BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 1101
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|AUTHOR: |Wieckowski |
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|VERSION: |March 28, 2016 |
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|HEARING DATE: |March 30, 2016 | | |
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|CONSULTANT: |Reyes Diaz |
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SUBJECT : Alcohol and drug counselors: regulation
SUMMARY : Requires the Department of Health Care Services (DHCS) to
issue licenses for alcohol and drug counselors, as specified,
and prohibits a person from using the title "licensed alcohol
and drug counselor," unless the person has applied for and
obtained a license from DHCS, and meets all of the criteria for
licensure.
Existing law:
1)Provides for the registration, certification, and licensure of
various healing arts professionals.
2)Creates, within the Department of Consumer Affairs (DCA), the
Board of Behavioral Sciences (BBS), which licenses marriage
and family therapists, clinical social workers, professional
clinical counselors, and educational psychologists, and sets,
communicates, and enforces standards for safe and competent
mental health practice.
3)Gives DHCS sole authority in state government to determine the
qualifications, including the appropriate skills, education,
training, and experience, of personnel working within any
substance use disorder (SUD) facility or program licensed or
certified by DHCS.
4)Requires DHCS to require individuals providing counseling
services, except as specified, at a DHCS-licensed or certified
facility or program to be registered with or certified by a
certifying organization (CO) approved by DHCS. Requires COs to
be accredited by the National Commission for Certifying
Agencies.
SB 1101 (Wieckowski) Page 2 of ?
5)Prohibits DHCS from approving a CO that does not, prior to
registering or certifying an individual, contact other
DHCS-approved COs to determine whether an individual has ever
had registration or certification revoked.
6)Gives DHCS authority to conduct periodic reviews of COs to
determine compliance with all applicable laws and regulations,
and to take actions for noncompliance, including revocation of
DHCS's approval.
This bill:
1)Requires DHCS to issue licenses for alcohol and drug
counselors and prohibits a person from using the title
"licensed alcohol and drug counselor" (LADC) unless the person
has applied for and obtained a license from DHCS.
2)Requires an applicant for LADC licensure to meet minimum
qualifications that include, but are not limited to the
following:
a) Has earned a master of arts, master of
science, or doctoral degree in addiction counseling,
psychology, social work, counseling, marriage and
family therapy, counseling psychology, clinical
psychology, or other clinically focused major that
requires no less than 21 semester units, or
equivalent, of addiction specific education approved
by a CO recognized by DHCS, from an institution of
higher learning accredited by a regional accrediting
agency, or a board for private postsecondary
education;
b) Has demonstrated competence by passing a
master's level exam accepted by a DHCS-approved CO;
c) Has a current credential as an advanced
alcohol and drug counselor and is in good standing
with a DHCS-approved CO, and has no history of
revocation by a CO, licensure board, or certifying
entity;
d) Has documented to the CO that three semester
units, or the equivalent, of the following courses
have been completed:
i. Psychopharmacology and physiology
of addiction, as specified;
ii. Clinical evaluation and
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psychopathology, as specified;
iii. Counseling/psychotherapy for
addiction, as specified;
iv. Case management, as specified;
v. Client education, as specified.
vi. Professional responsibility law and
ethics, as specified;
vii. Supervised fieldwork; and,
e) Has submitted to a state and federal level
criminal offender record information search as part of
a criminal background check.
3)Provides that, for a period not to exceed one year from the
date DHCS accepts applications for licensure, applicants with
12,000 hours of experience are not required to meet the
education requirements in a), b), or d) of 2) above. Requires
these applicants to sit for the master's level exam required
in b) of 2) above before the first renewal period of licensure
and to provide proof of passing the exam to the CO before one
year after the end of the first renewal period.
4)Authorizes DHCS to revoke an LADC license if either of the
following occurs: a) the licensee loses his or her credential
granted by a CO, or b) the licensee is convicted of a felony
charge that is substantially related to the qualifications,
functions, or duties of an LADC.
5)Requires DHCS to review an applicant's state and federal
criminal history before issuing a license. Requires DHCS to
deny, suspend, delay, or set aside a person's license if at
the time of DHCS's determination the person has a criminal
conviction or criminal charge pending relating to an offense
with circumstances that are substantially related to actions
as an LADC. Requires applicants who have a criminal conviction
or pending criminal charge to request the appropriate
authorities to provide information about the conviction or
charge directly to DHCS in sufficient specificity to enable
DHCS to make a determination as to whether the conviction or
charge is substantially related to actions as an LADC.
6)Allows DHCS, after a hearing or review of documentation
demonstrating that an applicant meets specified criteria, to
waive the requirements in 5) above as follows:
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a) For a waiver of a felony conviction, more than
five years have elapsed since the date of the
conviction;
b) For a waiver of a felony or for a waiver of a
misdemeanor conviction or violation, at the time of
application, prohibits the applicant from being
incarcerated, on work release, on probation, on
parole, or serving any part of a suspended sentence.
Requires the applicant to be in substantial compliance
with all court orders pertaining to fines,
restitution, and community service;
c) The applicant is capable of practicing LADC
treatment services in a competent and professional
manner, and the applicant has not been convicted of a
felony sexual offense; and,
d) The granting of the waiver will not endanger
the public health, safety, or welfare.
7)Establishes criteria for DHCS to oversee the disciplinary
actions of COs, including requiring COs to maintain national
accreditation by the Institute for Credentialing Excellence
(ICE) or another accrediting agency if ICE no longer performs
its functions to DHCS's satisfaction, and adopting a uniform
code of conduct, uniform disciplinary guidelines, and consumer
complaint procedures for LADCs.
FISCAL
EFFECT : This bill has not been analyzed by a fiscal committee.
COMMENTS :
1)Author's statement. According to the author, SB 1101 will
bolster the mental health treatment workforce and improve the
quality of addiction treatment for Californians by
strengthening DHCS's current certification program and
establishing title protection for substance use disorder (SUD)
counselors. By implementing a licensure program within the
existing certification program under DHCS, California will
make quality treatment a priority in the state's mental health
treatment delivery system, including in outpatient,
residential, and private-practice settings. The current lack
of professional standards, along with a disregard for the
public's health and safety by not requiring a criminal
background check, has created a statewide system that lacks
consistent employee retention, and places patients in
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dangerous situations when unknowingly seeking treatment from
unscreened counselors. Requiring licensees to prove
educational qualifications, advanced alcohol and drug
counseling skills, and experience, and to pass a nationally
recognized exam, will improve the quality of our addiction
treatment delivery system, keep dedicated counselors in the
profession, and generate career opportunities for higher
wages.
2)Background. According to the author's background information,
in 2011, the Substance Abuse and Mental Health Services
Administration (SAMHSA) published the "Scopes of Practice &
Career Ladders for Substance Use Disorder Counseling."
Certifying organizations are working toward adopting a
multi-level professional career ladder for the counselors they
certify. A state-issued license for counselors with a master's
degree (or higher) proposed by this bill would establish the
license level featured in SAMHSA's career ladder. The
combination of licensure and the current certification process
would complete the career ladder for the entire workforce,
from entry-level individuals with a high school or general
education development level education to those with an
advanced degree.
3)Suspect Treatment: State's lack of scrutiny allows unscreened
sex offenders and unethical counselors to treat addicts. This
May 2013 Senate Office of Oversight and Outcomes report stated
that for three decades the state and the SUD treatment
industry have been unable to agree on a framework to give the
state authority to credential counselors. The report concludes
that California's public-private hybrid system precludes
criminal background checks and leaves gaps that can be
exploited by SUD counselors who move between seven
DHCS-approved COs that register and certify them. (As of March
2016, DHCS's Web site only lists three approved COs.) While
the report acknowledged that many counselors draw from their
own struggles with SUD to excel at jobs with not much pay,
some come to the profession with serious criminal backgrounds,
which the report states raises questions about their fitness
to treat clients, who are often at the most vulnerable time of
their lives.
4)SUD counselor certification. To meet current counselor
requirements, individuals must be registered with or certified
by one of three DHCS-approved COs. (Current regulations
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adopted in 2005 list 10 COs.) In order for a CO to issue
certification, individuals must meet requirements established
in regulations, which include completion of at least 155 hours
of formal classroom education, as defined; have documented
completion of at least 160 hours of supervised alcohol or
other drug program counseling and 2,080 or more hours of work
experience; and received a score of at least 70% on an
approved exam. Regulations allow for individuals who are
registered with a CO to provide counseling services while
working toward completion of certification requirements.
Certification is valid for two years and a counselor is
required to complete 40 hours of continuing education every
two years for renewal.
5)Recent DHCS administrative changes. Prior to its elimination
and transfer of its programs to DHCS, the Department of
Alcohol and Drug Programs (ADP) approved as many as nine COs.
Each CO had its own code of conduct and disciplinary
guidelines, which, as noted in the SOOO report, made it
difficult for ADP to be consistent in enforcement. Since the
transfer of ADP programs to DHCS, the three currently approved
COs have agreed to a uniform code of conduct and disciplinary
guidelines, which DHCS enforces. According to the sponsors of
this bill, the three COs have requested DHCS to incorporate
both the uniform code of conduct and the uniform disciplinary
guidelines in DHCS's upcoming redrafting of counselor
certification regulations. DHCS also now has a Web page that
lists the current approved COs and a page that lists
counselors that have had their certification revoked, which
according to DHCS is updated monthly.
6)Prior legislation. SB 570 (DeSaulnier of 2013), would have
established the Advanced Alcohol and Drug Counselor Licensing
Act and created a licensing and certification system for SUD
counselors to be administered by a newly created board within
DCA. SB 570 was held on suspense in the Assembly
Appropriations Committee.
AB 2007 (Williams of 2012), would have established a licensing
and certification system for AOD counselors to be administered
by the Department of Public Health. AB 2007 was held in the
Assembly Health Committee.
SB 1203 (DeSaulnier of 2010), would have established a
licensing and certification structure for AOD counselors by
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ADP. SB 1203 was held in the Assembly Rules Committee.
SB 707 (DeSaulnier of 2009), was substantially similar to SB
1203. SB 707 died on the Assembly Appropriations Committee
suspense file.
AB 239 (DeSaulnier of 2008), would have established two
categories of licensed SUD counselors for persons licensed to
practice SUD counseling under clinical supervision, and
persons licensed to conduct an independent practice of SUD
counseling, and to provide supervision to other counselors,
both to be overseen by BBS. AB 239 was vetoed by Governor
Schwarzenegger who stated in his veto message that he was
directing ADP to work to craft a uniform standard for all
alcohol and drug counselors whether in private practice or in
facilities.
AB 1367 (DeSaulnier of 2007), would have provided for the
licensing, registration, and regulation of Alcoholism and Drug
Abuse Counselors, as defined, by BBS. AB 1367 died on Assembly
Appropriations Committee suspense file.
AB 2571 (Longville of 2004), would have created the Board of
Alcohol and Other Drugs of Abuse Professionals within DCA and
established requirements for licensure of SUD counselors. AB
2571 failed passage in the Assembly Health Committee.
AB 1100 (Longville of 2003), would have enacted the Alcohol
and Drug Abuse Counselors Licensing Law, to be administered by
BBS. AB 1100 was held in the Assembly Business and Professions
Committee.
SB 1716 (Vasconcellos of 2002), would have required BBS to
license and regulate SUD counselors. SB 1716 was held in the
Assembly Business and Professions Committee.
SB 537 (Vasconcellos of 2001), would have required DCA to
initiate a comprehensive review of the need for licensing SUD
counselors. SB 537 was vetoed by Governor Davis due to cost
concerns. In his veto message, the Governor directed ADP to
require counselors in drug and alcohol treatment facilities to
be certified for quality assurance purposes.
7)Support. The California Narcotic Officers' Association (CNOA)
states that there are an estimated 3.5 million people with an
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SUD diagnosis who receive treatment in more than 2,500 private
and public SUD programs throughout the state. CNOA also states
that California is among a minority of states that do not have
a state-administered licensing program for SUD counselors, and
one of only two large states that do not perform criminal
background checks on SUD counselors. Community Social Model
Advocates, Inc. and MARSTE Training Services state that this
bill allows SUD specialists to become full partners in the
integrated treatment teams required for the future of health
care, and that SUD professionals will be encouraged to
continue to obtain a greater degree of skill and education
while allowing program owners and directors to use a mixture
of licensed and certified counselors according to the
treatment parameters of each program.
8)Technical amendments. Provisions in this bill reference
counselor certification regulations that list COs not
currently approved by DHCS. Other provisions in this are not
consistent in the use of terminology. In order to ensure
consistency and avoid referencing outdated regulations, the
author may wish to accept the following technical amendments:
a. Section 1179.80:
(b) A person shall not use the title of licensed alcohol
and drug counselor "licensed advanced alcohol and drug
counselor" unless the person has applied for and obtained
a license from the State Department of Public Health.
department.
(c) The applicant for an advanced alcohol and drug
counselor license shall meet minimum qualifications that
include, but are not limited to, all of the following:
(3) Is currently credentialed as an advanced alcohol and
drug counselor and in good standing with a certification
organization recognized by the Department of Health Care
Services department pursuant to Section 13035 of Title 9
of the California Code of Regulations, as it read on
January 1, 2017, and has no history of revocation by a
certifying organization, licensure board, or certifying
entity.
b. Section 1179.82:
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(a) A license for an advanced alcohol and drug counselor
shall be valid for two years unless at any time during
that period it is revoked or suspended. The license may
be renewed prior to the expiration of the two-year
period.
(c) The department may revoke the license of a licensed
advanced alcohol and drug counselor who is licensed
pursuant to subdivision (b) (c) of Section 1179.80 if
either of the following occurs:
(2) The licensee has been convicted of a felony charge
that is substantially related to the qualifications,
functions, or duties of a licensed advanced alcohol and
drug counselor. A plea of guilty or nolo contendere to a
felony charge shall be deemed a conviction for the
purposes of this paragraph.
c. Section 1179.84:
(b) (1) The department shall deny, suspend, delay, or set
aside a person's license if, at the time of the
department's determination, the person has a criminal
conviction or criminal charge pending, relating to an
offense, the circumstances of which substantially relate
to actions as a licensed advanced alcohol and drug
counselor. Applicants who have a criminal conviction or
pending criminal charge shall request the appropriate
authorities to provide information about the conviction
or charge directly to the department in sufficient
specificity to enable the department to make a
determination as to whether the conviction or charge is
substantially related to actions as a licensed advanced
alcohol and drug counselor.
(C) The applicant is capable of practicing licensed
advanced alcohol and drug treatment counseling services
in a competent and professional manner.
(D) The granting of the waiver will not endanger the
public public's health, safety, or welfare.
d. Section 1179.87:
(a) This part shall not be construed to constrict, limit,
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or prohibit state licensed or certified facilities or
programs, county contracted alcohol and drug treatment
facilities or programs, or driving-under-the-influence
programs from employing or contracting with alcohol and
drug counselors registered with or certified by a
certifying organization that is accredited and state
approved under Chapter 8 (commencing with Section 13000)
of Division 4 of Title 9 of the California Code of
Regulations as it read on January 1, 2017 .
SUPPORT AND OPPOSITION :
Support: California Association of Alcohol & Drug Educators
(cosponsor)
California Association of DUI Treatment Programs
(cosponsor)
California Consortium of Addiction Programs and
Professionals (cosponsor)
California Narcotic Officers' Association
Community Social Model Advocates, Inc.
MARSTE Training Services
Sacramento Recovery House, Inc.
Sun Street Centers
Oppose: None received
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