BILL ANALYSIS                                                                                                                                                                                                    �



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          Date of Hearing:   June 17, 2014

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER  
                                     PROTECTION
                               Susan A. Bonilla, Chair
                    SB 1012 (Wyland) - As Amended:  June 11, 2014

           SENATE VOTE  :   37-0
           
          SUBJECT  :   Healing arts: licensure requirements.

           SUMMARY  :   Increases from five to six the number of hours which  
          a marriage and family therapist (MFT) trainee or intern, and a  
          professional clinical counselor (PCC) intern, may count towards  
          their weekly supervision requirement.   Specifically,  this bill  :

          1)Increases the number of hours from five to six which a MFT  
            trainee or intern may count towards his or her weekly  
            supervision requirements, and permits those supervision hours  
            to be gained on or after January 1, 2009, rather than 2010 as  
            existing law permits.

          2)Prohibits a MFT trainee from getting credit for more than six  
            hours of supervision, whether in an individual or group  
            setting, towards his or her weekly supervision requirements.

          3)Increases the number of hours from five to six which a PCC  
            intern may count towards his or her weekly supervision  
            requirements. 

           EXISTING LAW:  

          1)Provides for the licensure, registration and regulation of  
            MFTs by the Board of Behavioral Sciences (BBS).  (Business and  
            Professions Code (BPC) Section 4980 et seq)

          2)Defines the practice of marriage and family therapy to mean  
            "that service performed with individuals, couples, or groups  
            wherein interpersonal relationships are examined for the  
            purpose of achieving more adequate, satisfying and productive  
            marriage and family adjustments, as specified."  (BPC 4980.02)

          3)Defines an MFT "intern" to mean "an unlicensed person who has  
            earned his or her master's or doctor's degree qualifying him  
            or her for licensure and is registered with BBS."  (BPC  








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            4980.03(b))

          4)Defines an MFT "trainee" to mean "an unlicensed person who is  
            currently enrolled in a master's or doctor's degree program,  
            as specified, 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."  (BPC 4980.03(c))

          5)Defines "experience" to mean "experience in interpersonal  
            relationships, psychotherapy, marriage and family therapy, and  
            professional enrichment activities that satisfies the  
            requirement for licensure, as specified."  (BPC 4980.03(f)) 

          6)Requires an MFT applicant for licensure to complete the  
            following: 

             a)   A minimum of 3,000 hours completed during a period of at  
               least 104 weeks;

             b)   Not more than 40 hours in any seven consecutive days;

             c)   Not less than 1,700 hours of supervised experience  
               completed subsequent to the granting of the qualifying  
               master's or doctoral degree;

             d)   Not more than 1,300 hours of supervised experience  
               obtained prior to completing a master's or doctoral degree,  
               and the applicant cannot be credited with more than 750  
               hours of counseling and direct supervision contact prior to  
               completing the master's or doctoral degree;

             e)   No hours of supervised experience may be grained prior  
               to completing either 12 semester units or 18 quarter units  
               or graduate instruction and becoming a trainee except for  
               personal psychotherapy; and,

             f)   No hours of experience may be gained more than six years  
               prior to the date the application of examination  
               eligibility was filed, except that up to 500 hours of  
               clinical experience gained in the supervised practicum  
               required as specified.  (BPC 4980.43(a))

          7)Defines "one hour of direct supervisor contact" to mean "one  
            hour per week of face-to-face contact on an individual basis  








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            or two hours per week of face-to-face contact in a group."   
            (BPC 4980.43 (c)(2))

          8)Provides for the licensure, registration and regulation of  
            PCCs by BBS.  (BPC 4999.10 et seq)

          9)Defines "professional clinical counseling" to mean "the  
            application of counseling interventions and psychotherapeutic  
            techniques to identify and remediate cognitive, mental, and  
            emotional issues, including personal growth, adjustment to  
            disability, crisis intervention, and psychological and  
            environmental problems, and the use, application and  
            integration of the coursework and training, as specified."   
            (BPC 4999.20(a)(1))

          10)Defines a PCC "intern" to mean "an unlicensed person, who  
            meets specified requirements, and is registered with the  
            board."  (BPC 4999.12(f))

          11)Defines "clinical counselor trainee" to mean "an unlicensed  
            person who is currently enrolled in a master's or doctoral  
            degree program, as specified, 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."  (BPC 4999.12(g))

          12)Requires, prior to applying for the licensure examination,  
            applicants for licensure as a PCC to complete clinical mental  
            health experience under the general supervision of an approved  
            supervisor which shall include a minimum of 3,000 post-degree  
            hours or supervised clinical mental health experience related  
            to the practice of professional clinical counseling, performed  
            over a period of  not less than two years and includes:

             a)   Not more than 40 hours in any seven consecutive days;

             b)   Not less than 1,750 hours of direct counseling with  
               individuals, groups, couples, or families in a specified  
               setting using a variety of psychotherapeutic techniques and  
               recognized counseling interventions within the scope of  
               practice of licensed professional clinical counselors;

             c)   Not more than 500 hours of experience providing group  
               therapy or group counseling;









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             d)   Not more than 375 hours of experience providing personal  
               psychotherapy, crisis counseling, or other counseling  
               services via telehealth, as specified;

             e)   Not less than 150 hours of clinical experience in a  
               hospital or community mental health setting, as specified;

             f)   Not more than a combined total of 1,250 hours of  
               experience in the following related activities:

               i)     Direct supervisor contact;

               ii)    Client centered advocacy;

               iii)   Not more than 250 hours of experience administering  
                 tests and evaluating psychological tests of clients,  
                 writing clinical reports, writing progress notes, or  
                 writing process notes; and, 

               iv)    Not more than 250 hours of verified attendance at  
                 workshops, seminars, training sessions, or conferences  
                 directly related to professional clinical counseling that  
                 are approved by the applicant's supervisor; and,

             g)   No hours of clinical mental health experience may be  
               gained more than six years prior to the date the  
               application for examination eligibility was filed.  (BPC  
               4999.46)


           FISCAL EFFECT  :   None.  This bill is keyed non-fiscal by the  
          Legislative Counsel.

           COMMENTS  :   

           1)Purpose of the bill  .  This bill increases from five to six the  
            number of supervised hours that an applicant for licensure as  
            an MFT or PCC can count towards his or her weekly supervised  
            hour requirement, in an effort to accelerate the licensure  
            process and get more professionals into practice.  This bill  
            also clarifies that both MFT trainees and interns are eligible  
            to accumulate the six hours of weekly direct supervisor  
            contact, and that this bill retroactively applies this number  
            to individuals who gained hours on or after January 1, 2009.   
            This bill is sponsored by the author.  








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          2)Author's statement  .  According to the author, "MFT trainees  
            must receive an average of at least one hour of direct  
            supervisor contact for every five hours of client counseling  
            in each setting, and MFT interns must receive at least one  
            additional hour of direct supervisor contact for every week in  
            which more than 10 hours of client counseling is gained in  
            each setting.  Additionally, 'one hour of direct supervisor  
            contact' is defined as one hour per week of face-to-face  
            contact on an individual basis with a supervisor or two hours  
            per week of face-to-face contact in a group.

            "There are many cases [in which] interns are acquiring more  
            hours than they can count toward the requirement, as they work  
            at multiple counseling sites. LMFTs must obtain 3,000 hours of  
            experience in order to gain licensure, and no more than 1,000  
            of the required hours can be gained from direct supervisor  
            contact. However, in a given week many trainees and interns  
            accumulate more than the 5-hour cap on supervised hours.  This  
            bill will allow LMFT [and LPCC] trainees and interns to be  
            able to count an additional supervised hour each week toward  
            their licensure." 

           3)Marriage and Family Therapists  .  MFTs are employed in clinics,  
            counseling centers and private practice.  They use counseling  
            or psychotherapeutic techniques to assist individuals,  
            couples, families, and groups with a focus on marriage and  
            family relationship issues.  The minimum educational and  
            experience requirements for MFTs include a master's degree in  
            an area such as marriage, family, and child counseling,  
            marriage and family therapy, couple and family therapy,  
            psychology, clinical psychology, or counseling psychology from  
            an accredited school.  

          In addition, MFTs must complete supervised work experience of at  
            least 3,000 hours within a period of two years.  In order to  
            accumulate supervised hours, a person must register with BBS  
            as an intern or function as a trainee.  Trainees are  
            individuals who have been enrolled in MFT graduate programs  
            and who have completed at least 12 semester or 18 quarter  
            units of coursework.  Interns have earned the appropriate  
            graduate degree and registered with BBS, but have not taken  
            the examination.  In 2013, there were over 32,000 MFTs and  
            more than 15,000 MFT interns.  This bill explicitly authorizes  
            MFT trainees to accumulate the same number of direct  








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            supervision hours as interns.  

           4)Professional Clinical Counselors  . PCCs apply counseling  
            interventions and psychotherapeutic techniques to identify and  
            remediate cognitive, mental and emotional issues including  
            personal growth, adjustment to disability, crisis intervention  
            and psychosocial and environmental problems.  LPCCs are  
            required to meet specific educational standards including a  
            master's degree in an approved subject, and are required to  
            obtain supervised work experience as an intern amounting to at  
            least 3,000 hours.  

          Because PCCs are largely comparable to LMFTs, SB 146 (Wyland),  
            Chapter 381, Statutes of 2011, amended code sections so that  
            the same substantive provisions and requirements would apply  
            to LPCCs and MFTs.  

           5)Supervision requirements for trainees and interns  .  Current  
            law requires both interns and trainees to obtain 3,000 hours  
            of supervised work experience within a period of at least two  
            years.  Not more than 1,300 hours of supervised experience may  
            be obtained prior to completing the master's or doctoral  
            degree, and not less than 1,700 hours of experience may be  
            completed subsequent to the granting of the qualifying degree.  
             MFT Interns are not permitted to receive more than 1,000 of  
            the required hours of experience from direct supervisor  
            contact.  

          Direct supervisor contact is defined as one hour per week of  
            face-to-face contact in individual supervision or two hours  
            per week of face-to-face contact in a group supervision  
            setting.  Interns are permitted to receive an additional hour  
            of direct supervision for every week in which more than 10  
            hours of client contact is gained in each setting and no more  
            than five hours of supervision, whether individual or group,  
            can be counted per week.   Trainees must receive an average of  
            one hour of direct supervisor contact for every five hours of  
            clinical work with clients.  Interns must receive at least one  
            additional hour of direct supervisor contact for every week in  
            which more than 10 hours of client counseling is gained.  
             
             This bill seeks to increase the number of hours from five to  
            six that an MFT and PCC intern or MFT trainee can count  
            towards his or her required hours of supervision.  Because  
            individuals have up to six years to obtain the required hours  








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            of direct supervision, this bill would authorize individuals  
            who gained experience on or after January 1, 2009, to be able  
            to count six hours of direct supervision towards the hour  
            requirement.  

            Because MFT and PCC applicants have six years to complete the  
            supervised hour requirements, it is necessary to retroactively  
            apply this bill to 2009, in order for any hours earned prior  
            to 2015, to not be counted differently, which could slow down  
            the evaluation process and create licensing delays. 

           6)Arguments in support  .  According to the California Association  
            of Marriage and Family Therapists, "The purpose of this bill  
            is to remove the arbitrary limitation on the number of  
            supervisor contact hours [MFT] trainees and registered interns  
            may be credited toward licensure during a single week.   
            Increasing this limitation is to allow [MFT] trainees and  
            registered interns to count more of the supervisor contact  
            hours they actually obtain, which will result in many of these  
            applicants being able to complete their hours of experience in  
            a timelier fashion." 
           
          7)Arguments in opposition  .  There is no opposition on file. 
           
          8)Previous legislation  .  SB 632 (Emmerson) Chapter 50, Statutes  
            of 2012, clarifies which MFT trainees are allowed to counsel  
            clients outside of a practicum course, and clarifies a limited  
            exemption for trainees who are not allowed to counsel clients  
            outside of a practicum course.  

            SB 363 (Emmerson) Chapter 384, Statutes of 2011, authorizes,  
            among other things, MFT trainees to counsel clients while not  
            enrolled in a practicum if the period of lapsed enrollment is  
            less than 90 calendar days and is immediately preceded and  
            immediately followed by enrollment in a practicum course.

            AB 956 (Roger Hern�ndez) Chapter 166, Statutes of 2011,  
            requires a marriage and family therapist intern and a marriage  
            and family therapist 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 requires  
            any advertisement by or on behalf of an intern or trainee to  
            include specified information; requires an intern's  
            registration number to be disclosed to clients and patients  








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            and in advertisements.

            SB 33 (Correa) Chapter 26, Statutes of 2009, updates and  
            recasts the educational curriculum requirements for marriage  
            and family therapists to require persons who begin graduate  
            study after August 1, 2012 to meet increased total unit  
            requirements, increases practicum hours for face-to-face  
            counseling, integrates specified elements, including public  
            mental health practices, throughout the curriculum, repeals  
            current marriage and family therapist educational requirements  
            on January 1, 2019, revises requirements for applicants  
            licensed or educated outside of California, and makes  
            technical and conforming changes.

            AB 2552 (Leno) Chapter 204, Statutes of 2004, makes various  
            changes to the body of law licensing MFTs, including  
            clarifying the circumstances under which an applicant for an  
            MFT license is obligated to take and pass a clinical vignette  
            written examination, and provides specificity as to how an MFT  
            intern working in a private practice can get supervision and  
            count hours when the private practice supervisor is  
            unavailable due to vacation or illness. 
             
          REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          California Association of Marriage and Family Therapists
           
            Opposition 
           
          None on file. 

           Analysis Prepared by  :    Elissa Silva / B.,P. & C.P. / (916)  
          319-3301