeks, and consisting of specified types of  
          activities.  The experience must be gained under the  
          supervision, as specified, of an MFT, LCSW, licensed  
          psychologist or psychiatrist.








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          The Penal Code requires a person employed or under contract  
          to provide diagnostic, treatment, or other mental health  
          services or to supervise or provide consultation on those  
          services in the State correctional system to be licensed as  
          a physician and surgeon, psychologist or as an "other  
          health professional" (which includes LCSW, and MFT  
          licensees).  An exemption from the requirement to hold a  
          license provides for persons gaining qualifying experience  
          in order to become licensed as a psychologist, or LCSW.

           Prior Legislation  

          AB 2652 (Anderson) was introduced last year (2008) and was  
          nearly identical to this bill.  That bill was held in  
          Assembly Appropriations Committee.

          AB 1975 (Romero) Chapter 356, Statutes of 2000, waived the  
          license requirement to practice in the state correctional  
          system for clinical social workers gaining qualifying  
          experience for licensure.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  6/30/09)

          California Association of Marriage and Family Therapists  
          (source) 
          American Association for Marriage and Family Therapy,  
          California Division
          Board of Behavioral Sciences
          California Council of Community Mental Health Agencies
          California Psychiatric Association 
          Mental Health Association in California

           OPPOSITION  :    (Verified  6/30/09)

          American Federation of State, County, and Municipal  
          Employees
          California Psychological Association

           ARGUMENTS IN SUPPORT  :    The California Association of  
          Marriage and Family Therapists, states:  "MFT Interns have  
          education and experience requirements substantially  







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          equivalent to clinical social work associates and are  
          equally capable of providing the mental health services  
          necessary within correctional settings.  Permitting MFT  
          interns to be employed within the CDCR would help reduce  
          the mental health professional shortage currently at  
          issue."

          The Board of Behavioral Sciences states that marriage and  
          family therapy interns may already gain qualifying  
          experience for licensure in other settings when those  
          services are provided under the supervision of a qualified  
          mental health practitioner pursuant to the Marriage and  
          Family Therapy Act.  Therefore, this bill proposes a  
          practice already acceptable to the Board and merely makes  
          it possible for CDCR to allow interns to provide services  
          within its facilities.

          The California Psychiatric Association indicates that the  
          bill would take a small but significant step toward meeting  
          the crisis in providing constitutionally adequate mental  
          health care to California's prison inmates.

           ARGUMENTS IN OPPOSITION  :    The California Psychological  
          Association (CPA) states in opposition, "With nearly 20% of  
          the prison population in the mental health program designed  
          for individuals with severe mental illness, the CDCR needs  
          trained clinicians who possess the training and skill sets  
          to assist these individuals.  CPA does not believe that the  
          skills, training, and education of an MFT make for a good  
          fit within the prison system.

          "The scope of practice for an MFT is to assist individuals  
          to have healthier interpersonal relationships within their  
          families. This bill, in effect, is requesting a significant  
          scope of expansion for MFTs to work with individuals with  
          severe mental illness without any increase in training and  
          educational standards to accommodate the expansion.

          "CPA is also concerned that the training of these  
          individuals will not be effective as there will not be a  
          position for an MFT in CDCR once they are licensed.  There  
          is currently no state-approved position for an MFT in state  
          service ? Training an individual in a position in a  
          Department for a job that will not exist is a poor use of  







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          state resources."


           ASSEMBLY FLOOR  :
          AYES:  Adams, Ammiano, Anderson, Arambula, Beall, Bill  
            Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  
            Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,  
            DeVore, Duvall, Emmerson, Evans, Feuer, Fletcher, Fong,  
            Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,  
            Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,  
            Huber, Huffman, Jeffries, Knight, Krekorian, Lieu, Logue,  
            Bonnie Lowenthal, Mendoza, Miller, Monning, Nestande,  
            Niello, Nielsen, John A. Perez, V. Manuel Perez,  
            Portantino, Salas, Silva, Skinner, Smyth, Audra  
            Strickland, Torlakson, Torres, Torrico, Tran, Villines,  
            Yamada, Bass
          NO VOTE RECORDED:  Eng, Jones, Ma, Nava, Price, Ruskin,  
            Saldana, Solorio, Swanson


          JA:nl  6/30/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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