BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE JUDICIARY COMMITTEE
                             Senator Noreen Evans, Chair
                              2011-2012 Regular Session


          SB 146 (Wyland)
          As Amended April 12, 2011
          Hearing Date: April 26, 2011
          Fiscal: Yes
          Urgency: No
          EDO  
                    

                                        SUBJECT
                                           
                   Healing Arts: Professional Clinical Counselors

                                      DESCRIPTION  

          Existing law provides for the licensure and regulation of 
          professional clinical counselors by the Board of Behavioral 
          Sciences beginning January 1, 2012.  This bill would make 
          technical changes by updating and revising various provisions 
          throughout the codes relating to the practice of healing arts 
          and mental health professionals to include professional clinical 
          counselors, clinical counselor interns and trainees.  

                                      BACKGROUND  

          The Licensed Professional Clinical Counselor Act (the Act) was 
          enacted into law by SB 788 (Wyland and Steinberg, Chapter 619, 
          Statutes of 2009).  California was the last state to allow for 
          the licensure of professional clinical counselors.  Prior to 
          passage, many Californians and non-Californians held Masters 
          Degrees in counseling, but were unable to be licensed in 
          California.  This provided little incentive for these degree 
          holders to stay in California or to come to California for work. 
           

          Prior to the passage of the Act, California only allowed for the 
          licensure of Marriage and Family Therapists (MFTs), which is a 
          very similar field of practice to professional clinical 
          counselors.  MFTs are similarly only required to obtain a 
          Master's Degree, (although a doctorate is available as well) as 
          opposed to a Psychologist who is required to obtain a doctorate 
          of psychology (Ph.D.), or a Psychiatrist who must obtain a 
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          Doctor of Medicine (M.D.).  However, MFTs, as the name 
          indicates, specialize in issues relating directly to marriage 
          and the family, whereas a professional clinical counselor covers 
          a broader range of issues. There are currently over 30,000 
          licensed MFTs in California alone.  MFTs are included throughout 
          the California statutes relating to healing arts and mental 
          health professionals.  Consequently, MFTs are subject to peer 
          review and their communications with their patients are also 
          protected under the existing evidentiary psychotherapist-patient 
          privilege which is defined to also include licensed clinical 
          social workers, psychologists and psychiatrists.  

          This bill would make various revisions to the code sections 
          relating to the healing arts and mental health professionals to 
          include professional clinical counselors, clinical counselor 
          interns and trainees. 

          This bill has been heard in the Senate Committee on Business, 
          Professions and Economic Development and passed out of that 
          committee by a vote of 9-0. 

                                CHANGES TO EXISTING LAW  

          1.Existing law  provides that a patient has a privilege to refuse 
            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 worker 
            and licensed marriage and family therapists). (Evid. Code Sec. 
            1010.)

             Existing law  also extends this privilege to a psychological 
            corporation, as defined, and the patient to whom it renders 
            professional services. (Evid. Code Sec. 1014.)

             This bill  would extend the privilege to professional clinical 
            counselors, a registered clinical counselor intern or trainee, 
            or a professional clinical counselor corporation. 

          2.Existing law  provides for the licensure and regulation of 
            professional clinical counselors under the Licensed 
            Professional Clinical Counselor Act (Act), by the Board of 
            Behavioral Sciences beginning January 1, 2012.  The Act also 
            regulates clinical counselor trainees and clinical counselor 
                                                                      



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            interns. (Bus. & Prof. Code Sec. 4999.10 et seq.)

             Existing law  establishes peer review for certain healing arts 
            licensees and requires peer review bodies to review licensee 
            conduct under certain circumstances.  Existing law provides 
            that the proceedings and records of a peer review body for the 
            healing arts are not subject to discovery. (Bus. & Prof. Code 
            Sec. 805, Evid. Code Sec. 1157.)
           
            Existing law  requires certain health-related licensees to 
            complete training in human sexuality and authorizes the boards 
            regulating those licensees to adopt education and training 
            requirements related to chemical dependency and the assessment 
            and treatment of AIDS. (Bus. & Prof. Code Secs. 25, 29, 32.)
             
            Existing law  requires boards to provide specified information 
            on the Internet about the status of every license issued by 
            the respective boards.  (Bus. & Prof. Code Sec. 27.)

             Existing law  requires liability insurers, and state or local 
            government agencies that self-insure specified licensees, to 
            report specified settlement or arbitration awards or a claim 
            or action for damages for death or personal injury by that 
            licensee's negligence, error, or omission in practice, or by 
            rendering unauthorized services. (Bus. & Prof. Code Sec. 801.)
             
            Existing law  requires licensees to report to the board certain 
            settlements, judgments or arbitration awards.  (Bus. & Prof. 
            Code Secs. 801; 801.1 & 802.)
             
            Existing law  provides that there is no monetary liability or 
            cause of action against certain professional societies or its 
            members for an act performed within the scope of the 
            professional society or peer review. (Civ. Code Sec. 43.7.)

             Existing law  provides a cause of action against a 
            psychotherapist for injury caused by sexual contact with the 
            psychotherapist.  (Civ. Code Sec. 43.93.)

             Existing law  requests public postsecondary colleges and 
            universities in California to develop standards and guidelines 
            for curriculum in gerontology, nursing, social work, 
            psychology, marriage and family therapy, and rehabilitation 
            therapies.  (Ed. Code Sec. 66085.)
           
            Existing law  permits testimony in a criminal proceeding of a 
                                                                      



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            witness who has previously undergone hypnosis, by specified 
            licensees, for the purpose of recalling events. (Evid. Code 
            Sec. 795.)
             
            Existing law  authorizes the superior court family law division 
            to contract with specified providers for supervised visitation 
            and exchange services, education, and group counseling.  (Fam. 
            Code Sec. 3202.)
             
            Existing law  establishes provisions regarding mental health 
            treatment or counseling services and residential shelter 
            services by specified professionals.  (Fam. Code Sec. 6924.)
           
            Existing law  prohibits the license requirements of healing 
            arts professionals in state and other licensed governmental 
            health facilities from being less stringent than those of 
            professional personnel in privately-owned health facilities, 
            as specified.  (Health & Saf. Code Sec. 1277.)
             
            Existing law  requires health care service plans licensed by 
            the Department of Managed Health Care that operate, or 
            contract for telephone medical advice services to ensure that 
            those providing those services are licensed.  (Health & Saf. 
            Code Sec. 1348.8.)
           
            Existing law  requires health care service plans to provide, 
            upon request, a list of contracting providers within a plan of 
            enrollee's general geographic area.  (Health & Saf. Code Sec. 
            1367.26.)
             
            Existing law  prohibits a health care service plan, or 
            insurance carrier from prohibiting an enrollee from selecting 
            certain types of licensees for mental health services.  
            (Health & Saf. Code Sec. 1373; Ins. Code Sec. 10176.7.)
             
            Existing law  establishes requirements governing patient 
            records and the responsibilities of health care providers 
            regarding those records.  (Health & Saf. Code Sec. 123115.)

             Existing law  requires a person who provides mental health 
            services in local mental health facilities to be licensed, but 
            allows the licensure requirement to be waived in local 
            facilities for psychologists, clinical social workers, and 
            marriage and family therapists who are gaining experience 
            required for licensure.  (Welf. & Inst. Code Sec. 5751.2.)
             
                                                                      



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            Existing law  makes certain persons mandated reporters under 
            the Child Abuse Neglect and Reporting Act.  (Pen. Code Sec. 
            11165.7.) 

             Existing law  establishes staffing requirements for mental 
            health regional facilities, including requiring that the staff 
            include a pediatrician, dentist, and marriage and family 
            therapist, on an as-needed basis.  (Welf. & Inst. Code Sec. 
            5696.5.)
             
            This bill  would add professional clinical counselors, and in 
            most cases their interns or trainees, to the provisions 
            described above. 

                                        COMMENT
           
          1.  Stated need for the bill  
          
          The author writes:
          
            �This bill] is a follow-up to SB 788 (The Licensed 
            Professional Clinical Counselor Act), which went into effect 
            January 1, 2010.  The sole purpose of �this bill] is to add 
            Licensed Professional Clinical Counselors to the State Codes 
            where Marriage and Family Therapists (MFTs), a long-standing 
            comparable profession, are already included.  These additions 
            are not intended to affect any existing professions included 
            in these Codes.


            
          
          2.  This bill would revise statutes relating to the healing arts 
            and mental health professionals to include professional 
            clinical counselors  

          Under existing law, the Board of Behavioral Sciences is 
          responsible for regulating the practice of psychotherapy which 
          includes marriage and family therapists, psychologists, clinical 
          social workers and starting January 1, 2012 will include 
          licensed professional clinical counselors.  In order to become 
          licensed in these fields, certain educational requirements, 
          experience, and examinations must be completed.  As a result, 
          several statutes are impacted by including professional clinical 
          counselors in the list of licensed healing arts and mental 
          health professionals. 
                                                                      



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              a.   Psychotherapist-patient privilege
           
            Existing law provides that a patient has a privilege to refuse 
            to disclose, and to prevent another from disclosing, a 
            confidential communication between the patient and a 
            psychotherapist.  This evidentiary privilege is called the 
            psychotherapist-patient privilege.  Several mental health 
            professionals are included under the definition of 
            "psychotherapist," including most notably, for purposes of 
            this bill, MFTs.  This privilege also applies to registered 
            psychological interns or trainees who also fall under the 
            definition of "psychotherapist" and include MFT interns and 
            trainees.

            This bill would extend the privilege to professional clinical 
            counselors, clinical counselor interns and trainees.  This 
            bill would simply revise the privilege to include a reference 
            to professional clinical counselors as defined by SB 788. The 
            policy for having an evidentiary privilege for professional 
            clinical counselors "as with other privileges protecting 
            confidential information, is designed to serve a public 
            purpose, namely to encourage people to confide in their 
            attorneys, clergymen and doctors all information that might 
            lead to professional action for their benefit."  (Grey v. 
            Superior Court (1976) 62 Cal.App.3d 698.) Specifically, the 
            psychotherapist-patient privilege "is founded upon the notion 
            that certain forms of antisocial behavior may be prevented by 
            encouraging those in need of treatment for emotional problems 
            to secure the services of a psychotherapist. Indeed, the 
            legislative intent behind �Evidence Code Section] 1014 is 
            clearly in accord with the proposition that confidentiality is 
            the essential ingredient for successful psychotherapy." (Scull 
            v. Superior Court (1988) 206 Cal.App.3d 784.) Similarly, 
            professional clinical counselors treat patients in need of 
            mental health services, thus and so the author argues that it 
            is imperative that there is confidentiality between the 
            counselor and patient in order for successful treatment to 
            take place. 

            Further, under existing law, the privilege can be waived when 
            "the patient reveals a significant part of the communication 
            involved, or consents to disclosure, or fails to object when 
            he has the opportunity." (Roberts v. Superior Court of Butte 
            County (1973) 9 Cal.3d 330.) Also, under existing law, there 
            are certain exceptions to the privilege and this bill would 
                                                                      



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            not affect any of those exceptions currently provided for 
            under the law. 

            This bill would also apply the evidentiary privilege to 
            communications between professional clinical counselor interns 
            and trainees and their patients. An intern is defined as an 
            unlicensed person who has earned his or her master's or 
            doctor's degree qualifying him or her for licensure, meets all 
            of the qualifications for licensure and is registered with the 
            board.  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.)  Similar 
            allowances for other healing arts and mental health profession 
            interns and trainees are already included in the evidentiary 
            privilege, most notably MFT interns and trainees.

            b.    Peer Review 
           
            Under existing law, the healing arts professions and mental 
            health professions have instituted a peer review body which 
            reviews basic qualifications, staff privileges, employment, 
            medical outcomes, or professional conduct of the license 
            holders.  The purpose of these peer review bodies is to make 
            recommendations to improve the quality of service and if 
            necessary to improve the educational aspects of licensure.  
            This process is important for ensuring consumer protections. 
            Also, other professions employ similar peer review processes. 

            This bill would revise the list of healing arts professionals 
            subject to peer review to include professional clinical 
            counselors.
          

           Support  :  California Alliance of Child and Family Services

           Opposition  :  None Known

                                        HISTORY
           
           Source  :  California Association for Licensed Professional 
          Clinical Counselors

           Related Pending Legislation  :  
                                                                      



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          SB 363 (Emmerson) would authorize a licensed professional 
          clinical counselor to act as a supervisor of a marriage and 
          family therapy intern or trainee if he or she meets additional 
          training and education requirements.  This bill was referred to 
          the Senate Committee on Business, Professions and Economic 
          Development and passed out of that committee on a 7-0 vote and 
          is currently in the Senate Committee on Appropriations.

          AB 655 (Hayashi) would require a peer review body to respond to 
          the request of another peer review body and produce a summary of 
          specified information concerning a licentiate under review. This 
          bill has been referred to the Assembly Committee on Business, 
          Professions and Consumer Protection.

           Prior Legislation  :  

          SB 788 (Wyland and Steinberg, Chapter 619, Statutes of 2009) 
          established the licensing and regulation of professional 
          clinical counselors in California beginning January 1, 2012. 

          AB 1486 (Calderon, 2008) would have required the Department of 
          Consumer Affairs and the Board of Behavioral Sciences to 
          evaluate the licensing requirements and scope of practice for 
          licensed professional counselors, licensed clinical social 
          workers, licensed educational psychologists, and marriage and 
          family therapists, and to submit the evaluation and any 
          recommendations to the Legislature by December 31, 2009.  This 
          bill failed passage in the Senate Committee on Appropriations. 

          AB 894 (La Suer, 2005) would have provided for the licensing or 
          registration and regulation of professional counselors and 
          professional counselor interns by the Board of Behavioral 
          Sciences. This bill was held in the Assembly Committee on 
          Appropriations.

           Prior Vote  :  Senate Committee on Business, Professions and 
          Economic Development (Ayes 9, Noes 0) 

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