BILL ANALYSIS Ó ------------------------------------------------------------ |SENATE RULES COMMITTEE | SB 363| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ 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 CONTINUED SB 363 Page 2 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 CONTINUED SB 363 Page 3 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 CONTINUED SB 363 Page 4 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 CONTINUED SB 363 Page 5 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 CONTINUED SB 363 Page 6 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. CONTINUED SB 363 Page 7 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 **** END **** CONTINUED