BILL ANALYSIS Ó
SENATE JUDICIARY COMMITTEE
Senator Hannah-Beth Jackson, Chair
2015-2016 Regular Session
AB 1808 (Wood)
Version: June 2, 2016
Hearing Date: June 21, 2016
Fiscal: No
Urgency: No
NR
SUBJECT
Minors: mental health treatment or counseling services
DESCRIPTION
This bill would authorize a marriage and family therapist
trainee and a clinical counselor trainee, while working under
the supervision of certain licensed professionals, to provide
outpatient mental health services to a minor who is at least 12
years of age, as specified.
BACKGROUND
Nearly one in every 10 school-age children in the United States
has a mental health condition, and there are not enough child
psychiatrists to care for them. Children and adolescents
involved with child welfare have even higher rates of mental
health conditions stemming from serious physical, mental health,
developmental, and psychosocial problems rooted in childhood
adversity and trauma. This is especially true for those who are
removed from their family of origin and placed in out-of-home
care.
This bill, seeking to ensure that children and adolescents
receive the mental health services they need, would expressly
provide that licensed marriage and family therapist (LMFT)
trainees and clinical counselor trainees are able to counsel
specified minors.
CHANGES TO EXISTING LAW
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Existing law defines a "professional person" as a person
designated as a mental health professional, as specified; an
LMFT; a licensed educational psychologist; a credentialed
school psychologist; a clinical psychologist; a licensed
clinical social worker (LCSW); a person registered as an LMFT
intern, while working under the supervision of a licensed
professional; a board certified, or board eligible,
psychiatrist; a licensed professional clinical counselor (LPCC);
or a person registered as an LPCC intern while working under the
supervision of a licensed professional. (Health & Saf. Code
Sec. 124260.)
Existing law 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:
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,
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. (Fam. Code Sec.
6924 (b).)
Existing law 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
health treatment or counseling services. (Health & Saf. Code
Sec. 12460.)
Existing law defines both an LMFT intern and an 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. (Bus. & Prof. Code Secs.
4980.3, 4999.12.)
Existing law defines an LMFT trainee and an 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. (Bus. & Prof. Code Secs. 4980.3, 4999.12.)
Existing law provides that a patient has a privilege to refuse
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to disclose, and to prevent another from disclosing, a
confidential communication between the patient and a
psychotherapist. Existing law extends this privilege to
registered psychotherapist interns or trainees (defined to
include licensed psychologists, licensed physicians specializing
in psychiatrics, licensed clinical social workers, professional
clinical counselors, and licensed marriage and family
therapists). (Evid. Code Sec. 1010.)
This bill would add an LMFT trainee and an 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.
This bill would require a trainee to notify his or her
supervisor, or if the supervisor is unavailable, an on-call
supervisor from the site where the trainee is employed or
volunteering at within 24 hour of treating the minor pursuant to
requirements under the Family Code. 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.
COMMENT
1.Stated need for the bill
According to the author:
Currently, a therapist, clinical counselor, or intern can
provide services to a minor, 12 years or older in certain
circumstances. However, registered Licensed Marriage and
Family Therapists (LMFT) and Licensed Professional Clinical
Counselors (LPCC) interns are listed as appropriate providers,
LMFT and LPCC "trainees" have been left off the list of
eligible providers.
Leaving LMFT and LPCC trainees out of the list of eligible
providers creates an oversight that impacts the number of
providers available to treat minors, and contributes to the
lack of mental health services that is available in schools.
AB 1808 will add clinical counselor trainees and marriage and
family therapist trainees to the list of approved
professionals able to provide services to minors over 12 years
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old.
2.Consistent with existing law
This bill would expressly authorize LMFT trainees and an LPCC
trainees, while working under the supervision of a licensed
professional, to provide mental health services to a minor who
is 12 years of age or older. A trainee is an "unlicensed person
who is currently enrolled in a master's or doctor's 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." (Bus. & Prof. Code Secs. 4999.42-4999.46 and 4999.12.)
Aspiranet, one of the largest providers of foster care in
California, argues that this bill is necessary because it is
difficult to ensure that youth are receiving timely access to
mental health care with the current shortage of mental health
professionals.
In support, the California Association for Licensed Professional
Clinical Counselors (CALPCC) writes:
Currently Health and Safety Code Sec. 124260 and Family Code
Sec. 6924, authorize a psychotherapist or a clinical counselor
to provide services to a minor, 12 years or older in certain
circumstances. While LMFTs and LPCCs, and registered interns
gaining hours towards licensure are listed as appropriate
providers, LMFT and LPCC trainees gaining hours towards LMFT
or LPCC licensure have been left off the list of eligible
providers. AB 1808 would also permit an LMFT or LPCC trainee
to provide treatment or counseling to such a minor who
consents to treatment or counseling.
Staff notes that existing law, which establishes the
psychotherapist-patient privilege<1>, already extends the
privilege to communications between a patient and an LMFT or
---------------------------
<1> The psychotherapist-patient privilege provides that a
patient may refuse to disclose, and prevent another from
disclosing, a confidential communication between himself or
herself and a psychotherapist, and is defined to include the
following: licensed psychologists; licensed physicians
specializing in psychiatrics; licensed clinical social workers;
professional clinical counselors; and licensed marriage and
family therapists; and each of these professional's interns or
trainees. (Evid. Code Sec. 1010.)
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LPCC trainee, thereby indicating that the Legislature
anticipated that such trainees would be providing mental health
services. Thus, this bill is entirely consistent, and arguably
clarifying, of existing law.
1.Opposition's concerns
The California Right to Life Committee, Inc. writes, "mental
health issues are serious, affecting the entire family of the
individual. Families, and especially parents, need to be
involved. [?] CRLC has noted in the past that the growing
California 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 at a lessor cost to
the medical program. CLRC 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."
The author responds, "California Right to Life Committee has an
opposed position to the bill. The organization is concerned by
the lack of parental decisions made by allowing a minor to
request their own mental health services to be cared for by an
'undertrained' therapist trainee. We argue that registered LMFT
and LPCC interns are listed as appropriate providers while LMFT
and LPCC trainees are left out of the eligibility list."
Staff further notes that the author has amended the bill to
ensure that a trainee immediately notify his or her supervisor
if a patient appears to be a danger to himself or herself or
others, so that the minor may quickly receive appropriate
services when he or she needs them most.
Support : Aspiranet; Association of California Healthcare
Districts; Board of Behavioral Sciences; California Association
for Licensed Professional Clinical Counselors; California
Association of Marriage and Family Therapists; California
Council of Community Behavioral Health Agencies; California
Health + Advocates; California State PTA; County Behavioral
Health Directors Association
Opposition : California Right to Life Committee, Inc.
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HISTORY
Source : California Association for Licensed Professional
Clinical Counselors;
California Association of Marriage and Family Therapists
Related Pending Legislation : None Known
Prior Legislation :
AB 250 (Obernolte, Ch. 50, Stats. 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, Ch. 435, Stats. 2014), increased the number of
hours which an LMFT trainee or intern and a professional
clinical counselor intern, may count towards their weekly
supervision requirement from five to six.
SB 632 (Emmerson, Ch. 50, Stats. 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, Ch. 166, Stats. 2011), required a
marriage and family therapist intern and an 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, Ch. 503, Stats. 2010), expanded the rights of
minors to receive outpatient mental health treatment or
counseling services, as specified.
Prior Vote :
Senate Business, Professions and Economic Development Committee
(Ayes 7, Noes 0)
Assembly Floor (Ayes 74, Noes 1)
Assembly Business and Professions Committee (Ayes 14, Noes 0)
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