BILL ANALYSIS Ó
AB 1808
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Date of Hearing: March 29, 2016
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Rudy Salas, Chair
AB 1808
(Wood) - As Introduced February 8, 2016
SUBJECT: Minors: mental health services.
SUMMARY: Amends the definition of a "professional person" to
include licensed marriage and family therapist (LMFT) trainees
and licensed professional clinical counselor (LPCC) trainees,
while working under supervision, in order to provide specified
mental health services to a minor 12 years of age or older under
specified circumstances.
EXISTING LAW:
1)Defines "mental health treatment or counseling services" to
mean the provision of outpatient mental health treatment or
counseling by a professional person, as specified. (Health
and Safety Code HSC Section 124260)
2)Defines "mental health treatment or counseling services" to
mean the provision of mental health treatment or counseling on
an outpatient basis by any of the following: (Family Code
(FC) Section 6924(1))
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a) A governmental agency;
b) A person or agency having a contract with a governmental
agency to provide the services;
c) An agency that receives funding from community united
funds;
d) A runaway house or crisis resolution center; or,
e) A professional person, as specified.
3)Defines a "professional person" as any of the following: (FC
Section 6924(2))
a) A person designated as a mental health professional
including a licensed marriage, family and child counselor,
licensed social worker, psychiatrist, or licensed
psychologist, as specified in Chapter 1, Title 9 of the
California Code of Regulations;
b) A licensed marriage and family therapist;
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c) A licensed educational psychologist;
d) A credentialed school psychologist;
e) A clinical psychologist;
f) The chief administrator of a mental health treatment or
counseling services agency, or a residential shelter
services agency, as specified;
g) A person registered as a marriage and family therapist
intern or clinical counselor intern, while working under
the supervision of a licensed professional, as specified;
or,
h) A licensed professional clinical counselor.
4)Defines "residential shelter services" to mean any of the
following: (FC Section 6924(3))
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a) The provision of residential and other support services
to minors on a temporary or emergency basis in a facility
that services only minors by a governmental agency, a
person or agency having a contract with a governmental
agency to provide these services, an agency that receives
funding from community funds, or a licensed community care
facility or crisis resolution; and,
b) The provision of other support services on a temporary
or emergency basis by any professional person, as
specified.
5)Authorizes a minor, who is 12 years of age or older, to
consent to mental health treatment, or counseling on an
outpatient basis, or to residential shelter services if both
of the following requirements are satisfied:
a) the minor, in the opinion of the attending professional
person, is mature enough to participate intelligently in
the outpatient services or residential shelter services;
and,
b) the minor would present a danger of serious physical or
mental harm to self or to others without the mental health
treatment or counseling or resident services, or is the
alleged victim of incest or child abuse. (FC Section
6924(3)(b))
6)Defines a "marriage and family therapist intern" as an
unlicensed person who has earned his or her master's or
doctoral degree qualifying the individual for licensure and is
registered with the Board of Behavioral Sciences (BBS). (BPC
Section 4980.03(b))
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7)Defines a "marriage and family therapist trainee" as an
unlicensed person who is currently enrolled in a master's or
doctoral degree program designed to qualify the individual for
licensure, and has completed no less than 12 semester or 18
quarter units in a qualifying degree program. (BPC Section
4980.03(c))
8)Prohibits a trainee from acquiring supervised experience hours
while working in a private practice. (BPC Section
4980.43(e)(1)(C))
9)Defines a "clinical counselor intern" as a person who has
earned his or her master's or doctoral degree, as specified,
and is registered with the BBS. (BPC Section 4999.12(f))
10)Defines a "clinical counselor trainee" as an unlicensed
person who is currently enrolled in a master's or doctoral
degree program, that is designed to qualify the individual for
licensure, and who has completed no less than 12 semester or
18 quarter units in a qualifying degree program. (BPC Section
4999.12(g))
11)Requires a clinical counselor trainee, prior to performing
any professional services, to inform each client or patient
that he or she is unlicensed and under supervision. (BPC
Section 4999.36(d))
THIS BILL:
1)Adds a LMFT trainee and a LPCC trainee to the list of
professional persons who can provide mental health treatment
or counseling services, or residential shelter services, to a
consenting minor 12 years of age or older, as specified, and
makes other minor and technical clarifications.
FISCAL EFFECT: None. This bill is keyed non-fiscal by the
Legislative Counsel.
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COMMENTS:
Purpose. This bill adds LMFT and LPCC trainees, under the
appropriate supervision, to the list of mental health
professionals who may provide specified mental health services
to a minor age 12 years of age or older. This bill is sponsored
by the California Association of Marriage and Family Therapists
and the California Association for Licensed Professional
Clinical Counselors . According to the author, "[this bill]
would permit trainees, working under the supervision of a [LMFT]
or [LPCC] to treat a minor under the same limited terms and
conditions as interns. Trainees must be enrolled in a master or
doctoral degree program and must have completed at least 12
semester units in the postgraduate degree program. Currently,
trainees routinely work with minors as part of their training
towards licensure. By allowing trainees to provide services to
minors [this bill] will increase the availability of mental
health services to young people and provide more opportunities
for trainees to gain the 3,000 hours of counseling experience
needed to qualify to apply for licensure."
Background. LMFTs 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 LMFTs
include a master's degree or doctoral degree in an area such as
marriage, family, and child counseling, marriage and family
therapy, couple and family therapy, psychology, clinical
psychology, or counseling psychology from an accredited school.
LPCCs are employed in a variety of settings such as hospitals,
community-based mental health organizations and private
practice. LPCC's apply counseling interventions and
psychotherapeutic techniques to identify and remediate
cognitive, mental and emotional issues. The minimum education
requirements for LPCCs include a master's degree that includes
training in psychotherapy or counseling.
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Both LMFT and LPCC degree programs require students to gain
practicum hours of specified counseling experience. In
addition, LMFTs and LPCCs must complete supervised work
experience of at least 3,000 hours within a period of two years.
In order to accumulate supervised hours, a person must register
with the BBS as an intern, or function as a trainee. LMFTs can
obtain up to 1,300 hours of supervised experience during their
degree program, while LPCCs can only obtain supervised
experience after completing their degree program. Both LMFT and
LPCC trainees are individuals who have been enrolled in graduate
programs and have completed at least 12 semester or 18 quarter
units of coursework. LMFT and LPCC trainees are not required to
register with the BBS. Trainees are not authorized to attain
supervised experience hours in a licensee's private practice and
can only gain experience hours in settings such as a
governmental entity, a school, college, university, or an
institution that is both nonprofit and charitable.
For purpose of licensure, trainees can only count those hours of
supervised experience gained under the direct supervision of a
BBS-licensed individual who has been licensed for at least two
years, whose license is not under probation or suspension, and
has not provided therapeutic services to the trainee. This bill
adds LMFT and LPCC trainees to the current list of professional
persons who may provide mental health counseling or treatment
services or residential shelter services to a minor who is 12
years of age or older under specified circumstances. LMFT
trainees would be permitted to count these hours of supervised
experience towards licensure, as specified under their practice
act, while LPCCs would only be able to count these supervised
hours as practicum hours for completing the degree requirements.
Counseling Services for Minors. Under current law, a minor may
consent to specified medical care including mental health
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services. FC 6924 and HSC 124260 authorize a minor who is 12
years of age or older to consent to mental health treatment or
counseling services. FC 6924 provides the list of licensed
professionals who are authorized to provide specified mental
health services to minors including licensed social workers,
LMFTs, LPCCs, psychologists, psychiatrists, educational
psychologist, credentialed school psychologists, and both LMFT
and LPCC interns while working under the supervision of a
licensed LMFT, LPCC, psychologist, or social worker. The minor
may only consent to the specified mental health treatment or
counseling services if, in the attending mental health
professional's opinion, the minor is mature enough to
participate intelligently in the services and if the minor
presents a danger of serious physical or mental harm to self or
others without treatment services or if the minor is a victim of
alleged incest or child abuse.
This bill would add LMFT and LPCC trainees to the list of
professional persons who can provide mental health services to
minors under the specified conditions. Under the current
provisions, the only non-licensed professionals who are
authorized to provide specified mental health services to minors
are LMFT and LPCC interns who are required to be registered with
the BBS and have completed a master's or doctoral degree
program. Under current law, trainees are not required to
register with the BBS, and they have not completed a degree
program. This bill does not change minor consent laws; but
rather expands the list of professional persons who may provide
those mental health services to a minor, under specified
circumstances, to include LMFT and LPCC trainees.
Prior Related Legislation. AB 250 (Obernolte), Chapter 50,
Statutes of 2015, authorized LMFT interns and trainees to
provide services via telehealth, under specified supervision, in
order to gain supervised hours required for licensure, as
specified.
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AB 1012 (Wyland), Chapter, 435, Statutes of 2014, increased the
number of hours which a LMFT trainee or intern, and a
professional clinical counselor intern, may count towards their
weekly supervision requirement from five to six.
SB 632 (Emmerson), Chapter 50, Statutes of 2012, clarified which
LMFT trainees are allowed to counsel clients outside of a
practicum course, and clarified a limited exemption for trainees
who are not allowed to counsel clients outside of a practicum
course.
AB 956 (Roger Hernández), Chapter 166, Statutes of 2011,
required a marriage and family therapist intern and a LMFT
trainee, prior to performing professional services, to provide
each client or patient with the name of his or her employer, and
indicate that he or she is under the supervision of a licensed
person, as specified, and required any advertisement by or on
behalf of an intern or trainee to include specified information;
required an intern's registration number to be disclosed to
clients and patients and in advertisements.
SB 543 (Leno), Chapter 503, Statutes of 2010, expanded the
rights of minors to receive outpatient mental health treatment
or counseling services, as specified.
ARGUMENTS IN SUPPORT:
The California Association for Licensed Professional Clinical
Counselors writes in support, "[this bill] would also permit a
LMFT or LPCC trainee to provide treatment or counseling to such
a minor who consents to treatment or counseling. As with other
counseling professionals, the trainee would be required to make
his or her best effort to notify the minor's parent or guardian
of the services being provided, and to involve the parents
unless such involvement is inappropriate. These are the very
same provisions in current law applicable to psychologists,
clinical social workers, psychiatrists, as well as LMFTs and
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LMFT interns and LPCCs and LPCC interns. This bill will increase
access to essential mental health services by minors by
enlarging the pool of those who may provide services, and also
allow those trainees to gain vital experience in the counseling
field. These changes will help meet the mental health needs of
consumers in California."
ARGUMENTS IN OPPOSITION:
The California Right to Life Committee (CRLC ) writes in
opposition, "Minors would be counseled by [LMFT] and [LPCC]
trainees. CRLC has noted in the past that the growing CA
population of persons requiring medical care and treatment has
precipitated the development of new categories of medical
personnel. These new categories would not require the complete
training required of the certified or degreed professional, but
it would provide service and at a lesser cost to the medical
program. CRLC is concerned about the inexperience of a trainee
in counseling a minor in such a vulnerable state of mind and
body when seeking mental health treatment."
POLICY ISSUE FOR CONSIDERATION:
Under current law, a minor who is 12 years of age or older may
consent to mental health treatment or counseling, on an
outpatient basis, or residential shelter services if the
attending professional determines the minor is mature enough to
participate in the services, and if the minor presents a danger
to themselves or to the public or is an alleged victim of incest
or child abuse.
Although this bill would require trainees to work under
supervision, it is unclear who would be responsible (the
supervisor or the trainee) for determining the minor's ability
to participate in counseling services. Given that trainees must
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only complete a limited 12 semester or 18 quarter units of their
degree program in order to provide those mental health services
to a minor, the Committee may wish to request the author to
clarify who would be responsible for determining the
appropriateness of the minor to receive those services.
AMENDMENT:
To address the policy issue raised above, the author may wish to
consider the following amendment:
A trainee shall consult with a supervisor, as soon as reasonably
possible, when assessing if a minor is mature enough to
participate in mental health treatment or counseling services.
REGISTERED SUPPORT:
California Association of Marriage and Family Therapists
(co-sponsor)
California Association for Licensed Professional Clinical
Counselors (co-sponsor)
Community Clinic Association of Los Angeles County
REGISTERED OPPOSITION:
California Right to Life Committee
Analysis Prepared by:Elissa Silva / B. & P. / (916) 319-3301
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