BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON
          BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
                              Senator Jerry Hill, Chair
                                2015 - 2016  Regular 

          Bill No:            AB 1279         Hearing Date:    July 6,  
          2015
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          |Author:   |Holden                                                |
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          |Version:  |July 1, 2015                                          |
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          |Urgency:  |No                     |Fiscal:    |No               |
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          |Consultant|Sarah Huchel                                          |
          |:         |                                                      |
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                              Subject:  Music therapy.


          SUMMARY:  Establishes the Music Therapy Act and designates title  
          protection for the term "Board Certified Music Therapist"  
          (BCMT). 

          Existing law:
          
          1)Provides for the regulation of various healings arts  
            professions and vocations under the Business and Professions  
            Code.  (Business and Professions Code (BPC) §§ 500 et seq.) 

          2)Requires, for purposes of special education programs within  
            Department of Education, that music therapy be provided only  
            by personnel who hold a Music Therapist - Board Certified  
            credential from the Certification Board for Music Therapists  
            (CBMT) on the completion of all academic and clinical training  
            requirements, and after successfully passing the CBMT National  
            Board Certification Examination. (Title 5, California Code of  
            Regulations (CCR) § 3051.21)

          3)Defines a music therapist for purposes of the Department of  
            Developmental Services to mean a vendor who possesses a valid  
            registration issued by the National Association for Music  
            Therapy (NAMT) and uses music media and activities to effect  
            change or growth, as specified.  (17 CCR § 54342)
          4)Defines a music therapist for purposes of the Department of  
            Mental Health and the licensing of skilled nursing facilities,  







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            intermediate care facilities for the developmentally disabled  
            and adult day health centers, to mean a person who has a  
            bachelor's degree in music therapy and who is registered or  
            eligible for registration as a music therapist by the NAMT.   
            (9 CCR § 782.36, 22 CCR §§ 72069, 76105, 78065)


          5)Defines a music therapist for purposes of licensing general  
            acute care hospitals, acute psychiatric hospitals, and  
            intermediate care facilities to mean a person who is  
            registered or eligible for registration as a registered music  
            therapist by the NAMT. 


          



          This bill:

          1)Establishes the Music Therapy Act.

          2)Makes legislative findings and declarations regarding the  
            qualifications and standards of board certified music  
            therapists.

          3)States the Legislature's intent to :

             a)   Provide a statutory definition of music therapy thereby  
               enabling consumers and state and local agencies to more  
               easily identify qualified music therapists.

             b)   Not impact CalHR's classification requirements for music  
               therapists nor to displace any current music therapists who  
               are employed by the state.  This bill merely prohibits any  
               person from representing himself or herself as a Board  
               Certified Music Therapist unless he or she meets the  
               requirements of this bill.

          4)Defines "music therapy" to mean the clinical and  
            evidence-based use of music therapy interventions in  
            developmental, rehabilitative, habilitative, medical, mental  
            health, preventive, wellness care, or educational settings to  
            address physical, emotional, cognitive, and social needs of  








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            individuals within a therapeutic relationship.  Music therapy  
            includes the following:

             a)   The development of music therapy treatment plans  
               specific to the needs and strengths of the client who may  
               be seen individually or in groups.  Music therapy treatment  
               plans shall establish goals, objectives, and potential  
               strategies of the music therapy services appropriate for  
               the client and setting. 

             b)   Music therapy interventions, which include, but are not  
               limited to, music improvisation, receptive music listening,  
               song writing, lyric discussion, music and imagery, singing,  
               music performance, learning through music, music combined  
               with other arts, music-assisted relaxation, music-based  
               patient education, electronic music technology, adapted  
               music intervention, and movement to music.

          5)Prohibits use of the title BCMT by an individual providing  
            music therapy unless the individual has completed all of the  
            following:

             a)   A bachelor's degree or its equivalent, or higher, from a  
               music therapy degree program approved by the American Music  
               Therapy Association (AMTA) using current standards,  
               beginning with those adopted on April 1, 2015. 

             b)   A minimum of 1,200 hours of supervised clinical work  
               through pre-internship training at an approved degree  
               program and internship training through an approved  
               national roster or university affiliated internship  
               program, or the equivalent.

             c)   The current requirements for certification, beginning  
               with those adopted on April 1, 2015, established by the  
               CBMT for the BCMT credential.

          6)Prohibits the Act from being construed to authorize a person  
            engaged in music therapy to state or imply that he or she  
            provides mental health counseling, psychotherapy, or  
            occupational therapy for which a license is required, as  
            specified. 

          7)Clarifies that, while the use of music is not restricted to  








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            any profession, the use of music shall not imply or suggest  
            that the person is a BCMT if he or she does not meet the  
            criteria specified.

          8)States that this bill shall not be construed to impact the  
            State Personnel Board or the Department of Human Resources'  
            classification requirements for music therapists, nor to  
            displace any music therapists who are currently employed with  
            the state, however, a person so employed may not represent  
            himself or herself as a Board Certified Music Therapist  
            without meeting the criteria in this bill. 

          9)Declares the use of the title BCMT by an individual not  
            meeting the requirements of this bill to be an unfair business  
            practice.  


          FISCAL  
          EFFECT:  None.  The measure has not been keyed "fiscal" by  
          Legislative Counsel.  

          
          COMMENTS:
          
          1.Purpose.  This bill is sponsored by the  Certification Board  
            for Music Therapists  .  According to the Author's office,  
            although music therapy is not currently recognized in  
            California statute, there are at least eight separate  
            references in regulations to music therapy or music  
            therapists.  The Author's office believes this bill is  
            necessary to provide a uniform definition of music therapy  
            services and establish title protection for use of the term  
            BCMT.  

          2.Music Therapy.  According to AMTA, "Music therapy is an  
            established health profession in which music is used within a  
            therapeutic relationship to address physical, emotional,  
            cognitive, and social needs of individuals.  After assessing  
            the strengths and needs of each client, the qualified music  
            therapist provides the indicated treatment including creating,  
            singing, moving to, and/or listening to music. Through musical  
            involvement in the therapeutic context, clients' abilities are  
            strengthened and transferred to other areas of their lives.   
            Music therapy also provides avenues for communication that can  








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            be helpful to those who find it difficult to express  
            themselves in words.  Research in music therapy supports its  
            effectiveness in many areas such as: overall physical  
            rehabilitation and facilitating movement, increasing people's  
            motivation to become engaged in their treatment, providing  
            emotional support for clients and their families, and  
            providing an outlet for expression of feelings."

            The Author's office notes that music therapists serve a wide  
            population: clients range in age from babies in neonatal  
            intensive care units to older adults in hospice care.  Music  
            therapy services are provided in a variety of clinical  
            settings, including rehabilitative facilities, medical  
            hospitals, psychiatric hospitals, outpatient clinics, day care  
            treatment centers, agencies serving persons with developmental  
            disabilities, community mental health centers, drug and  
            alcohol programs, senior centers, nursing homes, hospice  
            programs, correctional facilities, halfway houses, schools,  
            and private practice.  

            Music therapy practitioners typically work with individuals  
            who have special needs, which may include medical, learning  
            and academic, mental health, rehabilitation, developmental,  
            communication, or wellness needs.  Music therapy services are  
            provided in individual or group sessions within various  
            healthcare and education settings.

            The use of music in therapy is not unique to music therapists.  
             However, while it is a growing specialty with academic  
            programs, tests, and certifications tailored to its  
            philosophies and practices, it is considered a subspecialty by  
            the Board of Behavioral Sciences (BBS), which licenses and  
            regulates marriage and family therapists, licensed  
            professional clinical counselors, and licensed clinical social  
            workers.  These professionals, along with psychologists and  
            occupational therapists, may choose to specialize in various  
            and emerging therapeutic subspecialties such as music, dance,  
            art, drama, and play therapy.

            This bill provides a standardized definition of music therapy  
            and title protection for BCMTs towards establishing music  
            therapy as an independent and distinct profession.  There are  
            currently 459 BCMTs in California.









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          3.Certifying Authorities.   This bill establishes title  
            protection for BCMTs who complete education approved by the  
            AMTA and pass a national certification exam administered by  
            the CBMT.

              a)   AMTA.   AMTA was formed in 1998 as a merger between the  
               NAMT and the American Association for Music Therapy.   
               Currently, AMTA serves over 5,000 music therapists.  It  
               publishes two research journals as well as a line of  
               publications, serves as an advocate for music therapy on  
               the state and federal levels, promotes music therapy  
               through social media streams, and provides research  
               bibliographies, podcasts, scholarships, and newsletters to  
               its members.  There are two schools in California providing  
               AMTA-approved degrees in music therapy: California State  
               University, Northridge and the University of the Pacific.

              b)   CBMT  .  CBMT was incorporated in 1983 to strengthen the  
               credibility of the music therapy profession by assuring the  
               competency of credentialed music therapists. CBMT has been  
               fully-accredited by the National Commission for Certifying  
               Agencies since 1986.  Certified individuals are required to  
               obtain recertification every five years.  The CBMT is  
               currently the only entity that certifies music therapists.   


          4.Title Protection v. Practice Act.  Statutes regulating  
            professions in California generally fall into two categories:  
            a "practice act" or a "title act."  A "practice act" regulates  
            the duties, responsibilities and scope of practice that a  
            licensee can perform upon meeting specific educational,  
            experiential or training requirements.  A "title act"  
            regulates the use of the title an individual may use in  
            practice.  In order to be permitted to use a title, a state  
            may require proof that an individual has a certain level of  
            experience or education relevant to the particular title being  
            regulated.  Title protection is generally intended to be a  
            means of market differentiation whereas a "practice act" would  
            literally prohibit individuals from engaging in the practice  
            regardless of how it is described.  The Author's office states  
            that this bill "does not propose a regulatory scheme nor  
            define a scope of activity. It is a title protection only  
            bill."
          








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          5.Arguments in Support.  The  Certification Board for Music  
            Therapists  write,
          "AB 1279 would protect consumers from potential harm or  
            misrepresentation from individuals that are not board  
            certified music therapists and are not practicing under the  
            CMBT Code of Professional Practice.  Board certified music  
            therapists not only would demonstrate competency, they would  
            have to adhere to continuing education standards that, given  
            the settings they work in, would ensure that their  
            competencies remain current and in the best interests of  
            patients.  Hence, only those who are actually board certified  
            should be able to hold themselves as being Board Certified  
            Music Therapists."  

          6. Arguments in Opposition.  The  California Association of  
             Marriage and Family Therapists  write, "Proposed section 4657  
             creates a ban on any state employee hired after 2016 using  
             the title 'music therapist' unless they are a board certified  
             music therapist.  If there is a state position that is called  
             'music therapist,' this bill would only allow current  
             individuals holding a job with that title from using it,  
             until they retire.  Therefore, anyone applying for a generic  
             'music therapy' job after this bill will have to be  
             certified.  This would disenfranchise MFTs who are qualified  
             for the state job, currently practicing in music therapy as a  
             licensed provider, but not board-certified.  The bill appears  
             to give preference to certified providers, over licensed  
             providers for these positions.  To date, CAMFT has heard of  
             no problem with licensed professionals working in this kind  
             of therapy that would compel such a change.  It is unclear  
             why this prohibition is necessary."
          
          SUPPORT AND OPPOSITION:
          
           Support:  

          Certification Board for Music Therapists (Sponsor)
          American Federation of State, County, and Municipal Employees  
          Local 2620, AFL-CIO
          American Music Therapy Association, Inc., Western Chapter
          Arts and Services for Disabled, Inc. 
          BRIGHT Children International
          California Athletic Trainers' Association
          Children's Music Fund








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          Coast Music Therapy
          Dental Hygiene Out & About
          McConnell Music Therapy Services
          Music Therapy Consulting
          Occupational Therapy Association of California
          The Music Therapy Center of California
          The Music Works
          University of the Pacific, Conservatory of Music
          Numerous individuals

           Opposition:  

          California Association of Marriage and Family Therapists

           Concern  :

          California Park and Recreation Society Recreation Therapy  
          Section
          California Association for Licensed Professional Clinical  
          Counselors



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