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March 19, 2010

California Bills Regarding MFT and LCS Licenses and CAMFT Position

Unpaid Taxes Effect on Licensees

ABX8 8 (Committee on Budget)



This bill, among other provisions, would require the Franchise Tax Board, should an individual licensee fail to pay taxes, to send a notice of suspension of license. The bill provides that the licensee who fails to satisfy the unpaid taxes by a specified date shall automatically have his/her license suspended. CAMFT has joined with a coalition to oppose this bill.



Child Custody and Visitation

AB 612 (Beall)



This bill, as introduced, would have prohibited a court from considering a nonscientific theory in making a determination regarding child custody or visitation with a child. It would also have prohibited a court from considering or receiving into evidence a report, assessment, evaluation, or investigation if it included a nonscientific theory. CAMFT’s position on the bill was “oppose unless amended.” The bill was later amended in a way that we no longer opposed, providing that a child’s expression of significant hostility toward a parent may be admitted as possible corroborating evidence that the parent has abused the child. The amendment prohibited a court from concluding that an accusation of child physical or sexual abuse against a parent is false based solely on the child’s expression of significant hostility toward the parent. But, this amendment was merely a maneuver to get it out of a committee. As soon as the bill progressed, the offensive language was restored and we are once again opposed. This bill is a two-year bill.



Medi-Cal Reimbursement for Same-Day Visits

AB 1445 (Chesbro)



This bill, sponsored by the California Primary Care Association, would provide that a MediCal patient could seek treatment on the same day from more than one health care provider and the providers’ services would be reimbursed. CAMFT is in support of this legislation. This bill is a two-year bill.



MediCal: Alcohol and Drug Screening and Brief Intervention Services

AB 1599 (Beall)

This bill would establish the MediCal Alcohol and Drug Screening and Brief intervention Services Program, which would be administered in consultation with the State Department of Alcohol and Drug Programs. Its purpose would be to increase the state’s ability to make alcohol and drug screening and brief intervention services available to MediCal beneficiaries who are pregnant or of childbearing age. This bill would provide that participating in the program would be voluntary for MediCal beneficiaries. The results of any screening under the program would be confidential. CAMFT is watching this bill at this time.



Parity for Mental Health Care Services

AB 1600 (Beall)



This bill would expand mental health care coverage for certain health care service plans and health insurance issued, amended, or renewed on or after January 1, 2011, to include mental disorders defined in the DSM IV. There has been similar legislation in the two prior years that has been vetoed by the Governor. This legislation goes hand in hand with the Federal Parity law and expands on the existing California parity law that only covers severe mental and emotional disorders of adults and children. CAMFT is in support of this legislation.



Out of State Insurance Carriers

AB 1904 (Villines)



This bill would allow an insurance carrier from out of state to offer, sell, or renew a health care service plan or a health insurance policy in California without holding a license in the state of California . This bill, if successful, would be problematic for MFTs seeking reimbursement from such plans. Due to legislation that CAMFT sponsored in the 80s, out of state insurance companies are required by law to reimburse MFTs. Because they are required, if doing business in California , to abide by California law, which means that they must be licensed to do business in California . We are opposed to this bill, but we are told that the bill is not likely to move forward. There is a companion bill in the Senate as well.



Clinical Social Worker Examinations

AB 2167 (Nava)



This bill would, on and after January 1, 2014, require the Board of Behavioral Sciences to issue a license to each applicant who successfully passes the Social Work National Exam. In other words, if this legislation passes, aspiring clinical social workers would no longer take state-developed examinations, and they would instead take the examination that is used throughout the rest of the country. This change would allow LCSW licentiates in California to compete for federal loan reimbursements, which they are not currently eligible for because of the state specific examinations. CAMFT is watching this bill.



Retired License for Licensees of the BBS

AB 2191 (Emmerson)



This bill would permit persons who are licensed by the BBS to acquire a “retired” license if they choose to. Such a person would not be permitted to engage in any activity for which a license is required. The retired license fee would be nominal at only $40 for the remainder of one’s life. It would be permissible to restore the license to active state, if eligible, by paying the required fees, completing the required mandatory continuing education, and taking the required examinations if more than five years have passed since electing the retired status. If fewer than five years have passed, examinations would not be required. (The bill currently says three years, but the BBS has committed to increase this exception to five years.) CAMFT is watching this legislation. We do have concerns about licensees electing the retired status who may at a later time return to practice. If there is such a possibility of returning to practice, we would encourage the licentiate to elect to have an inactive license during the period of inaction because examinations would not be required upon re-activation.



Repeal of Antiquated Law Regarding Research on Homosexuality

AB 2199 (Lowenthal)



CAMFT has taken a position of support on this legislation that would repeal an antiquated section of law that provided for research regarding the causes and cures of homosexuality.



Child Abuse and Neglect Reporting Act

AB 2380 (Lowenthal)



This bill, among other things, adds further clarification in the Child Abuse and Neglect Reporting Act with regard to the meaning of “reasonable suspicion.” Existing law says that “. . . ‘reasonable suspicion’ means that it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect.” Added to this definition would be the following: “‘Reasonable suspicion’ does not require certain knowledge that child abuse or neglect has occurred nor does it require a specific medical indication of child abuse or neglect; any ‘reasonable suspicion’ is sufficient. ‘Reasonable suspicion’ may be based on any information considered credible by the reporter, including hearsay.” CAMFT is watching this bill at this time.



Continuing Education and other Requirements with regard to Elder and Dependent Adult Abuse and Older Adults

(AB 2435) Lowenthal



CAMFT’s position on this bill is “oppose unless amended.” The bill appears to be intended to affect the professions of marriage and family therapists, clinical social workers, and psychologists, but at this time appears to be solely directed at marriage and family therapists. If such legislation is warranted, we believe it should be equally applied across all of the mental health disciplines. We further object in that there appears to be no intent to affect physicians or other health care professionals and we are curious as to why not. It is also not applicable to professional clinical counselors who will also be regulated by the effective date of the proposed implementation of this legislation.



The bill proposes that elder and dependent adult abuse be added to the seven hour requirement for continuing education in child abuse assessment and reporting. The manner in which the bill proposes to add the requirement to provide for training in elder and dependent adult abuse is confusing and will result in an inability to enforce what is intended. All persons who are already licensed, as well as many who are pursuing licensure, have already fulfilled the requirement to have had training in child abuse assessment and reporting. Placing the new requirement to get training in elder and dependent adult abuse assessment and reporting within this previously existing requirement for training in child abuse and assessment confounds the situation and professionals will not be able to interpret what it is they are supposed to do, i.e., are they to take a new seven hour training that combines the content for both child abuse and elder abuse, or are they to take a three and one-half hour course in elder and dependent adult abuse, which is half of the total requirement?



While we have expressed that we are not necessarily adverse to a requirement for professionals to be knowledgeable about the reporting of elder and dependent adult abuse, as long as equally applied across the professions, this legislation needs to be clear as to what is expected. At this point, it is not. The bill does not address persons who have already taken such courses, or taught such courses, or who have had the content adequately addressed in the content of other courses. This content is typically covered in law and ethics courses and human development courses that cover the lifespan of individuals and families.

The bill proposes changing the name of one (and only one) of the degrees that may qualify for licensure as a marriage and family therapist. Such a change would place a hardship on schools that may have difficulty rapidly changing the title of their degree programs. Adding the term “older adult” without a definition as to what is meant by such a term is also problematic. We would request that this term be removed from the degree title.



The legislation proposes that the 500 required hours of experience for marriage and family therapists in working with couples, families, and children be expanded to include older adults. Again, “older adults” is not defined. Further, while we do not object to required education in working with persons who are aging, we do not want to see the essence and focus of the profession changed. This profession was known as “marriage, family and child counselors” from 1964 until 1999 and then became “marriage and family therapists.” Working with couples, families, and children is at the core of the discipline and of course includes working with persons who are aging, as they too are a part of family systems. We therefore have requested that the focus of these hours not be changed. Additionally, if there were to be such a change in the marriage and family therapist requirements, it should be equally imposed upon the other disciplines and provide greater specificity as to what is intended by the term “older adults.”



Further, persons pursuing the MFT license are currently required to have had ten contact hours of education in working with the elderly and long term care, and those already licensed prior to the effective date of this requirement were required to gain three contact hours in working with the elderly and long term care.



Unpaid Taxes Effect on Licensees

SBX8 8 (Committee on Budget)



This bill like its Assembly companion, among other provisions, would require the Franchise Tax Board, should an individual licensee fails to pay taxes, to send a notice of suspension of license. The bill provides that the licensee who fails to satisfy the unpaid taxes by a specified date shall automatically have his/her license suspended. CAMFT has joined with a coalition to oppose this bill.



Health Care Coverage and Benefits

SB 316 (Alquist)



This bill would have required full service health care service plans and health insurers to expend on health care benefits no less than 85 percent of the fees/premiums collected for policies issued, amended, or renewed on or after January 1, 2011. CAMFT is in support of this legislation. This bill is a two-year bill.



Regulatory Boards

(SB 1111) Negrette McLeod



This is a lengthy and multi-faceted bill that has numerous objectionable provisions. We are generally opposed to the bill and will be working individually and collectively with the other disciplines to modify the objectionable provisions. The purpose of the bill, generally speaking, is to “clean up” enforcement throughout the many Boards, Bureaus, and Committees under the umbrella of the Department of Consumer Affairs. The Department and Administration, rightfully so, are concerned about the excessive amount of time it takes to investigate and prosecute disciplinary actions. These actions, on average, are taking three years to bring to fruition. Of course, both consumers and licensees have an interest in swift resolution of complaints and disciplinary actions. Further, the state’s budget likely exacerbates the delays as a result of cuts within licensing boards, the California Department of Consumer Affairs Division of Investigations (DofI), and the Attorney General’s (AG) office. This bill is seeking to improve efficiency and accountability specifically within the healing arts boards.



One of the changes being sought would require a person who is disciplined to pay to the licensing board the actual costs for the investigation, prosecution, and enforcement of the case. These costs include, but are not limited to, attorneys, expert consultants, witnesses, administrative filing and service fees, and any other fees associated with the prosecution of the case. Currently the licensee, as determined by the administrative law judge, is ordered to pay the “reasonable” costs of the investigation and enforcement of the case. Changing reasonable to actual provides no incentive to the board, the DofI, or the AG’s office to be judicious in how it handles these matters. If they drag cases on for years and years, engage in actions that violate the law or due process rights, and/or needlessly pursue wild goose chases, the licentiate should not be held responsible for such costs. These costs are generally payable 30 days after the effective date of the order and there appears to be no opportunity to challenge the costs as determined.



The bill would give additional authority to the executive officer of the licensing board in many cases. For example, the executive officer would, in some situations, be given the authority to adopt a proposed default decision or adopt a proposed settlement agreement, without such action going to the board. The bill would allow the executive officer of a board, where the licentiate has failed to comply with a request to inspect or copy records, to petition the director to issue a temporary order that the licensee cease all practice and activities that require a license. In such case, the executive officer would be required, to the extent practicable, to provide telephonic, electronic mail, message, or facsimile written notice to the licensee of a hearing on such a petition at least 24 hours prior to the hearing.



The bill seems to confuse confidentiality and privilege. The bill seems to say that the provisions of privileged communications (should be confidentiality when speaking of communications between licensees and their clients) shall not apply to investigations or proceedings conducted by a healing arts board. The board and its agents are expected to maintain confidentiality, but they would have the authority to examine records in the licensee’s office in certain circumstances, apparently without authorization. The psychotherapist-patient privilege belongs to the patient and only the patient should be able to waive the privilege—not a licensing board. The bill provides, “Any document relevant to the business operations of a licensee, and not involving medical records attributable to identifiable patients, may be inspected and copied where relevant to an investigation of a licensee.”



The bill provides that a licensee shall cooperate with the licensing board and sets forth severe financial penalties for those who are deemed to be uncooperative. In such a circumstance, it may not be in the licensee’s best interest to cooperate in order to defend oneself. Such an expectation is unreasonable.



Requirement for Healing Arts Practitioners to Wear Name Tags

(SB 1132) Negrete McLeod



This is a “spot bill” surrounding legislation that has passed in prior years. Existing law requires healing arts practitioners to wear name tags while working that disclose names and license status in at least 18-point type. This requirement is not applicable to health care practitioners working in a practice or an office where a license is prominently displayed. Existing law further provides that if a health care practitioner or a licensed clinical social worker is working in a psychiatric setting or in a setting that is not licensed by the state, the employing entity or agency shall have the discretion to make an exception from the name tag requirement for individual safety or therapeutic reasons. CAMFT is watching this legislation that could become more expansive requiring practitioners to wear name tags.



Restrictions on Advertising and Designations of Licensees

(SB 1150) Negrete McLeod



At this time this bill is not applicable to MFTs, but we are nevertheless watching the bill very closely to see what it will become. The bill, among other things, would require a number of professionals, when advertising, to list the abbreviations for the licenses held immediately after their names. Among other things, the bill would require psychologists to include the designation “Ph.D.” immediately after their names. Of course, the bill is incorrect with regard to psychologists because the supposed required designation is a degree and not a license. The purpose of this legislation may be directed, to some degree, at the potential misleading use of “Dr.” preceding the name of a professional, since such a representation is limited to use by physicians.
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This work is licensed under a Creative Commons Attribution 3.0 Unported License.