BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  AB 2198
          Author:   Levine (D), et al.
          Amended:  8/4/14 in Senate
          Vote:     21


           SENATE BUSINESS, PROF. & ECON. DEV. COMM.  :  5-0, 6/23/14
          AYES:  Lieu, Corbett, Galgiani, Hill, Torres
          NO VOTE RECORDED:  Wyland, Berryhill, Block, Hernandez

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  47-11, 5/19/14 - See last page for vote


           SUBJECT  :    Mental health professionals:  suicide prevention  
          training

           SOURCE  :     Author


           DIGEST  :    This bill requires a psychologist, marriage and  
          family therapist (MFT), educational psychologist, professional  
          clinical counselor and clinical social worker, who began  
          graduate study on or after January 1, 2016, to complete a  
          minimum of 15 hours of coursework on suicide prevention, before  
          being issued a license; and requires, commencing January 1,  
          2016, a person licensed in these professions or any applicant  
          for licensure who began graduate study prior to January 1, 2016,  
          to take a six-hour continuing education (CE) course on suicide  
          prevention in order to renew a license.

           ANALYSIS  :    
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          Existing law:

          1.Requires the Director of the Department of Consumer Affairs  
            (DCA), by regulation, to develop guidelines to prescribe  
            components for mandatory CE programs administered by any board  
            within DCA and requires that those guidelines ensure that  
            mandatory CE is used as a means to create a more competent  
            licensing population, thereby enhancing public protection.

          2.Establishes the Psychology Licensing Law which provides for  
            the licensure and regulation of licensed psychologists.

          3.Requires an applicant for licensure as a psychologist to  
            comply with the following requirements:  (a) not be subject to  
            denial, as specified; (b) possess an earned doctorate degree,  
            as specified; (c) have engaged for at least two years in  
            supervised professional experience under the direction of a  
            licensed psychologist, as specified; (d) take and pass an  
            examination, as specified; and (e) show by evidence  
            satisfactory to the Board of Psychology (BOP) that he/she has  
            completed training in the detection and treatment of alcohol  
            and other chemical dependency, as specified.

          4.Requires BOP to develop guidelines for the basic education and  
            training of psychologists whose practices include patients  
            with medical conditions and patients with mental and emotional  
            disorders who may require psychopharmacological treatment and  
            whose management may require collaboration with physicians and  
            other licensed prescribers, as specified.

          5.Establishes the Licensed Marriage and Family Therapy Act  
            administered by the Board of Behavioral Sciences (BBS) to  
            regulate MFTs and interns.

          6.Establishes the requirements of educational programs for  
            applicants for licensure as an MFT, as specified.

          7.Requires each educational institution preparing applicants to  
            qualify for registration or licensure to notify each of its  
            students by means of its public documents or otherwise in  
            writing that its degree program is designed to meet the  
            requirements, as specified, and certify to the BBS that it has  
            so notified its students.

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          8.Specifies that an applicant for registration or licensure  
            submit to the BBS a certification by the applicant's  
            educational institution that the institution's required  
            curriculum for graduation and any associated coursework  
            completed by the applicant meets specified requirements.

          9.Establishes the Licensed Educational Psychologists Practice  
            Act to regulate licensed educational psychologists (LEPs).

          10.States the practice of educational psychology is the  
            performance of any of the following professional functions  
            pertaining to academic learning processes or the educational  
            system or both:

             A.   Educational evaluation; 

             B.   Diagnosis of psychological disorders related to academic  
               learning processes;

             C.   Administration of diagnostic tests related to academic  
               learning processes including tests of academic ability,  
               learning patterns, achievement, motivation, and personality  
               factors;

             D.   Interpretation of diagnostic tests related to academic  
               learning processes including tests of academic ability,  
               learning patterns, achievement, motivation, and personality  
               factors;

             E.   Providing psychological counseling for individuals,  
               groups, and families;

             F.   Consultation with other educators and parents on issues  
               of social development and behavioral and academic  
               difficulties;

             G.   Conducting psychoeducational assessments for the  
               purposes of identifying special needs;

             H.   Developing treatment programs and strategies to address  
               problems of adjustment; and

             I.   Coordinating intervention strategies for management of  

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               individual crises.

          1.Requires an LEP seeking to renew his/her license to certify to  
            BBS, on a prescribed form, completion in the preceding two  
            years of not less than 36 hours of approved CE in, or relevant  
            to, educational psychology.

          2.Establishes the Clinical Social Worker Practice Act to license  
            and regulate licensed clinical social workers (LCSWs).

          3.Establishes the licensure requirements for an LCSW and  
            requires each applicant to furnish satisfactory evidence to  
            BBS that he/she has complied with specified requirements  
            including adequate instruction and training in the subjects of  
            alcoholism and other chemical substance dependency; spousal or  
            partner abuse assessment, detection, and intervention; human  
            sexuality, as specified; and child abuse assessment and  
            reporting, as specified.

          4.Requires an LCSW to complete CE coursework in aging and  
            long-term care, as specified.

          5.Establishes the Licensed Professional Clinical Counselor Act  
            to license and regulate professional clinical counselors  
            (PCCs).

          6.Establishes the licensure requirements for a PCC and requires  
            each applicant to furnish satisfactory evidence to BBS that  
            he/she has complied with specified education and practicum  
            requirements.

          7.Prohibits BBS from renewing a PCC license unless the applicant  
            certifies to BBS, on a form prescribed by BBS, that he/she has  
            completed not less than 36 hours of approved CE in, or  
            relevant to, the field of professional clinical counseling in  
            the preceding two-years, as specified.

          This bill:

           For Psychologists  :

          1.Requires an applicant for licensure as a psychologist, who  
            began graduate study on or after January 1, 2016, to complete  
            as a condition of licensure, a minimum of 15 contact hours of  

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            coursework in suicide assessment, treatment, and management  
            and prohibits BOP from issuing a license to a psychologist  
            applicant until the applicant has met the specified  
            educational requirements.

          2.Requires a licensed psychologist or any applicant for  
            licensure, who began graduate study prior to January 1, 2016,  
            to complete a six-hour continuing education course in best  
            practices for suicide assessment, treatment, and management  
            during his/her first renewal period, as specified, and submit  
            acceptable evidence to BOP of the person's satisfactory  
            completion of that course, and prohibits BOP from issuing a  
            license to a psychologist until the applicant has met the  
            specified educational requirements.

          3.Permits continuing education courses taken in suicide  
            assessment, treatment and management, to be applied to the 36  
            hours of approved continuing education required, as specified.

          4.Delays the implementation of the continuing education  
            requirement until January 1, 2016.

           For MFTs  :

          5.Requires a qualified applicant for licensure as an MFT, who  
            began graduate study on or after January 1, 2016, to complete,  
            as a condition of licensure, a minimum of 15 contact hours of  
            coursework in suicide assessment, treatment, and management.

          6.Requires an MFT or any applicant for licensure, who began  
            graduate study prior to January 1, 2016, to complete a  
            six-hour CE course in best practices for suicide assessment,  
            treatment, and management during his/her first renewal period,  
            as specified, and submit acceptable evidence to BBS of the  
            person's satisfactory completion of that course.

          7.Permits CE courses taken in suicide assessment, treatment, and  
            management, to be applied to the 36 hours of approved CE  
            required, as specified.

          8.Delays the implementation of the CE requirement until January  
            1, 2016.

           For LEPs  :

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           9.Requires an applicant for licensure as an educational  
            psychologist, who began graduate study on or after January 1,  
            2016, to complete as a condition of licensure, a minimum of 15  
            contact hours of coursework in suicide assessment, treatment,  
            and management and prohibits BBS from issuing a license to an  
            educational psychologist until the applicant has met the  
            specified educational requirements.

          10.Requires an LEP or any applicant for licensure, who began  
            graduate study prior to January 1, 2016, to complete a  
            six-hour CE course in best practices for suicide assessment,  
            treatment, and management during his/her first renewal period,  
            as specified, and submit acceptable evidence to BBS of the  
            person's satisfactory completion of that course.

          11.Permits CE courses taken in suicide assessment, treatment,  
            and management, to be applied to the 36 hours of approved CE  
            required, as specified.

          12.Delays the implementation of the CE requirement until January  
            1, 2016.

           For LCSWs  :

          13.Requires an applicant for licensure as a clinical social  
            worker, who began graduate study on or after January 1, 2016,  
            to complete as a condition of licensure, a minimum of 15  
            contact hours of coursework in suicide assessment, treatment,  
            and management and prohibits BBS from issuing a license to a  
            social worker until the applicant has met the specified  
            educational requirements.

          14.Requires an LCSW or any applicant for licensure, who began  
            graduate study prior to January 1, 2016, to complete a  
            six-hour CE course in best practices for suicide assessment,  
            treatment, and management during his/her first renewal period,  
            as specified, and submit acceptable evidence to BBS of the  
            person's satisfactory completion of that course.

          15.Permits CE courses taken in suicide assessment, treatment,  
            and management, to be applied to the 36 hours of approved CE  
            required, as specified.


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          16.Delays the implementation of the CE requirement until January  
            1, 2016.

           For LPCCs  :

          17.Requires a qualified applicant for licensure as a  
            professional clinical counselor, who began graduate study on  
            or after January 1, 2016, to complete, as a condition of  
            licensure, a minimum of 15 contact hours of coursework in  
            suicide assessment, treatment, and management.

          18.Requires a PCC or any applicant for licensure, who began  
            graduate study prior to January 1, 2016, to complete a  
            six-hour CE course in best practices for suicide assessment,  
            treatment, and management during his/her first renewal period,  
            as specified, and submit acceptable evidence to BBS of the  
            person's satisfactory completion of that course.

          19.Permits CE courses taken in suicide assessment, treatment,  
            and management, to be applied to the 36 hours of approved CE  
            required, as specified.

          20.Delays the implementation of the CE requirement until January  
            1, 2016.

           Background
           
          According to the Senate Business, Professions and Economic  
          Development Committee analysis, this chart reflects the  
          requirements for the mental health practitioners that will be  
          affected by this bill.  With the exception of the law and ethics  
          courses, which must be repeated upon renewal of one's license,  
          all others are one-time pre-requisites for licensure.

           
           -------------------------------------------------------------- 
          |     Courses      |Psychologis| LCSWs | LMFTs | LPCCs | LEPs  |
          |                  |    ts     |       |       |       |       |
          |------------------+-----------+-------+-------+-------+-------|
          |Human Sexuality   | 10 hours  |  10   |  10   |  10   |  n/a  |
          |                  |           | hours | hours | hours |       |
          |------------------+-----------+-------+-------+-------+-------|
          |Alcoholism/       |    one    |  15   |  15   |  15   |  15   |
          |Chemical          |quarter or | hours | hours | hours | hours |

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          |Dependence        | semester  |       |       |       |       |
          |                  |   long    |       |       |       |       |
          |                  |  course   |       |       |       |       |
          |------------------+-----------+-------+-------+-------+-------|
          |Child Abuse       |  7 hours  |7      |7      |7      |7      |
          |                  |           |   hours|   hours|   hours|   hours|
          |------------------+-----------+-------+-------+-------+-------|
          |Spousal/Partner   | 15 hours  |7      |7      |7      |  n/a  |
          |Abuse             |           |   hours|   hours|   hours|       |
          |------------------+-----------+-------+-------+-------+-------|
          |Aging/Long-Term   | 10 hours  |3      |7      |7      |n/a    |
          |Care              |           |   hours|   hours|   hours|       |
          |------------------+-----------+-------+-------+-------+-------|
          |HIV/AIDS          |    n/a    |7      |7      |7      |n/a    |
          |                  |           |   hours|   hours|   hours|       |
           -------------------------------------------------------------- 
           
           Comments
           
          According to the author, "Currently there are numerous  
          requirements in California Business and Professions Code  
          governing graduate and continuing education requirements.  There  
          is however no specific law in California that requires graduate  
          training or continuing education in suicide assessment?AB 2198  
          will lead to lives being saved through mental health  
          professionals identifying suicidal intentions before they become  
          life threatening."

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  7/31/14)

          American Foundation for Suicide Prevention
          American Foundation for Suicide Prevention California Chapters
          American Foundation for Suicide Prevention Greater San Francisco  
          Bay Area                                                     
          Chapter
          Asian Americans for Community Involvement
          Association of California Healthcare Districts
          California Association of Local Mental Health Boards and  
          Commissions
          California Catholic Conference of Bishops
          California Federation of Teachers

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          California Institute for Mental Health
          California Mental Health Directors Association
          California Professional Firefighters
          California State Sheriffs' Association
          Caltrain
          Community Solutions
          Didi Hirsch Mental Health Services
          El Camino Hospital
          Family & Children Services of Silicon Valley
          Momentum for Mental Health 
          NAMI (National Alliance on Mental Illness) California
          NAMI Santa Clara County Board of Directors
          NAMI Santa Cruz
          Veterans Caucus for the California Democratic Party

           OPPOSITION  :    (Verified  7/31/14)

          Alameda County Psychological Association
          Board of Behavioral Sciences
          Board of Psychology
          California Association for Licensed Professional Clinical  
          Counselors
          California Association of Marriage and Family Therapists
          California Psychological Association
          National Association of Social Workers- California Chapter
          San Gabriel Valley Psychological Association
          San Joaquin Valley Psychological Association

           ARGUMENTS IN SUPPORT  :    The National Alliance on Mental Illness  
          (NAMI) Santa Clara County Board of Directors, Community  
          Solutions, California Institute for Mental Health and Momentum  
          for Mental Health similarly write, "?numerous individuals and  
          professionals in California are being trained to recognize signs  
          of suicide; however, no similar requirement mandates that the  
          people being referred, i.e., our mental health professionals,  
          are competently trained.  Patient safety should be paramount and  
          excellent suicide assessment, treatment and management of  
          professionals must always be ensured."

          NAMI California writes, "By creating standards for suicide  
          prevention training for specified mental health professionals,  
          we can ensure that these mental health professionals providing  
          services to individuals living with mental illness are in a  
          position to identify and address potential signs that the  

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          patient is at risk of death by suicide."

          The California Catholic Conference of Bishops writes, "?mental  
          health professionals are on the front lines.  It makes good  
          sense and quality public policy to provide them with effective  
          training and tools for assessing and treating those that seek  
          their help."

           ARGUMENTS IN OPPOSITION  :    The California Psychological  
          Association writes, "There currently exist a number of mandated  
          CEs on psychologists, including law and ethics, domestic  
          violence, and aging and long-term care- all of these originated  
          on a piecemeal basis.  Moving towards a mandated CE will  
          increase the burden of professionals in this area, and will not  
          allow them to take other CE courses in areas that may be more  
          appropriate to their specialty.  The mandated CE creates less  
          room for other worthy topics such as multiculturalism, advance  
          in cognitive behavior therapy, current trends in family courts  
          and child custody proceeding, and new information on  
          psychopharmacology (to list a few)."

          The Board of Psychology writes, "The Board is aware that suicide  
          is an extremely important topic that has touched the lives of  
          many families in our state.  The Board is committed to educating  
          our licensees and the general public on this issue via various  
          outreach and educational tools.  The Board does not believe,  
          however, that AB 2198 is the appropriate vehicle for achieving  
          competence in this area.  Specifically, the Board opposes the  
          bill for the following reasons;

           The coursework and CE hours mandated in the bill will not help  
            a licensee achieve competence in the area of suicide  
            assessment, prevention and training.  The Board is concerned  
            that attending a six-hour course may provide a false sense of  
            subject area mastery to a licensee.

           Suicide assessment, prevention and training is currently  
            integrated into the curriculum of most graduate training  
            programs.  Additionally, suicide assessment is a knowledge  
            point tested in both the national and state examinations.

           The Board is opposed to CE courses being mandated by the  
            Legislature when the Board, is better positioned to determine  
            what areas of study will further their professional  

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            development."

           ASSEMBLY FLOOR  :  47-11, 5/19/14
          AYES:  Achadjian, Alejo, Ammiano, Bigelow, Bloom, Bocanegra,  
            Bonilla, Bonta, Bradford, Ian Calderon, Campos, Chau, Chesbro,  
            Cooley, Dahle, Daly, Fong, Fox, Gatto, Gomez, Gonzalez,  
            Gordon, Gray, Hagman, Hall, Holden, Jones-Sawyer, Levine,  
            Linder, Logue, Maienschein, Medina, Mullin, Muratsuchi, Perea,  
            V. Manuel P�rez, Quirk-Silva, Rendon, Ridley-Thomas,  
            Rodriguez, Salas, Stone, Ting, Wagner, Wieckowski, Wilk,  
            Atkins
          NOES:  Ch�vez, Eggman, Beth Gaines, Garcia, Grove, Harkey,  
            Jones, Olsen, Pan, Patterson, Williams
          NO VOTE RECORDED:  Allen, Brown, Buchanan, Conway, Dababneh,  
            Dickinson, Donnelly, Frazier, Gorell, Roger Hern�ndez,  
            Lowenthal, Mansoor, Melendez, Nazarian, Nestande, John A.  
            P�rez, Quirk, Skinner, Waldron, Weber, Yamada, Vacancy


          MW:e  8/6/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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