BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: AB 1808 Hearing Date: June 6,
2016
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|Author: |Wood |
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|Version: |June 2, 2016 |
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|Urgency: |No |Fiscal: |No |
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|Consultant|Sarah Huchel |
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Subject: Minors: mental health services
SUMMARY: Adds a marriage and family therapist (MFT) trainee and a
licensed professional clinical counselor (LPCC) trainee who
works under the supervision of a licensed professional to the
list of individuals who qualify as a "professional person" for
purposes of providing mental health services in the Health and
Safety Code (HSC) and Family Code (FC). Establishes supervision
requirements for the treatment of a minor by a MFT trainee and a
LPCC trainee.
Existing law:
1)Establishes the Board of Behavioral Science (BBS) to
administer the Social Work Licensing Law, the Licensed
Professional Clinical Counselor Act, and the Licensed Marriage
and Family Therapist Act. (Business and Professions Code (BPC)
§ 4980.34)
2)Defines "mental health treatment or counseling services" as
the provision of mental health treatment or counseling on an
outpatient basis by a governmental agency, a person or agency
having a contract with a governmental agency to provide the
services, an agency that receives funding from community
united funds, a runaway house or crisis resolution center, or,
a professional person. (FC § 6924 (a)(1))
3)Defines a "professional person" as a person designated as a
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mental health professional, as specified; a MFT; a licensed
educational psychologist; a credentialed school psychologist;
a clinical psychologist; the chief administrator of specified
agencies; a person registered as a MFT intern while working
under the supervision of a licensed professional; a LPCC; and
a person registered as a clinical counselor intern while
working under the supervision of a licensed professional.
(FC § 6924 (a)(2))
4)Defines "mental health treatment or counseling services" as
the provision of outpatient mental health treatment or
counseling by a professional person, as specified. (Health
and Safety Code (HSC § 124260)
5)Defines a "professional person" as a person designated as a
mental health professional, as specified; a MFT; a licensed
educational psychologist; a credentialed school psychologist;
a clinical psychologist; a licensed clinical social worker
(LCSW); a person registered as MFT intern, while working under
the supervision of a licensed professional; a board certified,
or board eligible, psychiatrist; a LPCC; or a person
registered as a LPCC intern while working under the
supervision of a licensed professional. (HSC § 124260)
6)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 are satisfied: (FC § 6924 (b))
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 him or herself or to others without the
mental health treatment or counseling or residential
shelter services, or is the alleged victim of incest or
child abuse.
7)Authorizes a minor who is 12 years of age or older to consent
to mental health treatment or counseling services if, in the
opinion of the attending professional person, the minor is
mature enough to participate intelligently in the mental
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health treatment or counseling services. (HSC § 12460)
8)Defines both a MFT intern and a LPCC intern as an unlicensed
person who has earned his or her master's or doctoral degree
qualifying him or her for licensure and is registered with the
BBS, as specified. (BPC §§ 4980.3, 4999.12)
9)Defines a MFT trainee and a LPCC trainee as an unlicensed
person who is currently enrolled in a master's or doctoral
degree program that is designed to qualify him or her for
licensure, and who has completed no less than 12 semester
units or 18 quarter units of coursework in any qualifying
degree program. (BPC §§ 4980.3, 4999.12)
This bill:
1) Adds a MFT trainee and LPCC trainee who work under the
supervision of a licensed professional to the list of
individuals who qualify as a "professional person" for
purposes of providing mental health services in the HSC and
FC.
2) Requires a MFT trainee or a LPCC trainee to notify his or her
supervisor, or if the supervisor is unavailable, an on-call
supervisor from the site the trainee is employed or by
volunteering at within 24 hour of treating the minor pursuant
to FC requirements. If upon the initial assessment of the
minor, the trainee believes that the minor is a danger to
self or to others, the trainee shall notify the supervisor,
or if the supervisor is unavailable, the on-call supervisor
immediately after the treatment or counseling.
3) Specifies that nothing in the amendment is intended to
supplant, alter, expand, or remove any other reporting
responsibilities required of trainees under existing law.
4) Requires a MFT trainee or a LPCC trainee to consult with his
or her supervisor as soon as reasonably possible when
assessing the maturity of the minor pursuant HSC
requirements.
5) Makes technical changes.
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FISCAL
EFFECT: None. This bill is not keyed "fiscal" by the
Legislative Counsel.
COMMENTS:
1.Purpose. This bill is sponsored by the California Association
for Licensed Professional Clinical Counselors and the
California Association of Marriage and Family Therapists .
According to the Author's office, this bill is necessary
because currently, a MFT, clinical counselor, or interns of
either of those professions can provide services to a patient
twelve years or older, in certain circumstances. However, LMFT
and LPCC "trainees" are not included as eligible providers.
"This oversight impacts the number of providers available to
treat minors, and contributes to the lack of mental health
services available in schools. Additionally, this oversight
limits the opportunities for trainees to gain the 3,000 hours
of counseling experience needed to qualify to apply for
licensure."
2. Background. The BBS is responsible for consumer protection
through the regulation of LMFTs, LCSWs; Licensed Educational
Psychologists; LPCCs; MFT Interns; Associate Clinical Social
Workers (ASW); and Professional Clinical Counselor Interns
(PCCI) in the State of California. The 2015 licensee
statistics are as follows:
MFT: 36,600
MFT Interns: 22, 275
LPCC: 930
LPCC Intern: 658
"Interns" are those individuals who have completed their
academic training and are seeking counselling hours for
licensure. "Trainees" are those individuals who are
currently enrolled in a master's or doctoral degree program
that is designed to qualify him or her for LMFT or LPCC
licensure, and who have completed no less than 12 semester
units or 18 quarter units of coursework in any qualifying
degree program. Current law places numerous parameters upon
the work of MFT and LPCC trainees to ensure the safety of the
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clients and appropriate supervision and learning experience
for the trainees. For example, an MFT and LPCC trainee's
school must approve each site at which the trainee provides
counseling, ensuring that there is a written agreement that
details each party's responsibilities, including the methods
by which supervision shall be provided, regular progress
reports, and evaluations of the student's performance at the
site. A trainee must also notify each client or patient
prior to providing services that he or she is an unlicensed
and that he or she is under supervision.
This bill provides additional protections for a client of an
MFT or LPCC trainee by requiring a trainee to notify or
consult with a supervisor under specified circumstances when
providing services to a minor.
3. Arguments in Support. The California Association for
Licensed Professional Clinical Counselors writes, "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."
Aspiranet , a provider of foster care, writes "Foster youth
have unique life circumstances and most require some level of
mental health services. Also, they are more likely than
their peers to suffer from depression, PTSD, child abuse, and
suicide. These are the same areas of focus which LMFT and
LPCC supervised Trainees are receiving Masters and Doctoral
degrees in, and would be able to provide quality, immediate
care, ensuring the safety of youth populations. With the
current shortage of LMFTs and LPCCs, it is challenging to
ensure youth are receiving timely access to mental health
care.
"Getting to these youth promptly is vital and making
treatment available will increase their chances to heal and
lead healthy lives. AB 1808 will increase the availability
of mental health services to young people immediately and
provide more opportunities for trainees to gain the 3,000
hours of counseling experience needed to qualify to apply for
licensure, creating more licensed mental health
professionals. This bill will help increase timely and
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adequate access to mental health services for youth."
4. Arguments in Opposition. The California Right to Life
Committee, Inc. (CLRC) writes, "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 for 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."
5. Prior 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.
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
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treatment or counseling services, as specified.
6. Policy Consideration. There have been increasing efforts to
parallel the licensure requirements for MFTs, LPCCs, and
LCSWs. The Social Work Licensing Law uses the term
"associate clinical social worker" to describe a person who
has graduated from an academic program and is amassing
clinical hours towards licensure, and "intern" to describe
someone who is still in school and may provide services. HSC
affected by this bill authorizes an LCSW as a "professional
person" to perform mental health services, but not an
associate, while it allows MFT and LPCC interns. It is
unclear why associate and intern clinical social workers are
not included in this bill.
NOTE : Double-referral to the Senate Committee on Judiciary.
SUPPORT AND OPPOSITION:
Support:
California Association for Licensed Professional Clinical
Counselors (Sponsor)
California Association of Marriage and Family Therapists
(Sponsor)
Aspiranet
Board of Behavioral Sciences
California Council of Community Behavioral Health Agencies
California Council of Community Behavioral Health Agencies
California State PTA
County Behavioral Health Directors Association
Opposition:
California Right to Life Committee, Inc.
One individual
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