BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 788
                                                                  Page  1

          SENATE THIRD READING
          SB 788 (Wyland)
          As Amended  September 3, 2009
          Majority vote

           SENATE VOTE  :36-1  
           
           BUSINESS & PROFESSIONS   11-0   APPROPRIATIONS      16-0        
           
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          |Ayes:|Hayashi, Emmerson,        |Ayes:|De Leon, Conway, Ammiano, |
          |     |Conway, Eng, Hernandez,   |     |                          |
          |     |Nava, Niello,             |     |Charles Calderon, Coto,   |
          |     |John A. Perez, Ruskin,    |     |Davis,                    |
          |     |Smyth, Monning            |     |Fuentes, Hall, Harkey,    |
          |     |                          |     |Miller,                   |
          |     |                          |     |Nielsen, John A. Perez,   |
          |     |                          |     |Skinner,                  |
          |     |                          |     |Solorio, Audra            |
          |     |                          |     |Strickland, Torlakson,    |
          |     |                          |     |Hill                      |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
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           SUMMARY  :  Establishes the Licensed Professional Clinical  
          Counselor Act which provides for the licensing and regulation of  
          professional clinical counselors (LPCCs) by the Board of  
          Behavioral Sciences (BBS).  Specifically,  this bill  :

          1)Adds one state licensed LPCC to the membership of BBS  
            commencing January 1, 2012.

          2)Increases from four to five public members and from five to  
            six licensed members of BBS to be appointed by the Governor.

          3)States legislative intent recognizing that LPCCs practice a  
            separate and distinct profession from licensed marriage and  
            family therapists (MFTs) and licensed clinical social workers  
            (LCSWs), and as such the Legislature recognizes the need to  
            appropriately test MFTs and LCSWs seeking to become LPCCs on  
            the difference in practice between the professions.

          4)Requires BBS to:

             a)   Communicate information about its activities, the  








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               requirements and qualifications for licensure, and the  
               practice of professional clinical counseling to the  
               relevant education institutions, supervisors, professional  
               associations, applicants, clinical counselor trainees,  
               interns and the public; and,

             b)   Develop polices and procedures to assist educational  
               institutions in meeting the educational qualifications for  
               those seeking licensure as a LPCC, as specified.

          5)Establishes the following guidelines for LPCC scope of  
            practice:

             a)   Defines "professional clinical counseling" as the  
               application of counseling interventions and  
               psychotherapeutic techniques to identify and remediate  
               cognitive, mental and emotional issues, including personal  
               growth, adjustment to disability, crisis intervention, and  
               psychosocial and environmental problems.  Includes  
               conducting assessments for the purpose of establishing  
               counseling goals and objectives to empower individuals to  
               adequately deal with life situations, reduce stress,  
               experience growth, change behavior and make well informed,  
               rational decisions;

             b)   States that professional clinical counseling is focused  
               exclusively on the application of counseling interventions  
               and psychotherapeutic techniques for the purpose of  
               improving mental health and is not intended to capture  
               other, nonclinical forms of counseling for the purposes of  
               licensure;

             c)   States that professional clinical counseling does not  
               induce the assessment or treatment of couples or families  
               unless the LPCC has completed additional training and  
               education beyond the minimum training and education  
               required for licensure, as specified; and,

             d)   Requires LPCCs to refer clients to other licensed health  
               care professionals when they identify issues beyond their  
               own scope of education, training, and experience.

          6)Prohibits persons from holding themselves out to the public by  
            any title or description of services as an LPCC unless they  
            are otherwise licensed to provide professional clinical  








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            counseling services.

          7)Requires that applicants for examination eligibility or  
            registration who begin graduate study before August 1, 2012,  
            and complete that study on or before December 31, 2018, adhere  
            to the following requirements:

             a)   Possess a master's or doctoral degree in counseling or  
               psychotherapy containing no fewer than 48 graduate semester  
               or 72 graduate quarter units of instruction, as specified;

             b)   Take the equivalent of at least three semester units of  
               graduate study in specified core content areas;

             c)   A minimum of 12 semester units or 18 quarter units of  
               advanced coursework, as specified;

             d)   A minimum of six semester units or nine quarter units of  
               supervised practicum or field study experience in a  
               clinical setting, as specified, and,

             e)   Specifies that in addition to the degree requirements,  
               an applicant shall complete the following coursework or  
               training prior to registration as an intern, as specified.

          8)Requires that applicants for examination eligibility or  
            registration who begin graduate study before August 1, 2012,  
            and do not complete that study on or before December 31, 2018;  
            begin graduate study before August 1, 2012 and who graduate  
            from a degree program meeting the requirements of this bill;  
            and, applicants for licensure or registration who begin  
            graduate study on or after August 1, 2012, adhere to the  
            following requirements:

             a)   Possess a master's or doctoral degree in counseling or  
               psychotherapy that contains no fewer than 60 graduate  
               semester or 90 graduate quarter units of instruction, as  
               specified;

             b)   Take 15 semester units or 22.5 quarter units of advanced  
               coursework to develop knowledge of specific treatment  
               issues or special populations; and,

             c)   Take no fewer than six semester units or nine quarter  
               units of supervised practicum or field study experience in  








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               a clinical setting, as specified.

          9)Requires each educational institution preparing applicants to  
            qualify for licensure to notify each of its students by means  
            of public document or otherwise in writing that its degree  
            program is designed to meet the requirements of this bill and  
            to certify to BBS that it has done so.

          10)Requires each applicant for licensure to complete a minimum  
            of 3,000 post-degree hours of supervised clinical mental  
            health experience, as specified.

          11)Authorizes BBS to begin accepting applications for  
            examination eligibility on January 1, 2012, and issue a LPCC  
            license to any person meeting the following requirements:

             a)   He or she has received a master's or doctoral degree, as  
               specified;

             b)   He or she has completed of 3,000 hours of supervised  
               experience in the practice of professional clinical  
               counseling, as specified; and,

             c)   He or she provides evidence of a passing score on the  
               examinations designated by BBS.

          12)Prohibits BBS from issuing a license to any person who has  
            been convicted of a crime involving sexual abuse of children  
            or who is required to register as a sex offender, as  
            specified.

          13)Establishes grandfathering provisions for persons who submit  
            an application for licensure between January 1, 2011, and June  
            30th, 2011, as specified.

          14)Requires BBS and the Office of Professional Examination  
            Services to jointly develop an examination on the differences,  
            if any exist, between the practice of professional clinical  
            counseling and the practice of marriage and family therapy;  
            and, the practice of professional clinical counseling and the  
            practice of clinical social work.

          15)Establishes provisions for persons seeking examination  
            eligibility who are licensed outside of California, which  
            includes having a passing score for the jurisprudence and  








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            ethics exam, having a license in good standing with another  
            state, and having education and experience substantially  
            equivalent to the requirements for licensure in California, as  
            specified.

          16)Authorizes BBS to refuse to issue any registration or  
            license, or suspend or revoke the registration or license of  
            any intern or LPCC if that person has been found guilty of  
            unprofessional conduct, as specified.

          17)Establishes a fee structure for licensure, licensure renewal  
            and examinations for LPCCs and interns.

           EXISTING LAW  :

          1)Licenses and regulates the practice of psychotherapy performed  
            by MFTs, licensed educational psychologists (LEPs), and LCSWs  
            by BBS within the Department of Consumer Affairs.

          2)Provides for an 11-member BBS, made up of:

        a)   Five professional members appointed by the Governor  
               consisting of:  two LCSW licensees, one LEP licensee, and  
               two MFT licensees; and,

        b)   Six public members consisting of:  four gubernatorial  
               appointees, one Senate appointee, and one Assembly  
               appointee.

          3)Defines a "psychotherapist" as a physician and surgeon  
            specializing in psychiatry or practicing psychotherapy, a  
            psychologist, a LCSW, a MFT, a psychological assistant, a MFT  
            registered intern or trainee, or an associate clinical social  
            worker.

          4)Defines the "practice of marriage and family therapy" as  
            service performed with individuals, couples, or groups wherein  
            interpersonal relationships are examined for the purpose of     
                   achieving more adequate, satisfying, and productive  
            marriage and family adjustments.

          5)Defines the "practice of clinical social work" as service in  
            which a special knowledge of social resources, human  
            capabilities, and the part that unconscious motivation plays  
            in determining behavior, and service that is directed at  








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            helping people achieve more adequate, satisfying, and  
            productive social adjustments.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, annual fee-supported special fund workload to BBS of  
          $1.2 million to $1.5 million to administer exams, licensure,  
          criminal background checks, and additional oversight in  
          establishing and maintaining a new licensure category and scope  
          of practice.

           COMMENTS  :  According to the author's office, "49 states  
          currently recognize LPCCs, yet California is the only remaining  
          state not to recognize this profession, whose numbers exceed  
          100,000 nationally.

          "This bill will not only allow out-of-state licensed counselors  
          who have moved to California to practice, but also allow the  
          counseling tracks in our CSU and private universities, to lead  
          to licensure beyond the one category California offers of  
          marriage and family therapy.  Consumer protection is of utmost  
          concern, as consumers who want to seek out a counselor for  
          issues not related to marriage and family could then seek out a  
          licensed professional which they cannot currently do.  With  
          recognition of the 'LPCC' California would benefit from federal  
          funding which includes the LPCC, including funding from  
          Veteran's Affairs for Rehabilitation Counselors to serve  
          veterans and their families, and Federally Qualified Health  
          Clinic funding as well."

          This bill is sponsored by the California Coalition for Counselor  
          Licensure who asserts that there is a particular shortage of  
          mental health providers in rural areas available to treat  
          Medi-Cal beneficiaries.  This shortage could increase due to the  
          passage of Proposition 63, the Mental Health Services Act  
          (MHSA), passed in 2004, which expands mental health care for  
          children and adults through a 1% tax on taxable personal income  
          over $1 million.
           
          News articles have reported that some counties are receiving  
          money from MHSA, but are finding it hard to recruit qualified  
          staff.  According to the sponsor, "In terms of sheer numbers,  
          the MFTs and LCSWs can fill the positions; however, they are not  
          filling those positions currently.  LPCCs curricula prepare them  
          to readily adapt to the needs of the public mental health system  
          under the principles of MHSA."








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          Background provided by the author's office states that  
          master-level counselors are currently employed in 36 county  
          mental health departments throughout the state.  Without a  
          license, there are limits to the services they can provide and  
          the reimbursements counties can receive unless the counselor is  
          licensed.

          The issues presented in this bill were part of "Sunrise Review"  
          by the Joint Committee on Boards, Commissions, and Consumer
          Protection (Joint Committee) in 2006.  The Joint Committee  
          recommended, "It has not been clearly established that there is  
          sufficient consumer protection justification for this proposal  
          [the licensure of LPCCs] and that this proposal meets the  
          threshold for licensure [the potential for serious injury or  
          death, or severe financial harm]."  The proposal did not receive  
          sufficient votes to be approved by the Joint Committee and went  
          forward without a support or oppose recommendation from the  
          Joint Committee.


           Analysis Prepared by  :    Rebecca May / B. & P. / (916) 319-3301 


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