BILL ANALYSIS                                                                                                                                                                                                    Ó







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        |Hearing Date:June 23, 2014         |Bill No:AB                         |
        |                                   |2213                               |
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                      SENATE COMMITTEE ON BUSINESS, PROFESSIONS 
                               AND ECONOMIC DEVELOPMENT
                              Senator Ted W. Lieu, Chair
                                           

                         Bill No:        AB 2213Author:Eggman
                         As Amended:March 28, 2014Fiscal: Yes

        
        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.

        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) § 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  





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           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 accepted  
           towards the licensure requirements for PCC 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)

        This bill:

         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 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 





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           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 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  





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             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 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  





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               3,000 hours of experience required while registered as an  
               intern.

           d)   Twelve semester or 18 quarter units in the areas of 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, an institution approved by the BPPE, or from a continuing  
          education provider that is acceptable to BBS, and does not include  
          undergraduate coursework.

        10)Requires an applicant to complete coursework, not already completed  
          in his or her education, from an accredited school, college or  
          university, as specified, an institution approved by the BPPE, or  
          from a continuing education provider that is acceptable to BBS, and  
          is not undergraduate coursework 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 semester unit or 15 hours of instruction in  
             psychopharmacology;

           b)   Training in developmental issues from infancy to old age,  





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             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  
               subjects 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.

             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;






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             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;

             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  





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               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;

             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: 





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         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.

         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  





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          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 timeline, 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 
        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;  





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             and

           b)   Coursework must be from an 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 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.






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        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 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;






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             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 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  





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             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 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.


        FISCAL EFFECT:  This measure has been keyed "fiscal" by Legislative  
        Counsel.  According to the Assembly Committee on Appropriations  
        analysis dated April 30, 2014, the bill would have minor and  
        absorbable costs to the BBS to update requirements.
        

        COMMENTS:
        
        1.Purpose.   The sponsor of the bill is the  BBS  .  According to the  
          Author, licensing requirements for out-of-state LMFT and LPCC  
          applicants are set to change on January 1, 2016.  After January 1,  
          2016, out-of-state applicants will be required to complete a long  
          list of very specific education al requirements, including courses  
          that deal with topics specific to California, which out-of-state  
          applicants are highly unlikely to have completed.  Moreover, the BBS  
          would not be able to accept coursework completed through continuing  
          education, but rather require all remediation coursework be  
          completed at the graduate level.  Additionally, all coursework would  
          need to be remediated prior to registration with the board as an  





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          intern.

        2.Background.  

           a)   Licensing Requirements.  Currently, requirements for licensure  
             for MFTs are consistent for out-of-state applicants and in state  
             applicants.  Further, according to the BBS, approximately 3% of  
             applicants for MFT intern and 1.5% of applicants for MFT exam  
             eligibility are out-of-state applicants.  However, 35% of  
             applicants for clinical counselor intern are out-of-state  
             applicants.  The BBS was unable to provide statistics reflecting  
             the exam eligibility for out-of-state PCC applicants because they  
             have issued registrations for less than two years.

            Senate Bill 788  (Wyland, Chapter 619, Statutes of 2009) established  
             the PCC Act which provided for the licensing and regulation of  
             PCCs by the BBS.  When the legislation took effect in 2010, many  
             sections of California law that applied to other mental health  
             professionals had not yet been 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.

           b)   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 regarding out-of-state applicants not being able to meet  
             those revised requirements without significant challenges, the  
             BBS sponsored  AB 451  (Eggman, Chapter 551, Statutes of 2013).   
             This bill 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  





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             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 prevent an  
             individual licensed or educated outside of California from  
             qualifying for licensure without providing a way to make up the  
             required coursework.

        3.Arguments in Support.  The  Association of California Healthcare  
          Districts  supports the bill and writes, "There is a growing demand  
          to provide increased mental health services in California; in order  
          to meet this growing demand, there must be a qualified workforce  
          able to offer mental health services within our communities?AB 2213  
          would ease concerns with current law, making it possible for  
          out-of-state licensees to consider employment in California.   
          Additionally, this measure is vital to increasing the number of  
          mental health professionals available in California."

           The  California Council of Community Mental Health Agencies  also  
           supports the bill and writes, "Workforce capacity is an enormous  
           challenge for our member agencies.  This measure will make it  
           easier to attract and retain workers from other states and will  
           improve our workforce capacity."


        SUPPORT AND OPPOSITION:
        
         Support:  

        Association of California Healthcare Districts
        California Council of Community Mental Health Agencies

         Opposition:  

        None received and June 18, 2014.



        Consultant:Le Ondra Clark, Ph.D.