BILL ANALYSIS                                                                                                                                                                                                    Ó







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        |Hearing Date:June 6, 2011          |Bill No:AB                         |
        |                                   |956                                |
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                      SENATE COMMITTEE ON BUSINESS, PROFESSIONS 
                               AND ECONOMIC DEVELOPMENT
                          Senator Curren D. Price, Jr., Chair
                                           

                       Bill No:        AB 956Author:R. Hernandez
                        As Amended:May 27, 2011  Fiscal:   Yes

        
        SUBJECT:  Marriage and family therapy: interns and trainees:  
        advertisements.
        
        SUMMARY:  Requires a marriage and family therapist intern and a 
        marriage and family therapist trainee, prior to performing 
        professional services, to provide each client or patient with the name 
        of his or her employer and indicate that he or she is under the 
        supervision of a licensed person, as specified, and requires any 
        advertisement by or on behalf of an intern or trainee to include 
        specified information; requires an intern's registration number to be 
        disclosed to clients and patients and in advertisements.

        Existing law:
        
        1) Licenses and regulates the practice of marriage and family 
           therapists (MFTs), and provides for the registration and regulation 
           of MFT interns, and MFT trainees by the Board of Behavioral 
           Sciences (BBS) within the Department of Consumer Affairs.

        2) Authorizes MFT interns and trainees to perform counseling 
           activities and services in certain work settings; and requires that 
           a trainee or intern shall at all times be under the supervision of 
           a supervisor.

           a)   Requires the supervisor to be responsible for ensuring that 
             the counseling performed is consistent with the training and 
             experience of the person being supervised, requires the 
             supervisor to be responsible to the BBS for compliance with all 
             laws, rules, and regulations governing the practice of marriage 
             and family therapy.  (Business and Professions (BPC) § 4980.43)





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           b)   Defines "supervisor" to include an MFT, licensed clinical 
             social worker (LCSW), licensed psychologist, or licensed 
             physician certified in psychiatry.  (BPC § 4980.03)

       3)Requires MFT interns and trainees to inform each client or patient 
          prior to performing any professional services that he or she is 
          unlicensed and under the supervision of a licensed marriage and 
          family therapist (MFT), licensed clinical social worker (LCSW), 
          licensed psychologist, or a licensed physician and surgeon certified 
          in psychiatry.  (BPC §§ 4980.44, 4980.48)

       4)Requires any advertisement for services performed by a trainee to 
          include the trainee's name, the supervisor's license designation or 
          abbreviation, and the supervisor's license number.  (BPC § 4980.48)

        This bill:

       1)Requires an MFT intern to additionally inform clients or patients 
          prior to performing professional services that he or she is an 
          unlicensed MFT intern, provide his or her registration number and 
          the name of his or her employer.

       2)Requires any advertisement by or on behalf of a MFT intern to include 
          at a minimum the following information:

           a)   That he or she is a registered intern.

           b)   The intern's registration number.

           c)   The name of the intern's employer.

           d)   That the intern is supervised by a licensed person.

        1) For MFT interns, prohibits the use of the abbreviation "MFTI" in an 
           advertisement unless the title "marriage and family therapist 
           registered intern" appears in the advertisement.

        2) Requires an MFT trainee to additionally inform clients or patients 
           prior to performing professional services that he or she is an 
           unlicensed MFT trainee, and the name of his or her employer.

       3)Requires any advertisement by or on behalf of a MFT trainee to 
          include at a minimum the following information:

           a)   That he or she is an MFT trainee.





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           b)   The name of the trainee's employer.

           c)   That the trainee is supervised by a licensed person.


        FISCAL EFFECT:  The Assembly Appropriations Committee analysis, dated 
        May 4, 2011, indicates a negligible state fiscal impact.

        COMMENTS:
        
        1. Purpose.  This bill is sponsored by  California Association of 
           Marriage and Family Therapists  (Sponsor).  According to the Author, 
           misleading and deceptive online advertisements offering mental 
           health services are becoming an emerging trend, and more 
           advertisements offering marriage and family counseling are created 
           by unqualified individuals.  The Author states that an increasing 
           number of such advertisements are published by MFT interns, who by 
           law, may only provide services to the public as an employee or a 
           volunteer for a licensed person or other lawful entity, and can 
           only do so under appropriate supervision.  Certain advertisements 
           appear to offer services performed by licensed professionals, but 
           are instead carried out by interns, and the Author indicates, the 
           advertisements can mislead consumers to believe interns are medical 
           professionals by using the acronym MFTI, instead of explicitly 
           stating the full title of the intern.  "Unfortunately, this type of 
           misleading advertising is increasing.  If left unaddressed, those 
           seeking mental health services from a licensed professional may 
           unknowingly receive inferior care from an unlicensed individual."

           The Author further indicates that this ambiguity is found not only 
           in online advertisements, but within some medical clinics as well.  
           Currently, MFT interns must disclose their intern status before 
           treating patients; however other critical information, such as the 
           disclosure of whether the MFT intern is under the supervision of a 
           licensed professional, may be omitted.

           This bill will encourage truthfulness in advertising and will allow 
           consumers to make informed choices when choosing a mental health 
           provider, according to the Author.

        2. Background.  Only licensed mental health professionals may 
           supervise MFT interns and trainees.  Licensed mental health 
           professionals include MFTs, LCSWs, licensed psychologists, and 
           licensed physicians certified in psychiatry by the American Board 
           of Psychiatry and Neurology.  Additionally, the supervisor must 





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           maintain a current valid California license for at least two years. 
            The Board requires supervisors of registered interns and trainees 
           to complete a minimum of six hours of supervision training or 
           coursework within two years immediately preceding supervision (or 
           within 60 days of commencement of supervision) and every renewal 
           period thereafter.  Psychologists and physicians certified in 
           psychiatry are exempt from supervision training.

        3. Related Legislation.   SB 363  (Emmerson), allows MFT trainees to 
           continue counseling clients while not enrolled in a practicum if 
           the lapse in enrollment is less than 45 days; limits the number of 
           client-centered advocacy hours for a marriage and family therapist 
           intern to 500 hours; and allows LPCCs to supervise MFT interns if 
           they meet additional training and education requirements to treat 
           couples and families.  That bill passed this Committee on April 11, 
           2011 on a 7-0 vote, and has been referred to the Assembly Business, 
           Professions and Consumer Protection Committee.

         SB 146  (Wyland) revises various provisions relating to the practice of 
           mental health professionals to also include the practice of 
           licensed professional clinical counselors, clinical counselor 
           trainees, and clinical counselor interns; makes technical updating 
           and conforming changes.  That bill passed this Committee on April 
           11, 2011 on a 9-0 vote, and has been referred to the Assembly 
           Business, Professions and Consumer Protection Committee.

         SB 704  (Negrete McLeod) revises and recasts examination requirements 
           for marriage and family therapists and interns and for licensed 
           clinical social workers and associate social workers; makes 
           technical cleanup and conforming changes.  That bill was approved 
           on Consent by this Committee on April 4, 2011, and is currently 
           awaiting hearing in the Assembly Business, Professions and Consumer 
           Protection Committee.

            AB 583  (Hayashi, Chapter 436, Statutes of 2010) mandates similar 
           disclosures for physicians and other health care professionals.

        4. Arguments in Support.  In Sponsoring the bill,  California 
           Association of Marriage and Family Therapists  writes, "Current law 
           governing advertising by or on behalf of a marriage and family 
           therapist registered intern or trainee?does not adequately inform 
           members the public who the employer of the intern or trainee is, 
           who the supervisor of the intern or trainee is, and what the 
           supervisor's licensure status is.  Additionally, the use of 'MFTI' 
           by marriage and family therapist registered interns is confusing 
           and misleading.  The Sponsor argues that is important for interns 





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           and trainees to identify who their employers are and that they are 
           under the supervision of an appropriately licensed professional.  
           "These changes in the law will assure that there is no ambiguity 
           with respect to how marriage and family therapist registered 
           interns or trainees advertise or identify themselves.  These 
           changes also insure that the public will know the unlicensed status 
           of the individual prior to engaging in professional services with 
           any marriage and family therapist registered intern or trainee."

        The  California Psychiatric Association  believes the bill will provide 
           transparency to the consumer related to the qualifications of their 
           therapist by requiring interns to disclose their status as interns 
           when they treat those consumers.

        The  Board of Behavioral Sciences  (Board) supports the bill, stating 
           that bill clarifies inconsistencies in the law relating to 
           advertising.  The recent amendments for requiring the registration 
           number to be included in MFT intern advertising and to be given to 
           clients were made at the Board's request, and will provide greater 
           consistency and clarity according to the Board.


        SUPPORT AND OPPOSITION:
        
         Support:   

        California Association of Marriage and Family Therapists (Sponsor)
        Board of Behavioral Sciences
        California Psychiatric Association

         Opposition:   

        None on file as of May 31, 2011


        Consultant:G. V. Ayers