BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 2213
                                                                  Page  1

          Date of Hearing:   April 8, 2014

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER  
                                     PROTECTION
                               Susan A. Bonilla, Chair
                    AB 2213 (Eggman) - As Amended:  March 28, 2014
           
          SUBJECT  :   Behavioral health care licensees. 

           SUMMARY  :   Revises the current education and curriculum  
          requirements for licensure as a Marriage and Family Therapist  
          (MFT) and Professional Clinical Counselor (PCC) for out-of-state  
          applicants who are applying for licensure on or after January 1,  
          2016.  Specifically,  this bill affects the following license  
          categories, as specified  :  

           For persons licensed outside of California and apply for  
          licensure as a MFT on or after January 1, 2016:

           1)Permits the Board of Behavioral Sciences (BBS) to accept time  
            actively licensed as a MFT towards licensure at a rate of 100  
            hours per month, up to a maximum of 1,200 hours if the if the  
            applicant has less than 3,000 hours of qualifying supervised  
            experience and the applicant's degree meets specified  
            practicum requirements without exemption and remediation.

           For persons who do not hold a license outside of California and  
          apply for licensure or registration as a MFT on or after January  
          1, 2016:

           2)Revises the current number of units required for an applicant  
            educated outside of California as follows:

             a)   For an applicant who obtained his or her degree within a  
               specified timeline, the degree must contain no less than 60  
               semester units or 90 quarter units of instruction, and up  
               to 12 semester or 18 quarter units of instruction may be  
               remediated if missing from the degree and may occur while  
               the applicant is registered as an intern;

             b)   For an applicant who obtained his or her degree within a  
               specified timeframe, the degree must contain no less than  
               48 semester units or 72 quarter units of instruction; and, 

             c)   An additional 75 hours of either face-to-face counseling  








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               or client-centered advocacy, or a combination thereof.

          3)Revises the coursework requirements for California law and  
            ethics as follows:

             a)   An applicant who completed a course in law and  
               professional ethics for MFTs, as specified, that did not  
               contain instruction in California law and ethics must  
               complete an 18-hour course, as specified, prior to  
               registering as an intern; and,

             b)   An applicant, who has not completed a course in law and  
               professional ethics for MFTs, as specified, must complete  
               coursework which contains content specific to California  
               law and ethics and completes the coursework prior to  
               registration as an intern.

          4)Clarifies for an applicant who completes specified educational  
            requirements, which were not completed during his or her  
            education, that the coursework must be from an accredited  
            school, college or university, as specified, an educational  
            institution approved by the Bureau of Private Postsecondary  
            Education (BPPE) or from a continuing education provider that  
            is acceptable to BBS, as specified, which cannot be  
            undergraduate coursework.

          5)Requires an applicant to complete the following coursework,  
            which cannot be undergraduate coursework, not already  
            completed in his or her education from a specified educational  
            institution:

             a)   At least three semester units or 45 hours of instruction  
               regarding the principles of mental health recovery-oriented  
               care and methods of service delivery in recovery-oriented  
               practice environments, including structured meetings with  
               various consumers and family members of consumers of mental  
               health services to enhance understanding of their  
               experience of mental illness, treatment, and recovery; and,

             b)   At least one semester unit, or 15 hours, of instruction  
               that includes an understanding of various California  
               cultures and the social and psychological implications of  
               socioeconomic position.

          6)Clarifies that an applicant may complete any specified units  








                                                                  AB 2213
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            and course content requirements not already completed in his  
            or her education while registered as an intern, unless  
            otherwise specified.

           For persons licensed outside of California and apply for  
          licensure or registration as a MFT on or after January 1, 2016:  

          7)States that education will be considered substantially  
            equivalent if all of the following requirements are met:

             a)   The degree is obtained from a school, college or  
               university accredited by an accrediting agency recognized  
               by the United States Department of Education and consists  
               of:

               i)     For an applicant who obtained his or her degree  
                 within a specified timeframe, the degree must contain no  
                 less than 60 semester or 90 quarter units of instruction  
                 and up to 12 semester or 18 quarter units of instruction  
                 may be remediated while registered as an intern.

             b)   For an applicant who obtained his or her degree within a  
               specified timeline, the degree  must contain no less than  
               48 semester or 72 quarter units of instruction;

             c)   Six semester or nine quarter units of practicum,  
               including but not limited to, a minimum of 150 hours of  
               face-to-face counseling, and an additional 75 hours of  
               either face-to-face counseling or client-centered advocacy,  
               or a combination thereof; 

               i)     An out-of-state applicant, who has been licensed for  
                 at least two years in clinical practice, as verified by  
                 the BBS, is exempt from the requirement above; and,

               ii)    An applicant who has been licensed for less than two  
                 years in clinical practice, as verified by the BBS, who  
                 does not meet the practicum requirement, is required to  
                 remediate it by obtaining 150 hours of face-to-face  
                 counseling and an additional 75 hours of either  
                 face-to-face counseling or client-centered advocacy, as  
                 specified, in addition to the 3,000 hours of experience  
                 required while registered as an intern.

             d)   Twelve semester or 18 quarter units in the areas of  








                                                                  AB 2213
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               marriage, family, and child counseling and marital and  
               family systems, and approaches to treatment, as specified.

          8)Specifies that an applicant must complete coursework in law  
            and ethics as follows:

             a)   An applicant who has completed a course in law and  
               professional ethics for MFTs, as specified, that did not  
               include instruction in California law and professional  
               ethics must complete an 18 hour course in California law  
               and professional ethics prior to registering as an intern,  
               and the content of the course must at least include,  
               advertising, scope of practice, scope of competence,  
               treatment of minors, confidentiality, dangerous patients,  
               psychotherapist-patient privilege, recordkeeping, patient  
               access to records, state and federal laws relating to  
               confidentiality of patient health information, dual  
               relationships, child abuse, elder and dependent adult  
               abuse, online therapy, insurance reimbursement, civil  
               liability, disciplinary actions and unprofessional conduct,  
               ethic complaints and ethical standards, termination of  
               therapy, standards of care, relevant family law, therapist  
               disclosure to patients, differences in legal and ethical  
               standards in different types of work settings, and  
               licensing law and licensing process prior to registering as  
               an intern; and 

             b)   An applicant, who has not completed a course in law and  
               professional ethics for MFTs, as specified, shall complete  
               the coursework which includes content specific to  
               California law and ethics, prior to registering as an  
               intern. 

          9)Permits coursework not already completed during an applicant's  
            education to be from an accredited school, college or  
            university, as specified, from the BPPE, or from a continuing  
            education provider that is acceptable to BBS, and cannot be  
            undergraduate.

          10)Requires an applicant to complete coursework, not already  
            completed in his or her education, from an accredited school,  
            college or university, as specified, from the BPPE, or from a  
            continuing education provider that is acceptable to BBS, and  
            is not undergraduate to include:









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             a)   At least three semester units or 45 hours of instruction  
               regarding the principles of mental health recovery-oriented  
               care and methods of service delivery in recovery-oriented  
               practice environments, including structured meetings with  
               various consumer and family members of consumers of mental  
               health services to enhance understanding of their  
               experience of mental illness, treatment, and recovery; and

             b)   At least one semester unit or 15 hours of instruction  
               that includes an understanding of the various California  
               cultures and the social and psychological implications of  
               socioeconomic position.

          11)Clarifies that an applicant's degree title does not need to  
            be identical to other specified degree titles.

          12)Specifies that an applicant may complete specified units and  
            course content requirements not already completed in his or  
            her education, while registered as an intern unless otherwise  
            specified.

           For persons who apply for licensure as a MFT between January 1,  
          2010, and December 31, 2015, and hold a valid license issued by  
          a board or corresponding authority outside of California:

           13)Permits BBS to accept time actively licensed to be accepted  
            toward licensure at a rate of 100 hours per month, up to a  
            maximum of 1,200 hours if the applicant has less than 3,000  
            hours of qualifying supervised experience.

           For persons who do not hold a license outside of California and  
          apply for licensure or registration as a MFT on or after January  
          1, 2016:
           
          14)Requires an applicant to meet the following educational   
            requirements:

             a)   A minimum of two semester units of instruction in the  
               diagnosis, assessment, prognosis, and treatment of mental  
               disorders, including severe mental disorders,  
               evidence-based practices, psychological testing,  
               psychopharmacology, and promising mental health practices  
               that are evaluated in peer review literature; this must  
               include at least one semester unit or 15 hours of  
               instruction in psychological testing and at least one  








                                                                  AB 2213
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               semester unit or 15 hours of instruction in  
               psychopharmacology;

             b)   Training in developmental issues from infancy to old  
               age, including demonstration of at least one semester unit  
               or 15 hours of instruction that includes the following  
               subjects:

               i)     The effects of developmental issues on individuals,  
                 couples, and family relationships;

               ii)    The psychological, psychotherapeutic, and health  
                 implications of developmental issues and their effects;  
                 and,

               iii)   The understanding of the impact that personal and  
                 social insecurity, social stress, low education levels,  
                 inadequate housing, and malnutrition have on human  
                 development and specifies that an applicant who is  
                 deficient in any of the subject above may remediate the  
                 coursework by completing three hours of instruction in  
                 each deficient subject.

             c)   Training in the broad range of matters and life events  
               that may arise within marriage and family relationships and  
               within a variety of California cultures, including  
               instruction in the following:

               i)     A minimum of seven contact hours of training or  
                 coursework in child abuse assessment and reporting, as  
                 specified, and any regulations promulgated;

               ii)    A minimum of ten contact hours of coursework that  
                 includes:

                  (1)       The assessment and reporting of, as well as  
                    treatment related to, elder and dependent adult abuse  
                    and neglect;

                  (2)       Aging and its biological, social, cognitive,  
                    and psychological aspects;

                  (3)       Long-term care; and

                  (4)       End-of-life grief.








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               iii)   A minimum of 15 contact hours of coursework in  
                 spousal or partner abuse assessment, detection,  
                 intervention strategies, and same-gender abuse dynamics;

               iv)    Cultural factors relevant to abuse of partners and  
                 family members;

               v)     Childbirth, child rearing, parenting, and  
                 step-parenting;

               vi)    Marriage, divorce, and blended families;

               vii)   Poverty and deprivation;

               viii)  Financial and social stress;

               ix)    Effects of trauma; and,

               x)     The psychological, psychotherapeutic, community and  
                 health implications of the matters and life events, as  
                 specified.

             d)   At least one semester unit, or 15 hours, of instruction  
               in multicultural development and cross-cultural  
               interaction, including experiences of race, ethnicity,  
               class spirituality, sexual orientation, gender, and  
               disability, and their incorporation into the  
               psychotherapeutic process;

             e)   A minimum of 10 contact hours of training or coursework  
               in human sexuality, as specified, including the study of  
               physiological, psychological, and social cultural variables  
               associated with sexual behavior and gender identity, and  
               the assessment and treatment of psychosexual dysfunction;

             f)   A minimum of 15 contact hours of coursework in substance  
               use disorders, co-occurring disorders and addiction and the  
               coursework must include:

               i)     The definition of substance use disorders,  
                 co-occurring disorders and addiction and defines  
                 "co-occurring" to mean a mental illness and substance  
                 abuse diagnosis occurring simultaneously in an  
                 individual;








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               ii)    Medical aspects of substance use disorders and  
                 co-occurring disorders;

               iii)   The effects of psychoactive drug use;

               iv)    Current theories of the etiology of substance abuse  
                 and addiction;

               v)     The role of persons and systems that support or  
                 compound substance abuse and addiction;

               vi)    Major approaches to identification, evaluation, and  
                 treatment of substance use disorders, co-occurring  
                 disorders, and addiction, including best practices;

               vii)   Legal aspects of substance abuse;

               viii)  Populations at risk with regard to substance use  
                 disorders and co-occurring disorders; 

               ix)    Community resources offering screening, assessment,  
                 treatment, and follow-up for the affected person and  
                 family;

               x)     Recognition of substance use disorders, co-occurring  
                 disorders, and addiction and appropriate referral; and,

               xi)    The prevention of substance use disorders and  
                 addiction.

             g)   A minimum of a two semester or three quarter unit course  
               in law and professional ethics for MFTs, including  
               instruction in the following:

               i)     Contemporary professional ethics and statutory,  
                 regulatory, and decisional laws that delineate the scope  
                 of practice of marriage and family therapy;

               ii)    The therapeutic, clinical and practical  
                 considerations involved in the legal and ethical practice  
                 of marriage and family therapy, including family law;

               iii)   The current legal patterns and trends in the mental  
                 health professions;








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               iv)    The psychotherapist-patient privilege,  
                 confidentiality, the patient dangerous to self or others  
                 and the treatment of minors with and without parental  
                 consent;

               v)     A recognition and exploration of the relationship  
                 between a practitioner's sense of self and human values  
                 and his or her professional behavior and ethics; 

               vi)    Differences in legal and ethical standards for  
                 different types of work settings; and,

               vii)   Licensing law and licensing process.

           For persons who apply for licensure as an MFT between January 1,  
          2010, and December 31, 2015, who have gained experience  
          out-of-state: 

           15)Permits BBS to accept time actively licensed as a MFT to be  
            accepted towards licensure at a rate of 100 hours per month,  
            up to a maximum of 1,200 hours if the applicant has less than  
            3,000 hours of qualifying supervised experience.

           For persons who apply for examination eligibility or  
          registration, as a PCC, between January 1, 2011, and December  
          31, 2015, and who are not licensed out-of state:  

          16)Exempts an applicant from taking an 18-hour ethics course, as  
            specified, if the applicant completed a course that included  
            instruction in California law and ethics.

           For persons who apply for examination eligibility between  
          January 1, 2011 and December 31, 2015, and who have held a PCC  
          license, out-of-state, for at least two-years:  

          17)Permits BBS to accept time actively licensed as a PCC to be  
            accepted towards licensure at a rate of 100 hours per month,  
            up to a maximum of 1,200 hours if the applicant has less than  
            3,000 hours of qualifying supervised experience.

          18)Exempts an applicant from taking an 18-hour ethics course, as  
            specified, if the applicant completed a course that included  
            instruction in California law and ethics.









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           For persons who apply for examination eligibility between  
          January 1, 2011 and December 31, 2015, and who have held a PCC  
          license, out-of-state, for less than two-years:  

          19)Permits BBS to accept time actively licensed as a PCC to be  
            accepted towards licensure at a rate of 100 hours per month,  
            up to a maximum of 1,200 hours if the applicant has less than  
            3,000 hours of qualifying supervised experience.

          20)Exempts an applicant from taking an 18-hour ethics course, as  
            specified, if the applicant completed a course that included  
            instruction in California law and ethics.

           For persons who apply for examination eligibility for licensure  
          as a PCC who are licensed outside of California and apply on or  
          after January 1, 2016:  

          21)Permits BBS to accept time actively licensed as a PCC to be  
            accepted towards licensure at a rate of 100 hours per month,  
            up to a maximum of 1,200 hours if the if the applicant has  
            less than 3,000 hours of qualifying supervised experience and  
            the applicant's degree meets specified practicum requirements  
            without exemptions or remediation.

           For persons who apply for examination eligibility or  
          registration as a PCC on or after January 1, 2016, who do not  
          hold a license outside of California:  

          22)Clarifies that education is considered substantially  
            equivalent if: 

             a)   For an applicant who obtained his or her degree within a  
               specified timelime, the degree must contain no less than 60  
               graduate semester or 90 graduate quarter units, and up to  
               12 semester or 18 quarter units of instruction may be  
               remediated while registered as an intern; and,

             b)   For an applicant who obtained his or her degree within a  
               specified timeline, the degree must contain no less than 48  
               graduate semester or 72 graduate quarter units of  
               instruction, as specified.

          23)Clarifies that an applicant whose degree is deficient, as  
            specified, may satisfy those deficiencies by successfully  
            completing graduate level coursework at an accredited or  








                                                                  AB 2213
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            approved institution and the coursework taken must be the  
            equivalent of three semester units or four and one-half  
            quarter units of study.  

          24)Provides that an applicant who completed a course in  
            professional orientation, ethics, and law in counseling that  
            did not contain instruction in California law and professional  
            ethics must complete an 18-hour course, as specified, prior to  
            registering as an intern.

          25)Provides that an applicant, who has not completed a course in  
            law and professional ethics for MFTs, as specified, shall  
            complete the coursework which includes content specific to  
            California law and ethics, prior to registering as an intern.

          26)Requires an applicant who completes any units, as specified,  
            not already in his or her education to comply with the  
            following:

             a)   At least 15 semester units or 22.5 quarter units of  
               advanced coursework to develop knowledge of specific  
               treatment issues or special populations in addition to  
               currently required coursework; and

             b)   Coursework must be from and accredited or approved  
               school, college of university as specified.

          27)Requires an applicant to complete the following graduate  
            level coursework not already completed in his or her education  
            to comply with the following:

             a)   A minimum of 10 contact hours of training in human  
               sexuality, as specified, including the study of the  
               physiological, psychological, and social cultural variables  
                       associated with sexual behavior, gender identity, and the  
               assessment and treatment of psychosexual dysfunction;

             b)   A minimum of 15 contact hours of instruction in spousal  
               or partner abuse assessment, detection, intervention  
               strategies, and same-gender abuse dynamics;

             c)   A minimum of seven contact hours of instruction in child  
               abuse assessment, and reporting, as specified; and,

             d)   A minimum of 10 contact hours of instruction in aging  








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               and long-term care, including biological, social,  
               cognitive, and psychological aspects of aging, and include  
               instruction on the assessment and reporting of, and  
               treatment related to elder and dependent adult abuse and  
               neglect.

          28)Requires an applicant who completes coursework not already  
            completed in his or her education to be at a graduate level  
            and include:

             a)   At least three semester units or 45 hours of instruction  
               regarding the principles of mental health recovery-oriented  
               care and methods of service delivery in recovery-oriented  
               practice environments, including structured meetings with  
               various consumers and family members of consumers of mental  
               health services to enhance understanding of their  
               experiences of mental illness, treatment and recovery; and

             b)   At least one semester unit or 15 hours of instruction  
               that includes and understanding of various California  
               cultures and the social and psychological implications of  
               socioeconomic position.

          29)Clarifies that an applicant may complete units and course  
            content requirements not already completed in his or her  
            education while registered with the BBS as an intern.

           For persons who apply for examination eligibility or  
          registration as a PCC on or after January 1, 2016, and hold a  
          license outside of California:

           30)Specifies that education is deemed substantially equivalent  
            if:

             a)   The degree was obtained at an accredited or approved  
               institution, as specified, and consists of the following:

               i)     For an applicant who obtained his or her degree  
                 within a specified timeframe, the degree must be no less  
                 than 60 graduate semester or 90 quarter units and up to  
                 12 semester or 18 quarter units of instruction may be  
                 remediated if missing from the degree while registered as  
                 an intern.

             b)   For an applicant who obtained his or degree within a  








                                                                  AB 2213
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               specified timeframe, the degree shall contain no less than  
               48 graduate semester or 72 graduate units of instruction;

             c)   Six semester or nine quarter units of practicum,  
               including but not limited to, a minimum of 280 hours of  
               face-to-face counseling: 

               i)     An applicant who has been licensed for at least two  
                 years in clinical practice, as verified, is exempt; and,

               ii)    An out-of-state applicant who has been licensed for  
                 less than two years in clinical practice, as verified by  
                 BBS, and does not meet the practicum requirement, shall  
                 remediate the requirement by demonstrating completion of  
                 a total of 280 hours of face-to-face counseling, as  
                 specified, in addition to the 3,000 hours of experience  
                 required and must be gained while registered as an  
                 intern. 

             d)   Specified areas of study:

               i)     An applicant whose degree is deficient in no more  
                 than six of the required areas of study, as specified,  
                 may satisfy those deficiencies by successfully completing  
                 graduate level coursework which must be the equivalent of  
                 three semester units or four and one-half units of study;

               ii)    An applicant who completed a course in professional  
                 orientation, ethics, and law in counseling that did not  
                 contain instruction in California law and ethics must  
                 complete an 18 hour course in California law and  
                 professional ethics, as specified; and,

               iii)   An applicant who has not completed a course in  
                 professional orientation ethics and law in counseling, as  
                 specified must complete this coursework prior to  
                 registration as an intern.

          31)Requires an applicant to complete any required units, as  
            specified, not already completed in his or her education as  
            follows:

             a)   At least 15 semester units or 22.5 quarter units of  
               advanced coursework to develop knowledge of specific  
               treatment issues or special populations, in addition to  








                                                                  AB 2213
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               specified requirements; and,

             b)   Coursework shall be from an accredited or approved  
               school, college, or university, as specified.

          32)Requires an applicant to complete the following coursework  
            not already completed in his or her education:

             a)   A minimum of 10 contact hours of training in human  
               sexuality, as specified, and any regulations promulgated  
               thereunder including the study of physiological,  
               psychological and social cultural variables associated with  
               sexual behavior, gender identity, and the assessment and  
               treatment of psychosexual dysfunction;

             b)   A minimum of 15 contact hours of instruction in spousal  
               or partner abuse, assessment, detection, intervention  
               strategies, and same-gender abuse dynamics;

             c)   A minimum of seven contact hours of training or  
               coursework in child abuse assessment and reporting, as  
               specified;

             d)   A minimum of 10 contact hours of instruction in aging  
               and long-term care including biological, social, cognitive,  
               and psychological aspects of aging and this coursework must  
               include instruction on the assessment and reporting of, as  
               well as treatment related to elder and dependent abuse and  
               neglect; and,

             e)   This coursework may be from an accredited or approved  
               school, college or university, as specified, and  
               undergraduate coursework will not satisfy this requirement.

          33)Requires an applicant to complete the following coursework  
            not already completed in his or her education from an  
            accredited or approved school, college, or university, as  
            specified, or from a continuing education provider that is  
            acceptable to the BBS and undergraduate coursework will not  
            satisfy this requirement:

             a)   A least three semester units or 45 hours of instruction  
               regarding the principles of mental health recovery-oriented  
               care and methods of service delivery in recovery-oriented  
               practice environments, including structured meetings with  








                                                                  AB 2213
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               various consumers and family members of consumers of metal  
               health services to enhance understanding of their  
               experience of mental illness, treatment, and recovery; and,

             b)   At least one semester unit or 15 hours of instruction  
               that includes an understanding of various California  
               cultures and the social and psychological implications of  
               socioeconomic position.

          34)Provides that an applicant may complete any units and course  
            content requirements, as specified, not already completed in  
            his or her education while registered with the BBS as an  
            intern, unless otherwise specified.

          35)Makes other technical and clarifying changes. 

           EXISTING LAW  : 

          1)Establishes licensing requirements for MFT applicants who are  
            licensed outside of California and apply for licensure on or  
            after January 1, 2016.  (Business and Professions Code (BPC)  
            Section 4980.72)

          2)Establishes registration, education and experience  
            requirements for MFT applicants who currently do not hold a  
            license outside of California, on or after January 1, 2016.   
            (BPC 4980.74) 

          3)Establishes the equivalent education guidelines for MFT  
            applicants licensed outside of California who apply for  
            licensure on or after January 1, 2016, and obtained education  
            outside of California, as specified. (BPC 4980.78)

          4)Establishes the licensure requirements for MFT applicants who  
            hold an out-of-state license and apply for licensure between  
            January 1, 2010, and December 31, 2015, and repeals these  
            requirements effective January 1, 2016.  (BPC 4980.80)

          5)Authorizes experience gained outside of California to be  
            accepted towards the licensure requirements for MFT applicants  
            who apply for licensure between January 1, 2010, and December  
            31, 2015, if specified criteria are met, and repeals that  
            authority effective January 1, 2016. (BPC 4980.90)

          6)Authorizes experience gained outside of California to be  








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            accepted towards the licensure requirements for PCCs  
            applicants who apply for examination or eligibility  
            requirements between January 1, 2011, and December 31, 2015,  
            if specified criteria are met, and repeals that authority  
            effective January 1, 2014. (BPC 4999.57)

          7)Establishes the examination eligibility requirements for PCC  
            applicants who apply for licensure between January 1, 2011,  
            and December 31, 2015, who hold a valid license outside of  
            California for  more  than two years and meet specified  
            criteria, and repeals these requirements effective January 1,  
            2016. (BPC 4999.58)

          8)Establishes the examination eligibility or registration  
            requirements for PCC applicants who apply for licensure  
            between January 1, 2011, and December 31, 2015, and hold a  
            valid license outside of California for  less  than two years  
            and meet specified criteria, and repeals that authority  
            effective January 1, 2016. (BPC 4999.59)

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           1)Purpose of this bill  .  This bill revises and updates the new  
            educational requirements for licensure as a MFT and PCC for  
            out-of-state applicants which are scheduled to become  
            effective January 1, 2016, to allow more flexibility for  
            applicants who reside outside of California and may have met  
            all other licensing requirements except certain coursework  
            relevant to California.  This bill will address the issue that  
            current education and experience requirements for out-of-state  
            MFT and PCC applicants may be overly restrictive and present  
            barriers to obtaining licensure in California.  This bill is  
            sponsored by the Board of Behavioral Sciences (BBS).  

           2)Author's statement  .  According to the author, "The BBS is  
            concerned that new requirements that are set to take effect in  
            January of 2016, for licensure of MFTs and PCCs from  
            out-of-state create unnecessary barriers to licensure for  
            these professionals, thus restricting portability of these  
            licenses to California.  These changes would come as a result  
            of SB 33(Correa), Chapter 26, Statutes of 2009, which modified  
            requirements for MFT licensure, yet inadvertently created  
            barriers for out of state applicants.  








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             "Beginning January 1, 2016, out-of-state applicants will be  
            required to complete a long list of educational requirements,  
            including courses that deal with topics specific to  
            California, which out-of-state applicants are highly unlikely  
            to have completed.  Under existing law, this coursework would  
            need to be completed at the graduate level and would thus  
            require out-of-state applicants to enroll in a graduate  
            program in order to remediate this coursework.  Additionally,  
            all coursework and practicum requirements would need to be  
            remediated prior to registering with [BBS] as an intern.  

            "This bill address[es] these concerns by allowing out-of-state  
            applicants to remediate coursework through continuing  
            education and to do so while registered as an intern.   
            Furthermore, it will allow applicants who are licensed in  
            another state to remediate practicum requirements while  
            registered as an intern with the BBS [and] exempt out-of-state  
            applicants who have been licensed for more than two years from  
            this requirement.  This bill will allow [BBS] to accept  
            supervised hours at a rate of 100hrs/months for up to 1,200  
            hours for applicants licensed in another state.  Finally, this  
            bill adds clarity to existing coursework requirements by  
            specifying the number of course hours or units required."

           3)LMFT licensure requirements .  MFTs are employed in clinics,  
            counseling centers and private practice.  They use counseling  
            or psychotherapeutic techniques to assist individuals,  
            couples, families, and groups with a focus on marriage and  
            family relationship issues.  

          The minimum educational and experience requirements for MFTs  
            include a master's degree in areas such as marriage, family,  
            and child counseling, marriage and family therapy, couple and  
            family therapy, psychology, clinical psychology, and  
            counseling psychology, from an accredited school.  In  
            addition, MFTs must complete supervised work experience of at  
            least 3000 hours within a period of two-years.  Requirements  
            for licensure are consistent for out-of-state applicants and  
            instate applicants; however, the way in which out-of-state  
            applicants are able to take additional coursework that meet  
            California-specific standards may be overly burdensome without  
            the clarification and revisions addressed in this bill to  
            ensure that those with the proper education and experience are  
            able to become licensed without unreasonable or unattainable  








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            constraints.  According to the BBS, approximately3% of  
            applicants for MFT intern and 1.5% of applicants for MFT exam  
            eligibility are out-of-state applicants, and 35% of applicants  
            for clinical counselor intern are out-of-state applicants.   
            According to BBS, they currently do not have statistics on the  
            exam eligibility for out-of-state Licensed PCC applicants  
            because they have only been issuing registrations for less  
            than two years. 

            The licensure requirements for MFTs and PCCs vary based on the  
            date an applicant applies for licensure, the time in which the  
            applicant obtained his or her degree, and whether or not the  
            applicant holds an active license from out-side of California.  
             This bill addresses each licensure category to revise and  
            update the current educational requirements including  
            specifying the number of units obtained and the specific law  
            and ethics coursework to allow more flexibility for  
            out-of-state applicants to meet California-specific  
            educational requirements. 

           4)PCC licensing  .  SB 788 (Wyland) (Chapter 619, Statutes of  
            2009) established the PCC Act which provided for the licensing  
            and regulation of PCCs by BBS.  When the legislation was set  
            to take effect in 2010, many sections of California law that  
            applied to other mental health professionals had yet to be  
            revised to incorporate PCCs.  

          Because PCCs are largely comparable to MFTs, SB 146 (Wyland)  
            (Chapter 381, Statutes of 2011) was passed to amend various  
            code sections relating to MFTs so that the same substantive  
            provisions and requirements would apply to PCCs as well.   
            Because the out-of-state applicant requirements for PCCs were  
            patterned after MFT law, with similar education, exam and  
            experience requirements, PCC applicants are faced with similar  
            licensure access and portability issues as MFTs.  This bill  
            revises the out-of-state educational and experience  
            requirements consistent with the changes for MFT requirements.  

          5)Out-of-state MFT and PCC applicants  .  Certain educational and  
            experience requirements were scheduled to take effect as  
            result of SB 33 (Correa) (Chapter 26, Statutes of 2009)  
            beginning January 1, 2014.  SB 33 revised the requirements  
            for MFTs seeking licensure or registration in California who  
            were educated or licensed outside of California.  Based on  
            concerns raised by the BBS, that out-of-state applicants were  








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            not going to be able to meet those revised requirements  
            without significant challenges, the BBS sponsored AB 451  
            (Eggman) Chapter 551, Statutes of 2013, which extended the  
            effective date for the new education, examination and  
            eligibility requirements for out-of-state applicants for MFTs  
            and PCCs by two years from January 1, 2014, to January 1,  
            2016. The two-year delay allowed the BBS time to revise  
            changes contained in SB 33 for licensure requirements for  
            out-of-state applicants.  


            Under the provisions of SB 33, new applicants are required  
            take a broad range of coursework, from understanding marriage  
            and family principles to cultural competency and sensitivity,  
            including a familiarity with the racial, cultural,  
            linguistic, and ethnic backgrounds of persons living in  
            California.  These courses could be difficult to obtain in  
            out-of-state programs as they relate specifically to  
            California and may not be offered at out-of-state educational  
            institutions which could potentially block an individual  
            licensed or educated outside of California from qualifying  
            for licensure in California without providing an appropriate  
            way to make up the required coursework.  

            In addition, because current law requires that specified  
            coursework must be taken in a graduate course, without the  
            clarifications provided by this bill, it may be difficult for  
            applicants to re-apply to a graduate program to take one or  
            two courses.  This could be both time consuming and  
            cost-prohibitive for out-of-state applicants who have already  
            completed masters' or doctoral degree programs outside of  
            California.  Because it could cost applicants several  
            thousands of dollars and potentially months of additional  
            delay to satisfy educational requirements, it could  
            discourage otherwise qualified mental health providers from  
            applying for licensure in California.  

            To avoid those problems, this bill modifies the current  
            requirements to allow a specified amount of coursework  
            remediation to be completed during intern registration,  
            clarifies the California law and ethics course content and  
            length, clarifies the required number of units depending on  
            graduation and application dates, and allows some supervised  
            experience gained out-of-state to be accepted in California.    
             








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           6)This bill the result of extensive BBS working group meetings  .   
            As a result of the current challenges predicted for  
            out-of-state applicants seeking licensure or intern  
            registration resulting from the education and curriculum  
            changes made by SB 33, BBS formed the  Out-of-State Education  
            Review Committee  (Committee) which was established to consider  
            the potential barriers to licensure for out-of-state  
            applicants after January 1, 2014.  The challenge that  
            out-of-state applicants would encounter as they applied to  
            California for LMFT licensure under the new curriculum  
            requirements was discussed during the Committee process.  

          The Committee held its first meeting on April 26, 2013 and  
            through a series of meetings the Committee and stakeholders  
            discussed and considered the following topics: current  
            educational requirements; educational requirements after  
            January 1, 2014; current options to remediate educational  
            deficiencies and potential cost; and options to remediate  
            educational deficiencies and potential cost.  The Committee  
            held its fourth and last meeting in November 2013.  The  
            Committee's work resulted in the recommended changes this bill  
            proposes with respect to continuing education, coursework  
            remediation, practicum experience, and course content  
            requirements.  

           7)Arguments in support  .  According to BBS, "Licensing  
            requirements for out-of-state applicants were set to change on  
            January 1, 2014.  However, BBS had concerns that these new  
            out-of-state requirements may be too stringent, restricting  
            portability of these license types to California.  The  
            resulting proposal makes changes to the practicum requirements  
            for out-of-state applicants as well as allows them to  
            remediate certain coursework through continuing education,  
            instead of requiring all coursework to be from a graduate  
            program.  It also allows certain coursework to be remediated  
            while registered as an intern." 

           8)Previous legislation  .  AB 451 (Eggman) (Chapter, 551, Statutes  
            of 2013) extended the current effective date for new  
            education, examination and eligibility requirements for  
            out-of-state applicants for MFT and PCC licenses from January  
            1, 2014, to January 1, 2016, and extended the operation and  
            repeal date for current examination, eligibility and  
            curriculum requirements for out-of-state applicants from  








                                                                  AB 2213
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            January 1, 2014, to January 1, 2016.  

            SB 146 (Wyland) (Chapter 381, Statutes of 2011) extended  
            existing law that applies to MFTs to apply to PCCs as well.  
             
             SB 33 (Correa) (Chapter 26, Statutes of 2009) updated the  
            educational curriculum requirements for MFTs to require  
            persons who begin graduate study after August 1, 2012 to meet  
            increased total unit requirements and practicum hours for  
            face-to-face counseling.  Additionally, it added new elements  
            to the curriculum, including public mental health practices,  
            revised the requirements for applicants licensed or educated  
            outside of California; and repeals the current MFT educational  
            requirements on January 1, 2019.
                                                                           
            SB 788 (Wyland) (Chapter 619, Statutes of 2009) established  
            the PCC Act which provides for the licensing and regulation of  
            PCCs by BBS.  

            SB 1218 (Correa) of 2008 attempted to update and recast the  
            educational curriculum requirements for MFTs.  SB 1218 was  
            vetoed by the Governor, stating that due to the 2008-2009  
            State Budget delay, only bills of the highest priority for  
            California would be signed.

            AB 234 (Eng) (Chapter 586, Statutes of 2007) revised to the  
            LMFT licensing law pertaining to the number of hours of  
            experience required for licensure.  


           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Board of Behavioral Sciences (sponsor)
          American Association for Marriage and Family Therapy
          Association of California Healthcare Districts
          California Council of Community Mental Health Agencies

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Elissa Silva / B.,P. & C.P. / (916)  
          319-3301 








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