BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 363|
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                              UNFINISHED BUSINESS


          Bill No:  SB 363
          Author:   Emmerson (R)
          Amended:  9/1/11
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON DEV. COMMITTEE  :  7-0, 4/11/11
          AYES:  Price, Emmerson, Corbett, Correa, Negrete McLeod, 
            Vargas, Walters
          NO VOTE RECORDED:  Hernandez, Wyland

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           SENATE FLOOR  :  38-0, 5/9/11
          AYES:  Alquist, Anderson, Berryhill, Blakeslee, Calderon, 
            Cannella, Corbett, Correa, De León, DeSaulnier, Dutton, 
            Emmerson, Evans, Fuller, Gaines, Hancock, Harman, 
            Hernandez, Huff, Kehoe, La Malfa, Leno, Lieu, Liu, 
            Lowenthal, Padilla, Price, Rubio, Runner, Simitian, 
            Steinberg, Strickland, Vargas, Walters, Wolk, Wright, 
            Wyland, Yee
          NO VOTE RECORDED:  Negrete McLeod, Pavley

           ASSEMBLY FLOOR  :  73-0, 9/6/11 - See last page for vote


           SUBJECT  :    Marriage and family therapists

           SOURCE  :     Board of Behavioral Sciences


           DIGEST  :    This bill allows marriage and family therapist 
          trainees to continue counseling clients while not enrolled 
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          in a practicum if the lapse in enrollment is less than 90 
          days, and if that period is immediately preceded and 
          immediately followed by enrollment in a practicum course; 
          limits the number of client-centered advocacy hours for a 
          marriage and family therapist intern to 500 hours; and 
          allows professional clinical counselors to supervise 
          marriage and family therapist interns if they meet 
          additional training and education requirements to treat 
          couples and families.

           Assembly Amendments  add double-jointing language with SB 
          943 (Senate Business, Professions and Economic Development 
          Committee), and make technical and conforming changes.

           ANALYSIS  :    

          Existing law:

          1. Licenses and regulates the practice of marriage and 
             family therapists (MFTs), licensed educational 
             psychologists (LEPs), and licensed clinical social 
             workers (LCSWs) by the Board of Behavioral Sciences 
             (BBS) within the Department of Consumer Affairs.  
             Beginning January 1, 2012, the BBS will additionally 
             license professional clinical counselors (LPCCs).

          2. Establishes education requirements for MFT licensure, 
             including a requirement for a practicum completed by an 
             MFT intern that involves certain types and hours of 
             experience, and specifies that not more than a combined 
             total of 1,250 of experience may be gained in the 
             following:

             A.    Direct supervisor contact.

             B.    Professional enrichment activities, including 
                workshops, seminars, training sessions, conferences, 
                or personal psychotherapy, as specified.

             C.    Client centered advocacy, generally defined as 
                activities, related to obtaining or providing 
                services and supports for clients.  

          3. Authorizes MFT interns and trainees to perform 

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             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.  

             B.    Defines "supervisor" to include an MFT, LCSW, 
                licensed psychologist, or licensed physician 
                certified in psychiatry.  

          4. Authorizes trainees to gain hours of experience outside 
             the required practicum under certain conditions, but 
             requires trainees who gain experience outside the 
             required practicum to be enrolled in a practicum in 
             order to counsel clients. 

          5. Prohibits a LPCC from engaging in the assessment or 
             treatment of couples or families  unless the LPCC meets 
             additional training and education requirements beyond 
             that required for licensure, including:

             A.    Six semester units or nine quarter units in 
                marriage and family therapy or a specialization in 
                marriage and family therapy, as specified.

             B.    No less than 500 hours of documented supervised 
                experience working directly with couples, families or 
                children.

             C.    A minimum of six hours of continuing education 
                specific to marriage and family therapy in each 
                license renewal cycle.
           
          This bill:

          1. Provides that an MFT trainee may also counsel clients 
             while not enrolled in a practicum if the period of 
             lapsed enrollment is less than 90 calendar days, and if 

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             that period is immediately preceded and immediately 
             followed by enrollment in a practicum course.

          2. Recasts the provisions of Existing Law #2, above, to 
             instead provide that an MFT intern practicum must 
             involve certain types and hours of experience, and 
             specifies that not more than a combined total of 1,000 
             hours of experience may be gained  in the following:

             A.    Direct supervisor contact.

             B.    Professional enrichment activities, including 
                workshops, seminars, training sessions, conferences, 
                or personal psychotherapy, as specified.

             C.    Limits to 500 hours, the number of experience 
                hours that may be gained from client-centered 
                advocacy, administering and evaluating psychological 
                tests, and writing clinical reports and notes.

          3. Authorizes an LPCC to act as a supervisor of a MFT 
             intern or trainee if he/she meets the additional 
             training and education requirements required for a LPCC 
             to counsel couples or families.

          4. Makes technical cleanup, and conforming changes.

          5. Contains double-jointing language with SB 943 (Senate 
             Business, Professions and Economic Development 
             Committee).

           Background  

          Revisions made in the MFT law by SB 33 (Correa), Chapter 
          26, Statutes of 2009, require MFT trainees to be enrolled 
          in a practicum course while counseling clients.  According 
          to BBS, a number of schools have voiced concern on how the 
          practicum course requirement would operate during 
          intersession and summer break when students may not be able 
          to enroll in a practicum course.  This could create 
          continuity of care issues when the trainee goes on summer 
          break leaving the client with another practitioner or even 
          without care.  Additionally, there are barriers to 
          licensure if the trainee is not able to gain direct client 

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          hours due to not being enrolled in practicum.  Therefore, 
          allowing a trainee to continue counseling clients while not 
          enrolled in a practicum if that lapse in enrollment is less 
          than 45 days will help address these concerns, according to 
          the BBS.

          BBS further indicates that under current law, the number of 
          client-centered advocacy hours that a marriage and family 
          therapist intern can obtain is only limited by the amount 
          of direct supervisor contact hours acquired by the intern.  
          For example, if an intern received the minimum number of 
          direct supervisor contact hours for 104 weeks, that 
          individual could potentially receive credit for 1,146 hours 
          for client-centered advocacy.  The BBS believes that the 
          majority of the MFT intern's experience hours should be 
          gained through a variety of training activities other than 
          client-centered advocacy, therefore, the bill proposes to 
          limit the client centered advocacy allowed for an MFT 
          intern to 500 hours.

          Currently, BBS states, licensed professional clinical 
          counselors are not allowed to supervise marriage and family 
          therapist interns.  However, the law authorizes all other 
          licensees of the BBS to supervise these interns.  
          Therefore, the bill authorizes LPCCs to supervise marriage 
          and family therapist interns if they meet additional 
          training and education requirements to treat couples and 
          families.

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

           SUPPORT  :   (Verified  9/6/11)

          Board of Behavioral Sciences (source) 
          American Association for Marriage and Family Therapy

           OPPOSITION  :    (Verified  9/6/11)

          California Association of Marriage and Family Therapists 

           ARGUMENTS IN SUPPORT  :    The American Association for 
          Marriage and Family Therapy (AAMFT-CA) argues the bill 
          ensures proper university supervision for graduate MFT 

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          students who are seeking clients and expands the pool of 
          eligible supervisors for MFT interns and trainees to 
          include LPCCs who meet state requirements to assist and 
          treat couples and families.  

          AAMFT-CA further argues that the Board worked with graduate 
          programs over two years to revise the MFT curriculum.  
          Those changes, made in SB 33 in 2009, did not increase the 
          academic unit requirement for practicum, but instead 
          included a requirement that students must be enrolled in a 
          practicum course while seeing clients.  This allowed 
          practicum hours to be expanded without adding mandatory 
          units to the curriculum, and at the same time meeting the 
          public- protection need for trainees to receive adequate 
          university oversight of their work.  AAMFT-CA suggests that 
          the bill's 45-day allowance for academic breaks, ensures 
          that client care is not unduly impacted by breaks between 
          academic terms, while maintaining appropriate school 
          oversight for trainees.

          AFMFT-CA argues that it is fully appropriate to require 
          LPCCs to complete specific coursework and supervised 
          experience in order to supervise MFT interns and trainees 
          since MFT interns and trainees under supervision are likely 
          to be working with couples and families.  To remove this 
          requirement would allow LPCCs to supervise an activity 
          (assessing or treating couples or families) that the 
          supervisor is legally prohibited from conducting, which 
          makes no sense according to AAMFT-CA.  Proponents further 
          suggest that adding a previously-unrecognized category of 
          supervisors, would expand the opportunities for MFT interns 
          to receive supervision, while ensuring that the supervisors 
          are appropriately qualified.

           ARGUMENTS IN OPPOSITION  :    The California Association of 
          Marriage and Family Therapists (CAMFT) oppose the 
          limitations which would allow a LPCC to supervise an MFT 
          intern only if the supervisor meets additional education 
          and training requirements.  CAMFT opposes the limitations, 
          especially for persons who will be "grand-parented" into 
          the LPCC profession.  CAMFT indicates it would be willing 
          to accept those limitations if they are applicable to those 
          persons who begin graduate study on or after January 1, 
          2012.

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           ASSEMBLY FLOOR  :  73-0, 9/6/11
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Buchanan, Charles Calderon, Campos, Carter, Cedillo, 
            Chesbro, Conway, Cook, Davis, Dickinson, Donnelly, Eng, 
            Feuer, Fletcher, Fong, Fuentes, Furutani, Beth Gaines, 
            Galgiani, Garrick, Gatto, Gordon, Grove, Hagman, Hall, 
            Harkey, Hayashi, Roger Hernández, Hill, Huber, Hueso, 
            Huffman, Jeffries, Jones, Knight, Lara, Logue, Bonnie 
            Lowenthal, Ma, Mansoor, Miller, Monning, Morrell, 
            Nestande, Nielsen, Norby, Olsen, Pan, Perea, V. Manuel 
            Pérez, Portantino, Skinner, Smyth, Solorio, Swanson, 
            Torres, Valadao, Wagner, Wieckowski, Williams, Yamada, 
            John A. Pérez
          NO VOTE RECORDED:  Brownley, Butler, Gorell, Halderman, 
            Mendoza, Mitchell, Silva


          JJA:mw  9/7/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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