BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       SB 707                                       
          S
          AUTHOR:        DeSaulnier                                   
          B
          AMENDED:       April 22, 2009                              
          HEARING DATE:  April 29, 2009                               
          7
          CONSULTANT:                                                 
          0
          Dunstan/                                                    
          7              
                                        
                                     SUBJECT
                                         
                 Alcohol and other drug counselor licensing and  
                                 certification

                                     SUMMARY 

          Institutes a system of certification and licensing for  
          alcohol and other drug counselors by the Department of Drug  
          and Alcohol Programs (DADP).  

                             CHANGES TO EXISTING LAW  

          Existing law:
          Requires all adult alcoholism or drug abuse recovery or  
          treatment facilities to be licensed by the Department of  
          Drug and Alcohol Programs (DADP).  Also requires  
          driving-under-the-influence programs and narcotic  
          replacement therapy programs to be licensed by DADP.   
          Grants DADP the sole authority in state government to  
          establish appropriate minimum qualifications, including  
          education, skills, life experience and training for  
          licensees, designated administrators and staff. 

          Requires DADP to operate a certification program for  
          treatment services, such as outpatient treatment services,  
          which are not subject to licensing.  Such certification is  
          voluntary on the part of the facility, shall not convey any  
          approval or disapproval by the department, and shall be for  
                                                         Continued---



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          informational purposes only.  DADP is also required to  
          develop standards for assuring minimum levels of quality  
          provided by alcohol and drug programs.  
          
          Requires all alcohol and drug abuse programs to register  
          with the county drug and alcohol program administrator in  
          order to coordinate efforts in the county.  Provides that  
          registration does not constitute approval or endorsement by  
          the county or by DADP.

          Establishes DADP as the lead state agency for alcohol and  
          drug programs and requires DADP to prepare a master plan to  
          eliminate drug and alcohol abuse in California.  Requires  
          DADP to cooperate closely with individuals and  
          organizations concerned with alleviating problems related  
          to inappropriate alcohol and drug use.  Requires DADP to  
          develop and maintain a data system that shall gather and  
          obtain information on the status of alcohol and other drug  
          abuse problems in the State of California.
          
          Existing state regulations
          Establish nine counselor organizations that are allowed to  
          certify alcohol and drug counselors who provide counseling  
          services in an alcohol or drug program, which is defined as  
          a program that is subject to state licensing, receives  
          state funding, or is granted voluntary certification.   
          Allow currently employed counselors five years, dating from  
          2005, to become certified.  Require that certification be  
          based on specific addiction counseling competencies,  
          including understanding addiction, knowledge of treatment  
          methods, and professional readiness.  Existing state  
          regulations require that, by 2010, at least 30 percent of  
          counselors in licensed facilities shall be in compliance  
          with certification requirements, and all other noncertified  
          counseling staff must be registered with a certifying  
          organization.
          
          This bill:

          General provisions
                 Establishes the Alcohol and Other Drug Counselor  
               Licensing and Certification Act. 

                 Creates a three categories of certified counselors  
               beginning with a Certified Alcohol and Other Drug  
               Counselor, and including an advanced and clinical  




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               supervisor certification, who would all be certified  
               by DADP to practice alcohol and drug counseling in a  
               program licensed or certified by DADP. 

                 Establishes a Licensed Alcohol and Other Drug  
               Counselor (LAODC) who may maintain an independent  
               practice and can also provide clinical supervision  
               and. 

                 Defines a registrant as a person registered with  
               DADP and is working towards certification or licensure  
               as a Certified Alcohol and Other Drug Counselor. 

          Certification and licensing
                 Requires DADP to develop standards for  
               certification and licensure of alcohol and other drug  
               counselors, including persons presently certified by  
               DADP and to begin issuing licenses, certificates and  
               registrations beginning January 1, 2011.  .

                 Requires DADP, beginning January 1, 2011, to issue  
               Certified Alcohol and Other Drug Counselor  
               certificates to a person who either: 1) completes 350  
               hours of education and possesses a high school diploma  
               or GED, or 2) possessed an associates or equivalent  
               degree.

                 Provides that the applicant is also required to  
               pass a required test, complete 250 hours of supervised  
               experience, complete 2000 hours of work experience,  
               submit and pass a required criminal offender record  
               information search and pay a fee set by DADP.  

                 Requires DADP to issue counseling certificates at  
               an advanced level and a clinical supervisor level to  
               persons who submit and pass a required criminal  
               offender record information search and pays the fee  
               set by DADP, and meets the requirements for of  
               education, supervised experience and work experience,  
               as specified. 

                 Directs DADP to issue a license to a person who  
               meets specified requirements and possess a graduate  
               degree in a related field. 

                 Requires that education required for the advanced  




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               counseling certificate and the licensed counselor meet  
               the requirements of specified publications of the  
               United States Department of Health and Human Services,  
               Substance Abuse and Mental Health Services  
               Administration, Center for Substance Abuse Treatment  
               and any other material specified by DADP. 

                 Establishes specified requirements for exams  
               required for certification or licensure by DADP.

                 Specifies the requirements for experience used to  
               meet the supervised experience criteria for  
               certification. 

                 Requires supervisors to comply with all  
               requirements for supervision as established by DADP by  
               regulation. 

                 Establishes standards for supervised experience as  
               a requirement for certification and licensing. 

                 Establishes that nothing in this bill shall be  
               construed to constrict, limit or withdraw the Medical  
               Practice Act, Nursing Practice Act, Psychology  
               Licensing Act, Marriage and Family Therapist Act or  
               Clinical Social Work Practice Act.  

                 Provides specific exemptions from the bill's  
               requirements for the California Department of  
               Corrections and Rehabilitation, employees or  
               volunteers of the State of California, employees or  
               volunteers for an agency of the U.S. government and  
               volunteers of peer or self help groups, clerics and  
               live-in alternatives to incarceration.   

          Existing practitioners
                 Requires DADP to certify or license each person who  
               is certified by the department as a counselor on  
               December 31, 2010, and requires this certification or  
               licensing to be in effect for a period of two to four  
               years and shall be renewable. 

                 Allows DADP to withdraw or condition a  
               certification or licensure for the same reasons that  
               it could take discipline against new registrations,  
               certificate or licenses. 




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                 Grants DADP the authority to issue regulations to  
               specify which persons may be eligible to be registered  
               or certified and receive appropriate credit for  
               education supervised experience and work experience.  

                 Provides for a person to qualify as an existing  
               practitioner, DADP must receive an application by  
               December 31, 2013. 

                 Requires the applicant to have the appropriate  
               advance certification as recognized by DADP before  
               December 31, 2010 or meet the requirements for new  
               applicants, submit and pass a criminal background  
               check, pay the applicable fee set by DADP and complete  
               the certificate application.  

                 Establishes that the clinical supervisor level must  
               meet additional work experience and continuing  
               education.  

                 Requires that the licensed counselor must meet the  
               requirements for a certificate and must have the  
               appropriate advance certification as recognized by  
               DADP before December 31, 2010.  

          Scope of practice.  
                 Establishes and defines the practice of alcohol and  
               drug counseling and makes it unlawful to engage in the  
               practice of alcohol and drug counseling without  
               holding a valid certificate or license.  

          Administration
                 Grants DADP authority to adopt rules and  
               regulations as necessary to administer the licensing  
               act. 

                 Provides that licenses or certification shall  
               expire within two year after the issue date and  
               specifies renewal procedures.  

                 Requires that a counselor display his or her  
               license or certification in a prominent place. 

                 Allows a license to be placed on an inactive  
               status.  




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                 Requires a person who is licensed, certified or  
               registered to provide written notice to DADP within 30  
               days of a name change or a change of address.  

                 Requires DADP to establish continuing education  
               requirements, procedures for the filing and  
               investigation of complaints, criteria to determine if  
               curriculum meets the licensing act's requirements,  
               parameters of unprofessional conduct, develop  
               examinations, registration and supervision  
               requirements for registrants and a database of  
               certified and licensed counselors and registrants.

                 Requires DADP to establish registration and  
               supervision requirements for registrants, including  
               those persons presently registered.  

                 Requires DADP to develop or adopt examination for  
               administering to prospective licensees. 
          
          Funding
                 Establishes the Alcohol and Other Drug Counselor  
               License Fund in the State Treasury.  

                 Requires that all fees collected under this act  
               shall be deposited in the fund and are available for  
               appropriation by the Legislature.  

                 Provides the fee for issuing a license or  
               certification shall be $155 for both a new license and  
               renewal.  

                 Specifies fees for application, renewals, written  
               and oral examinations, license issuance, rescoring an  
               examination, delinquency for renewal, replacement  
               licenses and others.  

          Enforcement
                 Authorizes DADP to take disciplinary actions,  
               including reprimands or probation or suspending or  
               revoking the license or certification. 

                 Allows DADP to issue administrative citations or  
               impose administrative fines not to exceed $5,000. 





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                 Makes it a misdemeanor to falsely represent that  
               the person has a certification or license from DADP.  

                 Authorizes DADP to deny, revoke, suspend or impose  
               conditions upon a license, certification or  
               registration for unprofessional conduct. 

                 Establishes that activities that constitutes  
               unprofessional conduct, among them securing a license  
               or certificate by fraud or deceit, administering  
               controlled substances, and gross negligence or  
               incompetence in practicing alcohol or drug counseling.  


                 Requires DADP to revoke any license, certification  
               or registration upon a finding of fact that the  
               counselor or registrant engaged in any act of sexual  
               contact with a client or former client, as specified.

                 Authorizes DADP to deny, revoke or suspend a  
               license, certification or registration, because of a  
               disciplinary action by another state or territory on a  
               license or certificate for alcohol and other drug  
               counseling.

                 Allows DADP to temporarily suspend a license,  
               certification or registration when the action is  
               necessary to protect a client from physical or mental  
               abuse, abandonment or other substantial threat to  
               health and safety. 

                 Establishes procedures for applicants use to appeal  
               decisions made by DADP.  

                 Requires that accusations against people who are  
               licensed, certified or registered shall be filed  
               within three years from the date DADP discover the  
               alleged act or omission that is the basis for  
               disciplinary action, with longer periods for fraud or  
               misrepresentation, sexual misconduct or if a minor is  
               involved.

                 Requires that an applicant for a license,  
               certification or registration consent to a criminal  
               background check and establishes related procedures as  
               specified.




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                 Requires DADP to revoke or deny a license,  
               certification or registration if an applicant:
                  a.        Has been convicted of five or more  
                    criminal offense within a thirty-month period  
                    ending two years or less prior to the date of  
                    DADP's determination
                  b.        Is required to register as a sex offender
                  c.        Has been convicted of a violent felony  
                    within three years prior to the date of the  
                    department's determination.

                 Adds certified and licensed alcohol and drug  
               counselors to the list of mandated reporters for child  
               and elder abuse and neglect.

                                  FISCAL IMPACT  
          Unknown.


                            BACKGROUND AND DISCUSSION  

          According to the author, there is no single standard for  
          the educational curriculum, testing, certification or code  
          of conduct for alcohol and other drug counselors providing  
          direct treatment services to clients in state licensed and  
          certified treatment programs.  Currently DADP authorizes  
          nine different certifying organizations to certify  
          counselors.  Each program develops its own classroom  
          curriculum, training, supervisor and work experience  
          requirements.  Background checks are not performed and  
          there is no central repository of counselor information,  
          including disciplinary action taken to suspend or revoke  
          certification for misconduct.  DADP can direct a certifying  
          organization to take action against a counselor for  
          misconduct, but there is nothing to prevent a counselor who  
          has had certification suspended or revoked from obtaining  
          certification from another organization.  SB 707 authorizes  
          DADP to register, certify and license alcoholism and other  
          drug counselors in California and to charge fees to  
          activities associated with counselor registration,  
          certification and licensure.  The bill creates a tiered  
          system for counselor certification and licensure with  
          specific education, supervision, training and experience  
          criteria for each tier.  The bill also requires DADP to  
          impose sanctions for counselor misconduct.




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          Background
          Alcohol and other drug dependency is a treatable condition,  
          but no one treatment modality is successful with all  
          persons who exhibit chemical dependency problems.  Due to  
          the fact that individual problems, needs and resources vary  
          greatly, a variety of treatment strategies must be  
          available.  Treatments for chemical dependency vary because  
          there are multiple perspectives about the condition,  
          itself.

          Most treatments focus on helping people discontinue their  
          alcohol or other drug intake, followed by life training  
          and/or social support in order to help them resist a return  
          to substance use.  Since chemical dependency involves  
          multiple factors which encourage a person to continue  
          using, they must all be addressed in order to successfully  
          prevent a relapse.  An example of this kind of treatment is  
          detoxification, followed by a combination of supportive  
          therapy, attendance at self-help groups, and ongoing  
          development of coping mechanisms.

          Besides being effective, treatment is widely considered to  
          save money by combating the problems associated with  
          substance abuse.  A benefit cost analysis done in  
          conjunction with the evaluation of the Substance Abuse and  
          Crime Prevention Act of 2000, which was Proposition 36 on  
          the ballot, found that, for every $1 invested in substance  
          abuse treatment, state and local governments have saved  
          $2.50 from reduced health care costs and crime.  Other  
          studies have found that the per capita cost of treatment is  
          significantly less than the cost of incarceration.   
          According to the Institute of Medicine, the cost of  
          incarceration is about $40,000 per year compared to $12,500  
          and $3,100 for residential and outpatient treatments,  
          respectively.  Despite the cost effectiveness of substance  
          abuse treatment programs, a substantial gap exists between  
          the number of people who need treatment and the number who  
          receive treatment.

          The number of people seeking treatment who have  
          co-occurring mental health disorders has steadily increased  
          in recent years, although it is not clear if the reason is  
          improved diagnosis of mental disorders or a change in the  
          population.  It is estimated that individuals with  
          co-occurring disorders now comprise 20 to 50 percent of  




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          those with addiction problems.  DADP has noted that, if  
          counselors were better qualified, they would be better  
          prepared to accurately identify these co-occurring  
          disorders earlier, treat the addiction and make appropriate  
          referrals to treat the co-occurring mental health disorder.

          Alcohol and drug counseling
          Alcohol and other drug counselors work very closely with  
          program participants, patients and residents, and provide  
          critical services including assessments, counseling,  
          treatment planning and case management.  Counselors are not  
          currently required to be certified or to have a minimum  
          amount of education or experience.  Most treatment programs  
          use or employ a mixture of counselors, who have some formal  
          education or personal experience with alcoholism, drug  
          addiction, and recovery.

          DADP adopted counselor certification regulations in April  
          2005, but they apply only to individuals providing  
          counseling services in an alcohol and other drug program  
          licensed or certified by DADP.  To be certified by DADP,  
          individuals must be certified by one of the organizations  
          identified in the DADP regulations.  In order for a  
          certifying organization to issue alcohol or other drug  
          program counselor certification, the organization's  
          certification requirements must meet DADP's minimum  
          standards.  These standards include completing at least 155  
          hours of formal classroom education, as defined, at least  
          160 documented hours of supervised alcohol or other drug  
          program counseling, 2,080 or more documented hours of work  
          experience, and obtaining a score of at least 70 percent on  
          an exam approved by the certifying organization.

          Many other licensed professionals provide alcoholism and  
          drug abuse counseling either in a medical setting or in  
          private practice.  These include MFTs and LCSWs, who are  
          licensed by the Board of Behavior Sciences; psychologists,  
          who are licensed by the Board of Psychology; and,  
          physicians and surgeons, including psychiatrists, who are  
          licensed and regulated by the Medical Board of California.

          Informational hearing
          The Assembly Business and Professions Committee reviewed  
          the issue of licensure of alcoholism and drug abuse  
          counselors at an informational hearing held on October 30,  
          2007.  Testimony was provided by stakeholders, including  




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          the California Association of Alcoholism & Drug Abuse  
          Counselors, DADP, the Board of Behavioral Sciences, the  
          Justin Foundation, the American Psychological Association,  
          the California Association of Marriage and Family  
          Therapists, and the California Association for Alcohol/Drug  
          Educators.  In addition to industry stakeholders and  
          regulatory agencies, a number of community members  
          testified before the committee.

          Little Hoover Commission Report
          A March 2008 report by the Little Hoover Commission titled,  
          Addressing Addiction:  Improving & Integrating California's  
          Substance Abuse Treatment System, describes the effects of  
          substance abuse on families, neighborhoods and government  
          coffers and recommends ways to reduce the misery and cost  
          of substance abuse by addressing addiction as a distinct  
          problem in many state-funded programs.  In the report, the  
          Commission called for a new treatment system model that  
          emphasizes screening for signs of alcohol and drug abuse  
          and early intervention strategies, employs evidence-based  
          strategies to treat addiction, links state funding with  
          improved outcomes, standardizes counselor certification and  
          creates multiple levels of certification, and improves the  
          Substance Abuse and Crime Prevention Act, or Proposition  
          36, by increasing the use of proven practices such as drug  
          court models.

          Previous legislation
          AB 239 (DeSaulnier) of 2008 would have enacted the  
          Alcoholism and Drug Abuse Counselors Licensing Law and  
                                                                                        would have provided for the licensing and regulation of  
          alcohol and drug counselors by the Board of Behavioral  
          Sciences (BBS).  The bill would have created two categories  
          of licensed alcoholism and drug abuse counselors, a  
          "licensed alcoholism and drug abuse counselor I,", who  
          would be a person licensed to practice alcoholism and drug  
          abuse counseling under clinical supervision, and a  
          "licensed alcoholism and drug abuse counselor II," who  
          would be a person licensed to conduct an independent  
          practice of alcoholism and drug abuse counseling, and to  
          provide supervision to other counselors.  The bill did not  
          address counselors working in licensed and certified  
          facilities, they would have remained under the jurisdiction  
          of DADP and subject to the existing certification process.   






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          This bill was vetoed by Governor Arnold Schwarzenegger.  In  
          his veto message, he stated that he was directing DADP to  
          work to craft a uniform standard for all alcohol and drug  
          counselors whether in private practice or in facilities.

          AB 1367 (DeSaulnier) of 2007 would have provided for the  
          licensing or registration and regulation of Alcoholism and  
          Drug Abuse Counselors, as defined, by the Board of  
          Behavioral Sciences.  This bill was held in the Assembly  
          Appropriations Committee on the suspense file in January  
          2008.
          
          AB 2571 (Longville) of 2004 would have created the Board of  
          Alcohol and Other Drugs of Abuse Professionals in the  
          Department of Consumer Affairs and established requirements  
          for licensure of alcohol and other drugs of abuse  
          counselors.  This bill failed passage in the Assembly  
          Health Committee.

          AB 1100 (Longville) of 2003 would have enacted the Alcohol  
          and Drug Abuse Counselors Licensing Law, to be administered  
          by the Board of Behavioral Sciences.  This bill died in the  
          Assembly Business and Professions Committee.

          SB 1716 (Vasconcellos) of 2002 would have enacted the  
          Alcohol and Drug Abuse Counselors Licensing Law requiring  
          the Board of Behavioral Sciences to license and regulate  
          alcohol and drug abuse counselors.  This bill was held in  
          the Assembly Business & Professions Committee.
          
          SB 537 (Vasconcellos) of 2001 would have required the DCA  
          to initiate a review of the need for licensing substance  
          abuse counselors.  This bill was vetoed by Governor Gray  
          Davis who cited as his reason the impact on the general  
          fund.  In his veto message, Governor Davis directed DADP to  
          require counselors in drug and alcohol treatment facilities  
          to be certified for quality assurance purposes.

          AB 79 (Tucker) of 1993 would have required the Department  
          of Consumer Affairs (DCA), to approve private organizations  
          which certify persons working in alcohol or other drug  
          abuse prevention, recovery or treatment programs.  This  
          bill was held in the Assembly Health Committee.

          Arguments in support
          The bill's sponsor, the Department of Alcohol and Drug  




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          Programs, argues that this is a necessary measure to better  
          serve the treatment community and, consequently, the entire  
          state.  They state that the bill provides for workforce  
          development and career ladders by establishing uniform  
          qualification and criteria for tiered levels of alcoholism  
          and drug counselors.  In addition, they note that the bill  
          would help them protect the public by instituting criminal  
          background checks.

          The County Alcohol and Drug Program Administrators  
          Association of California supports the bill as an important  
          step toward professionalizing and improving the field of  
          addiction treatment.  They argue that the provisions of SB  
          707 will raise the bar and advance the profession of  
          alcoholism and drug treatment, protect consumers and bring  
          all of the functions under a single state agency.  Most  
          important, the bill provides a career path for all  
          alcoholism and drug counselors and address many of the  
          problems in the deeply-flawed system of counselor  
          credentialing that is currently in place.

          The American Federation of State, County and Municipal  
          Employees, Local 260 argue that this bill will provide  
          higher standards for the valuable work of drug and alcohol  
          counseling.  There is a huge need for additional  
          specialists such as drug and alcohol counselors, especially  
          in prisons as well as the community.  They would like to  
          see amendments that strengthen the skills for supervising  
          to include education and training on leadership and  
          management.  
          
          Arguments in opposition
          Opponents are concerned that the passage of the current  
          version of the bill could lead to dramatic shortages of  
          skilled labor that is necessary for treatment programs.   
          Opponents are concerned about the specifics of the criminal  
          background check.  They note that there are many excellent  
          counselors with a criminal background, reflecting a  
          counselor's own history with substance abuse, a history  
          that can be very important for an alcohol and drug  
          counselor.  They argue that if treatment leads to  
          rehabilitation and changes lives, the state policy should  
          not be to eliminate qualified people through a background  
          check and they point to how the Board of Behavioral  
          Sciences runs their background checks.





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          Opponents are also concerned that those with a dual  
          diagnosis of mental illness and substance abuse issues will  
          not receive adequate care and won't be referred for  
          assessment, diagnosis and treatment.

          The California Association of Addiction Recovery Resources  
          questions the need for the bill.  They state that the  
          existing counselor certification program, which has been  
          fully operational for a mere 18 months and was 10 years in  
          the making is being set aside.  They argue that the current  
          regulations are very comprehensive and that the issues that  
          exist could be resolved easily.  They state that they have  
          spent more than $250,000 to develop a curriculum to certify  
          counselors as required by the regulations.  They are  
          particularly concerned about the impact on the workforce,  
          in that new counselors will be hard to recruit for the  
          foreseeable future.  They point out that it is a field with  
          high turnover and many new counselors are required each  
          year.  The high cost to comply with the new requirements  
          will be a significant deterrent to new qualified people  
          choosing this profession.  They point out that between all  
          of the fees that DADP will charge plus the cost of the  
          background check, someone entering the field will face a  
          $1,000 bill, in a field with traditionally low wages.  They  
          also argue that the process for disciplining counselors  
          will take up to two years, since the bill uses the Board of  
          Behavioral Sciences model, and that is unacceptably long.

          California Therapeutic Communities argue that many  
          currently in the field have been working for years without  
          meeting the education requirement in the bill as their life  
          experience is an important aspect in their counseling  
          qualifications.  They are also concerned that there are too  
          many levels of counselors within the bill, and that the  
          supervising level should be merged with the advanced level.  
           They also argue the treatment facility needs flexibility  
          to determine who meets the qualifications for supervisor.   
          They also argue that additional specific subject matter  
          education be required.

          The California Psychological Association expresses concerns  
          that a number of issues are not resolved in the legislation  
          but are left to the regulatory process.  They are also  
          concerned about making a department the licensing authority  
          for independent practitioners, as compared to the Board of  
          Behavioral Sciences, which oversees clinical psychologists,  




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          marriage and family therapists and licensed clinical social  
          workers.  They also argue that the scope of practice needs  
          to be tightened to ensure that activities are done in the  
          context of an integrated model, capable of treating dually  
          diagnosed individuals that also have a serious mental  
          illness.  They also argue that the requirement that was in  
          AB 239 for the referral for screening for mental illness be  
          included.

          The California Association of Marriage and Family  
          Therapists opposes the bill because of its ambiguity in  
          numerous sections.  They are also concerned that the large  
          number of regulations required for the program to begin by  
          January 1, 2011, may mean that important elements are not  
          enforced or adequately completed.  They also argue that the  
          scope of practice is defined by the mere listing of  
          services as opposed to defining principals that clarify the  
          practice of the profession.  They are also concerned that  
          the bill may limit the practice of other mental health  
          professionals to treat problems of substance abuse.

          The California Association of Alcohol/Drug Educators  
          opposes the bill because it should require that more of the  
          education should be in a face-to-face setting rather than  
          through distance education.  They point out that many  
          aspiring counselors are in the early stages of recovery and  
          have not yet developed the social skills necessary to  
          become effective, humane and ethical counselors.  They also  
          object to the exemption for prisons, which they argue is  
          inappropriate because all people with the disease of  
          addiction deserve quality treatment from certified  
          counselors.  They also believe that the education  
          requirements should be altered so that there is a minimum  
          alcohol and drug education component of the overall  
          education requirements.  They also argue that the scope of  
          practice language should be amended to reflect a different  
          scope of each of the four levels.

          The California Psychiatric Association argues that the  
          educational requirements are inadequate and that there  
          needs to be more education on mental illness.  They also  
          believe that behavioral disciplines require coherent  
          regulation and that DADP does not have the experience or  
          mission to regulate such a profession and that it belongs  
          in the Department of Consumer Affairs.  





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          The San Francisco Women's Rehabilitation Foundation opposes  
          the bill because the bill threatens treatment programs that  
          use the social model.  These programs used peer counselors  
          and often on a part time basis whereas the bill  
          contemplates full time counselors serving in a clinical  
          setting or a residential treatment program.

          The committee received many e-mails from individuals  
          opposing the bill.  In general, their concerns were that  
          the bill, as they understood it, put too much emphasis on  
          education and not enough on experience.  In addition, many  
          expressed concerns about the background check and the level  
          of the fees to become certified.

                                     COMMENTS
                                         

          1.  Many details of the program will be determined  
          administratively through the adoption of regulations.  This  
          bill is a structure for a licensing and certification  
          program for drug and alcohol counselors with many of the  
          details to be to established or changed by regulation.   
          Areas needing regulations include the specifics of  
          licensure and certification requirements for those  
          currently certified or practicing, educational requirements  
          for all applicants, the amount of fees, the specific  
          process for registrants to register, the content of  
          continuing education, specifics as to what constitutes  
          supervised work experience, additional detail on the  
          definition of the practice of alcohol and drug counseling,  
          and the processes for appeals and background checks.  With  
          the majority of the bill's provisions taking effect January  
          1, 2011, the timetable seems overly optimistic.  The  
          committee should hear from the DADP, the bill's sponsor, as  
          to why they think they can implement this complex bill  
          within the time frame allowed in the bill.

          2.  The timeframe for implementation could have deleterious  
          effects on the supply of counselors.  The majority of the  
          bill's provisions would take effect on January 1, 2011,  
          including significantly new requirements for certification.  
           Those applicants who are not already certified have to  
          meet significantly different new standards, which would  
          take applicants some time to meet.  Opponents have  
          characterized the field as having a high turnover.  If this  
          is true, it seems unlikely that a new supply of counselors  




          STAFF ANALYSIS OF SENATE BILL  SB 707 (DeSaulnier) Page 17


          

          will be available to meet the demand when the bill's  
          provisions take effect.  The bill does have grandfathering  
          provisions which could help keep people in the field, but  
          will not help with new entrants.  A suggested amendment  
          would be to delay the date of implementation from January  
          1, 2011 to January 1, 2012, which would also give DADP  
          additional time to complete the necessary regulations.

          3.  The scope of practice is a list of services.  Under  
          this bill, the scope of practice is the same for all levels  
          of certified and licensed counselors.  The bill currently  
          establishes four levels of counselors with very different  
          qualifications, but the types of work that each level  
          should be doing is not defined save that licensed  
          counselors can be in private practice and supervisors will  
          supervise.  This is an important area that the department  
          will have to develop by regulation.

          4.  Further significant amendments may occur.  This bill  
          may be significantly amended to reflect the results of  
          ongoing negotiations.  The committee may wish to ask the  
          author to bring the bill back to be heard again if the bill  
          changes significantly.


                                    POSITIONS  


          Support:   Department of Alcohol and Drug Programs  
          (sponsor)
                     The American Federation of State, County and  
                 Municipal Employees, Local 260 (if amended)
                 California Association of Alcoholism and Drug Abuse  
               Counselors 
                 (if amended)
                 California Association of Alcohol and Drug Program  
               Executives 
                 County Alcohol and Drug Program Administrators  
                 Association of California
                 Drug Policy Alliance Network
          
          Oppose:    A. K. Bean Foundation
                 California Association of Addiction Recovery  
               Resources
                 California Association for Alcohol/Drug Educators  
               (unless amended)




          STAFF ANALYSIS OF SENATE BILL  SB 707 (DeSaulnier) Page 18


          

                 California Association of Marriage and Family  
                 Therapists (unless amended)
                 California Psychological Association
                 California Psychiatric Association
                 California Therapeutic Communities
                 Northeast Valley Hospital Association 
                 San Francisco Women's Rehabilitation Foundation
                 Numerous individuals







                    
               

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