Brief(1)
H.B. 2213 amends a series of statutes that concern professional counselors, social workers, marriage and family therapists, licensed psychologists, and licensed masters level psychologists, all of whom are licensed by the Behavioral Sciences Regulatory Board.
In terms of policy changes, the bill, as amended by Senate Committee, creates a new clinical level of credentialing for professional counselors, marriage and family therapists, and masters level psychologists, restricts independent practice to the clinical level of provider, and authorizes the clinical level licensee to engage in the diagnosis and treatment of mental disorders listed in the edition specified by the Behavioral Sciences Regulatory Board of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. The Senate Committee amendments change the title "licensed clinical masters level psychologist" to "licensed clinical psychotherapist."
The Senate Committee also amended each of the practice acts included in the bill to require any mental health practitioner licensed by the Behavioral Sciences Regulatory Board, at the beginning of a client-provider relationship, to inform the client of (1) the level of the licensee's training, (2) the title or titles and the license or licenses held by the provider, (3) whether the licensee has a masters or doctoral degree and, if the licensee has a doctoral degree, whether such degree is a doctor of medicine degree or some other degree, and (4) if the provider does not have a doctor of medicine degree, disclose the licensee is not authorized to practice medicine and surgery or to prescribe drugs. As a part of the mandated disclosure the licensee must inform the client that certain mental disorders can have medical or biological origins and that the client should consult with a physician. Documentation of the required disclosures is to be included in the client's records.
The Senate Committee further amended H.B. 2213 to require professional counselors, specialist clinical social workers, licensed masters social workers, licensed clinical marriage and family therapists, certain licensed psychologists, and licensed clinical psychotherapists, when a client has symptoms of a mental disorder, to consult with the client's primary care physician or psychiatrist to determine if there may be a medical condition or medication that may be causing or contributing to the client's symptoms of mental disorder. A client may request in writing that such consultation be waived. A request to waive the consultation must be made a part of the client's record. The licensee may continue to evaluate and treat the client until such time as the medical consultation is obtained or waived.
In addition to creating a new level of licensure for professional counselors, marriage and family therapists, and masters level psychologists, the bill creates new qualifications to be met by each of the three disciplines in order to be licensed at the clinical level. After the effective dates set out in the bill, professional counselors, marriage and family therapists, and masters level psychologists who are not licensed at the clinical level may engage in practice only under the direction of a professional in their field who has a clinical level license, a licensed psychologist, a person licensed to practice medicine and surgery, or a person licensed to provide mental health services as an independent practitioner and whose license allows for the diagnosis and treatment of mental disorders.
The social work statutes are amended to expand the definition of social work practice to include the diagnosis and treatment of mental disorders specified in the edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association designated by the Board by licensed specialist clinical social workers. Licensed specialist social workers and licensed masters social workers may diagnose and treat (current law provides only for diagnosis) mental disorders classified in the diagnostic manuals commonly used as a part of accepted social work practice only under the direction of a licensed specialist clinical social worker, a licensed psychologist, a person licensed to practice medicine and surgery, or a person licensed to provide mental health services as an independent practitioner and whose license allows for the diagnosis and treatment of mental disorders. New requirements to be met by applicants for a license as a specialist clinical social worker are created by H.B. 2213. The Senate Committee amendments also make language in one of the social work statutes relating to the diagnostic and statistical manual to be used consistent with other sections of the bill.
Two of the statutes in the act under which psychologists (doctorate level) are licensed are amended. One such amendment expands the definition of the term "practice of psychology" to include the diagnosis and treatment of mental disorders specified in the edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association designated by the Behavioral Sciences Regulatory Board. A new continuing education requirement for relicensure is also established.
The acts relating to professional counselors, social workers, marriage and family therapists, masters level psychologists, and licensed psychologists are amended to require that a specified minimum number of hours of continuing education be related to diagnosis and treatment of mental disorders and a specified minimum number of hours be in professional ethics. Additionally, each of the acts is amended to expand and clarify confidentiality between practitioner and patient. The House Committee amendments further create an exception to practitioner-patient confidentiality as it applies in cases of child and adult abuse, adoption, and consultation with professional colleagues and administrators.
The House Committee amended H.B. 2213 to make the effective date July 1, 2000.
Background
H.B. 2213 was introduced at the request of the Task Force on Providers of Mental Health Services as a result of Task Force deliberations during the 1998 interim. See Report of the Task Force on Mental Health Services to the 1999 Legislature, pages 9 through 13. The Senate Committee amendments were developed by the affected provider groups to reflect concerns about the bill expressed in testimony before the Senate Committee.
The fiscal note on H.B. 2213 reports the passage of H.B. 2213 would generate more revenue and require more expenditures from the Board's Fee Fund. It is estimated $126,180 would be generated in additional revenue from the new clinical level licenses for the fee fund and $31,545 for the State General Fund. The Behavioral Sciences Regulatory Board estimates expenditures of $27,808 from the fee fund.
1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/bill_search.html