BILL ANALYSIS Ó AB 1917 Page 1 Date of Hearing: March 29, 2016 ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS Rudy Salas, Chair AB 1917 (Obernolte) - As Introduced February 11, 2016 SUBJECT: Mental health care professionals: qualifications. SUMMARY: Clarifies that education gained while residing outside of California should be based on the location of the school, instead of on the location of the individual, for applicants for licensure as a marriage and family therapist (LMFT) and a professional clinical counselor (LPCC); clarifies the coursework and practicum requirements for applicants for licensure as a LPCC, and makes other technical and clarifying changes to the practicum requirements for out-of-state LMFT and LPCC applicants. EXISTING LAW: 1)Establishes the Board of Behavioral Sciences (BBS) within the Department of Consumers (DCA) to license and regulate LMFTs and LPCCs. (Business and Professions Code (BPC) Sections 4980 et seq. and 4999.10 et seq.) 2)Specifies that a person engages in the practice of marriage and family therapy when he or she performs, offers to perform, or holds himself or herself out as able to perform services. (BPC Section 4980.10) AB 1917 Page 2 3)Authorizes the BBS to issue a license to a person who holds a valid license in good standing issued by a board of marriage counselor examiners, board of marriage and family therapists, or corresponding authority of any state or country if specified conditions are met including the applicant's education is substantially equivalent. (BPC Section 4980.72 (b)(1)) 4)Authorizes the BBS to accept education gained outside of California for purposes of satisfying the licensure or registration requirements, for LMFT applicants who do not hold a license, if the education is substantially equivalent, as specified. (BPC Section 4980.74(a)(b) 5)Allows an out-of-state LMFT applicant, who has been licensed for less than two years in clinical practice, and who does not meet specified practicum requirements, 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, or a combination of both, as specified. (BPC Section 4980.79(b)(1(C)(ii)) 6)Authorizes the BBS to issue a license to a LPCC applicant who, at the time of submitting an application for licensure, holds a valid license as a professional clinical counselor, or other counseling license, that allows the applicant to independently provide clinical mental health services, if specified conditions are met. (BPC Section 4999.60) 7)Authorizes the BBS to accept education gained while residing outside of California, for purposes of satisfying licensure or registration requirements for LPCC applicants who do not hold a license outside of California, if the education is substantially equivalent to in-state education requirements, AB 1917 Page 3 as specified. (BPC Sections 4999.61 and 4999.62) 8)Specifies the degree requirements for licensure as an LPCC to contain no less than 48 graduate semester or 72 graduate quarter units of instruction and specifies the core content areas. (BPC Section 4999.32(c)(1)(A)) THIS BILL: 1)Deletes the BBS's authorization to accept education gained while residing outside of California and instead permits the BBS to accept education gained from an out-of-state school for purposes of licensure or registration for both LMFT and LPCC applicants. 2)Revises the practicum degree requirements for licensure as a LMFT to include experience counseling individuals, couples, families, or groups, as specified. 3)Specifies that the practicum degree requirements for licensure as a LPCC include experience that involves direct client contact, for applicants who begin graduate study before August 1, 2012 and complete study on or before December 31, 2018. 4)Expands the practicum degree requirements for licensure as a LPCC to include experience counseling individuals, couples, families, or groups, as specified, for an applicant who applies after January 1, 2016. 5)States that an applicant for licensure as a LPCC, cannot have coursework deficiencies in assessment, appraisal and testing of individuals, or principles of the diagnostic process, as AB 1917 Page 4 specified. 6)Makes other technical and clarifying changes. FISCAL EFFECT: Unknown. This bill is keyed fiscal by the Legislative Counsel. COMMENTS: Purpose. This bill is sponsored by the BBS . This bill revises the BBS's acceptance of education gained out-of-state for LMFT and LPCC applicants; amends the coursework specifications for LPCCs in an effort to ensure that degrees obtained by out-of-state education will lead to licensure in California; and, clarifies the practicum requirements for both LMFT and LPCC applicants. According to the author, "the [BBS] has worked with its stakeholders through its Committee process to develop this proposal. It believes that together, these amendments will assist with license portability for applicants with degrees from out-of-state schools, while upholding public protection by ensuring that the qualifying degree was carefully designed to prepare an applicant for his or her chosen licensed profession." LMFTs and LPCCs. The BBS licenses and regulates LMFTs and LPCCs. LMFTs are employed in a variety of mental health agencies, counseling centers, and private practices. LPCCs work in a variety of settings including hospitals, community-based mental health organizations, and private practice. Both LPCC and LMFT applicants must demonstrate that they have taken courses in specified topic areas. Certain courses must be completed within the graduate degree program, while other courses may be remediated after completion of the degree program. Education and experience requirements for LMFTs include a master's degree in specified counseling, therapy, or AB 1917 Page 5 psychology from a school approved by either a regional accrediting agency recognized by the United States Department of Education (USDE) or approved by the Bureau of Private Postsecondary Education. Additionally, LMFT applicants are required to obtain 3000 hours of supervised work experience. LPCC applicants are required to have a master's degree that is in psychotherapy or counseling from an accredited or approved school and obtain 3000 of supervised work experience. Out-of-State Education. Both the LMFT and LPCC practice acts authorize applicants to apply for licensure in California if their out-of-state education is substantially equivalent and the specified curriculum requirements are met. Both LMFT and LPCC applicants, who obtain education at institutions outside of California, are permitted to remediate coursework deficiencies as out-of-state degree programs are not tailored to California specific licensing law, whereas students who obtain education from California institutions are not permitted to remediate coursework deficiencies. According to the BBS, BPC Sections 4980.74 and 4999.61 define education gained outside of California based on the location of the school rather than the residence or location of the student at the time the degree is earned. The BBS notes that online degrees are gaining popularity, and the BBS is encountering an increasing number of LMFT and LPCC applicants who complete online degree programs from out-of-state schools while residing in California. Current law prohibits these applicants from remediating any coursework deficiencies for in-state applicants whose education is acquired from an institution outside of California. Specifically, BPC Sections 4980.74 and 4999.61 state that the BBS can only accept education gained while residing outside of California. This bill will change that requirement to permit the BBS to accept education gained from an out-of-state school regardless of the residency of the applicant; thereby, allowing California residents who obtain out-of-state degrees to remediate missing California AB 1917 Page 6 coursework requirements. Degree requirements for LMFT and LPCC applicants who obtain education either in-state or out-of-state must include six semester or nine quarter units of practicum. Practicum requirements for LMFT applicants, who obtain their degree in-state, specify the counseling practicum requirements needed for licensure. However, the practicum specifications for those who gained education out-of-state are less specific. This bill will specify that practicum requirements include face-to-face experience counseling individuals, couples, families, or groups to be more consistent with the requirements for applicants who obtained a degree in-state. Practicum requirements for LPCCs include six semester or nine quarter units of supervised practicum or field study experience, or the equivalent in a clinical setting, as specified. Currently, those practicum requirements do not specify that the practicum coursework include direct client contact. This bill specifies the degree requirements for LPCCs to include direct client contact in the six semester or nine quarter units of practicum. LPCC Educational Requirements. Under current law, LPCC applicants are required to possess a master's or doctoral degree in counseling or psychotherapy, as specified. The intent of the degree requirement is for an applicant to obtain a degree in which the core content is designed to lead to LPCC licensure. However, the BBS notes that some degrees may include counseling or psychotherapy content, but are not necessarily intended for licensure as a LPCC in California because the core content areas do not meet specified core curriculum requirements. In an effort to address this issue, this bill will specify that a LPCC degree must contain coursework in two core areas: 1) assessment, appraisal, and testing of individuals; and, 2) principles of the diagnostic process. In addition, this bill specifies that those AB 1917 Page 7 two core coursework requirements must be completed during the degree program and cannot be remediated after completing the degree. Degree requirements for clinical counselor licensing can vary by state, and this bill aims to ensure that degrees obtained at in-state and out-of-state institutions meet core content requirements necessary for licensure. Prior Related Legislation. AB 428 (Eggman), Chapter 379, Statutes of 2014, authorizes certain coursework requirements for licensure as a LMFT and licensed clinical social worker to be completed through continuing education instead of formal classroom training, as specified. AB 451 (Eggman), Chapter 551, Statutes of 2014, extends the current effective date for new education, examination, and eligibility requirements for out-of-state applicants for LMFT and LPCC, from January 1, 2014, to January 1, 2016, and extends the operation and repeal date for current examination, eligibility, and curriculum requirements for out-of-state applicants from January 1, 2014, to January 1, 2016. ARGUMENTS IN SUPPORT: The BBS writes in support, "First, the bill amends the coursework and practicum required of LPCC applicants, in order to ensure that an applicant's master's degree was designed to qualify him or her to practice professional clinical counseling?second, the bill amends the LMFT and LPCC licensing law to define education gained out-of-state based on the location of the school, rather than based on the residence of the applicant. The [BBS] has historically allowed applicants with out-of-state degrees to remediate some education content, with the understanding that out-of-state degree programs do not gear their coursework toward meeting California-specific licensing requirements. However, as online degree programs have AB 1917 Page 8 increased in popularity, the [BBS] finds that the definition of out-of-state education needs to be modified to accommodate applicants living in California, but obtaining degrees online from schools in other states." ARGUMENTS IN OPPOSITION: None on file. REGISTERED SUPPORT: Board of Behavioral Sciences (sponsor) American Association for Marriage and Family Therapy, California Division REGISTERED OPPOSITION: None on file. Analysis Prepared by:Elissa Silva / B. & P. / (916) 319-3301 AB 1917 Page 9